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 Juneil and Im 17 years old. Ive been dipping for 10 years now, but I had a unusual small circles on my gums, why is that? I doubt think its mouth cancer, cause I take really good care of my teeth, and brush em 2 times a day. Please contact me back, and thank you so much ### REPLY: Hello, Thanks for consulting , Read your query, as you feel of small circle on your gum don't worry this is not mouth cancer it can be inflammation in gum due to localized enlargement of gingival, infection in tooth due to caries secondary to Periapical abscess, or localized inflammation of periodontal ligament secondary to Periodontal Abscess. I will suggest you to consult your dentist for examination and evaluation of gums and rule out the cause of circle in gum, in meanwhile do warm saline rinses, maintain proper oral hygiene, use regularly mouthwash. Hope this will help 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: My 5 month old baby began having frequent (8-10 per day) green mucousy bowel movements for about 1 week. He is exclusively breastfed and has been taking rice cereal for about 3 weeks. He has no fever, is happy and content and is not dehydrated (he is drooling a lot and has tears)...he is also teething (he got his first 2 bottom teeth last month). Today, his bowel movements went from being green and mucousy to a mustard yellow colour but very runny/watery. What does this mean? Could this be a virus that he is getting over and the bowel movements are returning to normal. He usually has 1-2 mustard yellow curdy bowel movements with some seeds per day - normal for breastfed babies. ### REPLY: Hi, Welcome to , More than the color, it's the consistency that worries me. Especially if the baby was started on top feeds, so there is a possibility of infection in gut which can be due to hygiene feed or may be just a viral gastroenteritis. Good thing is that this can be managed very easily by you by making sure you keep giving adequate milk and liquids orally. ORS is a good substitute to prevent deny .  Watch for any blood in stools. If yes, then need to see a doctor and start antibiotics. Make sure child is active and feeding well and no evidence of deny ### 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 a problem with all food suddenly tasting horrible. Even when I breathe through my mouth, the air tastes weird, a bit metallic, and yesterday I could not eat a mildly peppered clear soup because to me it tasted extremely spicy. I had a salmon burger the night before that tasted like mold. That was the first thing I noticed, but I ignored it then. Milk tastes like chemicals. Water tastes strange too. Tried to eat some fried vegetables, those did not taste right either. Bread and butter is tolerable, but I can t keep eating just that. I heard that this can be related to dental problems. My gums have been bleeding a LOT worse than usual lately. ### REPLY: Hello, Thank you for consulting with . This kind of taste alterations are observed when there is some kind of disease in the mouth for example Red or White lesion, which might occur because of some immune problem or habit of smoking or tobacco chewing. So better that once you should visit a dentist for proper examination of oral cavity and get it treated. The bleeding of gums can occur because of infection of gums called as gingivitis for which you have to get complete cleaning of tooth and gums done with dentist. Hope it will help 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: Ive been having rumbling and almost like a pulse feeling below my sternum for 3 days now. Also had pressure on my chest last night whuch lead to an anxiety feeling. Ive looked up the symptoms and have seen identical symptoms but no answers. The rumble and pulse feeling is very consistant and I can feel it with my finger even. Any help would be great. Thank you. ### REPLY: Hello, You should get an ultrasound abdomen, plus an ECG. These two will help in ruling out any cardiac problem and if there is any vessel or organ involved in epigastric region (below sternum). If these two are normal, this is most likely to be either anxiety or gastritis. Further management would depend on the reports. Please get the above-mentioned test as first and foremost we need to rule out cardiac problem. Anxiety can be helped with .  Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi.. dr.samuel i am from india. i am suffering from jaundice and typoid from the last 10 days.and my serum bilirubin levels are total-1.8 on december 01 and 1.1 now(total) and my typoid fever levels are o-1/80 and h-1/40 i think i recovered.. but i am very much scared about what could be the reason for my sickness.. please him me. thankyou ### REPLY: Hi, Thanks for posting your query. Typhoid fever is due to salmonella infection and gall bladder is the site of continuous source of infection in chronic carriers. Slight derangement in liver function test may occur in typhoid fever. Treatment of typhoid fever also cures abnormality in liver function test. Now your LFT is also normal and you don't need to scared. You should again go for LFT and tidal est after 2 weeks for detection of status. 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: Will valium become more effective over time? I know it is supposed to work instantly, yet I have been going up and down on doses for a few weeks now as I dont want to be on them.  I do ok taking 5mg at night for a week, and then try to stop, or lower the dose, and end up a few days later needing 20mg just to stop a night time anxiety attack. Then I drop back to the 5mg for awhile do ok for a week, and again try to lower or stop...and the cycle continues.  Is it better to just keep taking it at 5mg daily no matter what and leave it alone for awhile...husband and some web sites say that valium will become more effective if I take it daily to build up the same level in my body. ### REPLY: HI, thanks for using . You have not mentioned why you are taking Valium. Valium is diazepam, benzodiazepine in nature. It is used for sleep mainly associated with primary .  For a short term it may be used for anxiety. Valium is having addictive properties. As you go on increasing, you require higher dose of it. Rather than doing self-medication, You should consult psychiatrist for detailed evaluation and treatment. Valium use should be restricted only as and when required basis only. Meanwhile you can try stress management and relaxation techniques like yoga and meditation for better sleep and relaxation. 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, I am taking a generic birth control pill of Necon and it is called Cyclafem and it is 1-35-28. I was prescribed this on the 12th of July and I have been bleeding every day since then. It is sometimes a light bleeding such as spotting, but in some cases it gets a little heavier. I had switched my last birth control before this and have also upgraded this medication because of the same issue. At times it is a brown discharge but than at times it is red. I am getting irritated having to wear something everyday. ### REPLY: Hiiii, Welcome to . You have taking CYCLAMEN 1-35-28 birth control pill from 12th July. Now suffering from continuous spotting or heavy bleeding. It is due to side effect of the pill or other uterine pathology. So I advise you to do a USG Pelvis to rule out underlying uterine pathology. If no abnormality is detected, then change your OCP to NOVEL ON or FELON or anything suited for you. If pathology is there, consult your doctor for further treatment. 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: my 10 year old son had a lipoma removed 2 months ago, on his right leg, just below the knee. it was benign. the scar has healed perfectly, but i can feel a small lump under the scar line.  i was hoping never to feel a lump there again, as i was worried for so long. what is this lump? ### REPLY: Hi, Dear I studied your query in all it details and I understood your concerns. Cause and Remedy - On whatever limited facts given from you about the lump under the scar, it seems to be resolving post-surgical left out hematoma with progressive fibrosis.Hence, To reduce your worry Please consult for opinion from ER Surgeon. Plz hit thanks and write excellent Reviews if this would resolve your query. Plz don't worry and do Welcome for any further query in this regard to me. Have a Good Day. . N. ### 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: Dear Sir,I am in my late 30s and also an asthma patient. I have been trying to conceive for the last 2 years but in vain. Could you suggest me if taking Nutrilte tri-iron Folic help me in conceiving or does it have any side effects on my asthma problem.Thanks. ### REPLY: Hello, Welcome to , The iron folic acid supplement increases Hemoglobin (He) content, it has got no role in becoming pregnant, but it is very essential in pregnant women.  