Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im an athletic 26 year old male (5ft 10in and 145 pounds) and I have a hard, non-movable, pea-sized lump under the skin on my left calf.  It doesnt hurt and has been there for a few months at least - doesnt appear to be growing.  It has a slight brownish color to it. ### REPLY: I, Dear,Good Morning, and Thanks for your query to my virtual Clinic At . I studied your query in depth and understood your concerns. Causes for the lumps on the calf are as follows-a-Mostly they are -Bursitis popliteal ?or MB cyst with knee arthritis I would advise X-ray knee joint and consultation with Orthopedic Surgeon.Don't worry of them, as they could be relieved with proper treatment.-Treatment -a- Tab-NDAIDs/b-Hot fomentation, c-Rest and Elevation of knee and affected leg. D-Ortho-Surgeon consultation and needful further treatment with him is advisablee-To remove that lump-I would advise Diclofenac Gel locally x 2 was time. Hope above reply would help you to relieve of the issue you have. Welcome for any further query to ME and . Write Good review for the benefit of my new patients. Click thanks ASAP after this. Have A Good Day. With 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 twitching fluttering thing going on for about 2 hours now in my lower left peck i can see it moving also a slight pain and tightness in that area have had pains there befor but usually go away quick i just quit smoking in the last week after 15 years thanks ### REPLY: Thanks for your question on . Since you are having left sided discomfort, I think we should rule out cardiac cause first. Twitching and fluttering in chest is caused most commonly by palpitation (rapid heart rate). And these palpitations can be due to arrhythmia. So get done 1. ECG2.  2D Echo3.  Holder monitoring (24 hour continuous recording of ECG). If all these are normal than no need to worry about cardiac cause. Then this can be due to apprehension and anxiety as you left smoking. So better to avoid stress and tension. Keep calm. Consult psychiatrist and get done counselling sessions. ### 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 smoke cannabis to relax my mind, not to get wasted. I recently had a pacemaker implanted to correct the blockage between the upper and lower receptors of my heart. Will continued use cause further damage to my heart or disruption in the working aspects of the pacemaker ### REPLY: Cannabis per se can cause various heart issues including fluctuations in blood pressure, heart rate, spasm of heart rate is too clogging of the art is causing heart attack. So by all means cannabis even social use is not advised in patients who have any kind of heart issues. You had pacemaker put for a heart block, per se cannabis will not interfere in the functioning of the pacemaker, However as a cardiologist I cannot recommend that you continue the use of cannabis, as the risk of ill effects in long run are not worth the calming effect you experience.  Try weaning yourself off. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have been having right hip pain for over 3 months not but latley the pain is alot worse, i cant lif my lefs or spread them or lay on my right side with out the pain getting worse..i had a baby 4 months ago but this pain has been there for years but just got alot worse,..there is also a popping/ grinding sound when i move leg outwards ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have severe hip pain. Well there can be many reasons for symptoms you mention in query like rheumatoid arthritis, osteoarthritis, bursitis, hip labral tear, sprains and strains, tendinitis, herniated disk, sciatica or spinal stenosis. I would suggest you to consult orthopedic surgeon for proper examination. Doctor may order CT scan or MRI along with physical examination like movement of joint. Doctor may recommend physical therapy along with anti-inflammatory, muscle relaxant. Doctor may also recommend surgery in case of severe damage. For now do stretching exercises, take proper rest, apply warm compresses to joint ant take ibuprofen or acetaminophen for pain. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am afraid my boyfriend suffers from multiple personalities, or he might be faking it. We have been together nearly two years, and I have witnessed basically two different people when I am with him. He even has named the other person . The two people are complete opposites. One is loving and cares; while the other is rude and disrespectful. We have been fighting a great deal over this subject, and when I bring up some of the things one person said or did, the other person seems to be utterly clueless. I don t know how much more i can take before I loose my cool. The change can take only a few seconds but last hours to even days. Then suddenly, the switch back happens. I am confused on what I can do to help him, or if he is just faking it and using it as an excuse for when he is rude. Please help. ### REPLY: Oh, you are in such a helpless situation. There is nothing like multiple personality disorder. But yes there are many stories or movies regarding the same. From your narration I can say there are two possibilities. One is called dissociative order in which there are dissociative trans, dissociative fugue which contains the symptoms you described of change in personality. Second possibility is he is doing this on his own with full awareness. Both situation difficult to diagnose in one seating. I should tell you that you must take him to psychiatrist for consultation and detail evaluation. If really he has some problem, it can be treated and if he is faking, there should be some reason behind that also about which you need to deal sympathetically without anger to know the truth in detail. ### 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 fever and body ache since last evening. the doctor prescribed topcef 200 (1 tab twice a day), zyncef - d (1 tab one time) and crocin(whenever fever is there)..i have taken the medicines as told. but not yet feeling good. fever is not goin at all.. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have symptoms of persistent fever with body ache which seems to be due to viral infection of body due to compromised immunity of your body and susceptibility of getting infected. Sometimes initially the infection is viral but with times secondary bacterial infection occur, which cause further complication. Need not worry. You should take proper rest and muscle relaxants. Do tepid sponging to lower down fever. I would suggest you to consult ENT specialist without any delay. Doctor may prescribe anti-viral (acyclovir) , antibacterial penicillin, along with anti-inflammatory medications. Doctor may order throat swab test, viral culture test, and blood test to confirm the diagnosis. For now take steam twice a day to relieve the congestion. You should take proper rest. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query herehow long does pot stay in your system when pregnant I used to smoke and am now 8 months pregnant I have stopped though should my baby and myself be clean by birth?... ### REPLY: Hi, .  I welcome you to  VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. Furthermore, I will suggest you the best possible treatment options. Furthermore, I will suggest you to stop substance smoking at once.  As any kind of substance abuse is harmful to baby and mother. It can lead to mental health and learning disorders in the baby. Secondly, I will suggest you to indulge in a healthy diet and regular exercise regimen. Have plenty of water, use of cranberry juice can be of help. I will also suggest indulging in recreational activities like reading, music. Keep yourself cool, calm. Happy. MAY GOD bless you with a bundle of joy. I hope this answer helps you. Thanks  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is maria,for the past 2 weeks everytime i touch my armpit and down my arm,i feel tightness n it also feels hard..it hurts alot ..i could see like a vein or nerve swollen,that is noticeable and puffy thru my skin,,it starts from my armpit to my forearm,,Is hard to explain,please give me a few ideas,what could it be ### REPLY: Hello, I have studied your case and I think that this can be an enlarged lymph node. It can be due to infection. I would also suggest you to show it to a breast expert, and he may advise you to get needle test or an ultrasound of the breast. It will give us final conclusion if you need any further treatment.  I hope this answer will be useful for you. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my apologies this is maybe more for a dentist but this opportunity has arisen, thanks to people like you. I have a wisdom tootChatDoctoring through on my bottom left jaw, its been coming through for over a year, recently more of the tooth has come through and a piece of my back gum is still covering the back end of the tooth, the cheek that is slightly encroaching it is a little painful along with the gum, when i brush my teeth-specifically this one, it does bleed but there is a fair amount of gum movement. I am concerned a piece of food may get stuck under the gum and cause me problems, my latest dentist appointment date was only 5 weeks ago and he did a full scan and didnt mention there not being enough room etc so i assume this should all be normal and fine, it is also causing pain from time to time when i move my jaw a certain way or  open it wider than normal. Any advice would be greatly appreciated, thanks Vanessa ### REPLY: Hithe piece of gum you are talking about is called operculum... food and debris accumulation below it causes pain... you should go to the dentist and should get the area irrigated by normal saline and antiseptic... and he will prescribe you medication (antibiotics and anti-inflammatory) also... and will grind any sharp area of tooth irritating your gum... after your symptoms subside, he will take X-ray to see the space available for tooth to erupt... If sufficient space is available, small procedure called operculectomy i.e. removal of the operculum, will be proceeded and tooth will erupt by itself...if sufficient space is not available, you should go for the extraction of tooth...