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<s>[INST] I have a dent in the right side of my rib cage. I dont know how long Ive had it for but I remember having it for at least one year. Before I go to bed or before I get out of bed I feel some sharp pains over that dent and on the back of my rib cage too. What does it mean? And how can I get rid of the pains? [/INST] Hi. I can understand your concern. If the chest pain is disturbing your routine activity then get a chest x-ray done to rule out any lung infection, or it could be just a muscle pull. Do not lift heavy weightsPossibility of musculoskeletal pain is more. Ibuprofen is anti-inflammatory. You will definitely improve witChatDoctorbination of painkiller and muscle relaxant Chat Doctor. Also apply warm water pad on affected areas. Avoid movements causing pain. Don't worry, you will be alright in 1-2 weeks. But better to first rule out lung infection.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks </s>

<s>[INST] hi doctor,,i had anal sex few days back,while attempting to push his penis ,he by mistake went into the wrong direction.he got his part rubbed into mah Gpart..then we had a protected sex with a condom.In order to safeguard i had a pill next evening..but,still it had been 5 days and i didnt have my periods yet..am i pregnant? [/INST] Hello dear, I understand your concern. In my opinion the chance of pregnancy in your case is very rare. Because it was protected intercourse with condom and emergency pill was also taken. Emergency pill is 95% effective if taken within 72 hours of intercourse. The emergency pill causes hormonal imbalance and effects the timing and bleeding of the period. So the period can be either delayed or come early and bleeding can either be heavy or irregular or scanty. So relax the delay in period could be due to pill. I suggest you to do a urine pregnancy test a week after missed period. If the test is negative the delay can be due to pill. And wait for spontaneous onset of periods. But overall the chances of your pregnancy are very, very rare or nil. Avoid stress. Nothing to worry as such. Hope this helps. Best regards..... </s>

<s>[INST] Hi my 6 year old daughter has had fevers since sunday morning giving her nurophen and panadol to get temp down. the temp has eased last night but she woke with a vomiting twice throughout the night seems a bit better today but still a headache and the temp comes back when the nurofen runs out? [/INST] Hi... Thank you for consulting in Chat Doctor. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Chat Doctor are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. </s>

<s>[INST] Hi, Im into boxing, and a couple of weeks back I had a bit of a skin reaction to a pair of gloves I used. It left blotchy rashes in small clusters on both of my hands. I expected it to go away in a couple of days like a sweat rash, but about two weeks or so later its still there. Right now its very dry and flaky, but if Im in any sort of warm condition or if I try and wash it the rash turns red again. Its not itchy other than towards the eveningtime. How can I get rid of it? Its so unsightly. [/INST] From the information that you have given it looks like you are having "Contact Dermatitis"I would suggest you stop using those gloves. Please use cold water to wash your hands as it decreases constant irritation of the skin over your hands. You will also need antihistamines tablet to decrease itching and also steroid cream for local application. Please consult your family physician or dermatologist for prescription of the medications. </s>

<s>[INST] Hi I have a sore throat and a fever which started 24 hours ago. I keep getting a lump in the back of my throat and feel like there is something stuck there. Its not flu or a cold. This morning I felt a fairly large (6-7mm) yellow soft lump come out from the back of my throat, on one side, that side feels better now but the other side is still sore. It feels like there is another such lump stuck there and waiting to come out. Can you help diagnose this and recommend a treatment? Thanks [/INST] Hi, dairy have gone through your question. I can understand your concern. You may have upper respiratory tract infection. Granular pharyngitis may lead to lumpy feeling. You should take a course of antibiotics. Azithromycin or amoxiclav can be useful. Warm saline water gargles are also useful. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. </s>

<s>[INST] I have been having a dull pain in my left arm for about the past 3 days. This morning I felt ill and vomited once and have spent the rest of the day laying down. I had open heart approx. 3 years ago, and don t want to spend all evening in a waiting room, to just be told to follow up with my Dr. Monday. advice? [/INST] Thanks for your question on Chat Doctor. I can understand your concern. In my opinion, we should first rule out heart diseases in your case. Your symptoms like ill feeling, left arm uneasiness etc. are common symptoms of heart diseases. You also had open-heart surgery 3 years back. So better to get done ECG, 2d echo, stress test (trade mill test) and coronary angiography (if required) to rule out heart diseases. If all these are normal then no need to worry about heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] Hi I have revived 2 steriod shot for back pain 2 weeks apart from each other. The second shot made me have menstural cycle 2days later and I m still going (3weeks). What should I do is this normal? And I m scheduled for a 3 epidural next week. IS this treatment dangerous to damage my ferterile state since I just turned 40? So far 40 has not been the new 20! [/INST] Hellowelcome to ChatDoctorwell epidural injections will only give u TEMPORARY RELIEF and once the effect of injections is over the pain will come again...for a long term relief you should visit a physiotherapist n ask him to teach you SPINAL EXERCISES FOR STRENGTHENING OF YOUR BACK MUSCLES n then perform those exercises on a regular basis at home...strong back muscles will prevent back spasms (cause of back pain) n that way you can make yourself free from back pain for long periods, also along with that start wearing LUMBAR BELT specially during Chat Doctor. </s>

<s>[INST] A lump appeared on my little finger two months ago. I have been to my local gp twice and they have put me on antibiotics and antinflamentaries. The hard lump has not gone and hurts when you apply preassure. My wrist has been given me touble and is given me pain when i bend it. [/INST] HI, Dear,Thanks for the inquisitive query to Chat Doctor.1-I studied your query in depth.2-In my opinion, the 2 MTV old lump which has not reduced or responded to antibiotic treatment with NSAIDs, is -"chronic abscess with thick abscess wall" which gets hurt on pressing it and is with resistant bacteria.2-a-and needs to be treated with the changed antibiotics.3-Treatment of such chronic-abscess in the little finger-is very challenging-3-a-rule out the diabetes in you by FBS and PPS blood checking,3-b-Such resistant chronic lump-needs to be tested by -sending the aspirate of the abscess-" for pus-culture report"- for knowing the sensitivity study for the antibiotics and 3-c- such boils need to be removed surgically or Chat Doctor. 4-Hope this would solve your query to your satisfaction.5-Wellcome for more queries to me On Chat Doctor.6-Thnks once again for your inquisitive query. Have a Good Day.!! </s>

<s>[INST] My sister has what starts as a rash and grows in what looks like a wart. It hurts, bleeds, falls off. Starts and spreads all over. She went to 2 doctors so far, no answers. She had multiple biopsies, nothing. It has spread over her back front arms and now legs. No clue...I am going with her to another dermatologist. I need to have an arsnel of questions. A allergist wouldn t do a thing because she was so enflamed from neck to buttocks. She colors and perms her hair often, she re entry traveled to Mexico (Thanksgiving) and it started late November early December. By Christmas she had the biopsy done. Any thoughts? [/INST] Hello, This itching rash can be due to two reasons 1 Some people develop allergies for the metals used in hip prosthesis. . You haven't mentioned what type of prosthesis was used. But it is one possibility. 2 Other possibility is Chat Doctor. You haunt mentioned prior allergies. Allergy agent is different from one person to the her. You can't have allergy for celecoxib just because your neighbor is allergic.3 herpes zoster at a dermatome level. Reactivation of varicella zoster virus But after your doctor with </s>

<s>[INST] hello,dr..i have been scratched by our dogs nails while having swimming in the beach yesterday (saturday).Our dog wasnt vaccinated yet that time.Our dog is 4months of age and on that afternoon on the same day we have our dog injected with anti-rabbies for the first time.I have many scratches on my thighs and forearms.I dnt know if blood came out that time since were on the beach.Do I need to have anti-tetanus injections and anti-rabies?I had tetanus shots before,approximately 9yrs ago perhaps.pls reply.Ill wait for ur prompt reply.thanks. [/INST] HiT hanks for choosing Chat Doctor for your query. There is no need for anti rabies vaccine if it is due to simple nail scratch. As such anti rabies vaccine is not the treatment for rabies, it is used to prevent the disease after exposure (dog, cat or wolf bites involving saliva). The virus responsible for rabies is present in the saliva and nervous cells. So it is rather hardly possible to get infected through the scratch. It is only possible if the wound has direct contact with the saliva during bite. What you need now is simple wound cleansing, a booster dose of In tetanus toxic. So in conclusion, scratch should not cause virus infection. Hope this suggestion could be of help to you. Feel free to ask further questions. Regards </s>

<s>[INST] Respected Dr. sahab My wife is suffering renal problems. . two session PD dylisis done in Nov 12 . Now she is on perscribed medicines for 15 days . The cretinine is 8.2 on 27.11.12 test . the medicines suggested by Dr. .. are -- nifidine ip 10 mg two tabs TDS with arkamine [ clodine ] one tab TDS.. folic acid iron tab BD , B-complex one tab daily .. calcium carbonate 500 mg BD , You are requested to suggest us any other medicines but cheap cost to decrease critenine lavel Other hand she is also with Anemea, Hypothyriod, HTN, . THE THYRIOD PILLS IS TAKEN IN MORNING . WEwill be thank ful to you . we don t want to go Another PD or HD . She is regular with toilet comfertable stool two times & 1.5 ltrs plus urine daily without any problem . [/INST] First I feel sorry about the chronic kidney problem your wife suffers; nevertheless, medications which you mention are to control her Blood pressure as well she is on thyroid medicines. Taking calcium is very important and along with antacid to reduce phosphate absorption. I would like to know the present creatinine level after PD. Did your doctor perform renal biopsy? Did he say she has SHE? You must understand one important thing that the outcome depends upon the etiology as well the current renal status and then only I can suggest the prognosis. Don't carried away with the apparent recovery she is showing right now as renal failure management is a big commitment. </s>

<s>[INST] my brother in law has rectal cancer. had surgery to remove tumor. he was not abl to get chemo due to low tolerance. radiation produced scar tissue and a second surgery is too risky. pet scan lit up in bladder tailbone and lymph nodes away from orig tumor site. doctors are saying it is too complicated for them to treat. referred them to mayo clinic for second opinion. he is going down fast. how long if no treatment? [/INST] Hi, Thanks for writing in. I understand that your brother-in-law is having a cancer with local spread. Post surgery the primary cancer has been removed, but the disease process has continued to involve other areas; the sacrum and pelvic lymph nodes. In such situations, he can get high intensity focused radiation treatment if possible as decided by his oncologist to slow down the disease progress as he is not healthy enough to with stand chemotherapy. This way his disease progress can be slowed down but not stopped. The survival in such cases is usually 12 months to 15 months without treatment. I hope the second opinion at Mayo Clinic helps in improving his over all survival. </s>

