Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my heart rate is 115 per minute. I was recently told that this rate is dangerously high but everything I see does not tell me that.  I am 62 year old female and about 40 lbs over weight. While I have made an appointment with my doctor, I would like to know if 115 heart rate is dangerous. ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would explain that as long as your heart rhythm is always normally sinus rhythm, there is no place to get panic. Relax and don't worry! Sinus tachycardia is a normal physiological reaction against different exogenous or endogenous stimuli. You need to perform a medical check up by your doctor (GP or internist) for a physical examination and some additional tests (ECG, complete blood count to rule out anemia or inflammation, PCR, thyroid hormone levels for any dysfunctions, fasting glucose, liver and renal function tests, blood electrolytes, arterial blood gas analysis, etc.), to identify the right cause of your tachycardia. If everything results normal, then a psychological status evaluation is necessary to rule out any symptomatology of anxiety, which may be responsible for tachycardia. Hope to have been helpful! Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a 21 year old male. I sometimes get these pains right below my bellybutton and maybe right where my bellybutton is. It hurts to stretch it ( like when i lean back) but it goes away when i curl into a ball. If i stand straight up it hurts but kinda goes away until it goes away...only to return when i stretch it on accident. Worst part is when I pee. It feels as if my bladder is tightening up or pulling down or something. hard to explain but it hurts and sometimes makes me stop peeing. This has happened before but not for a few month. Can t remember how long it lasted last time. Also just in case it helps, it hurts to push on where the location of the pain comes from. Not horrible though just reminds me that its still there. To clear up other questions. I haven t had sex in a 2 1/2 months. Obviously not pregnant since I m a male. Also not sure if this is related but sometimes randomly i get a pain inside my guts somewhere and it hurts really bad for a few seconds and then goes away completely . No clue what either of these things could be. ### REPLY: Welcome to  Most probably u have one of three problems:1. Spastic colon: u can test ourself if these pains are related to certain meals or after meals or not2. GIT Inflammation: if u have continuous pain, vomiting, bowel changes & if u can have CBC test u will have high ABCs level.3. Abdominal muscle inflammation: this may come from sleeping in A/C or with direct cold air with not enough clothing, this may go alone with some pain relief tablets, Muscle relaxants & removal of the cause Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 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? ### REPLY: Thanks for your question on . 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 . Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having stomach pains every time I eat something when it happens I dont necessarily have to use the restroom but most times I do and also recently Ive notice that my poop has been green. Also my period is about 16 days late if that has anything to do with wrong with me. ### REPLY: Hi ! Good evening. I am  answering your query. Although your stomach problem might not be related to the delay in your periods, I would advise you to go for a serum  and an ultrasound abdomen if need be to rule out pregnancy in case you are sexually active. Your stomach problem might be due to some kind of intestinal infection which could come by eating outside which you should avoid if you do. If I were your doctor, I would get your stool test done for ova and cyst, and treat the infection which would relieve you. In case of no relief, I would refer you to a gastroenterologist for a possible endoscopic evaluation of your intestines. 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  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello , on the shaft of my penis i had a bead like lump under my skin but not on the hard part of the penis. recently, it has swollen up for a couple of days .It is very painful and then it eventually discharged through the skin. It was a creamy yellow orangish color. the bumb has reduced in size halfway. what do you think this is and what should I do. Also I have been taken amoxacillin because I was scared of infection. I also have very bad jock itch for over a year, my primary physician has given me fluconazole first the cream which made it somewhat bearable but no where near curing it. She then gave me a 7 day systemic fluconazole, but it didn t help at all. I then tried tree oil diluted in oil as well as garlic supplements which helped the most but still no cure. I am currently using sepia 10x shower gel but also no help. Please help I have no insurance and I cannot afford to go to a dermatoligist. Thanks ### REPLY: Hi. Thanks for your query. Read and understood your history and concerns. The history says you had a lump in the skin of the penis, you took antibiotics for fear of infection and the lump ultimately opened up giving creamy, yellowish orangish fluid. So this was an infected sebaceous cyst and may get completely resolved. Your another concern is the Jocks itch for which you have tried so many things but not amenable. Actually the problem lies with the temperature in which you stay, work, sleep. If you can stay from the hot and humid temperature, use really loose clothes, keep the area ventilated, work in AV environment, clean the area with plain water and keep .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Had kidney stone removal on Tuesday morning. the tell me when i wake up they found nothing. I was peeing blood & have not stopped I think something is terrible wrong.Why would they not do some scan to see where the stone is? Why am I bleeding so bad ? ### REPLY: Hi, Thanks for writing in. Stones are sharp-edged and during removal, can be broken down to small pieces. After breaking in to smaller pieces, the fragments also are sharp and can injure the urinary tract. This causes bruising along the walls of ureter. This can lead to bleeding and the blood comes out with urine. You may have such a process which has led to bleeding in urine. The stone has been rightly targeted and the blood in urine is a common occurrence in people with multiple residual fragments after lithography. Please .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just had my ChatDoctor level checked at 13dpo and they were 14, which the doctor said is extremely low. I will be having them checked again after 48 hours. Has anyone ever had that low of a number and finished the pregnancy or did it end in miscarriage? I just had a miscarriage in my last cycle and concieved again right away which was a surprise. If this ends in miscarriage too it will be my fourth miscarriage and I have two healthy kids. ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  value for non-pregnant person is very low.  Less than 5. With pregnancy  level increase to very high level.  