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Hi Joseph, Welcome to Chat Doctor, and thanks for your question... I can understand how difficult and distressing it must be to going through such feelings. From the picture you have given, I think you are definitely in the midst of a depression. Feeling low, lack of motivation, social with Chat Doctor. Are all symptoms of depression. Often, when we are depressed, our thoughts and attitudes can get clouded due to the depression and we don't feel like even seeking help, as everything seems pointless and a mere waste. It is a positive thing that you have a good insight about your feelings and are able to recognize that you may be going through depression. Now, it is very important to seek help for this, without hesitating or postponing. I would suggest that you first talk to someone close to you... may be your parents or relatives ...and let them know what you are going through. You will also need professional help from a psychiatrist who would be able to assess you in detail and treat you appropriately. There are various options available - talking therapies, medication, etc. and you will be able to come out of this soon. Wish you all the best. -
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Hi, You have several choices to make from the wide variety of oral contraceptives available and the side effects experienced vary from combination to combination and from individual to individual, but, essentially, they are hormone-related. It depends on what medication you had, and I cannot comment further on why you bled in the past. To be on the safe side, you can choose one of the micro-pills or progesterone-only pills and after a gynecologist assesses you in person for your fitness to consume them. Please do not self-medicate. Hope this helps.
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Hi.thanks for posting query. HepB can not be eradicated completely in patients infected with it. Your gave the details of antigens and antibody but I could not find the PCR results. You need to test for HBV DNA count via PCR. Complications can be prevented with proper care and treatment. Treatment is advised if AST and ALT are > two times the URN (upper limit normal) and HBV DNA count on PCR is very high. Liver enzymes and Bag status and HBV DNA PCR maybe done regularly every 6 to 12 months, Visit hepatologist for proper interpretation of results. Hope to answer concern regards Chat Doctor.
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Hello, Thanks for the query to Chat Doctor. Forum. Pain is on both side on the back over kidney area. Pain is also in stomach according to you. Seems to be a muscular pain since you are taking plenty of fluid and passing of urine is common thing. If female 41 years age than we will consider a premenopausal symptoms as, there is also complaint of palpitation (fast heart beat). Duration of pain is three months. Consult a physician and get in blood examination for sugar and lipid profile. Diabetes is the most common cause, beside heart disease in this age group. Hope I have answered your question. If further any question I will help. Good luck. Chat Doctor.
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Degree understand your concerns went through your details. I suggest you not to worry much. You definitely are suffering from schizophrenia with suicidal ideation, if the description given you is true. Your version is not acceptably because CBT is a proven way in the cure of so many mental problems. You seem to be taken things very lightly and did not pursue the treatment pattern. There are so many factors in the treatment. Determining the depth and breadth of the problem and proper diagnosis is the key. Then your psychiatrist, who know you better than anyone here, prescribes your medicines. If one medicine does not suit you, please make your psychiatrist aware, and he shall prescribe another one. Self diagnosis and medication is dangerous. We, here cannot prescribe any medications just based on the information provided by your here. Hope this answers your query. Available for further clarifications. Good luck.
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Hi, thank you so much for your question. I got that you have been suffering from painful neck gland, associated with night sweat and body and limb aches and pain. There are many reasons for neck gland enlargement, depending on your geographical residence, ethnics and dietary habits. Diagnosis also depends on the detail description about the lump, especially, accurate site, shape, painful or not, movable or fixed, and ulceration or inflammation present or not, on the underlying skin. Also, you should look for any constitutional symptoms such as fever, weight loss, fatigue, AMD so on. Let me also know your past medical, surgical and Chat Doctor. Thank you. Best of luck, and have a nice day!
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Hi, I do not know your gender. You seem to have halogen effluvium. The causes may be multiple.like thyroid dysfunction, vitamin and mineral deficiencies, anemia, stress,tension, worries,Dan Chat Doctor. .kindly consult the dermatologist for the perfect diagnosis and proper treatment. I would suggest...-treatment of the disease-biotin 10 mg daily-vitamins and minerals -mild steroid lotion-almond oil-herbal shampoo I hope this would help you. Thanks.
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Hi. With a history of diverticulitis and pain that is relieved by passing gas, I suspect the pain originates from your bowel - it can be some obstruction with gaseous distension of the bowel, and passing wind will make it feel better. My advice is gone for a checkup and X-rays will be able to pick up distension, fecal loading or a mass in the abdomen. Your doctor will be able to manage further. Hope that helps.
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Hello dear, I understand your concern. In my opinion the cause of spotting in pregnancy can be due to hormonal abnormalities like thyroid, progesterone insufficiency, bleeding from cervix, any abnormal pregnancy etc. Usually intercourse is avoided in first 3 months of pregnancy to prevent bleeding from cervix as the cervix is soft and highly vascular. I suggest you to get in ultrasound done to know the pregnancy status and get hormonal evaluation done. Avoid physical strain and intercourse. Take rest.Don't worry it will subside. Best regards...
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Dear friend,first thank you for your consultation.it seems that you are really suffering from acute gastroenteritis.I sincerely believe trichome is not going to do any harm your body.u can definitely take this medicine. As far as your back pain is concerned, from my day to day clinical experience, I am saying there are many causes of back pain. Most commonly people get affected by muscle spasm in the lower back region. For that you should go for a regular home regimen of physiotherapy like vertebral flexion exercise. Also take note of not bending forwards, avoid lifting heavy weight or burden. If the pain becomes unbearable you can take pain medication like Sailplane. Thank you.