<s>[INST] HI I had a back ache and Hemerroids during August of the last year.I have gone through the surgery for piles and was recovering and there were no symptoms of back ache too. But now all of a sudden the back ache increased, which includes a slight pain in the penile and perenium while sitting, Also tingling in the legs. Please suggest [/INST] As per your explanation looks like your pain is related to your back disc issue at lumbar level, or it may be sciatica. However it may be possible both are interrelated. When I get patient with similar symptoms I suggest them to do MRI of back. And based on report if there is severe disc problem or disc degeneration then will also to visit orthopedic and will advise them to start with medication as directed and suggested by orthopedic. For conservative management in physiotherapy I will suggest going for ultrasound therapy which helps for healing and reducing inflammation in soft tissue. As well the inter martial therapy can also be given on pain full area and on nerve for nerve block effect. Here this thing will help for mainly pain relief. Now to have permanent relief from pain and tingling most important thing is you have to do regular back strengthening, stretching, and twisting exercises. This will help to build strength and staining of spinal muscles. You can also use hot pack regularly to have some more pain relief by relaxing soft tissues. At any time you feel pain is increasing in terms of intensity and more frequent do take surgical opinion from orthopedic doctor also. Take care. </s>

<s>[INST] hello! sir i got compound nevi removed on my face some 3 months ago. it was removed by radio frequency. after the removal the wond healed leaving post operative scar mark in one and pigmentation in other places. doctor had prescribed melalite 15 cream. m using it since past 2 months but i guess the pigmentation has not reduced. please suggest something. [/INST] Hi, you have already mentioned that you had compound nevi. Compound nevi is basically a deep nevus that involves the epidermis and dermis both. There are chances of having scarring or pigmentation after radiofrequency and this must have been explained by your doctor. If Melanie 15 is not working, some other potent creams can be used to tackle pigmentation. Even chemical peels or lasers can be done to reduce pigmentation. However, what would suit your skin best can only be suggested when your skin has been thoroughly analyzed. In the meanwhile, use a good sunscreen and take vitamin C supplements. Take care </s>

<s>[INST] hello, I am a male. when I went to pee this morning, I was met with a burning sensation and began urinating, and peed out blood. this has gone on throughout the day. Just about an hour ago I went to thhe bathroom and urnatid what seemed to me like an inch long worm. it was elastic. since then I have urinated and everything is back to normal. what happened? [/INST] Good Day, and thank you for being with Chat Doctor ! You have passed out a blood clot. That is the elastic worm like structure you have urinated. I would suggest getting an urinalysis and a kidney unitary bladder ultrasound to check and rule out malignancy in the genitourinary tract. 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/ Chat Doctor. Best wishes </s>

<s>[INST] Hello Doctor,My mom is a resident here in Hyderabad, she is 55years & in good health. She used to have allergic reactions to sea-food & some other food items earlier but I write to you about a recent incident which has caused concern. She was travelling Uk & USA & had eaten out....for first time this reaction was so bad that her face & body got swollen & didnt subside too much. 2 days back she came back to hyderbad & her swelling got better. But last night she had food outside & now developed terrible allergic rashes on her body & face...its itchy but not painful.Where can we show her in Hyderabad (hi-tech city area) for this allergic reactions? Please help us. thank you [/INST] In my opinion you should see nearby doctor. As such no definitive cure for allergic reaction. We can prescribe medicine & she will be fine but if she eats seafood again surely allergic reaction will develop hence AVOIDANCE of allergic food is only the definitive treatment. Secondly watch out for breathlessness, wheeze,flushed face, swelling of tongue n neck if these symptoms occurs you must have to rush to emergency department as early as possible. Please go to nearby doctor for present allergic reaction treatment. Regards </s>

<s>[INST] I just recently was told I have an abnormal protein in my blood. In 2 wks appt for consult. I am a Nurse and imagine the worst. I have no symptoms. I was told on the phone that it could nothing or something. What the chance it could be nothing-such as what. Thank8100@gmail [/INST] Hello Thank you for trusting Chat Doctor Nothing to worry it may be simple response to ward infection. What is your blood protein level?? Abnormal blood protein is not a disease itself it is laboratory finding uncovered concerned to particular condition and symptom. Normal total blood protein 60-80gm/liter. Normally they increase in some infections is a part body response to infection. Few diseases they may increase AmyloidosisDehy Chat Doctor. Please consult your doctor he will guide you accordingly to your condition. </s>

<s>[INST] Hi there, my son will 5 in April. Two weeks ago he slipped and hit the back of head (more to the left) quite hard. Then four days ago whilst at basketball, the ball was thrown into his face quite hard. From four days ago he has a twitch in his left eye as well as movement of his head. He has had his eyes checked not too long ago and everything was perfect. Please advise. [/INST] Thanks for asking. Head injury preceding atypical movements of Head and neck would worry me. It may be due to increased pressure building inside head. Or may be bleeding inside head is lead to this directly or indirectly by exerting pressure. I would advise to immediately take your kid to Emergency department and they will refer you Neurosurgery. Your kid will be examined completely. They will carry out head and brain imaging like MRI and CAT scan if needed. Good luck </s>

<s>[INST] My husband is a 40 year old somewhat active male and has been having dizzy spells during which his heart races and his blood pressure goes through the roof. At time its almost as if hes going to pass out. I am not sure what to do. I recently had a heart attack and I believe he is more afraid and aware of these symptoms now than before. His family dr. put him on 10mg of amlodipine besylate once a day. It hasnt done anything to change the symptoms. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. In my opinion, we should first rule out heart diseases in his case. So get done ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry about heart diseases. His symptoms are mostly due to stress and fear. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in his life and start working on its solution. Try to identify remove fear of heart disease from his mind. He may need anxiolytic Chat Doctor. Don't worry, he will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your friend. Thanks. </s>

<s>[INST] Hi, I started with a mild discomfort to my left chest area a few days ago. Now the discomfort is in armpit area to my back left shoulder blade. My armpit is also tender but skin feels numb. I also experienced a period today when my entire arm felt tingly like it had fallen asleep and felt cool to the touch. Any ideas? [/INST] Thanks for posting you query to Chat Doctor .as this type of pain may be due to 1. Muscular causes or 2. Cardiac causes or 3. Neurogenic in origin because of age related degenerative changes leads to compression of nerve. I want to know some more information: is there difficulty in breathing or pain associated with sweating or is it a mild constant pain as these type of feature are usually associated with cardiac pain, and we have to take immediate action .if you are having such symptom immediately consult to cardiac center for father investigation .if such symptom are not you can do following thing :take rest, take hot compression, take pain receiving medicine ; 1. Diclofenac sodium 50 mg two times a day.2. Thiocholchicoside 4 mg two times day for muscle relaxation .hope you would be satisfied with my answer. Feel free to communicate if any query.regards, Chat Doctor. </s>

<s>[INST] I found a lump in my scrotum. It is not on the testicle, it feels like it is on the vas deferens. It is only on the right side and about the size of a large raisin. The left side has a very small lump, much smaller than a raisin. I had a vasectomy last December. Are these lumps likely from the vasectomy? [/INST] Good Day, and thank you for being with Chat Doctor ! Yes the lumps that you are feeling in your scrotum are due to the vasectomy that you underwent. These lumps could be suture granulomas that fibrosis during your normal healing process. You can just observe these lumps An Chat Doctor. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.ChatDoctor .com/doctors/ </s>

<s>[INST] Hi i have pain in my leg doctor proscribed me medication Nucoxia 60 two tab and PAN 40 one tab daily for 15 days.But after 4 and 5 day i am feeling heart pain in my right side chest. This is side effect of medications or another thing. please give me advise. [/INST] Hello, Nucoxia in few patients may cause allergic reactions like swelling of lips, breathing difficulty and palpitations etc. But as such it may not directly cause chest pain. It may be due to allergy or acid reflux may cause chest pain. Anyway don't neglect chest pain please consult with your physician he will do ECG and chest X-ray then treat you accordingly. Take care. Hope I have answered your question. Let me know if I can assist you further. </s>

<s>[INST] Yes please. I had Euflexxa injections in my left knee on 7/8, 7/15 and 7/25 was the last of three. I flew to Dallas TX from Philadelphia PA on 7/31. There was a connection flight both there and on the return so a total of four fights. I returned home 8/4. My left leg is swollen in the calf and ankle area. I am not feeling any hot spots. It is just the left leg. Should I be concerned about this? Would the injection be ok to fly so soon after? [/INST] Dear patient Intro articular euglena injections will not lead to swelling in ankle and calf. This is because joint cavity is not connected to intramuscular planes. Swelling might be frequent air travel which might lead to deep vein thrombosis, or it might be dependent edema. Is dorsiflexion of foot is leading to calf pain ? If yes than its deep vein thrombosis. I would like to advise Doppler ultrasound of left leg to confirm diagnosis. Visit radiology center nearby you and get it done. If its normal do not worry. If report us abnormal you need to consult expert vascular surgeon nearby you. All the best. </s>

<s>[INST] Hi I Had My Tubes Tyed 22 Months Ago.. Weeks Ago I Had What Appered To Be My Normal Period.. It Lasted About 9 Days... And Then This Am I Woke Up In A Large Amount Of Bright Red Blood. After Two Tampons In Three Hours The Blood Is Now Dark Brown Almost The Color Of Prune Juice.. I Have Some Abdominal Cramping And feel Very Sick To My Stomach.. Is There Something Wrong???? [/INST] Welcome to Chat Doctor .1. Tube legation generally does not give the above symptoms.2. Reason for bled need to be seen.3. If you are my patient I would ask for an ultrasound pelvis none to see the status of your uterus and ovaries to rule out many causes. (Mass/inflammations/Bulky ovaries)4. Yes there is something wrong and get medical help as soon as possible. Anything to ask ? Do not hesitate. Thank you. </s>

<s>[INST] my 2 month old is transitioning from breast milk to formula. I was feeding him 1 bottle of similac advance for about 5 or 6 days and the last 2 days after feeding him the bottle he broke out into a bad red rash with white bumps all over his back, arms, face, neck and legs. What could it be? [/INST] Hello. Thank you for asking at Chat Doctor. I went through your sons history and would like to make following suggestions for him:1. He may be reacting to any of the contents of the baby food. Personally I would suggest you to withhold the baby food for a few weeks and then reintroduce under your pediatricians' guidance. If apart from rash, your son has any other symptom like fever, cold limbs, vomiting, diarrhea, not feeding well, lethargy, etc., it may indicate an infection, and please consult your pediatrician immediately.2. For prevention of allergies & infections, only breastfeeding up to 6 months of age and introduction of other foods only after 6 months is the best strategy. So unless necessary, I would not suggest you to introduce any food/formula before 6 months of age. Hope above suggestions will be helpful to you. Wish your son the best of the health. Thank you & Regards. </s>

<s>[INST] My friend was cleaning out their water cooler and let bleach soak in it. I didn t know and drank from it. I swallowed three or four gulps before I felt it. I m pregnant and I was terrified. I immediately puked. What risks did it have to my baby. Is there anything else I can do [/INST] Hello, thanks for choosing Chat Doctor for your query... I understand your concern. By knowing your history you swallowed very small amount and diluted bleach. So it is most likely you will not have to face any serious complications. Most probably your baby will be completely safe. But bleach is corrosive.it can injure food pipe(esophagus) and airway pipe(trachea). IT IS HIGHLY RECOMMEND TO MEET DOCTOR IN PERSON IMMEDIATELY. I hope this helps. Feel free to ask any further queries. Chat Doctor. </s>