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 brother is an alcaholic who has not had a drink for 4 months he has been really well for a while but has been readmitted to hospital again , he is really confused and seems to be going back in time, he is talking about things that happened years ago, is this a result of his liver damage and is this permanent or can he recover from this. ### REPLY: Hi jams, i feel your brother has liver problem but to make sure please consult the doctor for routine tests for liver damage like Ultra sound abdomen, liver function tests. If these tests are suggestive of chronic liver disease, I am afraid it is not reversible. If your brother does not have jaundice, abdominal distension then he requires neurologist opinion. All this confusion can be avoided with above tests that advised. Hoping for the best outcome, bye ### 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: CKD. Kritinine 3.5 ,Urea 88, Prostrate glands mildly enlarged .Kidney size slightly reduced.Blood pressure remains high.Cyssts in both kidnies.Dr. openion suffering from cronic medical rena; disease .HB.12.1.tAKING nicardia 20R and Arkamine BD.URIMAX0.4 ,REBLET D ZYLORIC.pROBLEM hunger very week.Both feet griped .Weight is almost constant67KG .No blood in urine Protine in urine plus 2 ### REPLY: Hi, These symptoms indicate in most cases prostate issues such as prostatitis or hypertrophy, and rarely it may be signed of STD infection.  You should avoid intercourse for till symptoms persist and .  If symptoms persist it would be good to do prostate ultrasound and check your PSA levels to rule out prostate tumor or hypertrophy and further treatment depends on these findings.  In most cases it can be controlled with medications but sometimes, in case of tumor, open surgery is required. And severe benign hypertrophy may be managed endoscopically, so you should consult urologist about appropriate options. 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: For the past few years off and on, I have a very difficult time breathing. at times its so bad I take really deep breaths and never feel like I can get enough oxygen. I also feel like I have a lot of gas in my body, but its not relieved when I belch.  I also have this pinching feeling on my upper left side of my chest..closest the arm pit but in the chest.  I get dizzy at times to. I have had EKGs, ultra sounds on my heart, stress tests..and there is nothing. I also cant breath laying on my back flat sometimes, and there is pressure on the back of my head. I get tension in the back of my neck and head after so long of struggling to breath. I am on day 3 now with no relief.  its done this many times before and lasted days, then went away for a day or two or even weeks, then returns.  I dont know what else to do? Doctors tell me I am fine, but its not normal to not be able to breath all day. There are a few times where I felt like I can breath, but it lasts minutes then its is all back.  I am at a loss..and almost broke..any suggestions? ### REPLY: Thanks for your question on . I can understand your concern. Possibility of stress and anxiety related symptoms is more likely. But better to first rule out lung related diseases like bronchitis or asthma. So get done PFT (Pulmonary Function Test). If PFT is normal then no need to worry about lung diseases. Consult good psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic . Don't worry, you will be alright with all these. Avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have this feeling in my lower abdomen like I have to either poop or throw up. I poop, but I don t feel any relief, and if I do, it is only for a little while. I am usually a very active person, but today when I went to the gym, I was only able to run a little less than 1.5 miles before I felt like I had to throw up. So I stopped, and I thought I just overdid, or did it to fast, but the feeling didn t go away, and I didn t start going again. ### REPLY: Hello, 7 griffos,Your symptoms are suggestive of "Spastic colon" or Irritable Bowel Syn .  Feeling of incomplete evacuation, blowing and gas areal suggestive of this problem. When there is build up of gas this can make you nauseated and even bring on vomiting. Excerciseshould help movement of the gas in the intestine and give youth feeling to go to the bathroom. If you have had these symptoms for more than six months, you should really try to get on a regimen of high fiber diet,  ### 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: Have had a very bad congestion in my chest with a lot of excessive coughing for 3 weeks now. After the 1st week of this I started to have pain in my left rib cage and back and across my midriff,I also have had constant ache that only lets up when I lay down or lean too my left side, the ache goes around to my back too mostly on the left side.I get a some relief from taking Ibuprofen several times a day.It feels like I have strained or pulled something across my ribs or midriff section.Iam not coughing as much the last couple of days but I can still have wheezy sound when I do cough and the mucas is . more clear now . ### REPLY: Hi thanks for asking question. Here are few possibilities I your case.First this pain could be simple muscular strain related pain by heavyweight lift or by any unusual activity. It will heal within few days. Analgesic and hot compression useful. Second along with cough do you have fever?? Weight loss??? If yes then respiratory causes ruled out esp. Pneumonia or TB like condition. Chest x-ray and sputum examination useful. Do you have gastric problem? Like acid reflux or ulcer.? Then they can lead referred chest pain. Finally rule out card cardiac problem by simply investigation ECG. I hope my suggestion will helpful to 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 8 month old daughter has been diagnosed w asthma but been on albuterol/pulmicort for 6 months and no improvement. She had eczema and it is irritated all the time. I am planning to switch her formula to soy. I do believe it could be allergies. How long if this is the case to see improvement with the new formula? ### REPLY: Hi, Thank you for asking question on . You are rightly guessed it is due to allergy. Allergic rhinitis may be acting as a trigger. In addition to your Albuterol, add Basting and Montelukast in consultation with your doctor. This may help in alleviating symptoms fast. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### 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 ve had issues recently with piriformis syndrome. I fell outside and landed in my back tonight. I had excruciating pain in my left glute down to my ankle. The pain went away with aleve, Ice and rest. I m still sore, my ankle feels like I stubbed it and if I rotate my torso to the left I can feel soreness in my chest. Is this normal? Should I see a doctor? ### REPLY: Hello, I have studied your case. Due to compression of nerve root there can be gluteal, and leg pain associated with it leading to walking difficulty. Medication like methylcobalamine with neurotrophic like pregabalin will reduce pain; you can take them consulting your treating doctor. You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case. I will advise checking your it B12 and it D3 level. If MRI shows disc compressing on nerve root then surgical decompression is permanent solution. You can send your MRI films or report. So that I can help you better. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctors respect to you first.... see please help me, my dad had both knees replaced 4 years back still he is in pain, his knee has swollen up very much he cant take it any more many doctors have seen it but no result please can anyone help my dad to walk again pleaseee ### REPLY: Hello, As he has undergone total knee replacement in the past, has he undergone post knee replacement rehabilitation program?  If not then I will advise undergoing one with the competitive physiotherapist who can help him regain the strength in the core, hip muscles, thigh muscles and improve this gait and knee range of motion. In my clinical practice of over 12 years, most total knee replacement cases have responded well when guided physiotherapy have been implemented. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been so busy caring for my sick dog that I ignored the tight pain in my chest all week and now am finding my breathing laboured, I had a head cold 2 weeks ago and this is the outcome. Used my nieces easi breathe last night and this morn but not sure if its working as I taste or feel nothing coming from it. I would lovee to avoid antibiotics and have been using oregano oil which I feel is breaking it up a bit, anything eles I can do ? ### REPLY: Thanks for your question on . I can understand your concern. Possibility of post infectious bronchitis is more likely. Bronchitis (inflammation of airways) is common after viral upper respiratory tract infection (URI) like common cold. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease and treatment is based on severity only. You may need inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, you will be alright with all these in 1-2 weeks. Hope I have solved your query. I will be happy to help you further. Wish you good health. 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 a 38 year old female is advised to take Carnisure 500mg tablet once a day. I bought it and the tablet says Levocarnitine tablets. I had a neck pain and later noticed my hand is weak, cannot lift any weight. When i check details about this tablet, I found it is used for fertility treatment. Can you please advice how it works for my issue. ### REPLY: Hi, Thank you for posting your query. I have noted your symptoms. Carnivore (levocarnitine) is not recommended for your problem. The likely cause in your case seems to be nerve compression in the neck region, which can lead to neck pain as well as weakness and numbness of hands. The diagnosis can be confirmed by doing an MRI scan of the cervical spine. So, you should consult your neurologist and discuss these issues. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Two questions: 1) Can syphilis be transferred when a person with syphilitic chancres on his fingers prepares food for others? 