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Hi. Thanks for your query. History of blood in urine with the history of kick in the abdomen in spite of any symptoms has to be taken seriously. You should take him to the ER or the Hospital to get a confirmed diagnosis. I would suggest you the following
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Hello and welcome to ChatDoctorI have read and understood your query hope this will help you. Dengue fever is caused by DENGUE VIRUS transmitted through bite of mosquito ANDES EGYPT. July to Oct are the months in which the disease has peak incidence. The virus has got 3 subtypes. Once affected by a typical subtype of the virus causes lifelong immunity in our bodies.but infection with a second strain causes most severe form of the disease called dengue hemorrhagic fever.as you previously had the disease you will be knowing that disease accompanies high grade fever. At the moment from the history provided by you, I don't think that's the case. I think you should consult your local doctor. As any febrile illness can cause muscular pains especially viral illnesses. I don't think that you are having a second attack of dengue fever. I would advise you to have a temperature record of yourself and meanwhile consult your GP get a full blood count investigation advised and proceed accordingly.Meanwhile tab paracetamol 1 tab 3 times day will be helpful for you. I hope I answered your query can contact me any time for more questions. Thanks Chat Doctor.
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Hello! Welcome and thank you for asking on Chat Doctor! I carefully passed through your question and would explain that your symptoms are not related to any cardiac disorder. Anxiety or high blood pressure could be the cause of this symptomatology. Have you measured your blood pressure during these episodes? I would also recommend performing a complete blood count for anemia and thyroid hormone levels for possible thyroid dysfunction which can mimic this symptomatology. If the above tests result normal, and your blood pressure is normal too, you should consider anxiety as the main cause of your symptoms. In such case, I would advise consulting with a specialist of this field, in order to help you manage better your anxiety. Psychotherapy and an antidepressant could be helpful! Hope you will find this answer helpful! Best wishes,
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Hi and thank you so much for this query. I am so sorry to hear about this pain and diarrhea that you have reported. The reason why it is not advised to take these too Chat Doctor. However, because you are having diarrhea, it will be okay to take Imodium to stop the frequent stools. What is the cause of this diarrhea? If it has not lasted more than 14\u00a0days and the cause has been shown to be non-infectious, I will discourage any use of Imodium for it may rather be more harmful than helpful. Remember to
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Hi. Thanks for your query and an elucidated history. Your history of Chat Doctor. These are sites classically involved in pain when one gets colitis. This can be due to waterborne diseases. May not be parasite. Since all the tests are normal except the colonoscopy not yet done (last one was 5 years ago.). I would advise you to first take a course of an antibiotic, metronidazole, probiotic, activated charcoal tablets and anti-spasmodic whenever there is pain, continue Raniditidine. See the results, if you get well, nothing to be done further. If no relief you can go for colonoscopy and to see what exactly is the problem.
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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 nourishing you good health In case of further questions don't hesitate to ask
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It is never wrong to have a doctor look! Statistics show that if a child hits her head but never loses consciousness, never throws up, cries right away or returns to play right away, and doesn't seem sleepy or unusually out of it after a head bump, then the chances of a serious injury being present are extremely low. Most likely the nose/mouth got hit somehow on the way down or right when she hit, and that lead to the bleed. If it stopped right away, it is usually no cause for alarm. Again, if anything at all seems off, it is always right to have the doctor take a look.
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Degree understand your concerns went through your details. Penis size of 4.5 inches is more than enough to satisfy any girl across the globe and to have sexual satisfaction. The curved shape is good because it will give you more pleasure than a straight penis because of the extra friction it makes within vagina. You have to use some lubricants or soap liquid to practice movement of the foreskin for some days, or you should circumcise your penis foreskin. Masturbation is a healthy practice and can't slow down your growth or cause problems to your health if practiced moderately. 28 teeth also is normal. Now stop worrying and get to business and your career. Unnecessary thoughts could trigger anxiety. If you require more of my help in this aspect, please use this URL. http
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The condition that you describe could easily be explained by the combination of COPD and superimposed infection (commonly called pneumonia). Presence of metastatic disease in the lungs is also possible which can compound the problem. Either way, the treatment remains the same. Preferably the treatment should be in a hospital, but if you need to treat him at home, then you should start him on antibiotics (Tab Coamoxiclav 625\u00a0mg twice daily + Tab Ninefold 600\u00a0mg twice daily), nebulization with albuterol and decor thrice daily (nebulizer is a small easily available instrument at any pharmacist and is easy to use). He should eat anything he wants (home cooked only). Oxygen requirement depends on if he is breathless at rest, or develops bluish tongue or extremities in which case you should give him oxygen.
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Hi and welcome to Chat Doctor. Thanks for the query. You should find the exact cause of liver changes. This can be confirmed only by liver biopsy and then right treatment can be planned. Also you should check your hepatitis markers to rule out hepatitis infections. Till you do these tests you should avoid alcohol completely, eat hepatoprotective diet and regulate blood sugar and lipids. Wish you good health. Regards
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Dear friend. Thanks for sharing your concern. It appears from your history that you have developed an abscess in the region of extraction.Also, the extended swelling could be due to abscess only. As you are already taking antibiotics and analgesics please do not worry, complete the course, it should regress. If the lesion still persists then you can go for oral surgeon s advice after taking a biopsy the exact cause can be diagnosed. So far so good, lets wait and watch. With the change of antibiotics the abscess should resolve.Meanwhile, do warm saline rinses too and maintain good hygiene as speedy recovery measures. Hope it helps. Thanks. Take care.
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Hello! Thanks for putting your query in Chat Doctor. I am a Gastroenterologist (DM). I will advise you to visit a Gastroenterologist who will evaluate you and manage accordingly. You should undergo some blood tests like complete mammogram, liver function tests, Kidney function tests, ultrasound abdomen. From what all information you have given I will advise you to take high protein, salt restricted and diabetic diet. Blood sugar and HT should be strictly controlled. Take tablet ursodeoxycholic acid, multivitamins and Iron and calcium supplements 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.
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Hello, Thank you for consulting with Chat Doctor. It looks that you are having temporomandibular disorder means disorder of joints of jaw, it occurs because of exertion of jaw joint while chewing hard food and even because of stress. You should visit a good dentist and get an x-ray of the joint done, which will show the changes of joint. The treatment will depend on the condition of the joint, as either medicinal or surgical. Hope it will help you.