<s>[INST] I have pain in my left foot when walking. It varies in intensity. I also have clicking when walking. I exercise 3 times a week. The pain is on the left side of the foot is only painful when I walk. The pain is a sharp sometimes. I broke a bone in my heal 6 years ago. [/INST] Hi, thank you for providing the brief history of you. A thorough neuromuscular assessment is advised. As your chief complaint is that when you walk there is a sharp pain in the lateral side of the left foot, I suspect it to be muscular pain or either neuropathic pain for which a thorough neuromuscular assessment is advised. Also. When there is a nerve impingement in the lumbar spine, it all starts with the pain in most cases on the lateral side of the foot. As you even mentioned that you had a bony injury in the past, there might be a tendency of abnormal gait during that time and shortening of muscles of the spine due to walking in pain. As I feel, by strengthening the muscles of the core, spine, pelvic floor and lower limbs on both sides you should be able to walk. Since the nerve impingement gives the initial symptoms as pain in the lateral side of the foot and progresses over a period of time. So before it gets more on future you can get an MRI of lumbar spine and them proceed with physical therapy for the lumbar spine. In my clinical experience I see cases who initially comes with this sort of pain and later with Nerve impingement diagnosis. So, from past couple of years I have noticed that this is the first alerting symptom of the Neurological pain, so now I deal with first an MRI of spine and core stability. Results come on 3-4 weeks of time and post which in future complaints are less Regards Jay In Chat Doctor. </s>

<s>[INST] Hi, yes i have all my fully grown teeth but i seemed to have a baby tooth inside my gum. And my dentist said that before getting braces that I needed to get my fully grown adult tooth taken out . what happens if I decide not to get my tooth taken out and just get braces? [/INST] Hello.thank you for sharing your problem with Chat Doctor. Generally over retained deciduous teeth need to be taken out. In your case its orthodontic problem .and sometimes due to lack of adequate space permanent teeth need to be taken out too. In that case you can't skip extraction and go with braces only. You can get better treatment from orthodontist than general dentist. You can consult for further queries. Wish you good health. </s>

<s>[INST] I am 27 weeks pregnant and I have a severe pain in my upper back. Some spot between my 5th and 6th rib. on the Left side. It s rather deep and hurts when I take deep breaths stand sit or lay down. The baby is kicking and moving around just fine as usual. It started the day before today. It has not lessened. Most things I read say when your rpegnant this is normal but the pain is rather intense. On a scale from 1-10 i d place it at an 8 when moving around. [/INST] Hello Welcome to Chat Doctor forum The pain can be due to acidity or gastric esophageal reflux which is very common in pregnancy for which you should avoid spicy food and Chat Doctor. Another cause can be pressure of baby on diaphragm, and it can be muscular pain also. Anxiety and lack of sleep also causes similar pain. It is better to consult your obstetrician for further evaluation. Best wishes and take care </s>

<s>[INST] I have a pain in my back on right side above waist. I awoke with it this morning. Have taken Aleve two times and it doesnt!t touch it. I have taken a hot bath with Epson salts and have applied ice. No idea what it coul be. Should I just wait and see or something else? [/INST] Dear madam/sir can you please elaborate from when is your pain in the back, does it radiate to legs,the majority of p[population has back pain, it is to be worried if you have numbness/ heaviness in your foot, or bowel or bladder disturbances, or sensory disturbances or pain persists despite 3 weeks of rest, if you donor have any of above complaints probably it is mechanical in nature and not worrisome. </s>

<s>[INST] I have cysts multiple subcentimeter lymph nodes in the left axillary region. Could you explain where and exactly what this means. I have paperwork that states that my coronary arteries appear grossly perfused and sections of the lung demonstrate a tiny subpleural 0.5 cm nonsolid opacity within the anterior aspect of the right middle lobe. Could you explain the to me? [/INST] Thanks for your question on Chat Doctor. Lymphnodes in maxilla can be due to 1. Infection2. Benign enlargement3. Malignant spread. Since you are also having pleural based lesion on CT thorax, possibility of either infection or malignant lesion is there. So better to get done ultrasound guided FNAC (fine needle aspiration cytology) or biopsy from the Lymph nodes. This will diagnose the problem and start treatment accordingly. </s>

<s>[INST] I HAVE ACH IN MY LEFT SHOULDER , I HAVE DONE MANY TESTS & CT SCAN, BUT I DONT FOUND ANY DISCRIPENCY IN ALL TEST REPORTS, CT SCAN , ONE FRIEND SUGGEST TO ME FOR PET SCAN TEST, IS IT FAVOUR TO ME FOR SHOULDER PAIN & PL YOU GUIDE TO ME FOR RIGHT PLACE IN DELHI NCR FOR TEST & COST [/INST] Hello, I will suggest doing MRI shoulder. If the shoulder pain is persisting from long and no solution provided. Need to see the soft tissue of the shoulder joint. Exercise will help to stabilize the shoulder and improve the overall shoulder functions. Having a word with a physiotherapist who can help with therapeutic ultrasound therapy and TENS therapy for reducing the inflammation and pain. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In Chat Doctor. </s>

<s>[INST] My mother has gallstone, shes 37 years old and shes been doing well. The doctor put her on a diet, no fried food, or fatty foods. This includes no oil, but unfortunately someone gave her oil, now shes in pain and she says it feels like shes getting stabbed in the stomach. We would go to the hospital but her doctor is out of town and hes the only one who has her medical records, if we go to the hospital we might be running a heavy risk at the doctors not having any idea what to do with her due to lack of information. Weve given her some lemons in water to break up the oil. She cannot take her pain killers for another three hours. But is there something else that we can do? [/INST] Hello and thank you for asking Chat Doctor. I have read the symptoms of your mother and I understand your concerns. It seems she has a biliary colic, or worse even pancreatitis. No one can be sure for the diagnosis without tests. Usually the pain disappears in a few hours, but if the pain is prolonged, and she has other symptoms like nausea, vomiting, fever than probably she has cholecystitis (infection of the gallbladder) In this case she needs to check up at the hospital to do some tests.-ultrasound of her abdomen (to check the walls of the gallbladder, biliary ducts, pancreas etc)-blood tests (to check the white blood cells for presence of infection, liver enzymes, pancreas enzymes)-a consult with a surgeon. It doesn't matter that her personal doctor is out of tows. The other doctors will do the tests and will know what to do once they have a diagnosis. If you have any other question, feel free to ask me. Chat Doctor. </s>

<s>[INST] Hi doctor, I m 30 yr old. I having pcod and get treatment for 3 months i got conceived but it miscarriage in 37 days.after I didn t take any medication and got regular periods after 6 months again i conceived and miscarriage in 40 days. next month i got periods after that I didn t get periods. i went to the doctor , they asked to take several test, In that, I had prolactin of 62 and normal thyroid. I wanna try for pregnancy . what to do? [/INST] Hello, Go for Ayurveda treatment, you will get conceive. There are many medicines which help you. POD (Polycystic ovary disease), is normal for unmarried women, and it is not complicated. It never affects pregnancy. If you believe consult any good ayurvedic doctor for better treatment. Or call me 8818805637, or meet me at Brian Ayurveda clinic Blaster Chhattisgarh India. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] complains of nausea, vomiting, and general malaise and fatigue. The results of the tests show an increase in total bilirubin, a slight increase in ALP and GGT, and a marked increase in alanine aminotransferase (ALT) and aspartate aminotransferase (AST). [/INST] Hello, I understand your concern. I am Chat Doctor, Infectious diseases specialists, responding to you. Increase in various liver enzyme is suggestive of liver infection. Kindly check the reason for high enzymes. Treatment of such cause will cure your complaint completely. I will be glad to answer your further query. Thank you for your contact to Chat Doctor. Wish you the best health. Thank you, ChatDoctor. </s>

<s>[INST] my son had a small bubble under his tongue, he wouldnt leave it alone and now it is an ugly skin tag. our pediatrician says its harmless but my son wants it removed, what is the medical term for it? the doctor called it something starting with a "c" i think. [/INST] Hi. Welcome to Chat Doctor . I have gone through your query and can understand your concern.... As per your complaint a small bubble under the tongue can be due to a blocked duct of salivary gland leading to formation of a Mucous cyst also known as Muscle. It is true that it is harmless and will not cause any problem and will resolve gradually on it own. You can make him gargle with a concentrated salt water solution. In case if it does not resolve or continues to recur, then it ha to be removed surgically. Hope this information helps. Thanks and regards. Chat Doctor. . </s>

<s>[INST] I was minutes into ascent of airliner..suddenly my left side of my mouth became numb, quickly followed by the entire left side of my face. Once numbness had taken over the left side of my face..including teeth and gums..intense pain followed. The pain so debilitating I could barely keep my dignity on the flight.The numbness and pain lasted until the final minutes of the 2 hour flight. What could cause this scary symptoms? [/INST] Hi, Thank you for posting your query. Your symptoms are suggestive of a problem in the trigeminal nerve area, which starts in the brain stem and supplies the face. It may be useful to do an MRI scan of the brain, to identify the underlying reason. Mainly, we need to exclude any ischemic lesion (lack of blood flow to that area). Please get back if you require any additional information. Best wishes, Chat Doctor. Ly/ </s>

<s>[INST] my granddaughter is 6 she has a fever 102 , her puplis are diailated and eyes are glossy and she is complaining her head hurts is there a need to go to the hospital or just kind of wait it out for a bit , she only ate this morning and all she wants right now is oranges [/INST] Hello. I just read through your question. The symptoms you describe sounds like a typical pediatric viral illness. Fever typically last two to three days, and associated symptoms involving eyes and headaches are very common. I recommend doing your best to control the fever and maintain HY Chat Doctor. If the fever lasts beyond 3 to 4 days or if the symptoms don't completely resolve after 7 days, I recommend consulting with your doctor. No need to run to an emergency room or urgent care </s>

<s>[INST] Hello! I just found out that all my physical problems is becuase I have the Joint Hypermobility syndrome, well it all makes sense but im in my twenties and have not been able to run for 8 years due to the severe pain it causes. I have a messed up knee due to it going out of place, arthrosis in feet and back etc... I would like to know if there is any known successful treatment to this as I have a full time job (been off however for 5 months now) but want to know if it cane be healed or if I have to learn to live with what I have now. My husband is about to leave me cause he is so fed up and thinks it can be handled and that I just dont want to (!!!) but I cannot get anything across to him nor my boss either. Any good advices? [/INST] Hi, You will have to make a very determined effort to manage your condition. Hyper mobility cannot be cured, but you can protect the excessively mobile joints keeping the muscles strong and ad Chat Doctor. Firstly the hypermobile joints need to be braced for protection. These braces need to be lightweight, easy to use and washable. The muscles around the joint which move the joint should be strengthened by a training program under supervision. Your knee is giving way so needs to be supported by a brace and an exercise regimen started. The knee specialist should tell you if and when ligament repair can be done for you. The back and feet needs exam by a specialist, relevant x-rays taken to assess the degree of arthrosis. Steroid injections can help in early stages. You will need pain medications to suit your pain pattern. HY </s>

