Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 13 year old son been running a fever & has a cough since last week Tuesday making it a total of a week today. He does not state is having trouble breathing. Took him to ER on Friday this past week Dr. stated lungs sounded clear said did not need a chest Xray ears looked good as did throat was advised to just medicate for fever. Took my son in to Drs office today because I was worried since Monday night had fever of 103. At Drs office temperature was 99.5 i was told same thing lungs sound clear ears fine throat fine & to keep medicating if fever consist. Came home & again had fever of 101.3 which I gave him ibuprophen. Im really concerned not knowing exactly what going on being that he is having these fevers & to my understanding fever means infection what do you suggest I do next? Should I take him for a 3rd opinion since he was seen by Physicians Assistant & not his actual pediatrition or can this be viral & just let run its course? ### REPLY: Greetings from . Thanks for posting your query.  Fever indicates Infection, either bacterial or Viral. It needs to be differentiated as treatment is different for both.  She requires certain blood tests like Complete Hologram, IGM Ty phi dot, Smear for Malaria, SEPT, SGOT, Urine routine and Throat swab culture sensitivity. With the results of these tests we will get an idea of what is causing fever.  Till then continue giving him Ibuprofen. Ask him to do salt water gargling. Avoid oily food, non veg food and citrus fruits.  Kindly get these tests and revert with reports. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir/madam; I am Ameen from India Kerala. I am of wieght 56kg and hieght 172. sir problem is that my hand is shaking without any reason.for eg. When i rest my hand while writing its shaking and while holding a glass its shaking its a great difficult to me. I took long treatment for astma and now iam using FORAIR 250mg Novaliser as asked by Dr.Haris MD MBBS. Pls help me is it any symptom of diseases like parkison s or any other pleas help me iam tensed. ### REPLY: Hello, Clinical examination will help in differentiating between Parkinson's disease and essential tremors, the two most common causes of tremors. In PD, tremors occur at rest and reduce on performing any action.  On the other hand, in essential tremors, there are no tremors at rest, and they are brought on by action or activity. In your case, it seems to be essential tremors.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Feel like i have kidney infection under my right rib in my back for 2 mnths now. Dr did xray..results say, multiple rounded calific densities with lucent centers in pelvis, a small punctate clification in hemipelvis. Have ct scans today, but what could this mean? ### REPLY: HelloThanks for query. You have done X-Ray of the abdomen for suspected kidney infection since 2 months which is reported to have multiple rounded calcific densities with radiolucent centers in pelvis, and a small punctate calcification in hemiplegia. The multiple calcified densities with radiolucent center are stones in the renal pelvis whereas small punctate calcification represent small calcified particles less than 2 mm in diameter which usually pass out through urine spontaneously. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have discovered a 6 inch x 7 inch soft mass situated just left of my spine slightly below my shoulder blade. It is soft with a firmer center, non painful to touch, but I have had multiple symptoms that I have attibuted to other things....numbness in my left arm and hand, hot cold flashes, burning pain in my shoulder and neck as well as an increase in headaches. There is some area deep in my chest that at times does cause pain when I move a certain way or lift my arm it sort of takes my breath away. I have degenerative disc and history of headaches so wasn t too concerned. This is especially stressful to me as we have alot of lung cancer as well as breast cancer in the immediate family. Thanks for your help. ### REPLY: Hello, From the history you have given, (a really lucid one), the soft mass below your shoulder blade seems to be similar to a lipoma, which is nothing but accumulation of fat. The exact diagnosis can be given by the attending physician on examining it in detail. And your headaches and the numbness and burning sensations in the arm all seem to be the direct effects of the cervical disc degeneration which you have already been ad .  So a good posture and physiotherapy should help you. The chest pain aggravated on movement can mostly be a musculoskeletal one with inflammation of the rib joints. Though these symptoms do not seem to be associated with the family history of cancers, I would suggest you to get evaluated for the swelling, probably an ultrasound of the swelling can give a clue. The X-rays for the neck and chest can rule out any other suspicions. Talk to your physician about the family history of cancers and he might deem it necessary to screen you for the same if he suspects any from the complete history and examination findings. You can be reassured about the concerns of cancer. Take care! Hope everything goes on well! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my doctor found an unchanged posterior tongue spongy raised papillary lesion after 6 weeks. risks are hpv smoking alcohol. he suggests removal in 3 months. he is an ent surgeon. age 62. Does he seem concerned re squamous cell ca if waiting 3 months to operate? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have simple keratitis, papilloma or squamous cell carcinoma.  You should go for punch biopsy of tongue.  It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have received news today that a 2.5 cm nodule was found on the left T2 of my thoracic, my doctor has scheduled an US Thoracic. Just wanting to know my options. Before this I had a MRi brain which found 12 or more white matter in the postventricular region. ### REPLY: Hi there, It really depends on what the nodule is.  Some nodules turn out to be nothing more than scar tissue and others can be cancer. It's impossible to give a prognosis without knowing exactly what it is.  A biopsy will usually be able to tell what it is, and further options can be discussed at that time. I hope this answers your question. Please feel free to contact me if you have any further questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: how one can get c-diff, i am working with a patient with the problem, i am very nurvous about whole situation, i constantly wash hands, wear gloves, what else can be done and what are my chances being expose to it, and what would be the symptoms, i appreciate your help, tks a lot ### REPLY: Hello, THX to contact us. If I am your treating doctor I would like to advice you that it is caused by Clostridium difficile most of the infections are hospital-acquired, and mostly it is faeco-oral like the patients or staffs hands from a contaminated commode or equipment. Most of the cases occur in the elderly. Patients. Most common symptom for it is the diarrhea. In some advance cases it is a formation of membranous colitis. If you have anything else to ask please contact me. Than.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have a question for an infertility doctor. I started my first IVF attempt on August,18th with one endometrioma and one blood cyst of 5mm. However, doctor was ok to go ahead. On day 6, I have my first u/s showing one follicle of 20mm plus other small ones. Cycle was canceled and dr. told me to way until I get my next period for an ultrasound. Protocol was: 10 days BCP, then 5 days of gonal f (300mg) at night and 150mg of menopur. I am on day 26 after my first day of inyectables and not IF yet. I always have my period every 26 days and I am 38 years old with NAC and 10.7 FSH. I would like to know if this is normal? Can I have cysts? How long do I have to wait? Thank you, Lorena ### REPLY: Hi Lorena. When treatment is initiated in women with some amount of infertility issues, the treatment can lead to a change in the usual cycle duration and length. I don't think this should be a cause for cancer. As for cysts, I am sure at least one ultrasound of tour lower abdomen should have been performed by now, and the cysts would have been ruled out then. But if you still wish, and ultrasound conducted at anytime can help rule it out. Irregular cycles, inter-cycle bleeding, etc.; are some symptoms. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father age 55 weight 65 hight 56inch fell some upset docter advice a blood test so test is  total lipid ,570mg,triglyerides,180.4mg,cholestrol,195mg,hdl cholstrol,46mg, vldl,36mg,ldl clolestrol,113mg what is in any problem plese guide which test is sutable for this situtation  ECG or Engio or what is the cost of these test in chandigarh or delhi ? ### REPLY: Hello Your father findings suggests lipid parameters are towards upper limit. He conditions need few more investigations lie routine hologram, random blood sugar, liver function test. With these findings, I only suggest increased physical activity and diet alteration to my patients. He should avoid fried and fatty food. He should go for brisk walk.Follow-up lipid profile should be done to assess his condition. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 33 year old. I have a 5 year old son. Trying to conceive again! Taking medication, today had my TVS and it showed that the follicle has ruptured and details again:-End - 13mm (triple lining +)Free fluid in POD (+)Is it a sure hit?? Please let me know!! ### REPLY: Hi there, I have understood your concern. I will suggest you the best possible treatment options. It is a very good ovulation report.  You can simply opt for unprotected sex act on around the day of ovulation.  Or you can opt for GUI - intrauterine insemination, on the day of ovulation. Please seek prescription support from your treating doctor for getting micronized progesterone tablets for 10 to 15 days after the ovulation. I hope you must have confirmed the patency of the fallopian tubes beforehand, by doing post menstrual HSG - hysterosalpingography. Please start on Folic acid, vitamin B 12 and Omega-3 supplements. This helps to prevent many problems during pregnancy and delivery. Wish you all the best. May God bless you with a bundle of joy. I hope this answer helps you. Thanks.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. My 13 year old girl has had a fever of 39 for past couple of days. She has a cough, severe pain in her eyes especially when they move and looks in different directions, and has severe back pain in mid to lower back. Would appreciate any feedback Thankyou. Justina ### REPLY: Welcome to the ChatDoctorI understand your concerns. You daughter seems to be suffering from either an inflammatory or an infective cause of illness. There could be many possibilities such as Viral fevers, connective tissue disorders such as systemic lupus erythematous, a bacteremia etc. I would recommend you the following measures:1. Laboratory tests like complete blood count, C reactive proteins, ESR, CHEST AND SPINE X-Ray, ANA.2. Start her on acetaminophen or ibuprofen for fever. You can repeat the tablet after 6-8 hours. If still persistent, you may give her Mesenteric acid I.e. Metal P.3. A good rest and diet will be of help. You can contact your pediatrician for a good clinical examination. Many a times' diagnosis can be formed by a good clinical examination. You may contact me with the reports so that I may help you in a better way. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello Dr.Doctor my brother have a high creatinine level of 7.3. he is hospitalized. has pnemonia and also got effect on heart. his blood sugar was 200 and BP 200/150 when he was admitted before one week. he is still hospitalized but now BP is 130/90, blood sugar 190 and cretinine is 7.3........kindly tell me the line of treatment and diet to be taken. he is getting discharged today with medication. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He had very high blood pressure, sugar and kidney failure. His sugar and blood pressure is under control now. But his creatinine level is still very high. He may need dialysis to correct kidney function. So consult your doctor and take treatment accordingly. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: may i ask u. I have some problem in urine. I checked urine test today. the results are rbc- numerous hpf, epithelial cells 01-02hpf, wbc 02-04hpf, blood +++, backside of left abdomen are pain. Please may I know my diseas. May be kidney cancer? I have a major operation in R kidney because uretic stone. ### REPLY: Hello. I understand your concern please. You said you had an operation done on your right kidney for ureteric stone. It's an important history. Can you please tell me why did you feel the need to get your urine tested? Pain in the back (loin) guides me to think that it could be a kidney stone. Does the pain go anywhere else, or it just remains at the back itself? Like whether it goes up to the testicle or inner side of your left thigh or something like that? I guess based on the fact that there are numerous RBC, the color of urine might be red.Ply let me know if you have fever now or had any sore throat in the recent times last week or like that. First get the basic investigation done which is Ultrasound abdomen and pelvis which could be a screening test for many kidney related conditions and also an X-ray PUB to know if there are any stones. Based on the reports we could further proceed. For time being, to relieve the pain do take Tab Diclofenac and stay HY .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ive been taking vyvanse for add and have been on it for almost a year now. i want to stop because i dont like the way it makes me feel anymore and feeling like i need it to make it through the day. are there any suggestions for a good way to come off vyvanse that will lessen withdrawl symptoms? ### REPLY: Hello and welcome to . Thanks for your query. I understand that you are experiencing difficulties due to your ADD medication and would like to stop them. However, you have not mentioned the dose of Vyvanse that you have been prescribed. So, it is not possible for me to suggest a tapering schedule. Moreover, it is not a good idea to stop medication on your own without informing your doctor. So, I would suggest that you let your doctor know about your problems so that he can advise you on the further course of action. Wish you all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, Ive had on and off chest pressure for a few weeks.  It doesnt feel like pain but I guess it could be and doesnt move to other parts of body (on occasion I can feel it at the same point on my back.)  It is just constant pressure.  It doesnt usually last very long but it always seems to come back.  It is only on the left side around and above the nipple area.  Im 36yrs old, no health problems or family history of heart problems.  I had was layed off and had my first child a few days ago.  I am presuming this is stress or anxiety of some kind.  But Ive never had anything like this before so I figured Id ask. ### REPLY: Hi thanks for contacting ... You have constant chest pressure and radiating to back. . So to be on safer side investigate first with following investigations ....1. Blood pressure measurement2.ECG 3. Echo (if needed)4.Treadmill test If no cardiac cause present than no need for much worry .... It could be from stress if you are taking ... It could be muscular pain if any unaccustomed activity there .... Rest and analgesic need for it ... Consult pulmonologist with keeping my answer in mind... Hope your concern solved... Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good evening doctor.i had taken a contraceptive pill 3 days back.and since yesterday i am having the vaginal bleeding.my periods were on 23rd of dec and lasted for 4 days,I am confused whether my periods have been prior shifted or is it the vaginal bleeding as mentioned on the pamphlet of ipil.If its the later thing..how long will it continue ### REPLY: Hello, I have gone through your query and understood the concern. The emergency contraceptive pill contains high dose of progestin and this disturbs the hormone balance of the body. Hence, there is often some with .  This is what you are experiencing now. If you happen to be nearer to your natural period, it is also possible that your period has also been advanced due to the pill effect. With ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have sensitive canker like sores behind my front lip   my dentist diagosed it as auto immune disease from consulting a medical book and a look at some accompanying photos...the salve prescribed for me is no longer working as effectively    any suggestions or ideas?    thank you ### REPLY: Hello, You may have some trauma to the area causing a delay in healing. Are there any sharp teeth or irritating habits?  