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Thanks for your question on Chat Doctor. I can understand your situation and problem. Since you are lung cancer survival, ill-defined opacities can be due to 1. Relapse of lung cancer2. Malignant nodules3. Infection4. Fibrosis. So better to consult pulmonologist and get done1. CT thorax2. Bronchoscopy and BAD (Bronchoalveolar lavage) analysis to rule out above-mentioned causes. Possibility of relapse of cancer is more. So consult pulmonologist and get done above tests to diagnose your densities.
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Hi, dairy have gone through your question. I can understand your concern. You have fatty liver. It leads to increase in liver enzymes level. You should go for regular exercise. Avoid fatty food, alcohol and smoking. Ad\u00edlio like Chat Doctor. Your ultrasound study also suggests fullness inlet kidney area. There can be some pathology, and you should go for ct scan of kidney, ureter and bladder. Your rest of the reports like gall bladder, aorta, pancreas all are normal. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health.
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Hello, hit on cheek bone, swelling of eye and face, xray normal. No pain, rues out there is no extensive injury. Weekness or fatigue could be due to some other cause like your not taking enough food due to pain, or it could be due to anemia or vitamin deficiency or something else. Kindly evaluate by doing blood tests and general and physical examination. Sometimes X-ray will not reveal heamosinus and hairline fractures, evaluate by ct pans. All d best.
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Hi... Thank you for consulting in Chat Doctor. I understand your concern. Your kid is definitely overweight. There could be two reasons for this.1. Endogenous obesity - due to genetic and family predisposition.2. Exogenous obesity - due to lack of exercise and over eating. I have a few questions for you - 1. What is her height now?2. What was her birth weight?3. From when did she start gaining weight like this (form what age)?4. How are her daily activities and exercising pattern?5. Are there any complaints from school about her academic performance?6. Is there any family history of obesity?7. Can you get back to be me with a chart of whatever she eats from morning till going to bed - on any average day?8. Does she eat a lot of snacks?9. How many hours does she watch TV per day? Hope my answer was helpful for you. I am happy to help any time. You can approach me at the following link. Please find the link below.www.ChatDoctor .com/doctors/ Chat Doctor.
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Hi Dear, Welcome to Chat Doctor. Understanding your concern. As per your query you have lump on uvula along with fever is because of bacterial or viral infection of oral cavity. Probably you have developed Canker sores which is causing you high grade fever as well as uvula acts as a barrier to swallow food and prevents bacteria and infections from entering the throat and digestive tract. I would suggest you to Chat Doctor. Do warm saline gargles. If the underlying cause of the condition is a viral or bacterial infection, the appropriate medication should be taken. Antibiotics will help get rid of a bacterial infection and over-the-counter painkillers or anti-inflammatory
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Hi ! Good evening. I am Chat Doctor answering your query. Although a personal physical examination of the lump would be helpful in reaching a nearby diagnosis, most probably with a history of trauma, it could be an organized hematoma on the left side of your back. To confirm the diagnosis, if I were your doctor, I would go for an FNAC (fine needle aspiration cytology) followed possibly by an excision biopsy depending on the report of the FNAC. Considering the duration of more than 4 years, clinically it might be a benign lesion not to worry about. However, for cosmetic reasons it might be required to be taken out. Therefore, I would advise you to consult a general surgeon and get your self assessed for the same. 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 Chat Doctor to clear doubts on your health problems. Wishing you an early recovery. Chat Doctor.
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Hi dear, I understand your concern. Soreness, yelowish cheeks suggest dermatitis. If baby would like she should since mouth with soda water and Chlorhexidine or you can wash her mouth with cotton. Then you should apply Pastoral, it is very helpful antiviral, antibacterial and antifungal medicine, use it 3-4 times a day. For healing of inner surface of cheeks you can apply vitamin E. For boosting immunity of baby I usually advice Zirconia 5 ml daily for prophylaxis of any diseases. Hope I answered your question. If you have any further questions, please. don't hesitate to contact us, I am always happy to help. Wishing your baby good health
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Thanks for your question on Chat Doctor. I can understand your concern. You are having breathlessness in night (supine position). This is known as orthopnea. And it is characteristic feature of congestive heart failure (CHF). You are also having two blocked coronary arteries. So possibility of CHF is high in your case. So better to consult cardiologist and get done 1. Blood pressure monitoring 2. ECG 3. 2d echo 4. Stress test (trade mill test) 5. Repeat coronary angiography (if required). You will need diuretics and other cardiac supportive Chat Doctor. 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.
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Thanks for contacting Chat Doctor. 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.
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Dear member, Thanks for writing to Chat Doctor. I am Chat Doctor. Consultant organ specialist. I can understand your anxiety as infertility treatment requires lots of patience. If pics is mild it can be treated with weight loss and tab Ginette 35. The glycogen has to be taken regularly, and a diet has to be followed according to BMI. The husbands count of 43 millions is ok if motility is good. The treatment for you will be ovulation induction. In my clinical practice I have noticed that mild PCs can be treated easily if you have patience and show discipline in diet. Please call back with reports to
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Hi welcome to Chat Doctor forum. Thanks for choosing Chat Doctor. Forum. Your 11 years daughter and your self got stomach bug, since 1 weak. You are all right now, your daughter still having nausea, cramps. Your daughter is sick and suffering, and small to bear the pains. So I advise you to consult a doctor for diagnosis and treatment. Give her like food like bread, soups, milk, coconut water etc. Wishing for a quick and complete recovery. Best regards.