Your  level does not indicate pregnancy.  So if it was raised then chances of miscarriage is definitely there. 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 . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About 2 weeks ago, I slipped on ice and landed on my elbow. It bruised really bad, but seemed perfectly fine. An hour ago, I leaned on a soft cushioned armchair and it tingled a bit and when I looked at it maybe 2 minutes later, a huge knot or lump was there. Its still there, just curious what it could be. It s exactly where I landed on my arm and there s still a tiny bit of bruising from when I fell. ### REPLY: Hi! Good evening. I am  answering your query. Even though it might require a physical clinical assessment of the lump on your elbow for a proper diagnosis, from the history it seems to be a hematoma (collection of blood) of the elbow because of the injury. If I were your doctor, I would advise you with some ANI inflammatory . This would subside the collection for TH present. If the swelling increase in size, you might have to get it assessed by an orthopedic surgeon in your area.`Further management would depend on the X-ray report, and the related investigation 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  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello my husband lost weight 10 kg in 3 month .his family doctor did ultrasonography and said that,my husband has got fatty liver,my husband ate herbal medicine named:Milkthistle 10 drop 3 times  a day for 1 month.After that he lost weight and he have  had gaz feeling and uncomfortable stomach sensation .Most of the time he has got stomachache .They did abdominal CT scan just written: minor bibasilar dependent atelectasis and everything is normal.He is taking omeprazol and no use ,He always feels pain.He did endoscopy which was normal .I would like to know: why still he is losing weight and he is always with pain and what needs to do in this citation ?  His blood test for thyroids and liver ...was normal too!!! Kindly I am  looking  for your  reply pls.what things he should check? Thanks. Feri ### REPLY: Hello! Thank you for the query. When a patient lose weight without visible reason (like diet change or stress), cancer should be always first thing to rule out. Abdominal CT has revealed some atelectasis which is nothing serious indeed and can not be the reason of weight loss. If your husband is over the age of 50, colonoscopy should be the first test. He should also have prostate checked (PSA level and urologist consult). If he smokes, lungs CT is necessary as well. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: three weeks ago I had a bad headache, blurred vision and some numbness on l side of face.  I went to the ER and they did a CT and bloodwork.  I was told all was ok and they sent me home with ERY 333 in case there was an underlying infection of some sort.  They did mention a small amount of fluid on L eardrum.  I went ahead and followed up with an eye dr and dentist.  The eye doctor did the exam and dialated my eyes.  He was concerned about Giant cell arteritis and wanted the results of my bloodwork.  I had to go back and have that particular blood test drawn.  The number was a 10 and not 50 or more so he ruled that out.  I then went to my dentist and the xrays showed a possible abcessed root.  Second to last molar on the L side.  Because it was such a big filling he went ahead and pulled it.  I was then tols to continue my antibiotics and he prescribed more.  I still have a on again off again headache, never any fever.  Tooth area feels beter today is two weeks, although looks like it is still draining a bit.  I was out and about today and my husband said that my was was all red.  I looked in the mirror and it was all red and bloodshot looking.  Then after about an hour it was normal again.  I am starting to get a bit stressed wondering what is going on. I finished my last antibiotic tab today also. ### REPLY: Hello have read your query. Although having a tooth pulled is usually very safe, the procedure can allow harmful bacteria into the bloodstream. Gum tissue is also at risk of infection. If you have a condition that puts you at high risk for developing a severe infection, you may need to take antibiotics before and after the extraction. It is normal to feel some pain after the anesthesia wears off. For 24 hours after having a tooth pulled, you should also expect some swelling and residual bleeding. However, if either bleeding or pain is still severe more than four hours after your tooth is pulled, you should call your dentist.in your case I think tooth socket is healing. it'll take around 4 weeks to heal completely but if you feel that It's still . Hope this ans helpsRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Can a person continue to function with less than 20% of their heart functioning. They also have issues with the kidney not functioning properly & have had 4 litres of liquid removed & they still have to remove about another 10 to even come close to the lungs functioning properly ### REPLY: Thanks for your question on . I can understand your concern. Heart function of 20% with end stage kidney disease carry poor prognosis. His fluid build up in the body is due to failing of these two organs (heart and kidney). So according to my clinical experience, in his case life expectancy is less than 2-3 months. Hope I have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My filling came out and where the gap is now is really sensitive and giving me jaw ache tooth ache and really painful I cant afford to pay for treatment even through 111 for an emergency dentist I cant afford to pay for anything I dont no what to do and I cant register into my dentist until November ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint in case if there is loss of filling from the tooth and along with it there is sensitivity that is further leading to jaw pain, then it indicates that there is exposure of the nerves that are present in the center of the tooth causing nerve irritation and pain. You need to consult an Oral Physician and get evaluated and an x-ray has to be taken. In case if there is nerve exposure then root canal treatment of tooth or extraction will be advised depending on the depth of decay in the tooth. As of now you can take anti-inflammatory painkillers like Ibuprofen t relieve pain, but it is a temporary treatment, and you need to get the tooth treated for permanent resolution as taking painkillers for long durations without doctors advise can be harmful and will however give only temporary relief. So in case of tooth related problems' treatment of the tooth can only give permanent relief. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend had a Heart Attack.  All I know from talking to his wife is that they did not perform any surgery, and that his heart stopped beating for about 10 minutes before any attempt to resuscitate could be made.  He is in a "self-induced coma" on life support and they are starting a process to turn the life support down to see if the body reacts or starts to show signs of taking over.  