Normally these food supplements are known to be good for health but at times in certain type of patient it may have its side effect. This completely depends on the immune system of the patient and his allergic history. If any individual is allergic to the products of this .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my wife suffering right leg pinching. Due to  compression of the spinal cord or the nerve roots for L4 and L5. we have shown all doctors in bangalore. no use we did MRI scan also. Doctor please advice how we proceed. please let me know which dotor is specilest in banglore ### REPLY: The most common first step to a situation like this is to be SURE...VERY SURE that the MRI scan result is consistent with the location and type of pain your wife is having.  If that is certain then, treatment can begin.  If it's not totally convincing to you or the doctor that the MRI correlates with the symptoms or location of pain then, an EMG study should be performed.  Once you have confirmation that in fact this is the problem to treat the first step should always be PHYSICAL OR AROMATHERAPY.... Water jogging is a terrific exercise to do in a pool for this type of problem.  If however, there is associated WEAKNESS in the foot or leg because of this compression and/or if she is experiencing falls from sudden loss of muscle tone in the leg, ankle, etc. then, surgery should be contemplated.....but see if you can't find someone who is good at MINIMALLY INVASIVE PROCEDURES....or what is also referred to as KEYHOLE surgery for the lumbar spine. ### 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: Experiencing sharp prick pains on left chest area below the nipple. Lasts only a second.Also feel a slighter prick pain on inside left arm above the elbow. Both pains occur a couple times a day. How serious is this?                                Reno Ouellette ### REPLY: HAI, ur pain can be duet gastritis, pain of cervical spondylitis radiating to the arm and chest due to some common nerve supply, or cardiac problems, pleuritic pain .most pricking pains are due to gastritis, u can start with antacids and pantoprazole as a course. Pls go ahead with upper gastrointestinal endoscopy, ECG, Chester, mri neck to rule out any compression. U can meet a physician an .  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: Hi Doctor, i just want to know more about panic attack and how to deal it with it.. I never had this before in my life. But in the past a month seems like ive been a completely different person. So scare of everything, im a bit scare, bit lost.. hope you can help me ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Panic attack (clinical) comes to people with anxiety. Other type of panicky situation like roller coaster ride, comes naturally and should not be worried about. If your panic attack is due to anxiety, you should learn to live and overcome your anxiety. There are certain psychotherapy techniques like desensitization therapy, CBT etc. Please let me know the whole of anxiety and its history. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having pain in my Lowe abs from the left side of my stomach extending it to my lower back. I went in today to see a doctor and he ordered an X-ray,according to him he did not see anything wrong with me but prescribed naproxen to reduce inflammation, I came home with no diagnosis but still in pain. How can you help me? Thanks ### REPLY: Because of the limited information you provided, provisional diagnosis can not be made, if such patient com to my clinic I will anywhere did the pain start and where it goes thesis there any association with Woodrow much it is severe, is it aching dull or sharp painter you feel nauseated. Your bowel habits are normal? Then I would suggestUltrasound abdominal blood countering analysis. It is better to consult general surgeon in your area. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am 19 years old. I got mirena about 2 months ago. And about 2 weeks i started to notice that my urine color started to look dark yellow and has a really bad smell. I do not have pain when i urinate. I don t do any kind of drugs what so ever. What could it be? ### REPLY: Hello, I have gone through your query and understood the concern. From the description you have given, it appears as though you are passing concentrated urine and hence the smell and color. To clarify, you can get a simple urinalysis. This presentation cannot be related to the insertion of the IRENA. The intake of several foods and also mineral and vitamin supplements can give specific color and smell to the urine. You have to increase the intake of water per day to at least 2 liters. If you notice improvement, the cause is obvious. If not, you should check with a specialist for further management. 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 a monthly period for almost 2 months and it wont stop, my o.b. give me primolut that i will take for 7 days. she said after taking it i will have my monthly period and i can start using pills so that my period will get back to regular cycle but, it s my 3rd day after i finished taking primolut until now i dont have my monthly period. i m just worried. is this normal? or could i be pregnant if i have contact with my husband while taking primolut? thank you ### REPLY: Hi, Primolut-N (norethisterone) contains the hormone progesterone which prevents the womb lining from shedding and hence commonly prescribed in the treatment of menstrual disorders such as irregular or painful menstrual periods. Please bear in mind that Primal is not a contraceptive, and cannot be used to prevent pregnancy. It can also be used to postpone or advance the period. After you stop taking Primal, your period is likely to start after two or three days; however, the timescale may be different for every individual. I advise you to wait for five to seven days for your monthly bleed to occur. Then consult your treating bog after getting a home pregnancy test done. 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 am 26 years old weigh 240 lbs and recently had a tb skin test approximately 32 hours ago. About an hour after the injection my arm began to hurt and turn red at the injection sight. Now my arm has a small red spot on it and hurts from my neck to the tips of my fingers and the injection sight is hot like an infection. Is this TB or an allergic reaction. I have three other tests in the past four years and all were negative. ### REPLY: Hello, I read carefully your query and understand your concern. The symptoms seem to be related to a side effect of the injection. I suggest using anti-inflammatory medications such as Acetaminophen to relieve the inflammation. I also suggest using cold compresses for local application. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind 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 a question. i am an adult. i have had orthognathic surgery ..and then a revision of it along with total joint replacement of both tmjs this past july. i am still in braces. when i was a child the orthodontist extracted 4 bicuspids. the orthodontist i have been seeing prior to the most recent surgery..has helped me tremendously by reopening the spaces on the maxilla . i will hav implants when stable. the problem is..that i still feel that i do not have enough space for my tongue . i was okay prior to the 2nd surgery bc the orthodontist pushed the teeth way out..to where they should have been all along. i was told i never needed the extractions..just the surgery. now that the occlusion is back to the proper place..i now feel very crammed with the tongue..especially on the lower palate . my dr is trying to help me keep lips together..et..and tongue to roof of mouth..i am doing this the best i am able..but at times..the tongue literally seems too long. it is uncomfortable..and i am concerned that when the braces come off..i will have problems. i had a long face syndrome..from allergies i guess as child. i have kept in shape..however..my neck posture ..and the entire posture all around is off...and always will be. i dont know if this could be making the tongue posture forward. i just am to the point i am about wanting to have a tongue reduction. is it possible that my palate, upper and lower..are so underdeveloped that the tongue is too large..despite the sugeries. i was concerned of this prior to the 2nd surg..because this was a major problem after the 1st surg...and there was relapse. my oral surgeon is excellent..but he and the orthodontist are so focused on what they specialize in..im not sure they understand..there may indeed be a problem. the only other thing..is that maybe it is swelling...even so...it still extends past the lower arch..when at rest.. they do not want me tongue thrusting..et..or mouth breathing ..so if i keep lips together..et..tongue is crammed. i have had so much surgery..and other things..i just dont know if something rt the surgery is causing this.. i am concerned if i dont do something..i will continue to have problems...my palate is very narrow..despite that they split it..on the last surgery.. ### REPLY: Hello, Firstly, quite a strong person you are. You have had so much in past & still you are standing strong. You might be suffering from macroglossia or pseudomacroglossia due to narrow palate. Please provide some radiographic records so that we can understand the situation in a better way. Consult some other maxillofacial surgeon to have a second opinion. You might need a tongue reduction surgery. I hope this might help you. Please do follow up with the proceedings of your case. Get well soon. 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: My daughter has a bit of discomfort in her left shoulder blade and is home sick because of her asthma. She went to the doctor yesterday and was given steriod, antibiotic and a inhale. She is stressing about the discomfort. Is there anything to worry about? ### REPLY: HI WELCOME TO  I am a pulmonologist and I have gone through your query and will try to answer it your daughter is complaining of pain, discomfort in left shoulder generally asthmatics will have night time cough, shortness of breadth, chest tightness and the required treatment is inhalers depending on the severity we may advise oral steroids and antibiotics after having seen there X-ray and spirometry reports as you are saying of shoulder pain I would advise using some analgesics for pain relief along with your 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 had a chest CT in September 2013 which revealed a 7.5x7mm upper left lung nodule with some stippled calcifications. Dr recommended a repeat scan in 3 months. In December 2013 I had follow up CT which showed it had grown to 9mm with mild dependent atelectasis. Dr then said we would do another scan in 6 months. I am 29 years old and have smoked for 10+ years. I have pain in back and shoulder on left side which led me to the first scan. I also cough up phlegm daily. Dr doesn t seem too concerned based on my age. Is this likely benign (given the growth) or possibly cancerous? Should I push for a pet scan or just the usual ct in a few weeks? ### REPLY: Thanks for your question on . At your age lung malignancy is rare but since you are smoking (more than 10 years), possibility of malignancy can not be rule out. So better to get done follow-up CT scan. Also get done sputum examination for malignant cells. As it can be positive in early stages of cancer. And please quit smoking.  It will only harm your body. And chances of malignancy will be more if you continue smoking.  So better to quit it as soon as possible. ### 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 suffering from acute pain in my muscles of right hand elbow area and shoulders... It has started due to first day of gyming..bt problem is its has been 2 days yet it s not getting normal. It gets increased when I try to change position of my hands. Should i take combiflame or signoflam. Please help me with it. ### REPLY: Non-steroidal anti-inflammatories.signora has more anti-inflammatory effect at low doses. Besides being very effective for this type of pain, the mediators of THIS PAIN (prostaglandins) mediate MUSCLE BREAK DOWN and blocking the prostaglandins not only help pain, but they probably help get better gym effects (ok, this has ONLY been shown in middle-aged people who stop exercising for > 6 months...but still). ### 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 a,m taking my second round of Fluconazole 150mg. I was on heavy antibiotics, 3 shots of Gentamicin and was left with a severe yeast infection.My Dr. sent me 3 more pills to day, to take daily for 3 days, would I be better to wait a few days between? In the past I took one a week. ### REPLY: Hi I do care for your concern. Yes the antifungal tablet can be taken as once a day for three days, you have not mentioned the yeast infection and I do guess it might be less severe so that your doctor prescribed three-day course. Sure it will help you to get rid of yeast infection. You have not mentioned your age and also the reason for which the antibiotics were given. If the yeast infection is recurrent it is advisable to get a blood examination done along with blood glucose levels. Hope everything gets well soon. Hope I have answered your question, if you have more feel free to ask. 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 get cold that is in the form of allergy (that is running nose and sneezing) almost after masturbation or even if i get night fall. I am 100 % sure about it , if i dont do masturbation for say 7 - 10 days then i dont get cold (allergy that is running nose and sneezing) for that period of time . Sneezing continouly for 20-25 times is too much to handle for me . Allergy last for 2-3 days if i dont take any medicine . so i take anti allergy drug and get relive many times. is there any cure for it that is permanent ### REPLY: Please be assured that there is no allergy caused by your sexual stimulation. Allergy is caused when the body is exposed to a foreign substance that reacts with bodies antibodies and release chemicals causing symptoms of allergy. The sneezing you get is because certain foreign substances (allergens) enter your nose and respiratory organs to cause cold etc. You have to avoid allergens to prevent runny nose and sneezing, and if they happen, take recourse to antihistamines .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 8 yr old grand daughter was treated in the ER at one hospital. She had a mass in her rt groin area. It was painful and removed . SHE WAS SUTURED SENT HOME. TWO DAys later she developed a lg cyst (mass) on the other leg in the groin (lymph node). She was taken to another ER where they sttemptrd to aspirate with a needle. THEY THEN DECIDED TO biopsy the growth. She had a tissue biopsy done and we are waiting for results. No fever, swollen neck and groin lymph nodes, she has has some lethargy at times. She wakes up some nights stating she is scared. UNREMARKABLE HX, except for several pneumonia admissions. She appears to be asthmatic at times. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She has enlarged inguinal lymph node.  It can be due to reactive hyperplasia, tuberculosis or lymphoma.  She should wait for biopsy report.  It will give you exact diagnosis whether it is reactive hyperplasia, tuberculosis or lymphoma or something else. Then she should take treatment according to diagnosis. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . 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: Hi, I ve had surgery years ago to remove my left kidney because of kidney cancer but for a while now usually once a month on my right side where I still have a kidney remaining, I get this throbbing pain in the front part where my tummy is a little below my belly. Can you help? ### REPLY: Hi Sir, Welcome to , I understand your query and concern. Your symptoms are suggestive of a renal stone located somewhere in the Right lower ureter. For this you need to get him Intravenous paleography for accurate assessment. I advise you to have Tab Tramadol and Tab. Pantop 40 mg, a course of antibiotic taken under medical prescription to control this pain. Further expert management depends on the outcome of the MVP result. If the size of stone is more than 5 cm then depending on the location of stone Extra corporeal lithography can be done.Meanwhile, you need to take soft and less spicy foods. . Fruits, fruit juices, vegetable salads, soups should be taken. Consult your urologist for expert management. Post your further queries if any. 