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Hiwelcome to ChatDoctorI read your history n can understand your concern. Scarlet fever is streptococcal bacterial infection and glandular fever is a viral flue. Both the disease takes its own time to resolve, it depends on each individual immune system. And your hearing problem is not because of these two. But whenever u get cold, there will be slight decrease in hearing because of E tube blockage. Don't worry. Better meet ENT doctor. Thank you take care
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Hellowelcome to ChatDoctorthe pain you are suffering from is certainly from a condition called as PIED i.e. PROLAPSE OF THE PROTECTIVE DISC FROM IN BETWEEN THE 2 VERTEBRAL BONES, these discs works as a protective cushion and their prolapse from their place causes compression of spinal nerves and spasm of the surrounding muscles which in turn lead to pain n at times numbness in that region your X-ray was normal but its common not being able to diagnose this condition from a X-ray, so you should get a much more specific investigation to diagnose your condition i.e. MRI OF LOWER SPINE n than you can consult an orthopedic with your MRI REPORT who will prescribe you the appropriate treatment for your conditionregardsChatDoctor
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Hi, dairy have gone through your question. I can understand your concern. You have hypertension but with beta blockers your diastolic blood pressure becomes very low. You need to change the Chat Doctor. 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 Chat Doctor. Wish you a very good health.
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Hi. Thanks for your query and faith in Chat Doctor. The commonest causes of pain in right lower abdomen in a female patient of 55 years are
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HelloThanks for writing to us, I have studied your case with diligence. You may need x-ray or MRI of ankle and foot which can be advised after clinical examination consult your doctor and do require investigation. Till time take medication like analgesic and apply cr\u00eape bandage over foot or use supportive splint. Physiotherapy will help to reduce symptoms. Some nutrients which are important for recovery after injury include vitamin C, folic acid, calcium, vitamin D, IT B12.so supplements of these nutrients will lead to early recovery. Regular physiotherapy and exercises are very important for early rehabilitation as my patients find much relief by these therapies. Hematoma will be there on lower limb due to injury which is painful. This will subside after 3 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. If you are satisfied with the answer, please give your review at the end of the discussion. Wishing you good health. Take care
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Hi and welcome to ChatDoctorPull out method or also called coitus interrupts method is a crude method, and it has high failure rate. It's usually not recommended by doctors as a method of contraception. The fluid which is secreted by male partner before ejaculation may also contain sperms which can lead to pregnancy. Take a pregnancy test once again and if it is still negative and periods are not happening then please consult a local doctor. If test is positive and you don't wish to continue pregnancy, please consult a good obstetrician to terminate safely. Some safe methods of contraception are condoms, oral contraceptive pills, copper T (if u have one child). I advise you to communicate this your partner and ask him to use condoms. All the best Chat Doctor.
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Hi. Welcome to Chat Doctor . I have gone through your query and can understand your concern. As per your complaint a boil over the upper eyelid can be a style or a champion. In case if it is present just at the margin of eyelid it can be a style while if it is present slightly away from eyelid it can be a champion. I would suggest you to do warm compresses over the eyelid and also put steroid eye Chat Doctor. . Do it at least for a week and in case if it still does not resolve consult an Ophthalmologist and get evaluated, and he can put steroid injections over the lump directly to shrink it. In case if it still does not resolve surgery is the only option left. Hope this information helps. Thanks and regards.
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Hello! Welcome on Chat Doctor! Regarding your concern, I would explain that often there is comorbidity between epilepsy and pseudoseizures, because epilepsy patients tend to have psychiatric troubles (like depression or anxiety too). From the other hand the presence of abnormal EEG activity may be both in pseudoseizures and seizures. And sometimes epilepsy patients have a normal EEG. That is why the seizure description and even video registration of the patients during the seizures is necessary to distinguish between seizures and pseudoseizures. Anyway, it is true that antidepressants and anti-psychotics lower the seizures' threshold, but when psychiatric problems are present in epileptic patients, they are given concomitantly with anti-epilepsy Chat Doctor. Hope you will find this answer helpful! Kind regards,
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Hi.it is best if you consult with a doctor, preferably a general surgeon, for physical examination and clinical evaluation. It has been years since your initial problem. Your current condition may or may not be related to it. Imaging, such as CT-scan, will be requested for further evaluation of your complaint. Management (medical and surgical - repair of the laceration if needed), depending on the extent of the injury will be directed accordingly. Hope this helps. Good day!!~ Chat Doctor.
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Hello! Thanks for putting your query in Chat Doctor. I am a Gastroenterologist. You should have mentioned the exact value of increase in ALT levels, since if it is more than Food times normal then it may be due to acute viral hepatitis, or Chat Doctor. If they are slightly elevated it may be due to fatty liver only. Preeclampsia is different situation in which there is high blood pressure. I hope I have answered your query and this will help you. Wish you a good health
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Cellophane you for your query. Firstly, if you are anxious for conceiving, I fail to understand why you terminated your pregnancy. Kindly provide the details for me to understand better.THyroxine is given to patients with hypothyroidism, if your TSH is elevated, in order to normalize thyroid function, as hypothyroidism can lead to infertility and abortions. Nitrofurantoin is an antibiotic given for urinary tract infections. Clomid is camphene which is given to induce ovulation in case you have difficulty in ovulating. However, it cannot be started immediately, as you mention that you terminated a pregnancy yesterday. Please provide complete and detailed history. Take care
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Hello! Thank you for the query. Yes, there are few more issues which can give pain in the scrotum apart from varicocele. It may be epididymis or testis inflammation, inguinal hernia (can be invisible if the ultrasound were done on the lying position) or even urinary tract infection/stones. Too tight underwear can compress the nerve in groin area and give numbness and pain in the scrotum. I suggest you to start your diagnostics from urinalysis and urologist consultation. Antibiotic might be beneficial at your case. Hope this will help. Regards.
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Hello misunderstand your concerns think you have erectile dysfunction. Three are various causes of it, so you have to find out the cause of it. Causes are
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Thanks for your question on Chat Doctor. I can understand your concern. Treatment of tuberculosis should not be started only on the basis of MT (manitou test). MT is not very sensitive or specific test. It is not 100% confirmatory about active tuberculosis disease. It is false positive in person with previous history of tuberculosis, taken BCG vaccine in past etc. Positive MT result must be correlated with symptoms and sign of the patient. Since your other reports are negative for tuberculosis, no need to start anti-tubercular Chat Doctor. Consult pulmonologist before starting this
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Hello! Welcome to Chat Doctor. 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.