<s>[INST] I have had a traumatic childhood and recently went through a family break up. My hands fee like they are red and burning, i get covered in a rash , my bowels are not working properly, my feet sometimes feel like im walking on hot needles. I hricave seen my great gp which said i was suffering from acute anxiety phychosomatic illness . Im off to a new Phychologist on Friday, my question is will I have to see a Phychiatrist ? and why are my hands so hot and ichy, will i have this forever? [/INST] Dear J**** Hello thanks for your question first of all I would like to tell you that I can understand your trauma and It's very difficult to cope in such situation but its life, and we have to walk continuously. You have started experiencing burning sensation in hands and redness and altered bowels, needle like sensation. It is a part of Anxiety spectrum illness, but you need not worry as treatment is available. There are two modality of treatment for anxiety disorders and if its in beginning state then response is also very good.- first is non-medicinal treatment which include Relaxation exercises, deep breathing exercises, meditation, progressive muscle relaxation, biofeed back etc. In these modalities individual is taught to relax himself by own. Individual is made learn to control his involuntary system which is responsible for anxiety. Once individual become receptive he is progressed to other modalities as Behavior Therapy etc.- second is medicinal treatment in which antianxiety medicines are used to bring individual to level that he can start practicing first modality of treatment. Chat Doctor. Mild levels of sedatives are used to relax individual in special circumstances. These are used for short period of time. Dear friend as per my opinion combination of both modalities is best for you, and be assured that you will be all right in very less time. Thanks, hope I solved your query. Kindly rate. </s>

<s>[INST] My 9 month old baby suffering by some virus as yesterday Doctor told me. Babies feet & palm getting hot some times & cold some times. he is not filling well as we saw his face. His body temp is +_ 97 degree. Sir my question that is this a symptoms of brain fever ? [/INST] Hi...this looks like a viral illness as of now. The symptoms of brain fever include - 1. Seizures/ Fits.2. Altered sensorial/ unconsciousness.3. Weakness of the body parts.4. Patchy rash over the skin - blotchy.5. Not recognizing parents and care takers.6. Continuous vomiting. But, Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Regards - </s>

<s>[INST] What to cure fatty liver?Hello doctor, as per my report of lever scan, the doctors impression is FATY LIVER. how it happens.? i am not using any type of alcoholic products.what type of food ihave to avoide and inc lude.? now iam using multivitamin tablets . is there any other medicines for the... [/INST] Hi, Thanks for posting your query. I am Chat Doctor. K and I am pleased to assist you. The fatty liver you have is nonalcoholic fatty liver.Some common causes of nonalcoholic fatty liver are obesity, diabetes and high cholesterol. Just check which of these risk factors you have and treat it. Also get a liver function test done to see whether it is a simple fatty liver or if there is any damage to the liver. I hope that answers your question. </s>

<s>[INST] i have done hsg test .they took two x-rays then they took me to sonography then they said the tubes are open but in x-rays the tubes are not visible but based on ssg report they gave the tubes are patent.can i trust this report?i am so confused .kindly help me in this situation [/INST] Hi, Welcome to Chat Doctor . Tubal patency can't be commented on ultrasonography either done through abdomen or through vagina. Tubal patency can be visualized only on hysterosalpingo graph. In SG dye is injected which lines the uterus and tube. Then it is seen on x-ray. If tubes not seen means they are not open. It's difficult to trust your report as tubal patency never diagnosed on sonography. I would suggest you to discuss this with your treating doctor. Hope I have been helpful. Regards Chat Doctor. </s>

<s>[INST] hi...I am a girl..22 yrs old...I have pain on my right kidney for 3 days..At the begining the pain was not very thick...but now I can barely stand it...Specially when I breath deep...its like putting a knife on it...and the pain is spreading to the right side of my stomach and lately these hours Im constantly feeling that I need to urinate...when I urinate theres no blood or anything irregular, visible by eye. I started feeling the pain for the first time before three days when I get up from the couch where I was sitting in a strange position...Can someone please help me...is that pain dangerous, or what should I do? I would appreciate it ! Thanks in advance...! [/INST] HelloThanks for query. Severe pain in Rt kidney area radiating down anteriorly to epigastric and anterior abdominal wall is most likely to be due to presence of stone either in kidney or ureter and need STO be investigated.consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture. 2) Ultrasound scanning of abdomen and pelvis In the meanwhile start taking broad spectrum antibiotics like Cefuroxime along with urinary antiseptic like Nitrofurantoin and antispasmodic like Spasm Procyon twice daily and urine alkalizer thrice daily. Later on switch on to appropriate antibiotics as per culture report. Get the prescription of medicines from your family Physician. Ensure to Chat Doctor. To keep your urine dilute This will help to control dysuria. Further treatment will depend upon result of these tests and final diagnosis as regards size, site of the stone and degree of obstruction (HY </s>

<s>[INST] Hello, I had a TKR 6.5 years ago with no problems whatsoever until about a month ago when I stood up and it hurt so much I couldn t put my weight on it. This has happened 4 more times. Always in one very specific point on my knee. Does this sound like glue breakdown or loose prosthesis? Thank you. Susan [/INST] Hi, thanks for providing the brief history of you. As you mentioned you have undergone the TKR almost 6.5 years back and now giving you pain at one particular place in knee. What I recommend you is to first take hot water fermentation and relax the muscles first which has got into spasm. Post that try continuing the exercises which you have performed in the past, post knee replacement.Also, to mention that certain times' weakness of muscles leads to pain symptoms as repetitive pressure on the muscular tissue. You can also take one x-ray just to remove the doubt if the prosthesis is dislocated. whereas per me chances are less. Also try performing exercises at your own and get required strength in the muscles of the knee, hip and core. If you fine there is no Change then you need to take again a physical therapy session to improve the strength in your muscles. As guidance always give precision. I have seen people complaining me about the pain post TKR but only thing I have come across the reason is the patient have stopped doing any exercise which has lead to again the symptoms. So I Advise them again the physical therapy and intense exercise which have made a 100% difference. They come back to functionality again. I hope to hear from you soon, and you will be seen partying again. Regards </s>

<s>[INST] I just had sex recently, and I got sperm on my boob. I didnt notice it till the next day when I stood in front of my mirror. when I peeled the small amount of sperm off the tip off my boob I realized it looks like a ringworm. could it be a ringworm? [/INST] Hello, I had gone through your question and understand your concern. Short answer: NO, it's not a ring worm. Detailed answer: Thank you for your question on Chat Doctor. Semen when ejaculated gets coagulated immediately. After sometimes it gets liquified and sticks to the skin when ejaculated on skin. When this gets Chat Doctor. This is completely normal. Normally, semen does contains any ring worm. So don't worry. Ringworm infection will cause itchy patches, discharge. Ringworm infection spreads from infected person througChatDoctorb, shower, clothes etc. I hope I answered your question. You can con contact me at any time, if you have any further questions. </s>

<s>[INST] I had a tooth infection and was prescribed augmentin I have been taking it and started getting symptoms of a yeast infection, I took one day treatment miconazole but it didnt relieve the symptoms so I now have purchased 3 day treatment but at 4% I used it last night but when I used it it seem to make it worse the symptoms do feel a little bit better is this normal [/INST] Hi. Thanks for the query Augmenting is an antibiotic and many a time taking antibiotics can cause yeast overgrowth due to reduced resistance to infection as the antibiotics can kill the good bacteria along with the bad ones. This can cause overgrowth of opportunistic organisms like yeast. So it is better to get a prescription of antifungal medications after getting a proper prescription from the Physician. You should also eat more of probiotics like Yogurt and garlic. Hope this helpsRegards </s>

<s>[INST] my daughter has had severe stomach pain for the last two weeks with no relief. she has been put on acid blockers pepsid and also a medication to take to coat her stomach before she eats. she has had exrays ultrasounds ct scans and nothing has been diagnosed. she has had kidney stones in May that needed surgery, with a very rough recovery please help with any information you may have for us.... [/INST] Hi ! Good evening. I am Chat Doctor answering your query. I am not aware if your daughter eats food from outside frequently specially the fast food and fried, spicy items. If so, please advise her to avoid these, as intestinal infections could creep in and also some components of the food might be creating inflammation of the intestinal mucosa, like gluten used in fast food frequently. If I were your doctor, I would also advise for a routine stool test for ova and cyst, and a routine/microscopic/culture sensitivity test of urine to rule out a urinary tract infection. Till these are ruled out, she could continue with anti spasmodic and proton pump inhibitor Chat Doctor. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor. </s>

<s>[INST] Hi,I am male (21) and was bitten by a street puppy. The wound was very minor on my hand near thumb but blood came out from scratches. It healed after 10 hrs.(i was bitten at midnight. wound healed after the night sleep.) i didnt consult the doctor on day 1. But after many suggestion, i thought of having Vaccine just for the safety purpose. I took Rabipur and TT(titness) vaccine on day 3, about 50hr from the bite. now i have scheduled vaccine to take, (4 more injection). Am i safe.... ????? Or the delay was more? [/INST] Dear Friend. Welcome to Chat Doctor. I am Chat Doctor. I have read your query in detail. Furthermore, I understand your concern. You should take Rabies vaccination as early as possible after bite. Since was exposure was not very high, Vaccination would help you. If you want to be very sure, you may take Immunoglobulins, that are costly but would provide you best safety against rabies. If possible keep a watch on the puppy, in case it shows any awkward symptoms, contact the nearest health facility. This is my best opinion for you based on available details. If you have any further query please ask me. Stay Healthy. ChatDoctor, MD </s>

<s>[INST] Lately, I ve been have a pins and needles feeling on my chest between my breasts and also some itching. What causes this? I m 55, Black female- Pretty good shape. I do take Amlodipine for high blood pressure and I m about 20 pounds overweight. I ve been having some shortness of breath for about six months. Nothing that stops me from doing anything. My doctor prescribed an ihaler and I use it when I need it. They took all kinds of tests but they never diagnosed me with anything. She said all the tests came back fine. So I think I might have asthma. I don t know. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. In my opinion, you should consult pulmonologist for your breathlessness and pinching sensations in chest. Bronchitis can cause similar symptoms after 50 years of age. You will need pulmonary function test (PFT). PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease and treatment is based on severity only. You may need regular inhaled bronchodilator (formoterol or albuterol) and inhaled corticosteroids (ICS) (budesonide or fluticasone). Don't worry you will be alright with all these. First diagnose yourself and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] Hello doctors My brother in law suffered a mild cardiac arrest this afternoon in Muscat . He plans to travel to Bangalore late night flight. The flight time is 3 hours. Is it advisable for him to travel I talked to him and he appears very normal. You help is much appreciated. [/INST] DEAR USER, THANKS FOR CONSULTING WITH ChatDoctorI UNDERSTAND THAT HE MIGHT FEEL BETTER TRAVELLING AT HIS HOME.BUT HE CAN TRAVEL ONLY AFTER RECOVERY FROM THE ATTACK AND CONSULTATION BY THE PHYSICIAN THERESE PHYSICIAN WILL GO FOR ECHOCARDIOGRAPHY AND ECG AND DEPENDING ON THE FINDINGS AND CLINICAL STATUS WILL ADVISE YOU IF HE COULD TRAVELOGUE I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS </s>