My questions are:  What is the potential for brain damage?; and Is a recovery possible? ### REPLY: DEAR USER, THANKS FOR CONSULTING WITH ChatDoctorI UNDERSTAND YOUR CONCERN. I M REALLY SORRY AS ANSWERING ABOUT RECOVERY OF A CRITICALLY ILL PATIENT BEFORE GOING THROUGH ALL THE REPORTS AND THE PATIENTS PRESENT CLINICAL STATUS IS A BIT CUMBERSOME BUT I BELIEVE THE DOCTOR IN THE ICU OF YOUR PATIENT CAN TELL YOU BETTER AND THAT WILL HELP YOU LOT. YOU CAN TALK FREELY TO HIM ABOUT THE PATIENT.HOPE I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son (14 months) has been coughing, has runny nose and was vomiting for a few days. The symptoms started 2 weeks ago. When he breathes i can hear a little noise (probably in his chest). This noise goes away when he coughs and re-appears after a little while. The cough and runny nose symptoms are subsiding now but I am wondering if there could be any signs of asthma here. I am concerned regarding asthma because he has eczema already. ### REPLY: Hi... Thank you for consulting in . Cough and cold are viral 95% of the times in child .  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 15 mg/kg/dose (max ceiling dose 500 mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetirizine at 0.25 mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, i am a fifty year old female. suddenly i find myself shivering and my BP is 154 by 86 which is unusual for me(i am not a bp patient) and my pulse is 98. i suspect this could be due to the suspect hotel food this afternoon which did seem to be stale; what could be the cause ### REPLY: Hello, Thanks for posting your query on  ...* Brief Answer: Transient rise in blood pressure is indicator of nothing, stress or anxiety can raise your blood pressure, body shivering may be due to contaminated food.*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 does not help, medications are a must. That is usually decided by your doctor according to your condition and comorbidities. Some . 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 :follow-up blood pressure on different 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 other comorbidities like diabetes, hyperlipidemia etc. 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. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 8 yr old son has a red bump above his ear. It was very small like an insect bite but it has grown larger over the last few weeks. It does not appear to be an infected hair follicle. It looks like it has a watery substance inside and it does not itch or hurt. Wondering what it is and if his pediatrician needs to see him? ### REPLY: Hi.it could be an insect bite allergy getting secondarily infected, and I suggest you consult your pediatrician for this. Your son might require topical and oral antibiotics, probably. 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 and if so rate it.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My left ankle is always stiff  my foot aches when I am in bed.But suddenly when I put weight on it I had terrible sharp pain which lasted until I was able to lay down. Today it feels like any minute I will get that sharp pain. What would cause that to suddenly happen? ### REPLY: Hello there I have read through your question and would like to tell you that stiffness and pain in foot can be caused by a few conditions like gout, osteoarthritis or rheumatoid arthritis. I would advise you to get the following investigations done to rule out the above conditions 1. Seem uric acid 2.:RA factor 3. ESR and CRP 4. X-Ray ankle joint. Meanwhile, you should start taking calcium supplements to prevent further joint degeneration. Take an anti-inflammatory like naproxen to reduce pain. I hope that answers your question. If you have any further questions please feel free to write. Thank you for choosing . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good evening, my son is 4 yrs and 4 months and has a high fever with sever headache, he crys out and says his head is very sore inside....I have given him a Voltaren Suppositorie 12,5 mg twice in the last 6 hours and he is still sick, should I go to the local Hospital? ### REPLY: Hello dear. I would like to have a detailed history regarding your children symptoms. Is there also history of vomiting?? If yes please urgently go to the hospital and get him examined in detail by an expert pediatrician.IN the absence of vomiting, one can think of sinusitis or simple viral flu. Give him Paracetamol 250 mg/5ml (3 ml 4-6 hourly for fever and a good anti histamine like levocetrizine 5 ml at night along with steam inhalation preferably at night before bedtime. Get him examined by a pediatrician if it didn't settle with these medications. Hope it will help. Wishing your child good health :-) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello 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 ### REPLY: 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 Metonymic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Metal. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I 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 ### REPLY: Neurons injection are totally safe and has no side effect. But I would not recommend it unless you have very low serum B 12 level. So first get your B 12 estimation done. Even if your B 12 is low take 1000 microgram methylcobal able by mouth after consulting with your doctor. Injections are not useful because this is water-soluble vitamin, so excess doses will go in urine and would not remain in body, so injections will not have any storage effect. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor I have suffered from chronic sinusitis for the past two years,which resulted in surgery one year ago,at the moment I have been prescribed an antibiotic and sudafed by my own GP and am currently useing flixenase, I am also an asthmatic from when I was very young and use all the proper medication to controll my asthma ,could you please help me with some advice as i am in pain at the moment and for the past seven days,I was at my own GP yesterday who in turn precribed all the above but to be quite honest doctor I feel that im getting nowhere,dont feel I need hospital attention,maybe you can give me alternative advice please.Thankyou Dolores ### REPLY: Hi, you certainly got chronic sinusitis which has a more peculiar manner to be managed. I am afraid persistence of the pain might be an indication of other specific sinus X-rays to exclude a sinus collection. Considering the fact you are on an atomic/asthmatic terrain, .  Antihistamines, steroids and in case it's a collection, a culture and sensitivity test to orient anti biotherapy might be useful. For the moment, you got to avoid any nasal congestion, use Flonase as prescribed and see your ENT specialist for a reevaluation. Delayed treatment could lead to spread of the germ, in case it's a collection to nearby structures like the brain and could cause meningitis, thyroiditis which are serious. I would suggest you meet an ENT specialist for a reevaluation and discussion of an appropriate management plan, hope this helps, Luchuo, MD. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI 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 ### REPLY: 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 6 months and getting it done. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I 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? ### REPLY: 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... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I 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 . ### REPLY: Already you are suffering from acne for 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 about 6 months will reduce the acne permanently. But you need to meet a nearby dermatologist 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 .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 yr old son has had diarrea all day today. He vomited once. He was running a fever earlier of 101.3. I gave him tylenol. It came down. It is now the middle of the night and he is still nauseas. Put him in the shower for 25 min because he wanted to. Just go him out. His forehead is not hot but the rest of his body is burning up. Very hot. Just gave him more tylenol. His temp is 101. He is still complaining of his lower back both sides and his sides and lower front abdomen hurting him. What should I do?? ### REPLY: Hi, I understand your concern. Diarrhea and fever can be caused by a number of pathogens, viruses being most common. But as you have described pain in lower back and abdomen, child might have Urinary tract infection. As temperature is high, sponging or shower can be given again. Kindly give proper dose of Tylenol according to weight of child (10 mg/kg/dose) and repeat it after 8 hours. The Child can be taken to a clinic/hospital in morning where formal assessment and basic investigations can be done. Treatment would be according to the attending Physicians evaluation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son below 2 years is suffering from high fever 102 degree F or higher with dark stool sometimes, as well as he complains for stomach pain. His fever started 5 days back with 100 Deg F and is gradually increasing. He has been given Amoxycilin Tryhydrate & potasium Clavulanate & combination of paracetamol & Ibuprofen for 2.5 days. Now the medicine is changed due to increased fever and is given Taxim O(Cefixime) , Levofloxacin Ornidazole combination & paracetamol Ibuprofen combination. I am really worried what has happened. Please suggest. The fever comes back every 6 hours. ### REPLY: Hi... Thank you for consulting in . 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. YOU HAVE ALREADY USED 3 ANTIBIOTICS - PLEASE STOP UNNECESSARY USAGE OF ANTIBIOTICS. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am 26 years old female. Off late i have been experiencing severe pain in the left abdomen area. There is a slight swelling which feels like a lump right below the breast. I had absently hit myself a year back in the same spot to a table badly when some one pushed me from behind. The pain was on and off but now it seems be persistent and its getting difficult to carry on with daily activities. I recently consulted a doctor and she told me its the problem with my floating ribs and prescribed some pain killers. But it does not seem to help at all. Slight movements or traveling is causing discomfort. Can you please let me know what do i do? Is there a serious problem with my ribs? Thanks Deepa ### REPLY: Hi. Thanks for your query and an elucidated history. There is a history of trauma, localized pain in the same area, now is increasing. Yes, this can be due to costo-chon .  This is an inflammation of the cartilage part attached to the bony part of the ribs. Once inflamed and not diagnosed can cause a recurrent pain. Since this is the most mobile part of the chest, which moves with each and every movement of the body, rest is impossible. You have to take a long course of anti-inflammatory medicines, oral steroids if required.  Rest can be given by strapping the affected part with elastomer / sticking skin tapes in a position of exhalation.  3 weeks course can help you nicely. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor , My family was recently treated by a dentist declaring that we had holes in our teeth. I did not believe him but my mom convinced us to make a second appointment to get our teeth filled. My family have beautiful almost perfect teeth to the eyes. My question is, how does a dentist discover these hole in the teeth? ### REPLY: Helloactually we as a layman can see only those holes in our teeth that occur on the causal surface of the teeth but a dentist can locate hole between two teeth which is not visible by naked eye by running a probe and getting a catch point also he/she has aid of radiograph which easily shows carious lesion between two teeth so don't worry, your dentist is qualified enough and if he says that you need a filling than get it done because that will prevent you from future discomfort hope that helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: We just noticed last week that our six year old only has one testicle.  He has had a fever off and on for the past 3 weeks.  He has had no other "symtoms" after his fever broke, (except for this rash-like area around the pubic / pelvis).  That is when I noticed that he only has one testicle.  He is going in for an ultra-sound, but should I be concerned? ### REPLY: Hi, Orchiopexy is recommended. Based on the history given your son has monarchism while the other testis being descended (testicle that has not moved into its proper location in the scrotum). Unfortunately there is a high risk of complications like testicular torsion, trauma, and testicular cancer with the descended testis hence, it should be fixed to its normal position in the scrotum by a surgical procedure called orchiopexy. Let him undergo the ultrasound or MRI to confirm the diagnosis followed by the treatment as described above. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been wondering if i have some sort of anxiety disorder. Im always stressed out about everything, when good things happen to me im only happy for a short period followed by worry and a mix of emotions, and my hands also shake and have for as long as i can remember.also my appetite has been off the last year or so and had an endoscopy and tests run but nothing was out of the ordinary. ### REPLY: Thanks for your query on  .com. Based on your description, it seems that you are suffering as long as you can remember. So, there is no definite timeline of onset of your problems. To me, it appears that you might be suffering from mix of depression and anxiety which may be in the background of your personality (possibly shy, reserved, socially anxious). Alternatively, you might be suffering from low grade of depression (dysthymia). However, it will be helpful to rule out some medical condition which may cause or make your symptoms get worse such as thyroid problem, heart related conditions, medications for bronchial asthma such as theophylline etc. Once your family physician or local doctor has ruled out any medical condition which explains your problem, you can look for psychological help. You can start with self-help programs-regular exercise, regular sleep routine, giving up tobacco, alcohol, tea, coffee (etc.), meditation (if you like) and stress-reduction techniques. If symptoms doesn't improve, see your psychiatrist. You may require medication or psychotherapy or combination of both depending upon the assessment. Hope this will be of some help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: * Diagnosed with m in 2010 and initially treated with Hormonal injections, anti-androgen tablets and bisphosphonate ( Lucrin, Androcur to Casodex, Zometa)* Radiotherapy in 2011 for ?Bony pain* Started on Chemotherapy with Docetaxel (Textotere) 2013* Now rising PSA and evidence of disease progression on CT and Bone scan ### REPLY: Good Day, and thank you for being with  ! Yes a rising serum PSA is almost always considered as an evidence of cancer activity and progression. A rising PSA is considered as treatment failure. 