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Hellos you stated in you query that your doctor advised Benzedrine penicillin or endure 12 lac unit at the age of 16 years till 40 years. Now you are only 30 years and stopped the injection. In my opinion, you should take these injections for up to 40 years age as this injection are most suitable for streptococcus infection, which is the main cause of rheumatic disease. Now about these symptoms as you mention may be due to some bronchoconstriction caused by some allergy or due to other infection . So take some montelukast+albuterol tablet, once in day. Also take some cough syrup like dextromethorphan + ammonium chloride+chlorpheniramine. Since these are prescription Chat Doctor. Once again for endure, consult your treating physician and get his opinion regarding stopping of
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Hi, This condition of decreased platelets is called thrombocytopenia in medical terms. Decreased platelet count may have several causes such as Chat Doctor. From the description that you have given your condition appears to be adult ITP (IMMUNE THROMBOCYTOPENIA). It occurs due to molecules called autoantibodies on the platelets surface which destroys the platelets. Autoantibodies in simple terms is like an army that attacks the people of its own country. I would suggest that you get a peripheral smear evaluated along with your complete blood count by a hematopathologist. You may also get a Combs test done to find out if there are other immunological problems that are getting your platelet count down. I presume that your initial work up would have also included HIV testing as HIV can also cause low platelet count. However, in your case this does not appear to be the cause. The most important advice I would give is to monitor your platelet count regularly. Repeating the bone marrow test is not necessary for ITP as the problem is not in the marrow. If the platelet count falls below 50, 000/ cu. Mm then your doctor should be notified. Platelet counts below 20,000 have a risk for causing bleeding within the brain. Adults with platelet counts >50,000/mm3 do not require treatment. Treatment is indicated for adults with counts < 50,000/mm3 with significant mucous membrane bleeding. Treatment also is indicated for those adults with risk factors for bleeding (e.g., hypertension, peptic ulcer disease, vigorous lifestyle) and in patients with a platelet count < 20,000-30,000/mm3. If your platelet count falls to a very critical range your hematologist may treat you with medication such as glucocorticoids, IVG immunoglobulin or newer
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Hi, This means there are two possibilities. 1. Allergy or inflammation-induced sterile Syria where there will not be any urinary infection, but there will be plenty of pus cells in the urine.2. Urinary tract infection. If there is no fever or stomach pain with chills and rigors you can wait. But if there is fever she will require urine culture and butter to start on antibiotics, please. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor.
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Hello and thanks for the query. This is an excellent question. It does appear that you have a significant anemia. I am not sure that your doctors can conclude that you have actual bleeding going on. It is possible that your body is somehow destroying the red blood cells. This can sometimes happen through an autoimmune process. I am, sure you're hematologist has considered this. He may have requested some special laboratory studies to rule this out. It is important that you continue to receive your iron supplementation. As long as the other blood cells in your body, including platelets and white blood cells are within normal limits. It is most likely, your bone marrow is functioning normally and that some type of processes going on whether it is some type of bleeding that has yet to be discovered or whether your body is actively breaking red blood cells apart somehow through this immune process. Thanks again for sending your question. I can appreciate, that you're dealing with a very stressful and frustrating situation. Please let me know if you have any additional specific concerns.
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HelloThanks for query. Based on your statement it seems that your husband has undergone endoscopic surgery (URS) for removal of stone in left ureter and since then has not passed stools and has boated abdomen. This is mostly due to what is called as post-operative Paralytic Illus which happens once in a while after doing pelvic surgery. Please admit him in hospital and take following treatment 1) No fluids or food till he passes flatus or stools 2) I. V fluids to maintain fluid and electrolyte balance 3) Antibiotics It may take two or three days to recover completely. Chat Doctor.
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Hello, and I hope I can help you today. The effectiveness of the morning after pill has not been studied specifically regarding its success rates in preventing pregnancy with multiple episodes of intercourse. However, sperm remain in the female genital tract for up to 72 hours, which is why the pill is most effective within that window of time. The overall success rate for preventing pregnancy with the I-pill for one episode of intercourse is 90 percent, meaning 10 percent of the time the woman can conceive anyway. So I would recommend that in this situation that a second dose of the I-Pill be taken, even if the second episode of intercourse was within 72 hours, because live sperm could remain after the first pill has worn off. I hope I was able to adequately answer your question today and that this information was helpful. Best wishes,
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Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and I feel, it would have been better if you had described what knee surgery she had and what medication is she on. It seems there is infection, but you need to see the operating surgeon for confirmation, it's a thing to be concerned with, so do not waste time and consult 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.
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HelloWelcome to Chat Doctor, Your history and symptoms are suggestive of upper respiratory tract infection. As you are a frequent traveler that has made you more vulnerable for the infection. I would suggest you to follow1. Take adequate rest.2. Chat Doctor. 3. Tab Monte LC, once daily for at least 15 days.4. A course of antibiotics like Tab Autoclave 625 mg, twice daily for 5 days.5. Multi vitamins to boost up the immunity. The aforementioned measures will help to reduce the symptoms and improve your condition. Thank you.
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HI, thanks for using Chat Doctor Watery eyes and persistent nasal discharge implies that you may have allergies. In your case it may be severe. You may want to consider allergy testing. If you can determine what is causing your allergic reaction then you can eliminate your exposure to it and reduce your allergies. Oral antihistamines would help both the eye and nasal symptoms. Montelukast may also be very helpful to you. There are allergy eye Chat Doctor. The use of topical steroid nasal spray would help control the nasal symptoms. I hope this helps
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Hi ! Good afternoon. I am Chat Doctor answering your query. Even though it could be due to the movement or slipping of the kidney stone into the ureter, if I were your doctor, I would have advised you for a routine/microscopic and culture/sensitivity test of the urine to rule out a urinary tract infection, and treat it if positive. This kind of pain is less likely be due simply to varicose veins. Till the tests are ready, I would prescribe you with an anti-spasmodic Chat Doctor.