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: last September, I found a lump in my right breast and I had to have a biopsy on both breasts. Everything came back negative but since then the lump has gotten bigger and both breasts feel pain off and on. Both nipples are very dry and flaky as well, which is not usual. I would go get them checked, but is it too soon? Also, since my employer has switched our health insurance, I will be switching in July. Should I wait and then go to my new DR? Or go now to the old Dr? And should the old Dr send the results to the new one? I am confused. ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Cause and plan of Treatment-In my opinion on the given data, you seem to have Fibroadenomas with relapse due to cyclical changes. These changes do happen and should not make you panicky, as its benign non-malignant condition. So no hurry. You can plan if after you get the old reports from your old insurance  ### 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 mother had breast cancer 5 years ago. In decemeber they found cancer cells in her lining of her lungs. At the time they also found her stomach wall was thick but they dismissed it do not being anything. She told the doctors that she was having acid reflux and she could not eat and had little to drink. We are know in febuary and ahe is back in the hospital and her stomach wall is still enlarge. And now they thick it s cancer ### REPLY: Sorry to hear about your mothers' problem. She is suffering from metastatic breast cancer, which has already spread to the lungs and the doctors are suspecting spread to the abdomen as well. At this stage she is a candidate only for palliative chemotherapy and hormonal therapy (if the cancer is ER, PR positive). To confirm the spread to the stomach, a biopsy can be done, but it is not going to change the line of management. She can be given acid reflux medicines by the doctor. The lack of appetite can be explained due to widespread cancer. I would suggest that you consult your oncologist and palliative care specialist. For pain management, you can go to a pain clinic. Hope she feels better after the 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: Hi,I have been having a cough for the past couple days, lately with mucus. yesterday, I ended up having a fever of 101, which broke this morning and all day, when I cough, I have been getting a bad pain in my butt. When I am not coughing, it is more of an annoying, dull pain. Any ideas? Thank you ### REPLY: Thanks for asking your question I completely understand your question cough with yellow sputum means there is an infection of the respiratory tract, may b upper or lower resp tract infection. So u need to take some antibiotic like lifetime for a week or two after consulting a pulmonologist. Pain in butt may be due to excessive pressure applied during a cough, muscles contract. If this problem persists you can take consultation from a surgeon if u smoke, u have to quit smoking as early as possible thanks /regards feel free to ask more questions may god bless you with 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 dont no whot is going on iv got sever pains in my left kidney ad about 500 uti infections over 18 months now put on folic acid tablets my blood is all over the place im also taking statins for colestrial but im so confussed do i have a kidney pronlem as nobody is telling me anything thanks ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some infection in kidney or urinary tract.  You should go for urine routine and microscopic examination as well as culture and sensitivity test.  Ultrasound abdomen is also required.  You should also test for blood sugar level.  Diabetes is the common cause of recurrent urinary tract infection. Then you should take treatment accordingly. Continue your statins for cholesterol control. 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: Hi, I constantly have really bad back pain its the bottom of my back and also going up the right side. I like I was to vomit a lot and get a lot of headaches and for the past month and a half Ive going to the bathroom a lot not urinating but passing stools. Everytime I eat I have to immeditley go to the bathroom to pass stools. Can you give me any help of what could be the matter?RegardsEmily ### REPLY: Hello. Thanks for writing to us. The symptoms that you have described are likely to be due to an irritable bowel. The pain in the back could be due to a bad posture, poor nutrition, stress or indigestion. You need to get yourself physically examined to find out the cause. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://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: My neck spinal discs shifted and almost paralyzed my right arm. I had a successful operation and doing well now. But now I have lost sense of touch of my right leg up to the groin and sometimes fail to fully erect for sexual functions. How do I overcome this? ### REPLY: Hello I really appreciate your concern. Looking at your description I would advise you to consult your GP for physical examination for loss of touch sensation which might be related to any neurological deficit or any other cause. In my opinion you should take vitamin B 12 (methylcobalamine) and calcium supplements. Physiotherapy will definitely help you. As far as erectile dysfunction is concerned you can take sildenafil group of . Hope this answers your question, please feel free to ask for follow-up question, I will happily answer you. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi :) my head fell on the ground the force is very strong. Now , my tooth has a crack. My jaw hurts every time I talked, eat and open my mouth. When do I need to go to see a doctor? Should I wait until any bruises came out? Please answer :( my mom still doesnt know about it. ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have crack on tooth now you have pain, you should consult dentist and go for Local examination, and get Investigations IOWA done if your tooth fracture involves pulp then Root Canal Treatment should be done treatment plan You go to dentist as early as possible and go for treatment Hope this will help you.  Wishing you good healthRegards  ### 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: YESTERDAY, I WENT TO THE ER,WITH SEVERE PAIN.I HAD AN ULTRA SOUND DONE.  CAME BACK NORMAL. NEXT I HAD A CT SCAN.  THEY FOUND A LARGE MASS ON MY LIVER.  DR. TOLD ME IT WAS CAUSED BY BIRTHCONTROL.  I HAD THE MIRENA IUD 1ST 5YRS, 2ND ONE I YR. I AM IN SO MUCH PAIN ### REPLY: Hi thanks for contacting ... Noted in CT scan large liver mass present... It is right that hormones can affect liver and can lead hepatitis like condition... But as large mass discovered ....it has to be investigated.... Mostly triple phase CT or MRI with AFP estimation able to rule out malignancy.... But if you need detailed evaluation then USG or CT guided biopsy or FNAC done.... According to cause treatment given... If it is non-malignant bacterial infection then antibiotic given....Meanwhile, low fat diet taken... Fruits more. For fever take paracetamol.... If needed then per spectrum and detail gynecological work up also done..... For liver mass keeping this in mind consult gastroenterologist..... Hope my suggestion will be helpful... 