Avoid all irritants including smoking and alcohol. Acidic and spicy foods may best be avoided as well. Rinse your mouth. Warm salt water is an excellent choice. Avoid alcohol containing rinses. Make sure you are not deny .  Take vitamin B12. Maintain good day dental care. A endocrine gel such as Villain may offer protection and relief. You may need time and have reoccurring episodes when stressed.  Consider evaluation at an oral surgeon if the condition worsens. Thank you for your inquiry. I hope that these suggestions are helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My tongue and the muscles around it are so sore from coughing. My cough is more just hacking and producing little, yet, I keep doing it. I can barely talk or eat.  My throat is red but likely just from coughing. There are no spots on it.  What can I do to lessen the muscle pain? ### REPLY: Hello, You have symptoms of soreness in the tongue which seems to be due to laryngitis, acid reflux, nutritional deficiency of Vitamin B12 and folic acid, and could be due to stress. I would suggest you visit an oral physician once and get it examined. Go for blood and throat swab test once and start treatment accordingly. Take light food and do not lay on the bed immediately after having food. Do warm saline gargles as well. You can apply an ointment like McCoppin and you can take medicine like vitamin B12 supplements. Do soda bicarbonate gargles. Avoid intake of sharp and spicy foods. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello there, I am trying to find out how to tell the difference between a pulled muscle in the chest or heart problems symptoms. I go to the Gym 3 times a week and NEVER get breathless when training or after I do both cardio and muscular at least 3 times a week, Chest pecturol machine I lift 60k 36 times 3 reps or 12, lat pull the same, 10 min run, 5 min cycle, 500m row, 55kg leg curls up and down. I have recently had my blood pressure and pulse rate taken in the gym and in the docs coming in at blood pressure 128 in the gym and 127 in the docs, pulse rate 66 in the gym and 70 in the docs. I just need to know If after all the information given that the NON severe niggle I would call it that I am getting under my left breast plate and sometime near my nipples left side. I am a 30 year old male from the UK, 6ft, 95kg in weight. ### REPLY: Hi, The difference between a muscular source of chest pain and cardiac problem is that in a muscular chest pain, you can reproduce the pain while palpating the affected areas as well as when moving your left arm around, while the chest pain of cardiac origin is usually triggered by any form of exertion, associated with palpitations and difficulty if breathing, may be radiating to the arms, and is relieved by resting. If you have any of the above symptoms, I would suggest a consult with a doctor for work-up and advise. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have lump in right breast for the last five months. I recently did mammography which showed some fibrocystic disease and insisted upon FNAC the results of which will be obtained today (02-07-2012).Could you please suggest me the urther procedures to be done as I dont want to take chance. ### REPLY: Hi. Welcome to . You have not mentioned your age. For young females mostly it is fibroadenoma. For old females it can be cancer. FNAC is quite reliable test but to be 100% sure best is excision biopsy means take out the lump by surgery and send it for histopathology. Other option is true cut biopsy. Advantage of excision biopsy is that if lump is benign means simple then no further treatment is required. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am experiencing an occasional warm sensation in my left thigh. It feels like warm water is spilling over my leg. It last for a few seconds and then is gone. The leg does not feel hot to the touch, but the sensation has come several times in the last 24 hours. ### REPLY: It can be due to some temporary nerve compression. I would suggest you to take pregabalin M one tablet at nighttime daily for five days. Most probably this sensation will improve. If there is continuous sensation then you need to get EMG test to find out if there is nerve compression. Sometimes there is lateral cutaneous nerve of thigh can get compressed due to tight undergarments and that can also cause such symptoms. That will improve with stored injections. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a director of a child care center. We have a 3 year old girl who masturbates everyday at nap time for 1.5 to 2 hours. She does it so hard that her hair becomes wet, she breathes hard and makes noises. Her arms and hands become red and stay red for awhile after the nap time is over. She is even starting to do it at other times during the day. The parents have told the teachers to ignore it which we have done. However, we feel it is not normal for her to be doing it for so long a time and at other times when the other children may be watching. Also she has been doing this since she was 1 year old, but it has become a progressively longer period of time. Please let me know what you think we should do. Recently she has had a vaginal irritation and a staff infection. ### REPLY: Dear parent, I understand your concerns, but this is not normal. Severe itching may cause a child to take the habit of rubbing her private part that hard. Severe itching may be caused by fungal, bacterial infection or parasitic worms of the gastrointestinal tract. I strongly recommend a stool analysis and a swab culture from her private parts. If they came back negative then she will need a pediatric psychiatric. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 7 weeks post op from a fusion of the L 3-4 and laminectomy. I am experiencing, when walking left buttock, thigh pain and weakness, sometimes radiating into left thigh. Also both knees seems to be painful when walking and were not prior to surgery. ### REPLY: Thank you for asking .  My name is .  There is very rare chance that post-op laminectomy causes pain in knee. As this procedure is carried out by putting the patient on prone position and keeping appropriate sand bags below chest and thighs to free abdomen so that you might be experiencing these symptoms due to some physical mishandling during positioning. If the pain is not radiating to legs as before surgery it was, there is no much to worry about.just take good painkillers like naproxen sodium 250 mg TDS for a week and Gabapentin 150 mg BD. Also keep doing exercises as advised by physiotherapist for this problem, I am sure you will be feeling comfortable with in a couple of weeks. Hope this may help you. Let me know if anything is not clear. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I poured Clorox down my sink both sides of sink  . I have a bug problem thats why I did this. I live with my small dog. My window and front door is open. My friend said run cold water down the drains so I did. I also put Armen Hammer baking soda down drain. Its about 2 hrs now. Still smells. Im worried. I feel funny in my chest and alittle cough nose feels funny. Do I have poisoning . Should I be worried ? My dog Im worried. He seems fine. ### REPLY: Hello and welcome to , Yes, bleach can be very irritating to the membranes of the nose and airways.  If you can, run a fan near the bathroom, and stay away from the bathroom for a few hours.Don't pour anything further down the . If you continue to have discomfort, or it is worsening, then it would be wise to go see a doctor. Otherwise, consider going for a walk with the dog and getting some fresh air right now, while a fan runs and helps dilute the bleach in the air. I hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have an issue with the area of and around the nose. about 2 months ago, the skin on my nose started to become irritated & skin peeled off. About the time it would heal, the whole peeling process will start over again & again. I visited a local doctor who prescribed 1% chormotrizine cream. This did nothing towards healing this problem. My eyes are swollen & the skin on my nose, & around my nose is a bright red [inflamed] I have tried triple antibiotic cream, Neosporin & Equate antibacterial cream with no relief. Any help would be appreciated. David Smith ### REPLY: Hi, Does your cream contain a steroid? Creams containing steroids, if applied for longer period (more than 3 weeks) can damage the skin. So, please stop any over the counter cream. Other causes are bacterial or viral infection or an allergic reaction.  