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: http://www.ChatDoctor .com/doctors/ .  Best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went to the gyno today for 2nd opinion. Have had chronic pelvic pain. He said it was urology issue and urologist cleared me and said it was gyno issue. New gyno said it could be interstitial cystitis. I do not have bladder problems (beside occasion infections). No urgency or accidents. Any thoughts? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have chronic pelvic pain. Well there can be many reasons for symptoms you mention in query like endometriosis, muscle spasms, inflammatory disease, sexually transmitted, fibroid, irritable bowel syn .  I would suggest you to consult gastroenterologist for proper examination. Doctor may order ultrasound, endoscopy along with stool test. Doctor may prescribe  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I 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? ### REPLY: 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.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: what does grade 1/2 anterolisthesis of L3 and L4 mean? Had fusion at L3, L4 and L5 in 2012? And mild straightening of lumbar spine? What does mild intervertebral disc space narrowing mean? And moderate bilateral neural foraminal narrowing? And pseudo disc bulge secondary to anterolisthesis..with moderate bilateral neural foraminal narrowing. L4-L5 diffuse disc bulges seen here which indents upon ventral aspect of thecal sac..thecal sac measures 7-9 mm in AP dimension..moderate bilateral neural foraminal narrowing here. I am having pain in hips, and lower back in SI joint and had MRI with these results. Injections have not helped, and I do not understand language of this report. Thanks very much ### REPLY: Hi, Thank you for posting your query and sending the MRI report. I have read the report in detail, and would like to reassure you that there is no need to worry about them. They mainly represent degenerative changes in the lumbar spine (lower back area). This has resulted in bulging of discs (soft tissue located between the bones of back). These bulged discs cause pinching of the nerves that emerge out at this area. This results in back and leg pain. In some cases, tingling and numbness of legs may also occur. You would benefit from using pregabalin or gabapentin capsules. In some cases, surgery may be needed if medicines and injections fail to relieve the pain. 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, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a pulling sensation in my lower abdomen a few days after ovulation. Sore boobs, achy feeling in lower abdomen as well as tender to touch. Nausea off and on, headaches more than normal, and not feeling like myself. I missed my period by 5 days, took a 2 home tests, one negative and the other came up with a faint positive line, and had one day of heavy period and 2 days of spotting. My periods usually last 6-7 days. I still have all the same symptoms as mentioned above. Is it possible that I am pregnant? ### REPLY: HI Welcome to .Fewer chances of Pregnancy. May be Hormonal Disorders. May be Stress, Pelvic Infection. Get your Urine Test for Pregnancy, repeat after 2 to 3 days, take first morning sample, from a reliable strip/Lab.Wait for a week. Consult your doctor, she will examine Physically, advise you Urinalysis, blood tests, ultrasound for diagnosis & treatment. Take more liquid & rest. Thanks for query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi.I am a 27 yr old, with no significant medical history. I suffered a fall around 5 years ago and meniscal +ACL injury was suspected on physical exam ,though no MRI was done.I was advised physiotherapy which I wasn t ver compliant with. Since then, I ve had pain on and off, and am unable to run,jump etc. But of late, I ve been having pain even at rest. Could it be that the ?tear is progressing ,..should I go in for a scan? Is surgery advisable? What are the indications for surgery? ### REPLY: Hello, As this is an old ACL injury and not may behave progressed, I will advise for the MRI. If the MRI confirms a complete tear than surgical management will be advised.  But if its grade 2 injury still with physiotherapy management you can get help. But we need an MRI for sure without any doubt. Post MRI if surgical management or conservative management is thought for you still need to undergo physiotherapy management for the better outcome score. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: :) 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? ### REPLY: Hi Good Day, Welcome to . 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. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 36 years old and suffering from High BP (controlled), diabetic (controlled) and psoriasis, my height is 5.5 and weight is 70kg. I had ayurvedic treatment which really helped me in curing my hand chest and back psoriasis patches but in scalp it is still there...i m suffering from psoriasis for last 2 years and same to got diagnosed for diabetes. I used to apply diprovate and really control it very well but now its not avaialble in market and nothing works for scalp . Please help me to control my scalp psoriasis ### REPLY: Thanks for using . I understand your concern.1) You can apply fluocinonide generic solution 0.05% over the affected area in small amount, twice a day, maximum up to two weeks.2) You can use clobetasol propionate shampoo 0.05% once daily or clobetasol scalp solution(Cor max)0.05% apply over the affected area in small amount, twice daily, maximum up to two weeks.3)You can use topical calcipotriene solution or foam 0.005%(though little expensive)are also equally effective in treating scalp psoriasis. I would advise you to discuss this with your doctor preferably a dermatologist to consider any of the above prescription if it is appropriate for you. Hope this information helps you. If any further questions, happy to help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I habitually wear sandals in the spring/summer with a strap between my big toe and second toe (thong type). I woke up Tuesday after wearing/walking in them all day Monday with a swollen big toe/foot and pain upon standing. What could be causing this. I have worn this type of shoe for years. ### REPLY: Dear patient Acute swelling of big toe without trauma mostly is due to gout. This disease is characterized by increased levels of serum levels of uric acid and deposition of uric acid crystals in small joints especially of big toe. This needs to be investigated with serum levels of uric acid from reputed lab nearby you. You need to consult expert orthopedic surgeon with report. Meanwhile, start tab diclofenac 50 mg twice a day for pain relief.  