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: Thanks. Three weeks ago I fell on my bike. This resulted in several bruises which have mostly dissipated. A large lump is still present on my lower right leg however, on the calf. Would this be a hematoma? I am a 58 year old male. I am in mostly good health, but may have ChatDoctor. ### REPLY: Thanks for your question on . I can understand your situation and problem. Yes this is more likely to be hematoma. But better to get done 1. Clinical examination by orthopedic doctor 2. X-ray of affected part 3. Ultrasound examination of affected part These all are needed to rule out fracture and callus formation. At your age of 58 years, osteoporosis is inevitable. And fracture is common in osteoporosis bone. So the swelling can also be due to fracture or callus formation. If fracture is there then you need operative correction. So better to consult orthopedic doctor and discuss all these. ### 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 patient 41 old years with non alchoholic fatty liver , high    ALT& AST, high in level of insulin serum  .I used below regimen drug : cap ursobile (urso deoxy cholic acid ) , tab methformin  & vit E. please guide me. with warmest regardsmohamad ### REPLY: Hi welcome to ... You have NFL... So here you are taking correct . Continue it esp. Ursodeoxycholic acid which dissolve cholesterol in bile.... Cutt off oil in diet. Regular one hour exercise needed. In morning take grinned carrot and spinach juices. Green leafy veg salad and fruits taken more. Refined food avoided. Junk food and non veg very minimal... Use less oil in cooking.... Sunflower, canola, peanut like good oil can be useful.... Take care. Hope your concern solved. ### 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 fiancee is 59 years old and does a lot of physical work (moving vending machine products), constantly on the go and lifting cases of soda, boxes of food etc.  He is normally very healthy looking, yet lately has developed large purple bruises on his left arm that just dont seem to go away.  He will not see a doctor about it and I am concerned.  A couple of years ago he was diagnosed with low iron and I wondered if this could be contributing to the bruising not going away.  He does take krill oil to keep his cholestrol numbers in line (as he had ill effects from the prescriptions he tried).  Is there any way I can help with the bruising problem?  Can that arm being in the sun from driving most of the day have something to do with these ugly purple bruises?  Is there any way I can help him, since he refuses to see a doctor - his VA physician just tells him not to worry about it (ask he also does with his painful varicose veins in his legs). ### REPLY: Hithanks for your query can feel your concerns usually bruises are either due to low platelet count or deficiency of coagulation factor advice you to have his routeing blood examination to see his platelet count and also his coagulation profile after consulting your doctor.I would like to know if he has bruises or petechial on any other part of body or he has family history of any blood disorder detailed clinical examination is necessary hope it helps regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is it safe to take 0,5 (half of it) Rivotril same day (8 hrs later) when small dose of Xanax is already been taken (half of 0,5mg) ? It seems that Xanax is too strong for me, and I been on small Rivotril dosage until yesterday. Many thanks in advance! ### REPLY: Hello! Welcome on  ! You should know that both Pivotal and Xanax interact with each other, leading to increased sedation and a low physical performance. Anyway, Xanax should be taken only as a short term therapy, while Pivotal can be taken as long term therapy. The dose of Pivotal that you are taking is really low. So, it is OK to take 0.25 mg Xanax. Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have Foliculor non-hogkins lymphoma in the left abdomen 6-7 cm, for which I am treating with Rituxan infusion but now I have swelling under my left arm, left peck, lower abdomen, inner thighs on both legs. The tumor seems to be shrinking in the last CT scan with contrast. I am also experiencing itchy burning eyes 24/7, raspy voice, blurred vision, ringing ears. I have ruled out allergies though testing with allergist and EN&T. Your thoughts? Accept what terms? ### REPLY: Hello, Welcome to Ask a doctor services. I have read your query.  It is good to know that the tumor is shrinking. Swelling that you are experiencing in your hands & feet is a side effect of Rituxan. You need to report without delay to your treating PCP, you need to be examined & medications need to be monitored or altered. You should keep your PCP informed about any other medications you are taking. Stay away from addictions. 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 just got my lab work results. I dont have a lipid result but my triclycerides are always high. (I am overweight). verything came back normal except my ALT is 64. I am concerned as what I read on the internet talks about liver damage, but could the high ALT be related to the triclycerides level? ### REPLY: His read carefully all your concerns and I understood your query.In regard to high level of ALT it may be related with HIGH triglycerides. High triglycerides may cause fatty liver and high liver panel. You need to be examined with abdominal ultrasound to diagnose fatty liver. The first step of treatment is to change your lifestyle like avoid fatty foods, sweeteners, increase your physical activity, use plenty of water. Wishing you fast recovery .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 62 year old male drinking since about age 15years of age. Symptoms witnessed focal seizures with about 30min postictal confusion, bilateral arm pain, arm bruising without bumping or trauma, memory issues . What diagnostic tests would be recommended? suggestions, recommendations? ### REPLY: Hello, First, you should do some investigations such as; a CT Brain to exclude a focal brain lesion, an ECG to exclude heart block, Lipid profile in the blood and measuring blood pressure. If you had hypertension, you should receive medical treatment, take aspirin 160 mg twice per day after meals and do an ECHO on your heart, besides taking vitamin B complex once per day after meals and Benfotiamine 40 mg once per day after meals. You should change your lifestyle by decreasing fat and salt in your diet, besides stop smoking and .  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: Hi I m not sure if you could help me out with this, but I have a ear problem. Well, I got my ears pierced about 15 years ago when I was one. Im not 15, and I had stopped wearing earrings for like 6 months.Since I didnt want them to close up, I started wearing earrings again. But every time I have them on they hurt REALLY bad, theyre sore, red, and yellowish pus with a foul smell comes out of them. Could they be infected??? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint it seems like allergic reaction to the metal present in the earring leading to the symptoms of redness, soreness and can also cause infection leading to pus discharge. It occurs if you are not wearing gold or silver earrings as they are inert metals and does not react with water and air while other metals will react and the decomposition products of reaction cause allergic reaction on skin. You should gently remove the earrings and clean the area with antiseptic solution and apply a Triple antibiotic ointment over it at least twice a day. It will start resolving in 2 to 3 days and once it is resolved you can wear gold earrings. Hope this information helps. Thanks and 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: Dear Sir, My daughter 10 years, 48 kgs is suffering from fever since saturday afternoon the grade of fever is rising with every passing day by almost 0.5-1 deg f paracetamol(650) is not effective, doing sponging, now we have administered combiflam, fever is 104.7def f, please advise. ### REPLY: Hi, As she is having very high fever requires evaluation of her case. She requires complete blood checking like TC, DC, Platelet count to find out of having high fever. Go for routine and microscopic urine check up. After report your doctor will go for treatment accordingly. Continue with paracetamol or Coquitlam clock wise. Important is to give plenty of water and liquids and keep her well HY . Give her complete rest and light diet. Ok and 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 21,87 kg,I did unprotected sex but liquid was not inserted on my 5 day of period I did,later I got viral fever took injection the next day I got my period, Later my period stop for 2 months, I took pregnancy test with my first urine the result was negative Went to doctor gave me deviry tablet for 5 days 10 tablet days have be crossed 10 days but no period Can u plz help me whether I am pregnant or any problem is occurred ### REPLY: HI, I understand your concern.  Actually you had sex in safe days of your menstrual cycle (5 days prior to menses). You had viral fever, you took injection for that & you had the period following the sex in discussion. SO you do not have conceived this time.  