I recommend you to visit your Dermatologist to arrive at a proper diagnosis. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been falling down about 8 or so times within a period of about 1 1/2 yrs. I also veer to the side when walking straight, left more than right, sometimes fall backwards. I am going to chiropractor for 8-9 mths. lately, bending down to like at an item on bottom shelf in store and when I squat down to floor, I can only get up about 1 foot and I don t have stremgth to push up further, and I fall back, onto my back. Today, this happened in Home Depot, DIY store! Please advice on possibilities of what this could be causing this to happen. I am 61 and always been in good health, a multi tasker etc. Thankyou, Linda ### REPLY: Hello, It is important to perform a careful differential diagnosis between different possible disorders that could lead to falling: - a neurodegenerative disorder- orthostatic hypotension- chronic degeneration of the cervical vertebral column- an inner ear disorder- a cardiac arrhythmia. For this reason, I would recommend first consulting with a neurologist for a physical exam.  Some tests to consider would be: - a resting ECG and a cardiac ultrasound- a cervical spine X-ray study-thyroid hormone levels for thyroid gland dysfunction.  A Brain MRI and an ambulatory 24-48 hours ECG monitoring may be needed. If all these tests result normal, I would recommend consulting with an ENT specialist and performing labyrinthine tests.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 26 year old boy. I have had bad acne vulgaris problem for the last 12-13 years. I have tried all kinds of medical treatments (allopathy, naturapathy, homeopathy etc.) but it keeps coming back. Now I believe that I have been somewhat not-so-careful about my condition and let it go the way it went. But now I am dead serious to let it not affect me as for me, its affecting my self-confidence majorly. I have got huge scars all over my face and dark spots after the acne leaves. What can I do to get good skin again? I am open for all surgical and non-surgical procedures....thanks a ton! - Puneet ### REPLY: Hello. Thanks for writing to us at . Active acne particularly if severe can lead on to scaring and pigmentation. Before you can do anything about the scaring you must first take treatment to control acne activity. In my patients of acne I normally put them on one of the Oral antibiotics if they have moderately to severe grade of acne. Various options that I choose from are either Doxycycline or Minocycline Or Azithromycin. Topically I ask my patients to use benzoyl peroxide gel twice daily. Oral retinoids are an option too if acne is severe and not responding as desired to the traditional antiacne medications. These are all prescription products, and therefore you must visit a dermatologist for a prescription of these. Your dermatologist would be able to assess the severity of your acne and advice accordingly. Once acne is under control, you can then go for treatment of acne scars. Various methods that can improve the appearance of acne scars are Dermabrasion, Fractional CO 2 Laser, Microneedling, Chemical peeling etc. I would suggest that you seek an appointment with a dermatologist in your region for proper treatment of acne and later for acne scars. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. Im having a fever which has lasted for 3 days as of now, it doesnt seems to subside with Paracetamol, temperature is about 37.5 degree Celsius. Besides, I feel very tired and sleepy even though I have just woke up from a nap. The doctor has took some blood for Full Blood Count test, but the result is not out yet. Is it necessarily to go to the hospital, or what should I do? Please help. ### REPLY: Hello, I really appreciate your concern. From your description I think you are suffering from viral fever. First, 37.5 degree Celsius temperature is within normal range for an adult. So there is nothing to worry about it. Your temperature is in control. Tiredness and sleepiness is because of viral fever itself. You should .  Fresh fruits and juice are advisable. Have adequate rest and diet. There may be some feeling of anorexia. Try to divide your meals in small fractions to have enough nutrition. Further management if any needed, will be initiated by your physician after results of blood reports. Hope my answer has solved your query. Take Care. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have 3 little white bumps on my clitorius their very sore and swollen.i don t know if it could be from using my vibrator too much or if it s a pimple. I get check yearly for stds and only have had one partner for a long time so I know it s not an std. I ve been putting a warm compress and neosporane on the area but it s still sore. ### REPLY: Hello, Welcome to , Your history and symptoms seem to be Candidiasis of the genital region. First some general precautions should be followed 1. Wear cotton clothes and undergarments in order to reduce the sweating. 2. Do not apply any kind of oils / moisturizing lotion over the affected area .3. Just give warm saline compresses over the affected area twice a day and then apply an antifungal cream. 4. Something like clotrimazole cream helps in most cases. You need to take oral antifungals 2 weeks. In case of severe itching, take some antihistamine once a day. If inspire of the above measures, the lesions continue to persist or increase, then you might have to see a dermatologist for proper assessment and management. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 56 yr old female, who for the past 7 years, at times upon risingto my feet from a sitting or lying position my arms and legs shake involuntarily for a brief period of time. I have to sit down or hold on to something or somebody, or I will fall down to the ground before it stops. Sometimes I can t control my bladder. I have been checked for MS, but a local Neurologist could not find the cause. I do not black out and arms and legs are the only part of my body that shakes. It is visible by other people, and it is a jerking not a tremor. I have a referral to have a complete neuro evaluation at Mayo in Jacksonville FL. What do you think? My carotids are clear and a cardiologist has completed a complete cardiac evaluation and he is the physician that has referred me for a complete neuro eval. ### REPLY: A neurologist does MRI spine, neck and back for spinal cord diseases causing it. Other tests are neurologic physiological tests for muscles nerves transmission or electrophysiology studies for peripheral nerves implications. An endocrinologist or a physician for thyroid function tests, diabetes rule out. Symptomatic medicines are there to control tremors, which a neurologist can prescribe, levodopa or mirage, methycobalamin are few such medications ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am an XXXXX and one of my members is a 66 yr. old s/p brain surgery for a benign angioma with a metal plate in her head since 9/22/10. C/o daily pain- feels like a hat too tight on her head, can t really take aleeve, tyleno etc., CAUSES KIDNEY AND LIVER PROBLEMS. WAS WONDERING IF ACCUPUNCTURE, HOLISTIC THERPIES OF ANY KIND, HOMEOPATHIC THERAPIES WOULD HELP HER ??? SHE LIVES IN XXX ### REPLY: 1. It's been approx.2 years since he was operated, so in between when did the symptoms re-surfaced?2. Any visual disturbances, nausea, vomiting?3. Was regular follow up done with your health care provider, and were there any blaming signs he/she noticed?4. Alive (naproxen) and Tylenol (acetaminophen) are given to reduce inflammation, pain,headache and muscle pains, so what type of kidney and liver problems are you talking about, were any TESTS done for the same?5. Consult with a euro surgeon about the same, whether it's a false (phantom) headache or something serious. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, We had a baby who had conginetal heart problem(pulmonary venous Stenosis) and all docs said there is no cure. In sep he underwent a repair surgery at Narayana Hrudayala and became ok . but due to infection we lost him in october. now the question is, would this be a problem for next child birth? My wife had 3 abortions prior to that pregnancy which were lasting only for 2 weeks. We underwent chromosomal test which was normal and normal count. we are planning for our next child and we are in great tension thinking if the next child will have some problem due to this. Please tell us what to be done. ### REPLY: HI, Thanks for the query. I have read your query carefully & understood your concern.  