If serum uric acid levels are higher you need to take .  All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,may I answer your health queries right now ?  Please type your query here... Hi I am going in for  a HIDA scan tomorrow and forgot to mention to my doctor that I am allergic to shellfish etc ... is that a problem?  I know I can not have contrast for a CT scan because of this, but wondering if its the same for a HIDA scan. Thanks! ### REPLY: Hi and welcome to . Thank you for your query. I am  and I will try to help you as much as I can.  No, this is not problem since contrast that is used for the scan is not related to allergens in shellfish so you don't have to be worried. If you have iodine allergy this may be problematic for some scans. I hope I have answered you query. If you have any further questions you can contact us. Kindly regards. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, a 17 year old girl (my cousin) is having 104 fever from past 3 days. We got her blood and urine tested. Can you please let us know if this is a case of worry. The result is: Occasional pus cells, occasional epithelial cells, no bacteria, and no growth seen. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have high fever which could be due to bacterial/viral infection. You have presence of occasional pus cells and epithelial cells which is indicative of infection in your body.  I would suggest you to do tepid sponging for immediate relief as you having high degree fever. You should take proper antibiotic course in combination with Ibuprofen/ Acetaminophen. Visit general physician once and get it examined. You should get routine blood test done and start treatment after proper diagnosis. Normally viral fever take one week duration to get recovered. Avoid oily and sharp food.  . Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have disc herniations of T1-2, T6-7, T7-8, T8-9, L3-4, and L4-5, along with other things. My PCP is sending me to a Neuro surgeon, but I m not sure when I will be able to get in there and I have some questions... Based on the info you have is spinal fusion an option? If it is would I lose much of my range of motion? What other alternatives are there that I might be a good candidate for? ### REPLY: Hello, Thanks for posting this query in ChatDoctorI have noted your complaintsPlease note that, if the love described data are MRI findings you donor have to worry. Based upon these findings it is difficult to tell you that you need spinal fusion or north most important thing is to note the clinical symptoms and then the clinical/neurological examination findings. I am very sorry, but you have not provided us the exact clinical symptoms. If you have pain and symptoms are suggestive of nerve root compression which has not improved with conservative treatment, then only you should go for operative procedures. This may/may not involve spinal fusion. So you should not worry at all. Please get evaluated initially by a neurophysician who will assess you and will let you know if surgery is mandatory in your case. If surgery is required you may proceed to see a neurosurgeon. Hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir,my semen analysis says iquefaction time : >60 MinutesPh : 8.5 Microscopic examination:Sperm concentration : 30.0 Millions Sperm total count : 105.0 Millions Motility Grade:IV (Rapid forward progression) : 03 % forward progression) : 08 %II (Slow forward motility) : 15 %I (Immotile spermatozoa) : 74 %Morphology:Normal forms (%) 30 % >= 4.0 %Vitality 40 %.With this,what treatment choices do i have ?Thanks in advance ### REPLY: Hello, Your semen agglutination time high and your sperm motility if abnormal. You are having immobile sperm more which should not be present normally. You need further evaluation by ultrasonography pelvis, serum testosterone and prolactin estimation. The smoking habit is present need to be stopped. You need to be prescribed multivitamin tablet and hey Forte like a tablet to increase sperm motility. I suggest you consult an .  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have gallstones and one is in my bile duct i didnt have i have a bowel movement 4 10-14 days been in hospiltal and i have to back on to get it removed from my duct bt the past 2 days i have had no pain and had 3 bowel movements could it of pasted ### REPLY: Hi and welcome to . Thank you for your query. I am  and I will try to help you as much as I can. It is possible for gallstones to pass, but this is not common and usually these stay in gallbladder, grow and may cause symptoms in the future. So we recommend surgical removal of the gallbladder which can be done laparoscopically today in most cases. You can also decide to wait and see, but then you risk possible gallbladder inflammation. I hope I have answered you query. If you have any further questions you can contact us. Kindly regards. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, My mom is a chronic asthma patient and uses accuhaler 50/100 and ventorlin. She had a chest infection last week and was prescribed Synasma 400 twice a day. She suffered a severe headache , dryness of tongue , and uneasy feeling all over her head after taking it for two days. It started from her left side of neck and creeped towards head, behind her left ear. She was in acute pain for four hours at night and each time she tried to move her neck towards left, she experianced a vertigo like feeling. It was warm in that place and I tried to put some water (even if she had chest congestion). After few hours it was reduced to normal. We found she had this experiance way back in 2009-10 when she was prescribed synasma 400 for 7 days. We didn t realised that time that it is due the drug and had to admit her to a hospital, because we thought it was a symptom of cerebral irregularity. But obviusly nothing was diagnosed. Recently I was reading some reviews and found that this drug has caused some adverse effects on a few users, and may have some part to play specially on salbutamol users. Please confirm. The headache caused by the drug was reduced in a minute to a certain degree by using a simple ear wax removing drug like ceruklin. Please explain. Is it required to consult ENT specialist? Thanks and Regards ### REPLY: Hello. NASA does not cause this type of pain (I would suggest that you use generic .  