<s>[INST] I have to have root canal on a molar. But i had foot surgery on both feet nearly 4 weeks ago ( bones broken and pinned, bunions shaved etc). My tooth is so painful that it only goes away when standing and after 2 endones. Would ibuprofen be better and can I take it now 4 weeks after surgery? [/INST] Hi. Welcome to Chat Doctor . I have gone through your query and can understand your concerns. As per your complaint in case if you have a severe toothache it can be due to deep decay in tooth that is involving the nerves and irritation and inflammation of nerves cause severe pain. The first thing that you should do is to consult a Dentist and get evaluated, and he can do an IOP AR [x-ray] to rule out the exact cause of pain and advise treatment accordingly. As of now you can take Ibuprofen while if pain is severe you can also take higher painkillers that can relieve severe pain like Tramadol or Motorola. You should get the tooth treated if it can be saved Root Canal treatment can be done followed by antibiotics and painkillers while if there is gross decay extraction is advisable. Hope this information helps. Thanks and regards. Chat Doctor. </s>

<s>[INST] am suffering frm fungal infection on my penis.my foreskin is not opening & pains when i pull my foreskin downward.some cracks r there in the upper most part of my foreskin.i hv already taken medicine from a renounced doctor of orissa , bhubaneswar. [/INST] HelloThanks for query. Base on the facts that you have posted you have genital fungal infection unable to retract foreskin completely over glans penis and did not get cured even after taking antifungal medication. This could be mostly due to uncontrolled Diabetes Please get your blood sugar levels on empty stomach and 2 hours after lunch done to rule out Diabetes. Take antibiotics like Augmenting along with antifungal medication like Fluconazole twice daily and topical antifungal cream like Candid cream for local application for a week . If problem persist consult qualified Urologist for evaluation, you may need to get circumcised. This is a simple surgery done under local anesthesia as an out patient procedure and offers permanent cure. Chat Doctor. </s>

<s>[INST] have had foot pain when i wake in morning to go to the bathroom i walk like I am 90 and if i sit to long it has started bothering me also ,I walk 2 miles each day and a custodian for 8 hrs at school .i weigh 127 ,and petite.this started a couple of months ago [/INST] Foot pain during morning hrs may be because of plantar fasciitis, Achilless tendonitis. Wear cushion heel pads in your shoes, reduce weight, avoid smoking and Chat Doctor. Explaining you few exercises which will helps you roll a towel put under your heels (lie straight on your back) press the towel gently with heels and relax repeat this 10 times and do 3 sets next do ankle toe movement like pulling the toes and ankle towards body and relax downwards repeat 10 times and do 3 sets stand and do heel off and toe off. Next and most imp initial treatment take two buckets in one out warm water and in another put cold water(fridge water) now dip your feet in warm water for 3 mins and immediately transfer your feet in cold water for 1 min repeat this for 15 mins. Start with warm water and end with warm water. Once the pain subsides start the above exercises. And get your physiotherapy also these all will help you </s>

<s>[INST] Yes i m having bad bleeding problems from my gums i also noticed that they are now clotting around the teeth well between them but are still bleeding it hasent been this bad i also noticed that the gums are looking as they are being ate off from my teeth i have been proper brushing and using genavitus toothpaste but nothings working or helping but they have been bleeding for 3 weeks straight but never this bad or have got this bad and now there eating away any idea of what this is or if this is something i need to go see a doc asap about cause it seems like so [/INST] Bleeding gums can be caused by various conditions. Nutritional deficiency, especially deficiency of vitamin K can manifest in bleeding gums. It is the vitamin that is required for blood clotting. Deficiency of this vitamin can cause delay in blood clotting. Deficiency of vitamin C can also cause gum problems.Ill-fitting dentures, smoking and use of tobacco, improper flossing, infection of the teeth or the gums and use of certain medications like, anticoagulants, calcium channel blockers, nasal sprays, oral contraceptives and antidepressants are some other possible causes. Apart from these, frequent gum bleeding could be a sign of bleeding disorder, scurvy and leukemia. Chemotherapy Chat Doctor. </s>

<s>[INST] hi im on the microlite pill and hae been for about 2 years now, im with my boyfriend for a good few years now and for the first time he ejaculated in me, it happened 2 days ago and i have pains in my left hand side hip and lower back, but i usually have the pain in my back, so im wondering is there anyway i can be pregnant or is all the worry just in my head? [/INST] Hello, Welcome to this forum. You have pain following a sex in which your boyfriend ejaculated inside you. You may have a chance of getting pregnant through this act but as such there is no such scope of having pain or any other pregnancy symptoms so early. So, the pain may be due to other reasons. If at all pregnant, you may have symptoms which you could start feeling just before or after your missed cycle. Sincerely Chat Doctor. </s>

<s>[INST] HI I was suffering from low back pain since a month and now while i took the scanning of the spine i was diagnosed with Spina bifieda in the L5 of my spine (Ridge has not joined completely- birth defect).. I was always a very active person and now suffering from pain while i walk or bend. I am due to get married this december which has further increased my worry. Can you please suggest me some ways by which i can return to normal. It would be of very great help, Thank you. [/INST] HiT hank you for your question to Chat Doctor. First, you don't need to worry at all due to the spina bifida. Spina bifida occult is a type of anomaly that is asymptomatic and many people live with this through their life without symptoms (that's why occult). This spina bifida never causes back pain. This variation of spine development has been there in your back since birth and won't cause any symptoms. It is an incidental finding. A form of spina bifida which is symptomatic type presents in childhood with nerve problems and leg weakness related to those. Your back pain is very likely musculoskeletal and would respond to painkillers (ibuprofen, naproxen), local heat and painkiller ointments and physiotherapy. Avoid bending and twisting of back and lifting heavy weights for a month. Hope this is helpful. I would be happy to answer any questions you may have. </s>

<s>[INST] I had right ankle surgery on 28 May and recently had cast removed. I am scheduled for pt in the next week. I have noticed that when I put both of my feet on the floor my right foot turns red. I don t have any pain because of it but it turns an obvious red color. I would like to know why it does this? [/INST] Hi, Thanks for contacting Chat Doctor. Many times after ankle surgery, the ankle itself or the foot will have a faint discoloration and edema compared to the other side. The body is still healing from surgery and the swelling can bring in some more blood to the area as well, both contributing to this look. It would be wise to have the physical therapist and surgeon look at the area as well to make sure this is the cause. I hope this helps answer your question. Thanks. </s>

<s>[INST] Hi I have noticed a lump that grows small then into a larger ones later days under my armpits( occurs in both right and left armpits) and even on my thighs(both right and left thighs)...it feels painful when it touch them on their hard surface...when my armpit and thighs rubs against it becomes painful...when it becomes big and i squeeze it, pus and blood comes out....and these lumps comes back again like probably i would say every 7 months once or even once a year....i went to a doctor to remove it...he put an injection under my armpit to make it numb and cut it off...pus and mostly blood came out...the doctor told me it was because of heat...my body was to heat and it seems the reason for the lump to grow...im a gym crazy guy and doctor even told me when i exercise the heat from my body would cause these lumps...the doctor have cut it off like 4 times and it still comes back....im a little worried as it comes back...will this lead to serious problems? [/INST] Hi, dairy have gone through your question. I can understand your concern. You may have some axillary lymph node enlargement or soft tissue mass like lipoma. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact idea regarding cause of the lump. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. </s>

<s>[INST] Possibly sciatic problem?I feel a pinch, almost like a cramping feeling in one specific spot in my left buttock. It is constant and does not feel better or worse at any time or with any stretching or movement. this has been going on for two days straight with no end in sight. Ive had sciatic problems years ago and it radiated down my leg, extremely painful, until an injection fixed it immediately. I cant remember if this is how it started. what I remember most is the excruciating pain down my leg.I am 33 years old, female, with osteoarthritis in both hands, plantar fasciitis in both feet, and narrowing of my lower spine as found in x-rays after a couple years of back pain which is still an issue. Can this pinch be the beginning of the sciatic problem which will make its way down my leg again?? Its not that it hurts too bad to function, more like it hurts so bad because it has been hurting for SO long already that makes it seem more painful. [/INST] Hi there, welcome to Chat Doctor. Thank you for your question. Pinching like sensation in the buttocks may be due to spinal and non-spinal Conditions. L5/S1 disc(which is the lowermost functioning cushion like structure in your spine) degeneration can cause buttock pain with or without pressure on your never. During early part pain can only be restricted to buttock, with time there can be radiation of pain to back of thigh. It may or may not become associated with numbness also. An X-ray might show DC reset space between the L5 and S1 bone providing an in direct evidence of disc degeneration.IIF the symptoms persist for longer than 6 weeks or if the pain is unrelenting in spite of medications and physiotherapy and MRI might be indicated which has is more Conclusive. Spinal related pain can be one sided as in your case or it might affect both sides.Non-spinal buttock related pain is usually one-sided. Social bursitis which is inflammation of the covering of one of the muscles/social Bone on which we usually sit, can cause focal pain over the point of the buttock. Inflammation around the sciatic nerve in the buttock can also cause similar pain. Inflammation of the sacroiliac joint what is a joint between the pelvic and the spinal bones can also result in similar pain. If your pain as been there for more than 6 weeks it would be worthwhile to get radiological and blood tests done to rule out the above Conditions. I would suggest you to meet your physician and get evaluated so that these Conditions can be ruled out. In the meantime physiotherapy, strechtes,anti-inflammatory and analgesic mediations can help you tied over the pain. Hope your queries are answered the besting best regards Chat Doctor. </s>

<s>[INST] Since the 5th grade school has been very difficult for me and I dont think I can graduate high school or be accepted into college. My school tells me its my dyslexia but I think its something more. My school doesnt help me with it besides small group testing and offering some to read questions for me. I cant focus my grade are awful and I it just leads me to think Im an idiot. I should drop out and work in a fast food restaurant. Im stressed, I feel at times suicidal. Please help [/INST] Hello, Its true and you are aware of that you are suffering from Dyslexia.... but at the same time you are also suffering from secondary depression. The rest of the symptoms you have mentioned like sadness, decreased energy, not able to concentrate in studies. Thoughts of suicide. Are all because of depression. Remember one thing. Depression is not difficult to treat. BT living with it without treatment is very difficult task. For dyslexia, you need more efforts to adjust with surroundings with less acceptance from others .this might Precipitate the depressive episode. Please consult Psychiatrist. Start with treatment. You will definitely feel better. OK. </s>