2) If transfer of syphilis requires direct contact with a chancre, how can syphilis still be passed to another person after the signs of both stage one (chancre) and stage two (rash) have subsided? ### REPLY: Hi sir...your question is two part .the 1st part answer is no syphilis can't be transmitted through preparing food as it is transmitted mainly by contact with mucous membrane (mainly sexual contact)...so you need not worry about that.......2nd part : syphilis has four stages primary and secondary and latent and tertiary...primary and secondary stages are most infectious stage as bacteria multiplications and increased number of bacteria will be transmitted early by contact....latent stage bacteria decreased and not multiply, and it may be infectious in early latent and after that it will not be infectious ...in the tertiary stage although severe complication but is not infectious....thank you for your interest about that....take care of your health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I HAVE JUST STARTED TAKING VOTRIENT 800 MG DAILY. I HAVE RENAL CELL CANCER IN BOTH LUNGS AND IN MY TRANSPLANT KIDNEY . IS THERE A SPECIAL DIET I SHOULD BE ON? WILL A GLASS OF WINE BOTHER THE MEDICATION? I AM AWARE THAT IT IS BEST TO EAT SMALL MEALS AND EAT MORE OFTEN. I AM USED TO A NUMBER OF DIFFERENT MEDS AS TRANSPLANT WAS IN 2005 AND HAD NEPHRECTOMY OF LEFT NATIVE IN 2010. ### REPLY: Hi, Very sorry to hear about your problems. According to you the disease is at stage IV. Stage IV renal cell carcinoma has not got good prognosis. At your present condition protein restricted diet is necessary. Votrient is pazopanib, a targeted therapy used in metastatic renal cell carcinoma. Glass of wine should not be encouraged at this stage though it will not alter the metabolism of .  Considering your present medical condition, better to avoid wine. 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 have had horrible abdominal pain for months now. I have a previous history of ulcerative colitis which has been ruled in remission after undergoing an endoscopy and colonoscopy. I am seeing a pain specialist on Monday. Any ideas which medicines can be used to help relieve abdominal pain? ### REPLY: Hi ! Good evening. I am  answering your query. Your abdominal pain could be due to a reactivation of the disease process (ulcerative colitis) which was in remission till now. If I were your doctor, I would prescribe some anti-spasmodic . I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I violently sneeze upon waking in the mornings and get through several tissues. Troughout the day its the same,and this has been so for months.Somedays I can have slight earache which can be either ear.Am extremely tired every day and have no energy.I notice I often breath through my mouth.Have had antibiotics,but to no avail. ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. Were I treating you, I would prescribe you intranasal corticosteroid nasal spray for at least 2 weeks. If your symptoms are completely under control, I would stop intranasal corticosteroids and suggest you montelukast and levocetirizine regularly thereafter.2. I would suggest you allergy testing, especially for indoor air-borne allergens like house dust mite, common indoor molds in your region, cockroach allergen, pet dander (if you have pets). If you are keeping windows open during night, I would also suggest you testing for common pollen in your region. This will help you to know the substances causing troubles to you as well as to know how to avoid them. Based on the report, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on your immune system and improve allergy symptoms gradually.3. I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.4. Regular breathing exercises and a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc.) will also help improve your lung capacity and immunity respectively and will help you in a long run.5. I would think earache as related to repeated nasal obstruction and hence it will improve with improvement of nose symptoms. If you feel severe earache, ear discharge or reduced hearing, I would suggest you to consult an ENT specialist. Hope above suggestions will be helpful to you. Should you have any further concern, please feel free to ask at . Thank you & 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 doctors, I am from bangalore I am 29 years old and my husband is 32 years old we have been married for 7+ years now and trying for baby from past 3-4 yrs. My husband is diagnosed with astenozoospermia problem, His Analysis shows that sperm count=65 mill/ml, a+b=0.7%, c=1.5% and d=97 % and in his resent analysis shows that there are 1-3 motale sperms. Back in 2006 he had kidney stones while investigating further we came to know that he is having single kidney by birth and his seminal vesicle is blocked. We have met 2 doctors till now one suggeted to go for ICSI this doctor had put him under medication like Natoz,HIQ + and profert-M there were no much changes in the analysis and another has suggested for TESE with ICSI. Kindly suggest which procedure is best for us. ### REPLY: Hello, Thanks for the query, Asthenospermia refers to motility defects in sperm. This could be due to problem in sperm production., malnutrition, testicular injury, overheating, genetic, smoking. In your husbands' case the best treatment option would be:A transrectal ultrasound (THUS) in order to confirm the presence or absence of ejaculatory duct obstruction, Presence of a cyst or calcification at the ejaculatory duct, The size of the seminal vesicles will be measured to determine whether there is any significant obstruction. Following which last resort would be CSI, TEST, ESA. Wish you good luck. Regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, im 29 yrs old and today i experience something that i never had, my hrt started beating really fast, i got dizzy, and sweating. I tried to sit down and take a deep breath