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Hi, How are you doing? I don't understand use of these medications before pregnancy or IVF. If you want to try for IVF pregnancy, All you need a 1. Folic acid tab & maybe an antioxidant like Multivitamins tab-both once a day till third month of pregnancyYour husband also needs an antioxidant tab - once a day till Infix you have any other condition like Thyroid or diabetes or any infections, have specific medications for those. Hope I have cleared your overall the best Chat Doctor.
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Hi and welcome to Chat Doctor thanks for the query. Urine color is darker several days after bilirubin levels stabilize so you don't 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
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Dear Sir/Madam have gone through your query and read your symptoms. In my opinion, your symptoms suggest a compression of disc in the lumbar region of your spine and is not due to diabetes, it would be better judged if you can get an MRI of your LS spine done, second thing is that numbness in whole foot, the stocking pattern is due to neuropathy, but numbness in any anatomical distribution like sole could be due to compression of nerve in the vertebra. I hope that answers your query. If you want any more clarification, contact me back.
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It would be better to meet a behavioral therapist first instead of meeting a doctor right away. Personally I think he is still getting adapted to college and its different way of life. The new place and methods can disorient the best of us. There may also be other distractions that come with the life in college. I think a behavioral therapist would be better. The person can teach him how to adapt to the college life, and modify his routine to it best of luck Chat Doctor.
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Hello and thanks for writing. I can understand your concern and would try to help you in the best possible way. Your problem could be related to PSVT, a condition in which the heart beats too fast leading to improper filling of heart which owes the BP transiently leading to fainting or near fainting episodes. I suggest you consult a doctor and get yourself evaluated for the condition. A simple ECG with two minute rhythm lead would be a good initial investigation. You may also get a 24-hour ambulatory hotter recording of you ECG that may detect any episode that may otherwise not occur at time of your visit. Once a diagnosis is confirmed then there are treatment that improve the condition. Firstly one is started on medications which are quite effective. However, if medications fail to control it then Radio frequency ablation may be planned.
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Welcome to Chat Doctor you please take immediate consultation with neurosurgeon and get your baby examined and other tests done he will be the best person to guide you regarding your daughters management the condition is dilation of the pelvis of kidney with its ill effects on the kidney renal functions should be evaluated and treatment procedures determined hoping your daughter gets the best treatment and be cured
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Hello, I read carefully your query and understand your concern. Yes, the symptoms can be related to osteoarthritis. I suggest using anti-inflammatory medications such as Acetaminophen to relieve the symptoms. I also suggest using Voltaren gel for local application and ice compresses for relieve. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards! Chat Doctor.
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Hi Are you having any symptoms like urine hesitancy or urine Chat Doctor. If you donor have any complaints and it's just an ultrasound report. I would advise if you were my patient you don't need any treatment. Patients with mild symptoms or moderate-to-severe symptoms of benign prostatic hyperplasia (BPH) who are not bothered by their symptoms and are not experiencing complications of BPH should be managed with a strategy of watchful waiting. In these situations, medical therapy is not likely to improve their symptoms and/or quality of life. In addition, the risks of treatment may outweigh any benefits. Patients managed expectantly with watchful waiting are usually re-examined annually. I hope I have clarified your doubt. Wish you a good health.
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Welcome to Chat Doctor. I am Chat Doctor. Your doctor is right that surgery is possible, but there are risks. Oncologist in Mumbai are good usually Tata Memorial Hospital. You can believe on them for best management. In such cases surgery also depend on patient internal condition and cancer spread seen during surgery on surgery label. Go for ERCP as your doctor suggested for further planning. All the very best. Than for query.
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Good Day, and thank you for being with Chat Doctor ! 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
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Hi! Good afternoon. I am Chat Doctor answering your query. The lump in the location stated by you could be an inguinal hernia which could go inside the abdomen on pressure and on lying down, and might come back again on increasing the intro abdominal pressure. You have to verify by your self if both your testes are in position or not. Sometimes, one of the testes might not descend normally down the scrotum, and it might be felt in the area located by you known as inguinal region. Both the above condition might give rise to pain in the abdomen on pressure. The third possibility could just be an enlarged lymph node which would also move, but might not cause pain n the abdomen/stomach. All these could be diagnosed and managed only after a personal physical examination and related investigations, and so I would advise you not to worry, but to get in touch with your family physician/ a surgeon in your area with your parents/guardian for an appropriate opinion and 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 Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor.
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HiT hanks for posting on ChatDoctorClindamycin is a bacterium well indicated in the treatment of bacteria infections. While on treatment for sepsis, healing is a progressive process. I will advise she continues with her Chat Doctor. With a High BP, an antihypertensive may be prescribed. However, high BP could have been due to her infection. I will suggest her BP be controlled again and if still high, an antihypertensive will then be indicated. I will advise the following
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Hello, Thanks for posting your query. I have gone through it and understood your concern. Persistent bleeding after settling down with the contraception should call for further evaluation by an expert. You need a proper clinical examination, a sonogram of the pelvis preferably in the trans-vaginal route, blood counts, coagulation and liver profile and urinalysis. Pregnancy should be excluded. Local causes like erosion, polyps and infections should also be excluded. Weight disturbances, stress, infections and use of certain medications create hormone disturbances and can cause such bleeding. Hope you find this information useful. Wish you good health.
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Hi here, welcome to Chat Doctor. Thanks for your question. The leg pain is probably unrelated to your neck pain. Since this pain, is a new development, it should be given due consideration. Pain radiating down the calf of your leg is related to pressure on the S1 nerve in your back, which can be associated with disc degeneration at L5/S1 disc level. Narrowing of blood vessels can also result In similar pain. In either scenarios, it would be prudent to be personally seen and examined by a physician. The initial management will include rest, physiotherapy(like ultrasonic massage or short wave diathermy), analgesics(painkillers) and postural modification. Early investigations like MRI would be indicated if pain is unrelenting with appropriate medicines, any weakness in your leg, foot or toes, new onset numbness or any issues related to passing urine or motions. Since you have mentioned continuous unbearable pain, I would suggest you to get yourselves seen and evaluated by your treating surgeon. Hope this answers your questions. Thank you with best regards Chat Doctor.