You had 2 months delay in next cycle. Pregnancy test was -ve. But you did not get bleeding devilry pills for 5 days. Normally, bleeding occurs within 8- 10 days of stopping the pills. You had already waited for 10 days. .  In such case you should wait for bleeding for a couple of days more. Viral fever causes a lot of weakness. This might have caused delayed period/response. When pregnancy test is -ve the bleeding should follow if there is no other problem.  In case there is no bleeding an after 4 more days, you should - go for pregnancy test once more. If its +ve now you need MTP for you had taken Devilry.  - In case test is -ve, you need a gynecologists' consultation for physical examination & needful investigations to find the cause of delay in period. (It can be hormonal disturbance due to POD, thyroid, ovarian problem)& the specific treatment will be given you, which would help you.  Thanks.  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: after having an abdominal ultra sound the report suggesting of minimal coarsening of the hepatic echotexture size and possibly relating to hepatic parenchymal disease.  Ive been having lots of discomfort after eating a meal on my upper quadrant under the sternum where my liver is?? Please adivse ### REPLY: Hi.noted history of upper qua .  It is possible that you have a symptomatic gallbladder disease (probably due to a gallstone or a polyp). When was your last abdominal ultrasound done? It is best if you consult with a doctor, preferably a general surgeon or a gastroenterologist, for physical examination and clinical evaluation. Your gallbladder disease might have been there for a long time already (chronic cholecystitis). If your symptoms are occurring more frequently, surgical management will be advised, because you don't want your condition to be an emergent one. An elective (scheduled/planned) surgery has better outcomes and lesser risk of developing complications. Diagnostics (such as ultrasound, bilirubin, alkaline phosphatase, liver function tests, blood count, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly. Definitive treatment for gallbladder disease is surgical removal of the gallbladder (along with the stones or polyps). It could be done laparoscopically (gold standard) or through open technique. Low fat diet is also recommended. Hope this helps. Good day!!~ ### 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 punched a wall earlier hard and a lot and now my knuckle is really sore and has been for at least 15 hours there is no swelling or bruising but this hhappened last week and there was swelling and bruising it is the knuckle bbeside my pinky and iI just want to know if it is broken ### REPLY: Hi, Thanks for your query. An initial X-ray of the injured part is mandatory to rule out any bony injury (fracture). If the X-ray is negative for a fracture, then the other possibility is soft tissue injury either to the ligaments, tendons etc. I suggest you to consult an orthopaedician nearby for a detailed examination. You may get the X-ray of the area affected under his/her guidance. Beside icing and elevating it, you can take anti-inflammatory . I do hope that you have found something helpful, and I will be glad to answer any further query. 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: the thick part of the skin behind my big toe and on my heel fell off down to musle my DR. has me going from wet to dry with saline. my heel is almost well but behind my toe started about the size of a tennis ball. now it is alittle bigger than a inch but is about 1 eith deep. i trim the dead skin off as it gets high around the edje. this a year of work. what more can i do? ### REPLY: Hi, Dear,Thanks for your query to  virtual Clinic. I studied your query in all the details put forth by you. I understood your health concerns. Cause of the health problems you queried-There are many causes of the lump in toe. With the limited information, there is a bit confusion about the heel lump?which is not clear from your query. The tennis ball size lump behind your toe, seems to be with a lot of infection and cellulitis around, from the data given from you. And it seems that this lump is for 1 year almost. Cause in your case-So Don't treat it on your own as it could be-Paronychia with Granuloma of the great toe/ or it could be Ingrowing Nail(Onychocryptosis with Pyoderma with Granuloma)/ or could be benign or malignant tumor due to chronicity of infected growth in the toe.Hence, would advise you to consult ER Surgeon, who would rule out other causes of such a lump and would help you out with the fist hand information. So take his Second Opinion, on the above suggestion, as he would advise you with fist hand clinical information. Remedy-So till the time you consult ER Or tho Surgeon and get his definitive opinion after above investigations, DONT WORRY AT ALL but you need to be concerned as it would complicate into some other problem associated with it.In the meanwhile, Daily . Take Anti-inflammatory  ### 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: Dear doc , I am having a stomach ache since 1 yr . I went to my local doc , and done a endoscopy with biopsy . The result come that I am having multiple ulcers in duodenal region. It was treated with rabeprazole for 2 months but my stomach pain got increased. After that I consulted to another doc and for 1 month I took 5ml of sparacid with some other pills. Now I am having a permanent pain in upper right as well as whole left which is I am unable to resist. I am taking no medicines now, and need a advise which could be helpful in my case. Name: Milind Age:19 yrs Gender : male ### REPLY: Dear Mil ind, ulcer disease is a chronic disease which goes through different phases and each of these phases has specific treatment. First every patient with ulcer need to change his nutrition and lifestyle. This means you need to avoid stress (one of factors that increase incidence of ulcers) and specific food and .  But it seems like you've already developed a serious type of ulcers, you are pretty young, and it must be definitely treated in a right way. So second Line of Defense are medications. We usually use 3 of them (proton pump inhibitors, antacids and Ca channel locators). Omeprazole is proton pump inhibitor and one of most useful  ### 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 mother has had pyria of the teeth for many years and is now almost 80 years old, I ve tried to convince her to get her teeth pulled because it is probably causing her healtChatDoctorplications. I ve told her, her health could be a lot better if she would have her teeth pulled. Could you send me information on the health hazards of pyria, please, so I can read it to her from a medical standpoint? Thank you ### REPLY: Hello and welcome to  forum, pyorrhea is a periodontal condition which occurs as a result of poor oral hygiene, hereditary factors and sometimes is associated with a medical condition, it is good idea to guide your mother through this forum,first if your mother is not all convinced on getting her tooth extracted, then it is better not to force her, in fact take her to a dentist and get her teeth cleaned professionally, do not worry about the teeth getting mobile after scaling, it is just a myth. Also, I would suggest warm saline rinses, antibacterial mouth rinses(3-4 times/day), pyorrhea can increase the chances of heart diseases if she is diabetic, hypertensive or even if she is suffering from a present medical condition. I wish your mother good health, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The past several days I have been having redness and burning sensation on the inside part of my ankle, also very very itchy. My ankle became very swollen to where today I cannot even walk. It s even more red now and extremely painful. I am a 45 year old female, with no major health issues. ### REPLY: Hello, I understand your concern. The symptoms seem to be related to a strain ankle. I suggest to rest (avoid irritating it), ice pack 3 times daily for 10 minutes, compression 24/7, and as much elevation as you can. If it gets worse over the next several days, you should consult an orthopedist for further evaluation. Sounds like a common sprain, and I know some people forgot a minor twist until 2 days later when the symptoms develop. 