Congenital heart problems arise due to various causes like genetic (as you have already done both of your chromosomal analysis. The risk is lesser). If there is family history of such problem in both of your families. The possibility has to be checked in fetus / viral infection, rubella infection of mother in first 3 months of pregnancy/ Type one or two diabetes in mother/ mother taking alcohol/ Taking certain . . During pregnancy can affect heart development in fetus.  * While planning for child you should keep in mind the risk factors & prevent them as per possibility. Taking anti Rubella vaccine 6 months before pregnancy is advised.  * Be in regular touch with treating gynecologist when she is pregnant. Pregnancy fetal abnormality scan (in 5th month)/ triple guard test/ chromosomal analysis are few investigations which can indicate fetal abnormality ... if diagnosed in time necessary action can be taken in time.  Hope, this helps you in planning. BE careful & observant. Instead of being scared & stressed. This will definitely give you positive results.  Thanks, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Do you take multiple chemical sensitivities seriously and understand how debilitating fragrance chemicals are? Do you think there is always an under-lying cause for scent sensitivity/allergy (yes, I have allergic reactions to dryer sheets like Bounce and Scent Boosters)ie rash hot prickly skin, swelling of tongue, extreme thirst... do you think (my) immune system was already compromised or do you think the neurotoxic petro chemicals in fragrance products alone can cut a person s life down to the knees overnight? ### REPLY: It's a very good question and thousands of people who read it, I fact, can reap the benefits out of suggestions given herein, based on the principles of Ayurveda - the nascent science of life.First there is a principle cited in Ayurveda about how to prevent/ cure a disease. Its NIDAANPARIVARJAN (in Sanskrit language) which literally means avoidance of the cause. Now, in many cases people are not able to change jobs or circumstances are such that they have to remain in such conditions. Here comes the principle of PRAANVAYU (richness of oxygen and fresh air) that is achieved by rhythms of deep breathing exercises called PRAANAYAM. Indias Yoga has spread to the World and people who are aware are enjoying the benefits. It enhances immunity, gives strength to fight allergens and extends life as also betters quality of life. Then there are herbs to naturally support the fight of body against allergens. Simple herbs like Turmeric, Need, Manisha, Gilroy, Quasi (Holy basil) etc. not only counter allergens but detoxifies the blood and also raise natural immunity. The hitch among beginners is its slow pace of action. Yes naturals are slow as compared to man made synthetic and toxic medicines but then what advantage has these fast .  No doubt modern synthetics have won in emergency situations and saved lives. But lifestyle disorders and the one you are suffering from needs naturals to support you. These do not have side effects, no interaction with  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dr. my 10 months old baby often get cough and cold after every 10 days, which leads to chest conjunction. due to which is is unable to eat any thing, moment he eats his food he starts coughing and vomits out all the food. tried various medicines like Tminic, Airomal, Nebulising him 2wice with Duolin. Its been 2 weeks now his cough is not getting cured. Pls help ### REPLY: Hello, What are you feeding your baby cows milk, formulas or homemade food? Some babies are allergic to cows milk which results in episodes of coughing, sneezing, rash, etc. As your baby is having repeated episodes of coughing, nasal congestion, chest congestion, etc., there is possibility of allergies either to food or dust, etc. However, it is better to consult your doctor and ask for investigations like x-ray chest, CBC. If baby is also having fever, you may also ask your pediatrician for a course of antibiotics. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When I attempt to read an article, sentence or book I have to repeatedly go back an read sentences that I have allready read and feel I have trouble keeping a sequence in thought.  Could this be a symptom of attention deficit? ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. Yes it could be a symptom of attention deficit. Mostly these symptoms are present since childhood. There is a variant of ADHD where in the hyperactivity component is not significant. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi SirMy right is paining from last one week and moreover today it is gaining much pain and ticking and tingling in palm, fingers especially when I rest my hand on chair bar. What would be the reason for this sir. very little numbness of three fingers also started three months back in the same hand. ### REPLY: Hi. The reason is neural irritation from your neck.this could happen due to various reasons. Overuse.postural issue of neck...facet joint irritation...etc... I would suggest you to initially ice up your neck frequently...15 mins possibly once in every 2 hours.keep your neck supported properly...while sleeping. Keep your neck supported with a cervical collar-- soft collar... Condition will improve.once the pain and tingling sensation comes down then I should start with neck rehabilitation exercises like. Neck retraction . Shoulder shrugs...resisted neck extension...like keep your hands clasped behind the neck.press your hand towards head and head should be pressed against the hands.the position is maintained for 30 secs.same can be done sideways while hands kept head above your ear... Hope this is helpful. Please revert in case you need any clarification ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Good Evening I have speech problem while speaking in group. When i am speaking the same word alone i can speak clearly, but when i speak using same words in a group i can not speak, no matter how much i try. Also i feel very tense at that time. The particular words like agglomerates, employer, employee, h1b, extenisvely etc. Kindly help how to improve on these because this matter affect a lot to my professional carrieer ### REPLY: Hi welcome to ChatDoctorI have gone through your query regarding your concern about speech problem. It is not a big problem. Speech disorders occur when an individual has difficulty communicating through speech. Patients may have difficulty pronouncing sounds, talking in a fluent rhythm, or have abnormalities in the pitch, quality, or volume of speech. Speech disorders may be serious, minor, temporary, or permanent. It is a psychological problem and if try sincerely you can overcome this. Due to some reason or the other you have lost confidence. You introspect your self and find the cause and try to remove that cause. You should not care what people think about you. Furthermore, you just move on to excel forward. Try on to improve. One day you will win, there is no doubt about As you must be aware, body and mind depend on each other. Our mental health depends on health of our body. If our body is healthy only then our brain can work well, we can think properly. Our speech is also part of our mind.  & Take care of your physical health, regular exercise yoga , Panama and rest. It will enhance grace to your personality.  