<s>[INST] My 11 year old daughter just had a Renal US...showed moderate right pelvocaliectasis. Minimal intermittent dilatatioln of the distal right ureter. The urinary wall is well distended and is normal in morphology. The bladder wall is moderatelly thickened. There is an echogenic mound at the level of the right UVJ compatible with the clinical history of Deflux. Mobile echogenic material is present within the bladder. [/INST] HelloThanks for query. Based on the findings of Ultrasound Scanning your daughter has grade one HY Chat Doctor. You need to consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) DMS Scan to rule out any damage to kidney and function of the right kidney3) Renal function tests .4) Maturating Cyst Arthrogram (MCU)In view of grade one OUR she needs to be treated with long term prophylactic antibiotics like Bactrim once daily and get her urine culture done at frequent intervals It is utmost important to see that she does not get UTI. </s>

<s>[INST] After having fulguration done to genital warts using electrocautery, how long will it be before sexual activity can be resumed and how long will it be before enough healing occurs to return to work, under the condition that the patient has HIV but the viral load is low (undetectable) and the CD4 count is high? [/INST] Hi, I can understand your concern regarding achieve normal activity including sexual activity after the treatment like electrofiltration of genital warts...with HIV positive status. I am really sorry to say to avoid sexual activity for few months due to high chances of relapse of warts... as the immunity is poor. Skin is likely to recover in few weeks with proper treatment after the procedure. Hope this helps. Chat Doctor. </s>

<s>[INST] I have a pressure/pain for three years now. I have been told that I may have Pleursy yet a recent chest x-ray revealed nothing? The pain is in the bottom left side of my left lung . This pain started after my second bout of pnenoia (sp?). I am also asthmatic and my puffers don t help. I am prone to lung infections. This pain is mild but constant 24/7. No one knows what I have. I take a lot of medications, thyroid, lithium , quientaine, lorazpan, clorazapan. Could it be my liver that is causing the pain? Is some of the liver not located behind the lung? I drink lots of water as directed by my psychiatrist . I eat healthy, don t drink or smoke. What is this pain under my left lung?? Thank you. [/INST] Hi welcome to Chat Doctor forum. Thanks for calling Chat Doctor. Forum. Asthma is a chronic disease with lots of secretions every time you get attack. You should see that you use medicines till you get complete relief, till all the secretions are expelled or Chat Doctor. Otherwise, the remnant secretions may aggregate at the bottom of the lungs. These may cause pain after few such attacks. The pain could be due to gastric irritation caused by a number of </s>

<s>[INST] My wisdom teeth took forever to come in, and I was having a lot of problems with cheek biting during that. Now theyre completely grown in, and I dont think theyre at any odd angle or anything, but Im still biting my cheek because of the rope-scar on the inside of my cheek sticking out and getting in the way. I have to puff my cheeks out anytime I want to close my mouth to make sure it doesnt get caught. It even causes issues when I sleep because I lie on my side, and the pillow basically just pushes my cheek into them. Is there anything I can do about this, aside from having my wisdom teeth removed altogether? [/INST] Hello Sir, Thanks for posting the query, As I can understand from you question that the wisdom tooth has grown up and causing problem of cheek biting. There may be two reasons for this:- 1 The tooth is placed more on the buccal aspect means the tooth has erupted on the cheek side of the Jaw. It is not possible to see by the patient the exact position of the tooth. 2 The cusp of upper teeth is sharp which is engaging the mucosa of cheek between the teeth. So the remedy is -first you visit your dentist and get an IOWA means X-ray of the tooth done, if it is out of the arch then get it removed and if it is well in the arch forum then get the rounding of the sharp edges of both upper and lower third molar done. I am sure you will be relieved from pain. Do apply Ointment on the cheek bite to prevent soreness like Hegel. </s>

<s>[INST] IN 2008 I WAS DIAGNOSED WITH MRSA IN TNE GALLBLADDER. I SPENT A MONTH IN THE HOSPITAL, AS IT INFECTED MY ABDOMEN AS WELL. I HAVE LINGERING PAIN, FATIGUE AND SLEEPLESSNESS. IVE ALSO SUFFERED FROM CONTINUOS INFECTIONS OF THE DIGESTIVE TRACT. I WAS EXTREMLY HEALTHY PRIOR TO THE MRSA AND THE DRS. HAVE NO EXPLANATION FOR THE PAIN. COULD IT BE LONG TERM AFFECT OF MRSA OR ANTIBIOTIC TREATMENT? I M MOSTLY BED RIDDEN FROM THE PAIN AND WOULD LOVE TO HAVE MY LIFE BACK. [/INST] Thanks for your query at Chat Doctor! I understand your concern. Has your GB been removed? I think post surgery you might have developed adhesions which could cause pain. I don't think MRSA has any role in it now as you have no other systemic symptom. It is important to carefully follow your doctors instructions about your diet. Avoid high-fat foods. Take bulking agents, antispasmodic agents and proton pump inhibitors. You can get a follow-up USG done. You can visit Local doctor/pain and palliative clinic for relief. Take care! </s>

<s>[INST] My 18 year old daughter is experiencing numbness of her tongue, lower lip and left cheek. She has experienced numbness of her tongue and lip before but has always gone away quickly. This time its still numb and going into the left side of her cheek. she has no known dental issues. [/INST] Hi, If there is numbness of tongue, lips and left cheek with no known dental issue can be due to causes like either Allan reaction or nerve related issue or beginning of Bells Palsy. So I would suggest you to consult a Neurophysician and get evaluated and a thorough clinical evaluation and investigations like MRI scan can help in diagnosis and treatment will be done accordingly. Resolution of the cause can help in reversing the symptoms. For nerve related problem the medications that is steroids and antibiotics are appropriate and along with it, you should also do alternate warm and cool compresses and take Vitamin Supplements. For allergies into allergic medicine like Fexofenadine or Levocetrizine and steroid shot can help. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I had breast cancer 6 years ago, they found a spot near the chest wall and in the first node under the right arm. Had chemo prior to mastectomy and removed 16 lymph nodes. I am currently experiencing the same pain in my back that I did then. Any chance that it may be cancer again? [/INST] Hi, dairy have gone through your question. I can understand your concern. You have history of breast cancer. SO there is chance of metastasis in the spine and leads to back pain. Or you may have some other cause. You should go for bone scan and MRI spine. It will give you exact idea regarding cause of your back pain. Then you should take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ Chat Doctor. Thanks for using Chat Doctor. Wish you a very good health </s>

<s>[INST] I am 11days post op of a laminectomy-- lumbar 3-4 4-5 both left and right. I have a bloated stomach..could you please advise as to wether this is normal, or am I just getting fat. I have never carried any weight in my tummy and it would be normal to state that my hips usually protrude while my tummy has always sort caved inward. Please advise? [/INST] Welcome to Chat Doctor After multiple laminectomy procedures there occurs a kyphotic deformity of the spine where the spine is pushed forwards making the abdomen protrude out as well. The kyphotic deformity needs to be reduced by certain exercises and braces which will be explained to you by your Orthopaedician. Avoid constipation which can be common after this kyphotic deformity, by eating plenty of fresh fruits and green leafy vegetables, Chat Doctor. Do walking exercise every day for 40 minutes in keeping with your Doctors advise. </s>

<s>[INST] Hi I am 41 and normally in good health. I don t drink or smoke and keep fit. Today I have had a pain in my right hand side that comes and goes. When I bend over it hurts more and is a struggle to get back up as the pain is quite severe. I m also breathless . It cannot be my appendix as it was removed when I was a teenager. I feel perfectly well otherwise and have no other symptoms. I have eaten as normal today but did notice further discomfort on eating my lunch. [/INST] Hello, Thanks for the query to Chat Doctor. Forum. You mentioned that pain is on the right side, but where ? Is it in abdomen ? You mentioned two things that pain is more after lunch & there is breathlessness. So these two things are related. May be due to pain in the liver, Lower part of right lung, Thickened pleura. Consult a physician and get his opinion. Get in ultrasound of liver and X-ray chest PA view. Take treatment according to situation. Good luck. </s>

<s>[INST] I HAVE A SWOLLEN LYMPH NODE ON THE RIGHT INNER SIDE OF MY GROIN,IT HAS BEEN THERE FOR 2YRS.iT WOULD ONLY BOTHER ME IF i PUSHED ON IT,NOW ITS HURTING ALL THE TIME N HURTING DOWN MY LEG.iTS ABOUT THE SIZE OF WALNUT.wHAT COULD CAUSE THIS N WHAT TYPE OF DOCTOR SHOULD i SEE.mY DR. AT 1ST THOUGHT IT WAS A FEMORAL HERNIA N FOUND OUT IT WASNT N JUST SAID IT WAS A LYMPH NODE,HAVENT BEEN BACK SINCE N IT HAS GROWN IN SIZE SINCE THAT VISIT. [/INST] Hi there, Thanks for query. Causes for groin swelling are lymph nodes, hernia, dilated veins at the groin. Clinical examination and ultrasound will determine the cause of swelling. Lymph node enlargement at the groin is common as there will be repeated infection of the leg, like even walking barefoot can cause without apparent infection. So repeated infection causes persistence of the size of the lymph node and its progression. </s>

<s>[INST] I have had diarrhea now for 8 weeks. I go between 5-8 times per day and its very loose and mucusy. I have been on codeine to help the diarrhea which helps and the mucus stops but recently i have been on antibiotics for 10 days for cystitis , my diarrhea worsened during this time. I finished the antibiotics yesterday and am waiting for my diarrhea to settle down again. I have had a colonoscopy , my colon is totally normal and there is nothing to worry about. I am a type two diabetic and have been for 4 years now. Can you shed any light on this and tell me if taking antibiotics would stop my codeine from being as effective? [/INST] Since you had antibiotics for 10 days your bacterial flora in the intestine may be affected which helps in the re-absorption of water from the stools. So what you can try is stop codeine and take some probiotics available in your home, or you can get it from your family doctor. Since you don't have fever or abdominal pain or vomiting this is usually non-infective diarrhea induced by the antibiotics. Hence, whenever you take antibiotics for any reason next time take some probiotics containing Lactobacillus spores along with the antibiotics. </s>

<s>[INST] hallo Dr, i have a pain in the left breast and i have already seen the Gynecologist. he has said that there is no problem in my breast. is it ok to use ampiclox. or can i continue to massage it? infect in the beginning, the lump was very small, but when started to massage it, it was extended to be big! so, i go on? or i stop it? [/INST] HI, Dear,Thanks for the query to Chat Doctor. I understood your concerns about the painful lump in the breast. When your doctor has told you that its normal, Why you want to start antibiotics on your own? Why you massaging your painful breast ? The increase of breast lump-may be -due to increased blood circulation and supply and does not appear to be because of the infection in it -as your doctor has ruled it out. And also there is nothing to indicate in your query facts. So stop all this and take second opinion if -you still worry. Hope this would help you to plan the treatment with Your family doctor. Wishing you early recovery. You are always Welcome for further query to Chat Doctor in this regard. Have a Good Day...!! </s>