Although, theophylline group of medicines are known to cause neurological side effects including convulsions. So they should be used with caution. Remember a simple rule for asthma: Patient should be only on preventers (accurate in your case) regularly and should need very occasional albuterol as a reliever. If albuterol is needed on more than 3 instances in a week, you need to step up preventive treatment. Infection needs antibiotics and not theophylline ! Not all asthma exacerbations are due to infection. In fact very few are. - ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctors my name is rizwan and i am 23 years old i have 2 problems one is sgpt which is 90 to 100 before 4 months and triglycerides 227 i.am using silver twice a day for 4 months and rosubar 20mg for 1 months but i still have problem today i took test again but the problem is same what will you rcommend for me i am worried about it becouse i.am.going to australia after few months so i will have to take medical please help.me... i.am non.smoker and non.alcohol user.. ### REPLY: Hello, lucky, Thank you for contacting  with your query. You are a young manana have abnormal liver enzymes and elevated triglycerides. I want you to make sure that other causes for elevation of liver enzymes have been ruled out such as Hepatitis B, C or E that can cause chronic hepatitis. There is also "Metabolic syn .  You have been on Rosuvastatin for 4 months. I am not sure if you had baseline liver tests before you started this  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there I am extremely tender on the right side of my rib cage (not the bones themselves) Sore enough that I cannot sleep on that side, and it also hurts when I twist my body to the left. Have had this pain for about 10 days now. Have also had a bit of very mild nausea. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Right lower side of rib cage is the area of the liver. So you must be having pathology of liver which is causing pain to you. I advise you should do x-ray chest PA view. This will help in localizing the lesion. It may be either muscular pain or liver pain. If the muscular pain is their than you can't have any type of lesion in the chest. I advise you should avoid heavy exercise which requires a use of right rib cage. Take proper rest. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife was diagnosed with TB in January 2011.Plural effusion had taken place for removing water from her right chest n then she was put on antibiotics for TB.She is taking medicines from last 1.5 months now.Since then we have not indulged in kissing,oral sex or penetrative sex.Is it safe to kiss n ve sex now or shud we wait for couple of months more? ### REPLY: Thanks for your question on . I can understand your concern. Your wife is having tubercular pleural effusion. It is classified as extrapulmonary tuberculosis. And so it is not infectious to you or others. Only pulmonary tuberculosis (involving lung) is infectious. So you can do kissing, sex without fear of spread of infection as your wife is having extrapulmonary TB. Hope I have solved your query. I will be happy to help you further. Wishing good health to your wife. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i wake up every morning for the past 90days with watery eyes and runny nose a cough and sore throat which sometimes last all day,what is your best suggestion,i tried several otc medication with little relief. what can i try to help me with my condition. Thank You. ### REPLY: Hello, Welcome to , Your history is suggesting of some allergic reaction. As it is there for last 3 months the cause should be found out. The reason for the allergy can be tested by skin prick test using all kind of allergens like food, mite,dusts and . Skin prick test help to identify the allergen causing the symptoms, after identifying the allergen you can decide whether to take sublingual immunotherapy or subcutaneous immunotherapy. For immediate relief of symptoms you can take some medicine like Monte LC after consulting your doctor. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m experiencing weakness in my non-dominant left hand, making it difficult to do simple things like fasten my bra. I m having trouble playing the piano (controlling my little finger in particular. I recenly had some numbness in my right pinky but it is much better. ### REPLY: Welcome to  I have gone through your query and understand your concern. You are having neuropathy both hands. It may be due to compression of your nerves in cervical spine region due to compression of nerve roots. You have not mentioned your age to judge the cause of disease. You may need your MRI of cervical spine to see compression. Other causes of neuropathy such as thyroid disease and diabetes should be ruled out by proper investigation. 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. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having lower right abdominal pain. It is a shooting pain when I get up and the first few steps I take then it just goes to a dull ache. I have been having constipation and hip pain for the last few weeks. I am not sure if it is all related but it became worse today with the lower abdomen pain. ### REPLY: Hi. Thanks for your query. The combined symptoms of right lower abdominal pain, hip pain and the character of increasing on getting up, taking few steps and then going to dull ache along with constipation is suggestive of some sinister problem. I would advise you the following:CT scan of the abdomen and the hip joints. Colonoscopy. This will help to decide whether there is a primary hip[joint inflammation or a cancer or inflammatory process in the appendix colon area. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi a quick question. today I was prescribed 500 mgs of amoxicillin/claulanic acid 125mgs by my GP to combat a severe infection stemming from my wisdom tooth and now am swollen in my cheek area plus my gums along my upper right left are swollen up into my cheek bone, right by my nose . I went to GP to get anti biotics because my dentist could only give me an earliest appointment in four days. my question is will the anti biotic treat the infection to allow extraction by then? and also should i have the wisdom tooth removed ? ( it is empacted and broken of at one side- happened a week ago) ### REPLY: Hello There, Thanks for writing in.First, i would like to tell you that wisdom teeth are vestigial organ, if you have problem during their eruption like insufficient space, it will be best to get them removed. In case of infection in wisdom tooth, antibiotics along with painkillers and multi-vitamins and in case of swelling serration should be prescribed prior to extraction and should be taken at least 3 days prior to extraction of that tooth.Meanwhile you can perform warm saline gargles 3-4 times a day. Nothing to get worried. Take Care. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was told 2 years ago by a cardiologist that I hve a left bundle branch blockage.  I am on blood pressue meds, that have been adjusted.  Now I am experiencing some dizziness with slight nausea.  I am trying to get back in to see the cardiologists.  Is that the correct Dr I need to see? ### REPLY: Hello, Bundle branch don't need any treatment at this moment. It's because of hypertensive effects on the heart, you need to control your BP and frequently monitor. It's a right decision to visit doctor.  