but did not work. It lasted about 20 mins, this happened after a cup of coffee(which i have everyday)...should i see a dr asap and can it be that im anemic. ### REPLY: Hello, This can be a cardiac arrhythmia like PSV or atrial fibrillation, or just rapid heart rate both precipitated by the coffee, in which heart rate suddenly goes up and also suddenly decreases. Blood pressure falls during these episodes and one has dizziness, fainting, blackouts, sometimes syncope. Usually ECG is normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You will need 24 hour holder monitoring. So visit nearby cardiologist for this investigation. Avoid coffee and other stimulant if any. Also, hemoglobin and thyroid test should be done. Ln order to abort such episodes you should try to cough hard. Is there any stress or anxiety associated. Till the time your evaluation is complete, you can ask your local doctor for tab collar LA 20 mg once a day.  If none of the above is successful and episodes recurs then last option is of electrophysiologist studies which is invasive test which can diagnose and treat the arrhythmia permanently in most of the cases. ### 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 18 weeks pregnant and have a schedualed amniocentisis on tuesday to check for chromosonal abnormalities my doctors office called two days ago and diagnosed me with bacterial vaginosis and called in my perscription for flagyl wich i have been taking for two days .is the amniocentisis still safe to have with my diagnosis of bv and the perscription i am currantly taking flagyl ### REPLY: Hi, .  I welcome you to  VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. Furthermore, I will suggest you the best possible treatment options. Bacterial vaginosis is purely vaginal infection, and it is restricted to vagina only. Amniocentesis is done under USG guidance from abdominal side. So there is no vaginal connection. You came safely go ahead with amniocentesis and continue with treatment for bacterial vaginosis I hope this answer helps you. Thanks  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i was wondering if i should call my doctor about swelling in my right foot is more swollen than my left and i could not spread my toes apart because of the swelling. i also had blurry vision the night before last. should i be concerned i am almost completed with my 37 week of pregnancy. ### REPLY: Hello dear, I understand your concern. In my opinion the presence of swelling in right foot more than left foot is a normal finding. Because the uterus slightly rotates to right side this causes compression over the veins over the right side leading to swelling on right side. The swelling of feet is due to various reasons:-1)Physiological edema -This is normally seen due to compression of uterus over blood vessels. This will subside after 12 hours of bed rest. This is seen more in later months of pregnancy.2)Anemia with low proteins.3)Hypertension in pregnancy.4)Excess liquor. I suggest you to rule out anemia by getting done HE. And as there is blurring of vision along with swelling I suggest you to rule out high BP. Nothing to worry. It will subside. Preferably lie on left side and observe your fetal movements. Hope this helps. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My nephews wife who just delivered a baby two months ago and is 33 years old, just had surgery to remove a tumor that they thought was a cyst on her ovary but actually was a tumor that started on appendix and attached to ovary. They removed her appendis, ovary, and ovarian tube. The lab results just came back and they said that she had precancerous cells. Are chances likely where it started on the appendix that they will come back? ### REPLY: Hi, Thanks for writing in. Precancerous or cancerous cells in the appendix are rare, but they can become aggressive. Recurrence rate is high but since the patient got a surgery done therefore the risk is less than precancerous cells were confirmed. The patient should follow up with the oncologist as and when required. This can be every 2 to 3 months and get follow-up ultrasound scan done. If required, CT scan must also be done as per recommendation of the doctor. If she has any pain or discomfort in the right lower abdomen then she should consult her doctor immediately at the earliest. ### 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 Samuel....we are trying for a baby and i was tested positiove with my ovulation kit day yesterday and we had sex(missionary position). My husband wasnt able to have a deep penetration and his liquid came out of the vagina. However I maintained an elevation position for around an hour. Could I get pregnant.? ### REPLY: Hello...thanks for trusting the  doctors for your health related queries. I guess your concern is about.can you get pregnant if u maintained an elevation position.right.well.my answer is- YES, u can pregnant if u maintained an elevation position after sex, but the ejaculation should occur inside the vagina. Ejaculation inside the vagina is more important thing. At least some amount of ejaculation should occur inside the vagina. As u told that your husband liquid is come out from the vagina, but u didn't give info regarding the amount of ejaculation. Whether your husband ejaculate outside the vagina or only some amount of this is ejaculated. So it is difficult for me to comment on this. With the above discussion u can try out my suggestions-1. Ur husband try to ejaculate inside the vagina, it gives better result.2. If your can't able to ejaculate inside the vagina, then u can try GUI (intrauterine insemination), in this the husbands' semen directly injected inside the womb, so that chances of getting pregnancy is high.3. If u r in hurry then visit nearby infertility specialist. He /she can help u. I hope the above information is useful, informative and helpful for u.regards- .  