<s>[INST] I have been diagnosed with colon tb, im 29 yeras old female. firstly i want to know if it is contagious or not? my medical tests shows mildly enlarged liver and lymph nodes in upper abdomen . I do night shifts, should i leave my job beacuse it will effect on the timings of prescribed medication. what kind of diet should benefit me? please advice. ur reply is awaited. [/INST] Hi. Abdominal TB is not usually contagious. U should get a chest x-ray and sputum examination done to rule out active pulmonary TB, or consult a chest & TB physician. Enlarged lymph nodes are common in TB. there is a risk of perforation of gut from ulcers in small intestine. So u should avoid constipation and at the same time the diet should not be very high in fiber that will create high intraluminal pressure in gut. to if u have deranged liver function tests the diet should be low in fat and protein. I dot think job will affect the timing of medication. U can take medication while on duty also. But the treatment should be regular for at least 6 months. The disease causes weakness in body, so have high energy diet and avoid hard work till recovery. Get well soon. </s>

<s>[INST] I have had a cough for about 5 mnths now. I seen a doctor last Friday. She said I have underlying asthma issues. I am still coughing alot. For the past hour I have kinda had pain in my chest. Could something be strained from coughing or is it possibly something else? [/INST] Hi thanks for asking. Here long duration cough is there. If associated history of fever and weight loss then sputum for TB done. You do your pulmonary function test to rule out asthma and about restrictive or obstructive lung lesion. Avoid smoke strictly.Don't take spicy food. Here cough can be because of chronic bronchitis. So better to do sputum for TB and PFT first. Then according to report further work up done. If Chat Doctor. Don't worry. You will be alright. Thank you </s>

<s>[INST] Im a 38 year old woman,I have been on birth control for the past year with no issues until this past month.I have been experiencing spotting a week before I finished my birth control and not having a normal period,what is the answer,could I be pregnant or just my pills arent strong enough? [/INST] Hi, The possibilities in this situation are the development of hormonal imbalances perhaps due to weight gain secondary to pill intake which in turn could have created the need for a higher dose or failure of the pill or disturbances of the hemopoietic system secondary to pill intake. In this scenario, I would ask you to see your consultant for a complete evaluation including blood profile, urinalysis, pregnancy test, sonogram and monitoring. Please maintain a healthy weight and a healthy diet. Take care. </s>

<s>[INST] Ive been having stomach pains for the past 4 days that tend to exacerbate at night. It is not related to heartburn but it does hurt. I went to the hospital on the 3rd day since I had a lot of pain but nothing could be diagnosed. I was just prescribed zofram and protonics. Only thing that helps a little bit is taking a warm bath but shortly after the pain comes back. [/INST] Hi friend, Thanks for your query. The details are very sketchy and vague. I wish you had mentioned your age and gender; the exact area (above/below navel; right or left side of abdomen) where pain occurs; your bowel movements; nausea/vomiting, if any; urine problems if any; itching at the anus; passage of mucus or blood in stools; details of periods (if you are a female).however, for the time being, you may take a deforming course and anti-emetic (such as Metronidazole) course days. You may either revert to me (AS PREMIUM QUERY, ad Chat Doctor. </s>

<s>[INST] HI Doc, I just have diagonised with Fatty Liver & my family doctor has suggested me to have Reheptin twice a day..I came to know the same through my ultersound reports where my Liver is showing Enlarge in reports (16.5 cms)...Psl advice if i have to do any thing else on this subject..Pls note that i m doing daily excerise which i have started from last 15-20 days only...My height is 5 2 ft. & weight is 80 kgs [/INST] HelloSign hepatomegaly with diffuse fatty infiltration is a reversible condition. It may be due to many reasons like hepatitis, obesity,alcohol intake, altered lipid profile, medicines,autoimmune causes etc. Findings may be due to obesity in your case. You need few other investigations like random blood sugar, liver function test, lipid profile. You may need to take some medicines after proper evaluation. It is good that you have increased your physical activity, and you should avoid fried and fatty food. You have been prescribed right medicines, you should take it. Get well soon. Take Care Chat Doctor. </s>

<s>[INST] Hi, I have a rash that seemed to start with itchy shoulders I thought it was just from being out in the sun, this lasted about a month, then I ended up with a tick bite on my right thigh, not sure how long it was there, the tick was imbedded pretty deep. I was able to get it out but then my rash spread to my forarms and was very itchy. It was a welted rash that got worse when I would go outside in the heat. It ended up spreading to my chest , under my breast , my stomach and on my thighs between my legs. I went to the doc and they ended up treating me for scabbies, and an antibiotic for lymes just in case. I ended up with a horrible reaction to the antibiotic a week later and quick taking it. They also ended up prescribing me a topical antibiotic. The rash now a little over a week later covers my inner forarms, up under my arms pits, my chest and my inner thighs. It is scabby looking now with some of the bumps with deep centers that are black in color. I have some on the sides of my hands that are really deep. I still feel the flushy itchy feeling when I do outside so I am just advoiding it. I am hoping it heals on its own now but I am worried that I dont know what it is. No on else in the family has gotten it and I am married and sleep in the same bed as my husband. I have photos but dont see where I can upload them. [/INST] Hi, It seems that you may be having lichen ultimatum. The cause would be hypersensitive reaction to insects.like ticks. There may be itchy popular eruptions anywhere on the body. Take anti histamines like levocetirizine till, you feel better. If the condition is embarrassing, you may take steroid in tampering dose. Apply combined cream of steroids and antibiotics. Avoid soap bath. Important thing is to be away from insects. For that, you may use insecticide to keep the room insect free. I hope you got my answer. Thanks. </s>

<s>[INST] Hi this morning, i fell and bumped the bottom of my cheekbone, the area instantly swelled up but felt numb, as the day has gone on the swelling has gone down however it is starting to become painful. No bruising has come up where I actually hit my face however at the end of the cheekbone next to my nose a bruise has come up. What would you reccomend? I am female & 21 years of age [/INST] Hello, I read carefully your query and understand your concern. The symptoms seem to be related to the injury on the cheekbone. I suggest using anti-inflammatory medications such as Acetaminophen to relieve the pain. I also suggest using cold compresses for local application and rest. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards! Chat Doctor. </s>

<s>[INST] Hi, I have a sore very lumpy area around +my right nipple area. It feels very hard + just under the skin. I am 46 and have small breasts. I have recently fin3 weeks of steroids for asthma - 4 week ago + have had hormone probs since. Please advise - thanks [/INST] Hello, Thanks for the concern. You have lump in the right breast near nipple beneath the skin. For lump in breast you have to watch it for few days give hot compresses twice daily. If still it persists than you have to do mammography, ultrasound and Fine needle aspiration. At present, you can take painkillers for symptomatic relief. So immediately consult your treating surgeon, get investigated and start treatment accordingly. Hope this might help you. Take care. </s>

<s>[INST] Hello, I have had a bony lump on my jaw below a tooth broken off at the surface for some time now. It didnt hurt and would get larger and smaller. But overnight that size of my face has swollen. It does not hurt like abcesses I have had in the past. I am wondering what is going on. [/INST] Hello and welcome. Thanks for sharing your concern. Please understand this fact that it appears to be an abscess only. Hard board like swelling could be cellulitis too.it is a kind of long-standing infection of spaces in the jaw. Please visit your dentist soon get it thoroughly examined and start with your antibiotics and analgesics soon. Do not ignore as prolonged delay might cause Chat Doctor. Hope it helps. Thanks. Take care. </s>

<s>[INST] hello doctor ,i am 26 year old,last year i got my mri done and found diagnose with arnold chairy malformation,because of that i having burning sensation in my right hand,no sensation in hand means that dosent allow me to fell warm or cold ,so what is the treatment ,also i am not able to sleep ,every night i have to wake for 3 to 4 times hello doctor,i am 26 year old and my weight is 71,last year i got my mri done and found diagnose with arnold chairy malformation,because of that i having burning sensation in my right hand,no sensation in hand means that dosent allow me to fell warm or cold ,so what is the treatment ,also i am not able to sleep ,every night i have to wake for 3 to 4 times [/INST] Hello, welcome to Chat Doctor thanks for the query since you have lost the sensations of cold and hot it appears to be due to spinal cord problem. It may be due to spinothalamic tract involvement. It can be also thalami disorder. Have you any other associated symptom? A detail neurological examination is needed for it it's better to consult the nearest neurologist and get evaluated for it take care </s>

<s>[INST] hello,my name is christina i feal roller skating about 4 months ago.i have been doing p90x.i have a knot in my arm that will not go away.i have been to the doctor 2 times.i have been taking inflamation meds.dose not seen to help.still hurts.what do u think [/INST] Hello! Thank you for the query. The knot can be caused by hematoma or ganglion cyst. Both can appear due to injury. Hematoma is caused by small veins rupture. Due to blood presence in the soft tissues, some kind of fluid collection appears. If its large enough, won't disappear by its own. Moreover, can get infected and turn into an abscess. Ganglion cyst is less probable, as it usually appears on the wrist. Ganglion cyst is more like a rounded and soft lump caused by tendon injury. I suggest you to have soft tissues' ultrasound of the lump area at first. This allows to determine the nature of such lump. If its hematoma should be Chat Doctor. Hope this will help. Regards. </s>

<s>[INST] My son has elevated liver enzymes, his CT shows a fatty infiltration on his liver/an enlarged spleen, and his VitD levels are falling, despite taking a VitD supplement. he has fatigue, and has noticed delayed healing process. any thots on what might be going on? [/INST] Dear Friend. Hi, I am Chat Doctor, I have read your query in detail, I understand your concern.it is very difficult to comment on with these details. Also need to know his age, alcohol status, and need to see the reports. Vitamin D production in body involves liver also, if his liver is not functioning well, levels will fall down. If he is an adult possibility of Chronic Liver disease (Cause can be Alcohol, Viral Hepatitis) is high since he has enlarged spleen. Let us know if he has jaundice, esophageal varices, ASCIIs. If you could give us detail history and also if you could share the reports, we would be able to guide you better. This is my personal opinion based on details available here. If you want to discuss your issues further, you may please ask stay Healthy. Chat Doctor, MD </s>

<s>[INST] I had an abscess in a upper tooth late last year and had a root canel and put on anitbodics. Yesterday I felt the bubble on the roof of my mouth and sent and seen the dentist today. Took xray and infection still there. Am being sent to an endontics dentist on April 12. Now this afternoon I have a nose bleed on that side of my nose where the infection is. Is this normal or not. [/INST] Hello, Well, nose bleeding may or may not be related to your tooth infection. As it can be commonly seen. If there is an infection in the upper front tooth. It can co-incidental however if there is repeated episode of bleeding then it needs clinical examination. For re-infection in your root canal treated tooth. You should consult an endodontist and a re-root canal treatment advised. Also, a course of antibiotics like Augmenting and painkillers like Ibuprofen will be advised. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] My husband was recently diagnosed with diabetes. He is also on medication for high blood pressure and high cholesterol. He is an alcoholic and his most recent Alt test was 140. He has convinced himself that the alcohol does not have an effect on his liver function test. [/INST] Hello Thanks for writing to ChatDoctorYou husband has increased ALT, and it indicates liver injury. Increased ALT may be due to hepatitis, altered lipid profile, autoimmune causes, medicines etc. In your husbands case, increased ALT is related to alcohol intake. Alcohol causes devastating effect on the liver, and he should quit it immediately. He needs clinical examination and few other investigations. He needs few more investigations like random blood sugar(RBS), renal function test(RFT), complete lipid profile, Liver function test, viral markers, GGT estimation, urine RE/ME, ultrasound of abdomen. He should avoid red meat and high fat milk products. He should avoid fried and junk food. Medicines should be prescribed after complete investigations. I suggest my patients to take tablet ursodeoxycholic acid 300 mg twice daily after food for three months. This help in regeneration of liver cells. He also needs medicines for high blood pressure and high cholesterol level. Get well soon. Hope I have answered your question. Take Care Chat Doctor. </s>