Regarding your nausea, dizziness you should check your blood pressure and pulse rate. Is it too high or low. Also, it can also be caused by gastritis and acidity problem. If you have bloating burping vomiting upper abdominal pain etc. it supports gastritis as cause.  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 MMH, then BP med needs to be hiked up. 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 this helps you and get back if you have any doubts. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my 11 year old seems to have the chicken pox. She has appox. 10-15 chichen pox right now. This is day 2, she noticed yesterday a hard pea sized lump between the middle of right ear and bottom center of head.(hairline)  It is sore when touched. Today she has one more not quit as large, about a half inch above the other. Neither of these look like a chickenpox? Any idea? ### REPLY: From what you have told, your son may have two enlarged lymph nodes. Lymph nodes are small pea shaped lumps present all over body. It gets enlarged and painful when infection is there. Many a times chicken pox will not cause any lymph node enlargement. But Since his immunity is weak now, a bacterial infection may set in and may have caused the lymph node enlargement.It's better to wait and watch. If the Lymph node does not subside on its own, a course of antibiotic may be given.In the meantime give plenty of water and paracetamol tablets to reduce fever. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi.. 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 ### REPLY: 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.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I fell about three weeks ago and it hurts to sit which is to expect, but just recently noticed that the pain is coming from a lump or swollen something that is hard,  next to my anus.  It hurts to touch and iI have to sit just right. It is only on one side. What could this be. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have hemorrhoids (piles). You should go for per rectal examination by general surgeon.  .  Take high fiber diet. Avoid constipation. Local anesthetic gel like Xylocaine can be used for pain relief. If medical treatment does not help then surgery is the treatment of choice. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I 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 ### REPLY: Welcome to  Keep your Blood Sugar your blood sugar report is 245 -is High No 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 HBC at 6.50 Percent(indicate 3 months blood sugar 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 Funds Exam to rule out Retinopathy.  Yeary. Discuss your doctor for teary check up & for vaccination. Thanks & Relax, DONT EXPECT MIRACLES. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, 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. ### REPLY: 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.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Accidentally took and chewed half a pill of Aleve, thinking it was a TUMS tablet, which was laying directly next to it on the dresser. Within minutes, I noticed the burning & odd sensation, and tried to spit out remainder of it.. Rinsed mouth thoroughly, then took the intended TUMS. Had a past with a very mild allergy to ibuprofen.. Is this incident anything to be concerned about? No immediate side effects. ### REPLY: Hi, I can understand your concern regarding the accidental ingestion of half a pill of Alive. There is nothing to worry about it. In addition to TUMS you can also take a stomach acid suppressant such as pantoprazole to minimize the stomach acidity related issues caused by half a pill of Alive. Alive (naproxen) may also have a similar allergic potential as that of ibuprofen. So, if you experience difficulty in breathing or rash you must visit the emergency room immediately. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I saw the post from the mom of a child with a 12p12.1 deletion and was intrigued. I too have a son 9 y.o. who has been diagnosed with a 12p12.1 deletion and cerebral palsy. The geneticists at a top children s hospital had no experience with 12p12.1 deletion and could only find two other cases in the world in the medical journals. The geneticists nor the neurologist could tell us what to expect. The two cases found in the medical journal were apparently much more severe. My son has mild developmental delay, mild speech and motor delays, vision issues and has recently developed a movement disorder. He is able to run and play and is served under an IEP in the inclusion classroom to address reading, writing and math delays. I have done internet research and am concerned that I see genes in that region associated with cancer. Could this increase the likelihood of him developing cancer. Also, With the diagnosis of 12p12.1 deletion, would there not be another chromosome 12 (since they occur in pairs) that would contain the genes that are missing. ### REPLY: Hello, Having a genetic deletion does not automatically increase the risk of cancer. Cancer is always multifactorial and genetics is a certain risk factor. Chromosome occurs in pairs. But sometimes gene requires two copies for normal expression to be produced. So one chromosome has deletion, end product won't be there. As there is limited knowledge in present deletion, not much can be commented upon. Now about risk of cancer - what cancer are we talking about. If we check ourselves, we would have plenty of mutated gene causing us high risk. As it has a multifactorial cause, cancer risk would be the same as most of us. However, better nutrition and healthy habits can still further reduce the risk. Hope I have answered your query. Happy to help, if you have any further queries.PS. Facebook seems to have a 12p mutation group - join and share informational care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI.MY MOTHER,55 YO,IS SUFFERING FOR PRIMARY AMYLOIDOSIS SINCE 2003. FIRST IT AFFECTED HER STOMACH,INTESTINES CAUSING CONSTIPATION,WEIGHT LOSS,ANEMIA. SHES BETTER NOW WITH HOMEOPAPHY/AYURVEDIC TREATMENTS AND EVEN PUT ON A LOT OF WEIGHT . SHES ALSO DIEBETIC AND SUFFERS FROM HYPERTENSION . OFF LATE IT HAS AFFECTED HER KIDNEY HER CREATINE AS OF TODAY IS 1.79/MG.AND SHE IS BECOMING WEAK WITH SEVERE JOINT PAINS.PLEASE GUIDE US AS TO WHOM DO WE GO TO AND HOW DO WE TREAT HER.MOST DOCTORS HERE IN CHENNAI DONT EVEN KNOW WHAT AMYLOIDOSIS IS! WE ARE FROM INDIA,CHENNAI. ### REPLY: Hi. Primary systemic amyloidosis involves the deposition of insoluble monoclonal immunoglobulin light chains or L-chain fragments in various tissues. All the above symptoms including increased serum creatinine is because of Primary systemic amyloidosis. Alternative medicine is not effective in Primary systemic amyloidosis. New . (like Lenolidomide)Please do not waste further time, very effective treatment is now available for this disease as compared previously. You can consult medical oncologist. You can consult your mother to medical college in Chennai. Take care. ### END