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Hello! Welcome and thank you for asking on Chat Doctor! A TMT positive tests indicates possible coronary artery disease. In such case coronary angiogram would be the golden standard test to examine the blood flow in the coronary arteries and also possibly treat coronary artery disease (with stent implantation). Anyway, if your friend does not want to take the risks of this miniinvasive procedure, he can perform a nuclear stress test or coronary Anglo CT scan, which are not as exact as coronary angiogram, but are less invasive. But, you should know that if these tests result abnormal, the next step would be coronary angiogram. Hope you will find this answer helpful! Kind regards,
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Hi.I've gone through your query and I can understand your anxiety. If there is history of unprotected sex during the period of breastfeeding, there are high chances of pregnancy. To avoid it, you can safely go ahead with hormonal methods of contraception either as birth control pills or implants or IRENA. As you have taken gynaecosid pill, It's safe to use during breastfeeding & it won't cause any harm to the baby. But can expect common side effects of birth control pills like Nausea, vomiting, headache, breast tenderness, abdominal bloating, swelling of the ankles, weight gain, irregular periods etc. Hope I have answered your query. Let me know if I can assist you further. Take care.
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Glue ear or medically speaking
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Hi there, thank you for writing. I would recommend that your sister seek immediate medical attention in an emergency room. If she is having slurred speech, confusion, and dizziness, along with persistent vomiting and an inability to walk without help, her symptoms are very concerning to me because they could be caused by an intracranial process, like a brain tumor or stroke. Since she has not gotten any better in the past month, and is not acting like her usual self, or able to participate in any of her normal activities, let alone walk, I think she needs emergent medical attention. I hope this answer has been helpful to you, wish you the best.
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Thanks for your question on Chat Doctor. I can understand your aunts situation and problem. Any tumor which is around major arteries is inoperable. At the same time chances of homogenous spread is also high and hence chances of metastases are also high. So prognosis in her case is poor. Five year survival rate is 40-50 %. Usual life expectancy is less than 3 years. Treatment options are palliative chemotherapy, radiotherapy, nutritional support and pain management. Hope I have solved your query. I will be happy to help you further. Wishing good health to your aunt. Thanks.
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Thanks for your question on Chat Doctor. 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.
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Hi dear,first why you are not adjusted in company ?it is salary issue or other issue?and you have such feelings only at your work place or at home also?sometimes due to adjust at your work place also cause such problem. Sertraline is a good molecule to overcome depression and anxiety so took it in an adequate dose. As you are having past history of similar complain so take medication regularly and also go for counselling. Consult psychiatrist face to face. Thank you
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Hi, Thanks for writing in. Dizziness on one side of the body can be due to decreased blood supply reaching that part of your brain. It can be a pre stroke symptom, and you should consult your doctor and get completely examined. The blood supply to the brain from the heart is through the carotid and vertebral arteries. It is important to study the blood flow at the neck level and look for any narrowing or stenosis in the carotids and vertebral arteries on both sides. This is done by doing a Doppler study. You might also require a brain scan like CT scan or MRI scan to know if there is any condition inside the head causing your symptoms. It is important that you also tell your doctor of any heart conditions and medications you are taking for it. This is because there are many heart conditions which lead to symptoms in the brain like dizziness as a complication.
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Hello. I can tell you that your physical symptoms are secondary to your stress about your orientation and inability to disclose it. You need to consult a psychiatrist regarding your feeling for two reasonsFirstly, it will relieve your tension by disclosing about it in a confidential and accepting environment. Secondly he can tell you the mean of calming ourselves by therapy and if required medication. Along with that he can assess your level of conviction about your orientation. Once its become clear and you are calm you can deal it more confidently and can divulge it to others. Before disclosing about it, you should be prepared to deal with the expected consequences and to continue in the direction you feel appropriate for you.
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Hello, I have gone through the query and understood your concern. Home pregnancy tests read well when performed 3-7 days after the missed period with a fresh early morning sample of urine. This means that if at all you were pregnant, the result of the test would have been positive if performed properly. Your symptoms are more likely due to some hormone imbalance. Please see a specialist for a proper appraisal of the situation and plan further management. Hope this helps.
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Thanks for the query dear. His level of awareness at your age is really commendable. As per your description it seems you have almost decided that you are suffering from ADHD. You have not mentioned what your doctors said regarding your condition, that is before you shifted to a new place. You may be quite simply a disorganized adolescent so to speak, then you will need support of a psychologist. But again it is best to find a good doctor in your new place, take your parents in confidence and take help from the doctor. He shall be able to guide you or prescribe medication if needed, in better way.Don't suffer unnecessarily by obsessing over something that has not been diagnosed as yet (you have not mentioned that it's a confirmed diagnosis). Take professional help, and you shall be better and improve on your grades.
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Hi, Thanks for posting your query. Were your father was suffering from chronic kidney disease? Were there any defect in clotting time/ bleeding time/ prothrombin time? Had your father derangement of liver function test or any abdominal symptoms? Those patients who had already deranged liver and renal function may have deranged platelet function & prothrombin time with defect in coagulation. All these factors predisposes patient to bleeding with decreased clotting ability. Although heparin is given during dialysis but all these are applied by trained staff by measurement. So there is the least likely possibility of wrong medicines. You can also understand that when dialysis was not started, he got hemorrhagic episodes. So I think medicines are not the likely cause. Once bleeding is started, then a vicious cycle starts in body and if not controlled within time then It's very difficult to save life whether all medicines have been given by expert doctors. So doctors are also helpful at few places, and we have to accept the judgment of god. Thanks,
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Hello, you have high chances of conceiving within 6\u00a0months of ova mid treatment. It boosts your ovulation. Ovulation takes place using 14\u00a0days prior to the start of next menstruation. Your menstrual cycle seems to be regular. If your try to conceive from 4\u00a0days before to 4 days after ovulation then you have high chances of getting pregnant. Additionally ova mid words best with healthy weight. You should not be overweight or underweight. Plan healthy diet accordingly.