I pray the God that u will be blessed with a cute n healthy baby as early as possible.hopefully TWINS) ### 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 red/pink dry spots on the front of my upper body and my back. They do not itch . I went from having two to about ten in about 3 days. I have also been having a sore throat , I had puss pockets... thinking it was strep , but I tested negative when I went to the doctor. The doctor said that the spots were possibly pityriasis rosea . I was just wondering what your thoughts were and if there is anything I could do about it? I ve never had anything like it before in my life, and I m just curious as to why it would start now? I am a 21 year old female, if that is information you need. ### REPLY: Hi, Thanks for writing to us. From the description provided it could either be satyriasis rose or psoriasis. Both of these conditions can sometimes be preceded by upper respiratory tract infection. So firstly consult a dermatologist and get your diagnosis confirmed. P rose is a self resolving condition and responds to application of steroid creams, calamine lotion and oral antihistamine. Psoriasis requires emollients and steroid creams. Hope that answered your 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: I had a ct scan and they said that I have a small spot that is thin on my aorta it is in the abdominal area and they were doing a ct scan of my chest. they want to do another ct of my abdoman to zero in on the spot is this something that sounds like I should consider doing. ### REPLY: Hi ! I had gone through your question and I understand your concern. The conditions when we find thin spot in abdominal aorta we call it Abdominal Aortic Aneurysm.  Depending on the size of the spot you may have symptoms or no. When you start to have abdominal or back pain, it shows that the spot is getting bigger or a rupture. A CT is used to measure the size and the anatomy of the spot . The spot that are more than 5 -6 in diameter must be repaired less than that we keep monitoring. The thing that you should do is to quit smoking if you do. Check you blood pressure, It's important to keep it low. Less than 140/90 Check your cholesterol level , take statins (atorvastatin) if it's high. Wish you good health. Thank you for using . ### 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 Mom had a single Plasmacytoma in her thoracic spine in 2011 and was treated with radiation. She has been in remission until this week when her oncologist found 2 tumors or places of malignancy on her hip and her ribs. Mom is almost 85 and when she told her oncologist she did not want chemotherapy the oncologist suggested we get Hospice on board. Not sure what her blood work showed but can I assume from the Hospice suggestion that she has less than 1 yr to live w/out Chemotherapy? ### REPLY: Thanks for your question on . Plasmacytoma is highly aggressive bone malignancy.  It can rapidly spread in other bones and distal organs. And it is highly responsive to chemotherapy and radiotherapy. Usual life expectancy with chemo and radiotherapy is up to 1 year. But in your mothers' case as tumor had spread in hip bone and in ribs, plus she denied further treatment, prognosis is not good. Life expectancy will be less than 6-7 months in your mothers case. Better to discuss end of life issues and give palliative treatment for bone cancer. ### 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 Lundi, II Hv been depressed with some 43 years now, as well as schitophrenia since 1981. I get high and low moods, and am wondering if this bi-polar 2, or psychotic depression I have? I am 64 years old, and female. YYYY@YYYY ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. You know yourself better than anybody else, this includes your doctor. I think you are being treated by psychiatrist for the last 43 years. You must know about bipolar disorder to diagnose it. You don't have enough knowledge. So leave the job to your psychiatrist or psychologist. Just present yourself in front of them and relax. They know how to do the job well, and they will do it. Worrying increases your anxiety and mood swings. Learn to relax. Relaxation is possible when you be free of thoughts. Such a state is possible when you understand life and its value. I can help you as a psychotherapist if you post a premium question with all details about your illnesses and lifestyle and family etc. 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 fell on the ice and landed on my back kind of on the left side. Now the side and back and front of my lower right ribs hurt when I press on them or get up or down to sit or sleep.  