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: my baby is 10 wks old...at one and a half wks he got very constipated and was screaming trying to poop. we added 1/2 tsp prune juice to every bottle for a wk and it started to help. but we had to keep that up and also he was spitting up and vomiting all the time and wheezing and arching his back feeding and very uncomfortable so we put him on prevacid and started switching formulas. after 4 or 5 diff ones he is actually worse now soaking 4 bibs a day and vomiting all day. it is projectile and it is often and it hurts his sometimes. we also have had to put milk of magnesia is every bottle for 6 wks now to help him poop. it helps but nothing is consistent or great . the gastro dr. put him on a laxative instead and uped the prevacid. nothing is working i am running out of ideas. should i try soy? he is 10 wks now and he is thriving greatly so they dont see any issues but he is misserable please help me!!!!! ### REPLY: Your baby may be suffering from digestive problems like gastroesophageal reflux, pyloric stenosis (narrowing of the opening between the stomach and intestines), food allergies, overfeeding, or improper position while feeding in infants, infections of gastrointestinal tract etc. Ask your doctor for investigations like USG abdomen, CBC, stool examination, urinalysis, CBC etc. These investigations can diagnose the exact cause. For vomiting give medications like ondansetron or risperidone. Put baby upright on shoulder for at least 10 to 15 min after every feeding. If possible breastfeed baby instead of formula. For further queries regarding this disease or its medications you may take my appointment at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend s son (5.5 month old) has been diagnosed with G6PD from birth and last week he was given a taste of some chocolate cream on a cake and developed facial and eye swelling which required a trip down to the ER for jab to relieve the effect. (? Egg allergy induced). Now the mum is wondering if the boy could proceed with MMR vaccination or is there an alternative. ### REPLY: Hello,first, the swelling had nothing to do with G6PD deficiency. G6PD deficiency has nothing to do with allergic reactions. It only causes hemolysis (red blood cell destruction) under certain circumstances (inciting . Regarding the MMR vaccine, egg allergy is not supposed to cause problems and the vaccination can be done. You can also read the MMR summary of product characteristics (SPC) for the details, if you'd like. You can contact me again, if you have more questions about it. I'll be glad to help. Kind 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: hey there. My niece who is 6 is always hungry, as a baby she was always hungry and it has continued., She is 6 and weighs 90 pounds. She can eat more that 2 adults together. She has been tested for dibates, negative. She is always hunbgry, obessed wiht food, wakes up first thing in the am, food at night in bed. food She plays soccer. Parents try to talk about healthy options but is she eats a apple then she wnats more and more. Help, this child needs help and this is a medical condition for this constant hunger? any research going on. She gets sad when she asks for seconds and thirds but she says I am really hingry. She is super smart and she gets she is eating ltos of food but her stomach growls/ help- any reaerach or data or doctors we can contact. Thanks, Angie ### REPLY: Hi, I had gone through your question and understand your concerns. You should be worried but not too much. If she eats, and then she has overdone it played soccer an extra time. She may also tend to eat more when she grows. - persistent stress and anxiety;- bipolar disorder and manic depression; - genetic factors;- bulimia;- worm infestation in the intestine;- hyperthyroidism;Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your baby and you are 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 fell 2 days ago face down on concrete. my head is fine but have very sore ribs mainly left side. Very bad bruising to my left under from elbow to shoulder. Had X-rays and doc said nothing broke. I have a hard time clearing my throat and coughing. Could this be due to a damaged spleen. ### REPLY: Hello, This is not an injury to the spleen. I would suspect this to be the weakness of the respiratory muscles which have tended to be painful and not allowing the sputum to come out easily.  I will advise taking hot water fermentation at the injured site like the elbow and the rib cage. This will help the muscles to relax. Do steam inhalation, so the lungs get moisturized. Simple breathing exercises will help to ease the pain and symptoms. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 58, 5 2 , 150 lbs, female with history of PAD (claudication in both legs) fifteen years ago. Angioplasty to open arteries in both legs. I recently had endovascular surgery to repair triple AAA. Lower extremities began to bother me (burning while walking, stop, rest, resume walking), more particularly, stabbing pain in right leg, mid way between knee and ankle (shin area). Had lower extremity arterial ultrasound. Doctor called and said numbers are good. I received a copy of the report. Normal........ except in the distal right anterior tibial that is difficult to visualize . Is that particular artery difficult to see on all ultrasounds? Seems that this area is where I am having the most difficulty with stabbing pain. I found it odd that when I spoke with the doctor on the phone, he didn t mention it and didn t request additional testing. ### REPLY: Hello! Welcome on ! I carefully read your question and would explain that your symptoms seem to be related to low blood perfusion in this area. Regarding the Doppler ultrasound, I would explain that sometimes vessels can not be visualized properly. But, considering the fact that your symptoms are located in this region, I would recommend repeating the Doppler ultrasound or performing an Anglo CT scan of the lower limb vessels. Hope you will find this answer helpful! Kind 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: Hello! My Dad is 77, just suffered a major heart attack a week ago Friday. They couldn t go in and do anything for him do to an ulcer (they were afraid it bleeding out after a stent being put in do to the blood thinner he would have to be on). He went in on a Friday night, the bad enzyme level continued to rise for about 24 hrs (highest was 27), then started to come down. They did a cath on that following Monday to find that the artery 100% blocked and decided they couldn t put a stent in due to it possibly rupturing the damaged part of the heart. He s being doing fairly well, went in for an echo today and meets with the heart dr. this upcoming Monday. For some reason, he thought they had put a stent it and when he found out yesterday that they had not, he made the comment no wonder his heart felt funny. He told my sister today that he has these little electric shock feelings in his chest. Is this just a result from the blockage, or something that we need to see about prior to his appt. w/the heart dr. on Monday? ### REPLY: Hey a stent is a foreign body which bis inserted into the body our body is a closed environment it takes one time for the body to adapt to new changes done inside ITAs stent will take 4 weeks to make the body comfortable and adopted for it mild currents tingling numbness are ok and a usual phenomenon just get an ECG done and compare the post stent ECG with this ECG if there are no fresh issues in ECG then It's nothing to worry about as your doctor to add some benzodiazepines for 2,3 weeks to your father meds as this will held him to overcome his hidden anxiety which is very usual post heart attack!!!! ### 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 brother is a hepatitis b carrier, in good health, 31 yrs old.  he is getting married in 6-7 months. what is the chances that his wife getting the infection from him, whether it will be active or non active like my brothers?  any chance the wife getting infection be prevented? ### REPLY: Hi thanks for asking question... Let me know you hepatitis b antigen can be spread by sexual route . So your brother wife can get acquire infection by sexual intercourse.... Use condom or barrier method to prevent its spread. Blood and secretions having this virus. So avoid contamination of things by secretions. Items contaminated by secretion wash by diluted bleach.... If your brother have young it is . ... Your brothers wife and you must be vaccinated ... Regular check up of both you for hepatitis b done.... 