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Hi, Thanks for your query. Neck pain and severe muscle spasm that you are having are suggestive of degenerative -spondylitic 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 immobilization and brings relief. 2. Medical Chat Doctor. 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
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Hi, The problem may be endometriosis and the best way to decide is to have a diagnostic laparoscopy where the inside of abdomen is visualized it shows the extent of endometriosis and any involvement of the surrounding tissues. There are good medications available to treat endometriosis once diagnosed. It is definitely possible to conceive with this problem, but it is better to conceive earlier rather than delaying the pregnancy. Wishing you a good health.
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Hello! This is Chat Doctor. Thank you for posting your concern to Chat Doctor. From the symptoms you are describing looks like you have a urinary tract infection, and you may need antibiotics to prevent it from getting worse. If I was your caring doctor I would suggest the following
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Hiii, Welcome to Chat Doctor. Your last period was on 1st August and took pill up to the 10th august after that you got another period on 14th August. It was with Chat Doctor. You did unprotected sex at the end of August & beginning of Sept and started Depot Shot on 8th Sept after getting negative pregnancy test. Depot shot contains MPA and is very effective birth control method. Effectiveness is up to 3 months. Chance of pregnancy is very low more likely less than 1% per year. You may confirm your pregnancy by doing blood test for Chat Doctor after 7 days of your missed period date.Also, you have to concern about several side effects like irregular vaginal bleeding for first 6 to 12 months, sore breasts, change in appetite or wt gain etc. Always consult with your doctor if serious problem persists. Be well.
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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 gelatinous type). These lesions can occur anywhere in the body and have the tendency to recur. The one near your groin area might be lymphadenopathies secondary to an infection or other pathology. Management (medical and surgical) will be directed accordingly. Hope this helps. Good day!!~ Chat Doctor.
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Hi, Sometimes screening blood work for thyroid disease is not entirely accurate since most primary doctors will only check a TSH to detect an abnormal state. In your case, since it appears as if low metabolic function may be to blame for your symptoms I would recommend expanding the blood work a bit to include several other thyroid tests such as a FREE T4, Total T3 and Free T3. I might even check a random cortisol and also look at your vitamin D, B12, and folate levels due to the very mild anemia which may or may not be relevant to the rest of your symptoms. Hope I have answered your query. Let me know if I can assist you further.
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Hi, Thanks for your question at ChatDoctorI understood your problem and from the ways symptoms are described there are two things that bothers you1. Back pain2. Pain below the rib cage in the front. Firstly, I think you are having gastritis which can cause nausea and also pain when you press below your rib cage in the front. Secondly, back pain on the left side can be caused by either wrong position while sleeping or sitting or could be a cause of any problem in your neck bones. To know exactly what is the reason for the back pain better show to orthopedic surgeon. For your gastritis you could take Pastoral 40 mg tab, 1 tab 1 hr before food on empty stomach and avoid taking spicy foods. Hope this answers your question
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Hi, happy to help you on your health concern on part of Chat Doctor! In the present case of needle prick injury I would say that yes, you have to take this injury as any other contaminated wound! As per your description, it is more contaminated by the specific fluid you mentioned; there must be some Chat Doctor. .but the amount is negligible therefore not to worry about that. Now you have to think of possible infection and tetanus! Therefore, take antiseptic wash, a toxic and local adhesive for 2/3 days and if this looks unhealthy to you take antibiotics also for 5 - 7 days! Take caution not to get injured again there by rubbing it! Hope you got your answer. Please feel free to write to us if any more queries. Wishing you the best health!
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Your symptoms suggest that you have soft tissue injury over right side of chest may be due to an unnoticed trauma. These injury takes at least 15-20 days to heal. Rest, icing, local application of non-irritant analgesic gel and anti-inflammatory analgesics such as ibuprofen will decrease pain and swelling. Deep breathing exercise will also be helpful. Hope this helps. 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.
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Howell come to ChatDoctorI really appreciate your concern, looking to the history given here, underlying cause of the cirrhosis is important here, because this could be due to viral infection, or could be due to alcoholic cirrhosis, here serum creatinine is high and this need to be taken in consideration, (Renal function might be affecting) such case of curse need intensive medical care, some time may need some surgical minor procedures, better to have words with medical team, hope this information helps, take care.
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Hi, Thanks for writing in. It is important to know if you are having multiple lipomas or neurofibromas. Lipomas are pure fat containing tumors and are soft to touch. On clinical examination they slip under the skin. Neurofibromas are nerve related tumors and appear at many placers all over the body. Since they are related to nerves, these tumors can get painful. It will help to do ultrasound scan on the swellings which have now become painful and to know their nature. Please consult a surgeon and get clinically examined to make diagnosis. A needle testing called FNAC might be required to study the cells in the swelling. Some neurofibromas trap the nerves and then this causes pain. Severe pain requires the neurofibroma to be removed and the pressure over the nerve released by doing a surgery. Please do not worry.
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Hello and welcome to Chat Doctor, Ultrasound of the left buttock is required to know the type of lesion and its extent to surrounding structures. A growth in the left buttock region can involve the surrounding structures and thus have deleterious effect on surrounding structures. A fine needle aspiration cytology and/ or biopsy of the lesion may be required to know exact nature of the lesion. If the lesion turns out to be neoplastic, surgical excision of the mass may be done. Thanks and take care Chat Doctor.
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Hi. Thanks for your query and an elucidated history. Pale skin indicated that you have severe anemia and be due to a serious problem in the abdomen. Loss of appetite with abdominal pain and excessive sleep yet feeling fatigues indicates that you need a proper clinical examination and investigations. I would suggest in such a patient the following