Intake of Proper balanced diet - fiber, fruit, green leafy veges ginger, garlic, in raw form, Diet with essential nutrients - may include vitamins, minerals, herbs, amino acids &.antioxidants which is taken regularly, tend to increase resistance to body from diseases giving strength to immune system will lead to healthy successful life ahead . Avoid fried fast foods, tea coffee alcohol, mental worry anger and constipation Last but not the least, I suggest you to consult a speech therapist, He may be helpful in your problem. Hope this helps in your query. Take care All the Westmont hesitate for further query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Abd pain upper center between ribs radiates to rt upper quadrant and though to back. Have seen GI Dr and hida scan, which was normal. They have me take 1 gas X each morning. It lasts about 24 hrs then gradually gets better. I have been to ER several times for extreme pain. It s been occurring about once a month. No vomiting,diarrhea or constipation. Lab work normal except liver enzymes were slightly elevated. ### REPLY: HI. The cause of such a pain in upper center of the abdomen which radiates to back can be either due to gastric ulcer or cancer or pancreatitis. I would advise you to first get your Upper GI Endoscopy and ultrasonography of the abdomen and serum amylase and lipase, EKG to rule out refereed cardiac pain. This will help to get a proper diagnosis to get a proper treatment. Repeat the liver function tests to see the changes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i am 35..at present studing for my higher ranks..some days back some one suggest me to take rericap tablets to increase the memory...since due to age i cannot remenber much what i read. so should i take rericap tablets..if yes then how much in a day. ### REPLY: Hi, Radical is a formulation of a medication produced by BAFA Pharma in India.  It contains Calcium Citrate, Iron 50 mg, and Folic Acid 0.3 mg.  It is indicated for use in lactating women as well as those women who have anemia while pregnant.  I can see where someone may believe this to be a MEMORY supplement because of the folic acid element and possibly iron.  I would caution you not to take too many of these capsules daily due to the iron content as this could change your bowel habits, and you may become constipated.  The calcium citrate can also cause side effects that are not pleasant if taken in excessive doses.  If you feel your memory is not functioning at peak performance there may be a better solution than to take something like Radicals though this appears to be relatively safe if taken as directed by a physician. Otherwise, see a doctor who can evaluate you for more specific causes of cognitive/memory dysfunction such as B12 or vitamin D deficiencies, underperforming thyroid gland, as well as other hormonal imbalances). Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had pain in lower left area below breasts...it feels as if its under the rib cage..the pain is also traveled to the right side.i experience shortness of breath, stabbing with unbearable pain,chills, sweats, spasms in the areas of pain which also travel to the back. Wheezing with a whistle sound. What could this be? I honestly feel like I am dying..doctors thought it was intestinal problems but all test have came back fine. My original ct scan said that ther was a thickening of the walls..what walls I do not know. The inflammation was shown to go under the breast across as well as down both sides ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. In my opinion you are having bronchitis. Your symptoms like cough, wheezing and shortness of breath are seen in bronchitis. And the thing you are mentioning "wall thickness" is seen in bronchitis. The bronchial walls are edematous and appears thickened. So better to consult pulmonologist and get done1. Clinical examination of respiratory system. 2. PUT (pulmonary function test). PFT will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and antihistamine .  So consult pulmonologist and first diagnose yourself and then start appropriate treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just got all 4 of my wisdom teeth pulled today and I experienced some bleeding around 7 hours post-op. The blood did stop after applying gauze for an expended amount of time along with ice. I do I have some skin in my mouth, most likely a clot, that is just hanging in there. How long until it dissolves?Coll ### REPLY: Hi. Thanks for the query. Well, skin hanging inside mouth and to know what exactly it is first I would like to know the exact site where it is present. Is it hanging out from extraction socket or is it protruding from mucosa of the cheek. If it is hanging from extraction socket then it can be most probably the healing tissue or the blood clot that might be dislodged. If it is from the cheek mucosa then it can be probably a fibrous tissue overgrowth or fibrous. So to pinpoint the exact cause and suggest treatment this information is a must. Please provide the following information so that I can guide you accordingly. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have hematospermia after a heavy night of drinking. I also drink protein shakes and creatine, but make sure to drink lots of water/orange juice as well. The first time it was mostly dark red, but the second time it was a bit brownish. No pain and urine is clear. ### REPLY: Good Day, and thank you for being with  ! How old are you? If you are more than 45 years of age I would suggest having your Prostate checked to rule out cancer that may have caused your Hematospermia.Otherwise, if you are still young then majority of the Hematospermia are usually self-limiting and caused by inflammation. It will go away on its own in a few days without treatment and is not a cause of worry. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.ChatDoctor .com/doctors/ .  Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, as i am drifting off to sleep I get a weird sensation as if my breathing has stopped and i wake up and gasp for  breath this has been happening for several weeks. they were initiallly terrifying but i then diagnosed myself with sleep panic as it was the only thing that described the sensationhowever the "attacks" keep happening and there is no obvious anxiety before they have gotten increasingly worse this week happening lik 10 times in a row is it potentially something more serious? ### REPLY: Hello dear, welcome to .come have evaluated your query thoroughly.* Suggestions for better recovery-Maintain HY . - Avoid smoking, alcohol if using.- Avoid stress with help of various meditation techniques.- Walking in fresh air, exercises, YOGA, deep breathing techniques are vital things to recover early.- Avoid late night parties, dinner, watching horror movies or else. Hope this will help you for sure. Wishing you fine recovery. Regards dear take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am diagonised with Dermatomyositis (DM) , taking streoids 30 mg ( prednisolone ) for 6 weeks . Now iam in 20 mg dosage past 1 week. My general physician would bring down the dosage to 5mg (0r) 7.5 mg shortly. My CPK is at 50 , ESR is 30 , LDH - 209 , SGOT -27, SGPT-50 . Only ESR is alone above the range . I am not diabetic , after taking this streoid my fasting sugar increased to 141. Kindly advise , how to bring down ESR count . Blood sugar is because of Streoid . regards AAAA ### REPLY: Hi, Welcome to ChatDoctorYou are taking steroids for connective tissue disorder namely Dermatomysitis, You are in a phase where dose of steroid is being tapered. I presume your disease must be in control as far as ESR is concerned please do not worry it is a marker of inflammatory state and has prognostic value that means if it shows continuous declining readings the disease is improving. Your Fasting blood sugar may be due to steroids as they are known to increase blood sugar but keep a watch as your dose is reduced,In the meantime take diabetic diet and walk regularly if you can. Once your steroids are tapered off recheck FBS and PPBS after 15 days to make sure you are not diabetic, may also get HBA1c to know status of blood sugar in the past. Please take care Good Luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has been experiencing bilateral generalized ligamental joint pain and stiffness lupus and ANA negative . The best way he describes it, is that it just hurts, even to get out of bed and get dressed in the morning. These symptoms have just occurred over the past 6-8 weeks or so. He gets some relief with NSAIDS but not entirely. He complains of a lot of his discomfort in his hips and in the groin area. ### REPLY: Hi, thank-you for providing the brief history of your husband. As he has a pain, and on medication, which helps him to get ease of pain, he should try undergoing physical therapy for strengthening the muscles and a non-invasive way of handling pain by Therapeutic ultrasound therapy and TENS therapy. Usually patients in my clinic respond well once the physical therapy is initiated and muscles are Strengthened. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been through chemo the last year. Have finished 1 1/2 months ago. Doctors had taken me off all meds in the beginning. Reintroduced me to one high blood pressure 3 months ago. Sugar levels started rising again, so they said I needed to go back on Metformin. Did that about 20 days ago. At this time, I went yo the gym twice and worked out on machines maybe too hard, but on machine I felt were fairly safe and would t hurt me. My muscles started started tightening up on my whole body and kept tightening, like torquing, to excruciating pain with 7-9 days. I used to take 200 mg of Metformin a day before the cancer, so when I started again, I took only 1000 mg. When my body was torquing me so bad I cut it to 500 mg. I also took 10 mg of baking soda as I sensed I was acidosis, and the next day, I took no Metformin because I just was in too much pain, but I took 30 mg of baking soda to try to turn by body alkaline. I was in so much pain through my lower back, hips, all side of my legs, knees, lower calves, a little torguing in my arms and hands with elbow and knees burning. I ended up in Emergency at the hospital. They did several blood test, and no, I didn t have Lactic Acidosis. They felt that maybe the baking soda had made my ph normal. I left the hospital with all the pain. Suffering one week until I see a doctor, they also did test, everything came up normal including Vit. D. So I at a loss, I take Actaminophen 325 mg. Either two of these or one of these and one Advil, but I also have to take one Oxyecotden? (I take 3/4 of one pill) to finally cut into the pain to make it bearable. Doctors have no answers. They say do I want to make an appt with them or not. Their suggestion is to up my Gabapenton ( nueropathy in my feet and ankles from the chemo). That is their answer to my overall pain going on in my body. I also want to mention I was only a lot of homeopathic tablets which I went of when my muscles were torquing so bad and have no been on them for over a week. I also tested the one high blood pressure med, Lozartan. I went off for one day just testing that, and no all the pain was still there, so I went back on because I know I need to be on that. And so there is my problem. ### REPLY: Hello, Possibilities of your aches are post chemo break down of muscles. Restart of exercise usually leads to aches and pains. Metformin may aggravate acidosis caused by reintroduction of exercise. You will have to get pH when you are off the baking soda. Get CPK levels done for muscle break down and readings of blood sugars should be from 80 to 140. I think these steps will improve your aches. Meanwhile, you take help from paracetamol 1g thrice a day. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: most morning when i wake up i cant fell my legs as they are numb and have constant pins and needles , i also get bad pains within the joints , legs ankle fingers and hips , i keep getting sick when i eat and its been going on for a long time now but seems to be getting worse . any help would be much aprrcieated ### REPLY: Hello, Have u met any accident or fell down before? It seems to me there is nerve compression over lumbar region or sciatica pain.in sciatica, the pain with low back referred to lower limb with foot ankle and thigh and sometimes along with numbness and tingling sen sating whole lower limb due to nerve compression. There are many other causes of nerve compression or tingling sensation as lumbar stenosis, fracture,lumbar radiculopathy, herniated disc, diabetes,nerve root injury. Usually, the non-surgical treatment for the lumbar radiculopathy or sciatica are physical therapy, massage,acupuncture, medicines and some spinal injections. You can take hot/cold therapy, apply ice packs or hot water fomentation either therapy is convenient for you for 20 mins. Take massage therapy. Take medicines as ibuprofen or naproxen which reduces the pain with spasm. Avoid long sitting or standing, avoid forward bending or heavy weight lifting these can aggregate the pain. Although you don't get the relief get MRI or X-ray. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father is a kidney patient. his creatine level was maintaining consistently around 2.7. But from last two month, level increased to 3.5. he is taking nephrosave as medicine including medicines like amtas 50,moxovas. From one week his health condition has been detoriated drastically, he is not able to walk at his own. please suggest for improvement if possible. Age is 80 years approx. ### REPLY: Welcome to . I am . My pleasure to help you. Norma Cretonne value is 0.7 to 1.3 mg/DL. Your father creatinine level is high. Your treating doctor is giving correct medicine. But even after proper treatment Creatinine value can increase. You have to give him strictly renal diet. Strictly avoid fruits. Repeat creatinine level twice in a week and if not increases then once in a week. Because if persistently increases and condition deteriorated then dialysis all be required. Thanx. Keep in touch. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I  have very low antibodies to hep b and I have never gotten the vaccine. Does this mean I have chronic hep b or am I a carrier???? Iam so scared. Everyone explains this differently. Does having very low antibodies,2.8 mIU/mL,mean that I have chronic hep b?? ### REPLY: Hi thanks for asking question. Your doubt us obvious. But here if you provide full report then I can give still more comment... First you have not vaccinated. So here you have form protective antibody after getting infection. Usually after resolving acute infection protective antibody remain for long time.... And here HBV DNA, Bag result needed... If Bag also positive then chance of chronic infection .... You can follow up with full report of viral marker to gastroenterologist. Happy to help you further. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was released from the hospital yesterday for dizzy spell and nausea. The test results I just looked at said there are streak nodular opacity in my right lung? What does this mean, is it damage from radiation therapy? And why didn t the hospital doctors mention it ### REPLY: Thanks for your question on . There are many possibilities in your case as you are cancer patient and taking radiotherapy.1. Radiation pneumonitis. 2. Infective etiology3. Malignant spread itself. In my opinion it seems radiation pneumonitis more. As it is seen immediately after radiotherapy due to inflammation in lung. Since your lung defense has been lowered possibility of infection is always there. So better to undergo CT Thorax and if needed bronchoscopy and BAD (BronchoAlveolar Lavage) analysis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 10 yr.old that has had fever for 1 week,was diagnosed with strep given a antibiotic was fine for a week and again got 101 to 104 temp again, was said it was sinus and given antibotic again, after 1 day of no antibiotic again has 104 temp. What can this be? ### REPLY: Hi... by what you say I feel that your child is going through a recurrent viral illness. I will explain to you how a viral illness behaves so that you can be more confident. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 8 year old son has had some swollen lymph nodes. he has no other symptoms. He had a physical by his pediciatrian and she found some more. Thought it was viral and did some blood work. negative mono negative EBV. High lymphocytes, low MPV, low nuetrphils, low monocytes. he has a biopsy schedule. Could it be something serious with out any other symptoms? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He has enlarged lymph node. It can be due to reactive hyperplasia due to some infection other than infectious mononucleosis, or it can be due to tuberculosis or lymphoma. It is possible that without symptoms he may have any of these conditions. So go for biopsy. It will give you exact diagnosis. Then he should take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my wife check the pregnancy kit and found that she is pregnant. She taken some atibiotic drugs in this period of pregnacy because she don t konw that she is got pregnant it is now 15 days form ovulation[The doctor prescribed the atibiotics asked her that whether she is pregnant on consultation and she told that she she is not pregneant]. Is this will affect badly to the fetus? ### REPLY: Hello, and I hope I can help you today. Many women accidentally ingest medications or alcohol before they find out that they are pregnant. However, there is no fetus that even develops before the 7th week or so, so the effects of medications on a developing fetus would not yet be able to pose any harm to the pregnancy. Furthermore, there are only a few, very strong IV antibiotics that can actually cause significant harm to a developing fetus.  