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 had erythrasma over half a year ago, and I was too embarrassed to have a doctor check my crotch area, so I bought some medications (fusidic acid, miconazole, erythromicin, clarithromicin) and was able to stop the infection. The skin stopped itching, and the discoloration stopped spreading, but it s been months now and the skin in the affected area is still very dark. Is this normal? How soon can I expect my skin to return it its normal color? Is there something I can do to help speed it up? I d greatly appreciate any help. Thanks in advance. ### REPLY: Hi, Groin area is quite prone for fungal infections, intertwine, erythema. Sometimes seborrhea dermatitis, inverse psoriasis, satyriasis tricolor may also mimic such infections in groin. Erythrasma or fungal infections usually heal in two to three weeks with adequate medication. The medications that you took were good enough to treat erythema. I would like you to consult a dermatologist, to rule out three possibilities1)if there is a persisting infection fungal or erythrasma2) if it is some other disease that you misdiagnosed as erythrasma3) if the lesion actually healed and it's only the pigmentation that is persisting. If it's only the pigmentation that is persisting, keeping the area .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi , dr , i am 24 year old , i feel Rt testicular pain , i sought medical advice . i was asked to do semenal analysis and scrotal doplex. doppler was normal semenal analysis:-ph : alkalin concentration94mllion per ml liquifaction time more than2 h rapid active motility30% slugish progresiv35% volum:3.5ml WBC1-2per HPF Can i father achild? many thanks, ### REPLY: HI, thanks for using  Semen analysis provides a general idea of fertility. Your concentration or count of 94 mill/ml is normal, it is considered good if it is above 20 mill/ml. The motility is normal if more than 50% are moving. In your result a total of 65% were moving though only 30% were rapid. The volume of semen is also normal. The low white cell count shows that no infection is present. Semen analysis also generally looks at the morphology (shape of sperm, does it appear to look normal). This is not mentioned. Based on the results given, there should not be any major fertility issues. I 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: hi sir,my baby is born at32 weeks on 28/02/2011 his apgar score came with in 5 minutes n doctor said that it was ok .nd keep in PICU .but now he is complaining of breath holding n on c pep with support of other medi..eg aminophylinampiciline100mg, KCL,CALCIUM GLUCONATE etc ??IS TREATMENTOK ### REPLY: Hello dear!your baby was born premature and so the treatment includes antibiotic for possible infection, aminophylline for apnea of prematurity and fluids including Potassium and calcium that are normally required in a neonate who is admitted in ICU. Cpap OS continuous positive airway pressure to help the preterm babies breath if they have RDS. So the treatment is appropriate. Hope it will answer your question :-)Wishing your child a speedy recovery and sound 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: Hey Doc. I have low back problems and have for the past 8 years. 1 neurosurgeon said total fusion of my 5 lower vertebrae. I opted to do pain management instead. I stopped all pain medications in February of this year. Couldn t live with pain. Had surgery at Laser Spine Institute in July. Need 2 more surgeries due to problems at 3 levels. I live with chronic pain. I am an assistant principal at a high school in tennessee. I want to make it until for retirement. Can you reccomend Pain Management doctors in west tennessee? Little druggies have made it impossible for me to get help. They treat me like some street addict. I have a lovely wife and 3 kids and want to enjoy life. PAIN has taken my life from me. ### REPLY: Hi, Welcome to  forum.  You got medical treatment for backache for 8 years. Had surgery at laser institute in July yet 2 surgeries are to be done, and feeling chronic pain.  The information of the doctors, is difficult to fetch, but you can have some suggestions to go through.  I to my patient with such symptoms prescribe neurotrophic injections for 10 consecutive days, and then one injection every week, fortnight and then monthly forever.  Avoid taking potato, other tubers, tomato, egg, chicken, and seafoods. These will bring down the dosages of the pain medication slowly.  Besides, you can have your surgeries, pain medication, and rest every thing as usual.  Wishing for a quick and complete recovery. Thank you. ### 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 dr i am zarina age 45yrs and iam suffring from hcv and also under treatment ing peginterfiron + cap ribazol now i have raise sgpt 94 i am warried about it i am olso taking med for joint pain in ultra sound show bulky spleen plz advice diet for my problam thank you ### REPLY: Hi Ms Marina, How are you? My name is .  I am a Liver transplant Surgeon and I hope to answer your question today. I am sorry to hear about your diagnosis. By your symptoms, you seem to be suffering from active Hepatitis C infection (elevated SGPT) and also seem to have developed a complication of HCV namely portal hypertension (enlarged spleen). This is usually preceded by development of cirrhosis of the liver. Please do get yourself checked for it. Although a level of 94 is not very high, but given the fact that you have HCV, it should be considered significant. Regarding your diet, please avoid taking excessive fatty food as this taxes the liver. Also make sure to take in adequate calories. If you are not feeling hungry, then, please eat 5-6 meals a day instead of just 3 meals. Also make sure to eat a lot of fresh fruit as this is rich in anti-oxidants. Besides refrain from any alcoholic beverages. Hope this helps and hope you start to feel better. Please do write back for further clarifications. Have a great day ### 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, Last year i had root canal treatment on my front teeths. After few months my gum from inside got Swollen and also started feeling pain. My dentist asked me to go through the dental surgery . I did so and the Surgeon removed the swollen part from my gums by cutting the front side of the gum. Aftr that I used to feel the hole in my gum. My surgeon advised me that the hole will get fill um in few days. The hole got filled up in feww days but i feel the ineer side of my gum is still quit soft. I also fee little pain some time at the same part. Kindly advise what i need to do get rid of this pain. ### REPLY: Hi, Welcome to the forum.I would like to inform you that pain with swollen gums is something which is following infection, which either may be from a decayed tooth or infected gums. Until then, you can perform warm saline rinses(3- 4 times. Day) to relief pain and swelling, use an antibacterial mouth rinse(twice/day), Do not apply any hot compresses over the swelling you can get an x-ray done under the guidance of dental surgeon hope this is helpful to you. You can consult me again directly through my profile http://www.ChatDoctor .com/doctors/ .  ### 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 29 years old, 65 kg ,married (no child) and have PCOD. I had two missed abortions (First Trimester) in last 3 years. SAC was always smaller by 1-2 weeks. My Lupus Anticoagulant and Toxplasma IGM has come positive. Last conception was done while i was on Letroz 2.5 and Glycomet Sr 500 , for a year for my PCOD. Periods are always delayed by a month. Want to conceive but am quite apprehensive whetehr this time also i will miss it. Suggest treatment and the way forward ### REPLY: Hi, I think you can conceive by metro tablets. The chance to get pregnant in one cycle of timed intercourse is 7 to 10 percent only.  So, try at least 3 to 6 months.  Track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband every 2 to 3 days after your periods stop.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  If it doesn't work, then you can go for GUI.  When you conceive, you need to take aspirin also and may be infections of heparin daily.  Discuss with your doctor regarding this.  Hope I have answered your question. Regards ### END