<s>[INST] I went to ER with chest pains. Results no heart attack. Had echo and stress test next day and the dr said enlarged heart ? I ask what causes that aND he said high BP, but Ive never had:( my BP runs about 117/74 to maybe 120/76.. Any idea about what I should or shouldnt do? [/INST] Hello, I have gone through your query. Thanks for using ChatDoctor.in your information there is some paradoxical information. ECHO can not be normal if heart is enlarged. But sometimes thickened wall of ventricles produce enlarge shadow on X-ray chest, this may be a possibility. Commonest cause of such thickened heart walls is high BP.few normal readings of blood pressure do not rule out hypertension. I suggest you to get Ambulatory BP monitoring RO rule out hypertension in your case.I need to review your ECG, echo to guide you properly best wishes Chat Doctor. </s>

<s>[INST] Hi, I have a painful pins a needles sensation down the length of my penis. Im 26 years old and have two disc injuries in my spine after a car accident four years ago, which has also caused nerve damage to my bladder. I also have high blood pressure. What could this sensation be? [/INST] Hello dear, Thank you for your contact to Chat Doctor. I read and understand your concern. I am Chat Doctor answering your concern. No nerve damage to bladder won't cause pain after a so much time. If you receive a pain immediately after injury than we can count it because of injury. This type of sensations are common in nerve regeneration, so if your damage nerve are getting repaired than you can have such a feeling. In my advice you should take tab pregabalin, tab vitamin B complex. This will help in recovery from such a problem. Please do perineal muscle exercise in other word stop and release urinary sphincters as much time in the day as possible. This will help recover fast from the problem you are having. Some physiotherapy and electrotherapy can also cure such a problem. You can visit nearby physiotherapist they can guide you regarding exercise. I will be happy to answer your further concern on bit.ly/ Chat Doctor. Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. </s>

<s>[INST] hi im jeric 26 yrs old im planing yo go abroad but sadly im pending in my medical result because of my sgpt 120 sgot 54, now im starting go on diet because after 2weeks i need a low sgpt to make me fit to work. please help me, wat should i do? please to decrease my sgpt thankyou [/INST] Hi, dear. I have gone through your question. I can understand your concern. Your Sept level is really very high. Sept is a liver enzyme. Its level increase in any liver damage. It may be due to viral hepatitis, Chat Doctor. You should go for complete liver function test. Find out the cause of that and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. </s>

<s>[INST] hi i have problems breathing on and off i got my lungs checked twice i use to take lot of pills supplement that is could it be over the years it has affected me my doctor says no i believe it might be my respiratory system? maybe my thyroid thank you for your time [/INST] Thanks for your question on Chat Doctor. I can understand your situation and problem. In my opinion you should consult pulmonologist and get done1. Chest x ray2. PUT (pulmonary function test). Many times clinical examination of respiratory system is normal but chest x-ray and PFT are abnormal and indicative of disease. Chest infection can cause breathing problem. So chest x-ray is needed. Bronchitis can cause breathing problem, so PFT is needed to rule out it. If both are normal then you may have anxiety and related symptoms. So better to avoid stress and tension. Be relax and calm.Don't worry, you will be alright. </s>

<s>[INST] Hi,My bilirubin was high when I got my results back for a life insurance policy. The result was 2.6 and all other numbers were in range. I did receive the best plan ad nothing was said. Last year my number was little high and 1.9. I do not drink or have any other conditions. What can I do or should I be worried like I am now? [/INST] Hi, Thanks for using Chat Doctor, You have detected to have high bilirubin level and other enzymes about liver function are normal. In Such cases there are many causes you should visit Internal medicine specialist or Gastroenterologist to examine and investigate for cause like hemolytic anemia and Ultrasonography and CT scan of abdomen. The bilirubin can be high due to Chat Doctor. Sometimes even some defects from birth where slight bilirubin level remains due to some defects in membrane transport. If everything is fine and you are healthy. Just followup with your doctor to keep an eye over liver functions. Hope this helps and take care Good Luck. </s>

<s>[INST] my patient who was 2 years old. He eats so much and has hepatomegaly. No splenomegaly. Serum sugar, ferrum, CPK were normal while ASAT, ALAT increased. Abdominal CT: Hepatomegaly. We are suspecting metabolic disorder? but i could not define exactly what illness. what do you think? [/INST] Hi thanks for asking question. Noted this 2 year child having elevated liver enzymes and hepatomegaly.... Here yes chances of metabolic disorder is present....like that if glycogen storage disorder or tyrosine.... Detailed investigation and complete history taken ....If you need liver biopsy might be needed...for his to pathological examination..... Niman pick disease or Wilson disease also congenital causes.... And yes finally congenital hemolytic anemia also has to be ruled out....If you need electrophoresis might be done from blood sample to rule out sickle cell or that. Hope your concern solved... </s>

<s>[INST] My brotherinlaw is having severe pain in the calves of both legs. He has been having this problem for years and he recently had knee replacement on both sides. That seems to be OK. Muscle pain in the calf is the problem. He said it feels like cramping. When hestretches the muscle of the calf it seems to help. [/INST] Hi, You did not mention the age of your brother-in-law and for what reason, he underwent knee replacement. Assuming that he was suffering from osteoarthritis these could be the causes of his calf pain.1. The most common one in osteoarthritis patients is virus deformity i.e. legs starts bending inwards, if that was the reason, he will be relieved with calf muscle pain now as he underwent the replacement surgery in which deformity is also corrected.2. Calcium and vitamins deficiencies are also one of the cause, so start taking supplements.3. Sodium potassium imbalance is also a cause for calf muscle pain, so take oral rely Chat Doctor. 4. Wrongly designed footwear is also a cause of calf muscle pain.5. Chronic venous malformations in calf muscles like varicose veins, or venous incompetence can be a cause so to rule out getting a color Doppler done. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] hi doc iam suffering frm back pain just below the scapula from 3 days and yest i gt a type of rashes on it i consulted a do WWW.WWWW.WW den he gave me a herpikind gel to apply on it what must be d reason fr it and my pain is horrible [/INST] Hi, Based on the given history you seem to be suffering from herpes zoster for which you have been advised to heroizing gel. Heroizing gel is an antiviral agent which is used in the treatment of infections caused by herpes virus such as chickenpox and herpes zoster. I recommend you to take tablet carbamazepine for the relief of this type of neuropathic pain. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Dear sir my son is suffering pain back of Ankle , and stiffed from Thai to ankle, while standing it is pain , whether is is sciatica or what and what is treatment , He is suffering last 3 months .Used pain relief medicine , Aurvedic etc but not cure , please advise [/INST] Hello, I read carefully your query and understand your concern. The symptoms seem to be related to arthritis. I suggest doing an x-ray and a rheumatoid Factor blood level for further evaluation. Meanwhile, I suggest to use anti-inflammatory medications such as Ibuprofen to relieve the pain. I also recommend cold compresses for local application. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards! Chat Doctor. </s>

<s>[INST] I just noticed a purple/yellow circular bruise on my right upper arm with a while lump in the middle...feels like the size of a pea. The entire bruise is about the size of a quarter. It doesnt hurt! I know it is not a bug bite, no shots and nobody has grabbed my upper arm. What could this be? My Grandmother on my Dads side had breast cancer. [/INST] Hi, Dear,thanks for the query to Chat Doctor virtual Clinic. I studied your query and understood your health concerns. The worry of the lump on your right upper arm, is only due to the fear of it being cancer, as your grandma had breast cancer. I reassure you, after studying the details of your query, that you should not worry about possibility of cancer in your right upper arm. Your lump appears to be an unknown insect bite. Possibility of it being boiled or sebaceous cyst is not there as the history is short. Hope this would resolve your query. Welcome for any further query in this regard. Write good review and hit thanks, if this reply helps you. Have a good day. Chat Doctor. N. </s>

<s>[INST] Allergic, my nose not breathenk and my eyes is rad... Before I did Diprospan inside my nose but it was in Ukraine. Now I live in Australia but here dont practec this treatment ... they sugest only pels but it doesn t work for me... [/INST] Hello, Welcome to Chat Doctor forum. Diprospan nasal spray contains dexamethasone a corticosteroid which can be used for severe cases of allergic rhinitis. Corticosteroid nasal sprays such as Alone and Rhinoceros can also be used to relieve the symptoms of sinusitis, hay fever, allergic rhinitis and non-allergic (perennial) rhinitis. However, they can cause side effects such as headaches, nausea and nose bleeds.Hence, their use should be limited and only on prescription. For symptomatic relief you can alternatively use anti histamines either nasal sprays or oral pills available freely on prescription and over the counter. In Australia sprays like Release (Triamcinolone acetone) and listing (Levocabastine HY Chat Doctor. Please understand that allergy is best prevented than treated. So do consult an allergist for long term relief rather than repeated self medications providing temporary relief. Wishing you good health, </s>

<s>[INST] Hi, i have a seven month old daughter. She doesnt really seem to like baby foods as such. She likes to eat what we eat with all those spices n seasonings but in a mashed, easy to swallow consistency. Can i add cornflakes in her diet with whole milk. She is still on breastfeed. She loves apple but apples, pears n potatoes constipate her. Also which other dals can i add in her diet besides the normal yellow moong dal? [/INST] Hi... At this age you can start giving Carla stage one rice or Nestum rice stage 1 etc. All are same in calories and energy. Only thing is palatability which is subjective for each kid. Other home-made food options will be - 1. Deal and rice well cooked and made into a oatmeal along with ghee2. Boiled apple or banana and mashed into a paste.3. Any made cereal oatmeal preparation with additional ghee added. Remember certain principles like -1. Add one food material / cereal or fruit per week. This will be useful because if he develops vomiting or diarrhea, we will know what to avoid.2. Add vegetables and fruits made into a paste surely to avoid constipation.3. Do not add too much sugar as it may cause diarrhea. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Chat Doctor are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. </s>

<s>[INST] Hi I have the mirena and had it for about 7 months and my my cycle has stayed on the same schedule and my cramping has gotten worse and I have already had my cycle this month and I am cramping all the time and tonight it is hurting even worse on right side and sorda hurtin and in my back close my spine .... and I m wondering why or what it could be [/INST] Hi Hope this message finds u in good health. I have gone through your msg and understand your concern.it may be due to some sort of hormonal imbalances or variations in the body, though there may be other reasons as reclothing to worry about, You should eventually get back to normal. Take multi vitamin and calcium supplements Do consult a gynecologist if symptoms worsened back to me for any FOLLOW-UP QUERIES anytime. Chat Doctor. .(MBBS, MS,MCH) </s>