So it is unlikely that the antibiotic that your wife was taking was even unsafe during pregnancy.  Asking whether a woman is pregnant when prescribing medication is a common routine practice and does not mean that the medication prescribed is in any way. So in summary, I do not think you need to be worried about the medication your wife took in this very early stage.  To enhance the health of her pregnancy, she should follow a well-balanced diet, avoid alcohol, and begin to take a vitamin supplement designed for pregnant women.  Your should also choose a prenatal care provider for her and have your first visit about a month from now. I hope I was able to adequate;y answer your question today, and that my advice was reassuring. Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 3 weeks ago i had a high fever for 2 days, bad cough and weezing. the cough is still bad. no mucus just a really hard dry cough. i ve tried suppressants expectorants otc .no releaf. what should my doctor prescribe?i even need to use adult diapers now because of the violent coughing. ### REPLY: Hello, As per your clinical history is concerned, please follow like this:1) Do a clinical examination by your treating Doctor and do blood differentials count to know the exact cause.2) Discuss with your Doctor about [codeine phosphate] for a cough. Do follow lifestyle modifications like this:1) Try to wash your hands. Thorough and frequent hand-washing is an effective way to prevent many common infections. Or use alcohol-based hand sanitizers if soap and water aren't readily available.2) Cover your mouth and nose when you sneeze or a cough. To avoid contaminating your hands, cough or sneeze into a tissue. Do gargle with warm saline every 3 hours.3) Try to avoid crowds and use a mask when you go outside. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have an infant duaghter on amoxicillin for an ear infection. When she sweats and touches my skin I get hives in that spot.  She also smells different at this time, which I expected. I havent changed anything else in my life, but my whole face has hives right now.  I am allergic to sulfas, and my mother said I had a reaction once to penicillin, and had red dots all over, but I dont have it listed as an allergy. ### REPLY: Hello, I understand your concern. I am , infectious disease specialist, answering your concern. Your reaction is because of allergy reaction you are having. I suggest you to take cetirizine and prednisolone tablet under your doctors guidance. This . If you are getting allergy because of this than you should avoid touching the person who has taken the sulfa and penicillin group of  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i had my gallbladder removed September 2014. For about a year now i have constant dull ache (like a toothache ) that is located around the left rib cage area. I also have acid reflux and wondered if this would cause this constant pain. I take one omeprazole 20g once a day and paracetamol every fours hours. The pain is worse whenn lying down, but even through the day, it is still there. I had an mrcp, as at the pre op assessment, my blood test result showed minor abnormalities, but the mrcp came back normal. I have had an abdominal ultrasound which was normal (only showed the gallstones ) hence the gallbladder removal. My gp advised this pain is normal with acid reflux (i don t get any other acid reflux symptoms, other than this pain). Please help/advise. Sally johnson, aged 52 ### REPLY: Hi there. Yes, You seem to be suffering from Acid reflux. Avoid consuming hot, spicy, hard food and fluids. Avoid colas, coffee, alcohol, smoking. Avoid lying down for at least half an hour after food or fluid consumption. Consume curds, plenty of fresh fruits and vegetables, plenty of water. Get an upper GI endoscopy to confirm gastritis or ulcer due to acid reflux to get the best treatment as necessary. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: a 54 year old women has hepatitis b positive, she had liver function test and the results were : ALT=34.3 u/l AST=25 alkaline phosphatase=406 so what would you reccomend? ### REPLY: HELLO & WELCOME TO  FORUM MOHAVE NOT MENTIONED ANY SYMPTOMSREGARDING LIVER DISEASE:YELLOW Color OF CLERK/ URINE, ASCITES, VOMITING, ABDOMINAL PAIN, LOSS OF APPETITE REGARDING SEPT/ SEPT LEVEL : YOU SHOULD REPEAT THIS TEST FOR THE COMING SIX MONTHS IF THIS Persists >19 AND IF SEPT/GOT LEVEL WILL RISE AND CROSS 38 THEN IT INDICATES PERSISTENT LIVER INJURY, TREATMENT IS MUST AND YOU SHOULD CONSIDER ANTIVIRAL MEDICINES. MOST OF THE LABORATORY AND DOCTOR CONSIDERS GOT/SEPT UNTO 100 NORMAL BUT THIS IS MISNOMER AND YOU SHOULD CONSIDER TREATMENT ONCE SEPT/ GOT >38. ALPINE PHOSPHATASE IS RAISED AND WITHOUT ANY OTHER INFORMATION, VERY DIFFICULT TO COMMENT. ALKALINE PHOSPHATASE MAY BE ELEVATED IN OTHER ORGAN DISEASE ALSO. TAKE CARE & GET WELL SOON .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: iam in my infertility treament and HSG report says that features suggestive of mild d extrorated uterus.Bilateral block(?Temporary)at fimbria.what does it mean I also have chocolate cysts in my left ovary . what treatment should i take to get pregnant.i am 31 years old.Is there any chances of getting pregnancy.suggest me any hospital which is in india near to tirupati ### REPLY: Cellophane you for your query. The HSG report says that your uterus is mildly deviated to the right, which is of no issue for conception.The fibrin, that is the distal end of the tube is blocked.HSG cannot determine the cause of block.Chocolate cysts in ovary means that you are having endometriosis, in which there is collection of old menstrual blood within the ovaries, forming cysts and leading to adhesions, tubal blockage, destruction of ovarian normal function and hence infertility. Please consult a leading infertility specialist in your area for detailed workup.Your ovarian reserve needs to be checked. You require a laparoscopy to confirm tubal blockage and if possible have surgery to open the blocked tuberous partners semen analysis is a must. Go through this link and choose a relevant hospital based on local reviews :http://www.justdial.com/Tirupati/Infertility-Clinics/ct-10265454 Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m on 5mg of Coumadin for DVT. I recently had an Echo and it showed slight calcification of aortic valve, so should I be on Vitamin K2 and if so how much and I have read it should be MK4 not MK7? Is this true, K1 thins the blood and should not be used with Coumadin, but MK4 has nothing to do with blood thinning, but only with calcium regulation? ### REPLY: No form for vitamin should be taken while you are on Coumadin analogue.  Also, the calcification on aortic valve is age related degeneration and no studies throughout Europe, America or Asia, have found it to reverse with vitamin K analogue, it's a fad and not backed by scientific data, so as a cardiologist I would ask you to refrain from it, as there is no evident benefit, and in your case it can harm.  Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed for Disc prolapse on L 6-7 left shoulder and left arm pain for the last 1.5 months. I was treated with pain killers and now been asked to do neck exercises. At the begnning situation was improved and I started the neck Exercise. When I do the exercise I expereince pain which I didnt have for the last couple of days. When I consulted the doctor he advised to take Dicloran 75Mg for one week to manage the pain during the exercise. Is pain is natural during exercise? Please advise. Thank you. The diagnosis of MRI Loss of cervical lordosis Left paracentral extrusion of C6-7 disc with nerve root compression Right Paracenral bulge of C5-6 disc with nerve root compression ### REPLY: Hi, I understand your concern. Physiotherapy is one of the treatment options available in the treatment of cervical disc prolapse. Here pain reduction occurs gradually; however if the pain is immense it is advisable to avoid those.  In these circumstances, if I were to be your treating doctor, I would suggest you to continue the analgesics prescribed to you along with warm compresses. We can hold the physiotherapy till pain reduces. Restart it slowly after pain reduction.  Discuss this with your treating doctor. Hope this helps. Regards ### END