Also when I cough there is pain.Should I be concerned, or will it get better on its own in time. ### REPLY: Welcome to ChatDoctorAfter going through your query I concluded that you got soft tissue injury to your chest, it seems to be mainly muscular injury. You need treatment as rest and analgesic such as ibuprofen for pain relief. It will heal in nearly 15 days. If you develop fever than you need to worry. You can discuss with your Doctor about it. Hope your query get answered. If you have any further questions then don't hesitate to writing to us. I will be happy to help you. You can also write to me directly on below link:https://www.bit.ly/ask . 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 wife is undergone 3 failed IUI two with Letroz and one with Siphene along with LH surge. All the previous IUIs have 22- 28 mm matured follicles and IUIs done after rupturing the follicles. Now we are about to do fourth one .While on this follicle study mature follicle is 22 mm with 8.4 mm endometric size is noticed. Im having Levocarnitine as our doctor told my motility is 2-3% less than normal,my sperm count is normal. My wife is having normal menstrual cycle and she is 33 years old and Im 40. We have been identified as unexplained infertility and doctor suggested IUI. After 3 IUIs she had undergone a diagnostic laproscopy and found everything normal in that part also. All the IUIs done are with sperm washing which increases the chances for getting more motile sperms and even after that what will be the reason for not conceiving? And when will we move to IVF? and how much it cost normally? And what are the other treatments which we have to carry out further? We are really disappointed upon the failed IUIs. Please help. ### REPLY: You need a good counselling regarding this. Even if all the things are fine, there are some very minute things that can go wrong like the protein that should be there in the sperms to be able to get inside the egg may be mining. This is the last thing that can go wrong. The point is to see if the IVF is happening or not. In the IVF if the sperm is still not able to get inside the egg then the protein concerned is to be blamed. You can ask your doc to prescribe and refer you for IVF. ### 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 14 year old son has been refusing to go to school because he is sad. He has therapy with a psychologist but is not on medication. He goes through this periodically but is not an medication. We are at a point where talking is not fixing the school refusal problem. What is the best medication to help 6 160lbs 14 yr old boy with depression anxiety disorder? ### REPLY: DearWelcome to ChatDoctorWe understand your concerns went through your details. The condition of your son could be categorized under school delinquency. Further, comes under the category of OCD rather than anxiety. Best option is Behavioral Therapy. You may consult a psychiatrist and a psychologist for combined treatment. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. 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: my grandmother is 65 yrs old and recently she had a sour throat which turned so severe that she could not even speak properly.doctor took x ray and the report says "LUNG FIELD REVEALS MILDLY PROMINENT BRONCHI O-VASCULAR MARKINGS". her ESR  is 20 mm.and the doctor says MILD BRONCHITIS. SHE IS GIVEN RABON-20,XYZOL,MONTELUKAST SODIUM,LEVOCYTRYZENE DYHYDROCHLORIDE, AND LYCO GEL since about a week with no improvement. PLEASE TELL YOUR OPINION ### REPLY: Thanks for your question on . I can understand your concern. She is not improving because she is not taking appropriate treatment for bronchitis. Bronchitis needs inhaled treatment based on severity of the disease. So better to get done PFT (Pulmonary Function Test) first.PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease and treatment is based on severity only. She will mostly improve with inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, she will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your grandmother. 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: Hello DoctorMy wife is in stage 5 of CKD, GFR of 14 now she is 30years now, our doctors told to be prepared for Transplant or dialysis. For this age which is best transplant or Dialysis. We are in USA and like to come to Chennai for Transplantation. Are you doing Kidney transplants in your hospital How long do the patient need to stay in the hospitalHow long it is required to stay in Chennai post surgeryWhat will be the average cost of surgery Will the hospitals provide detailed invoices with CPT codes to claim it from my insurance at USA ### REPLY: HelloThanks for query. Based on the information that you have provided I would like to answer your queries as under 1)In view of age of your wife being 30 years (she is young) and has very long life to live hence I would suggest you to go for Renal Transplant.2) I would suggest you to arrange for related donor It gives good results and longer life to the recipient after transplant as chances of kidney rejection are very less with kidney of a related donor.3)Patient has to be in hospital for 10 -15 days .4)You will need to stay in Chennai for one more week just for observation .5)The cost of surgery differs from hospital to Hospital but on an average it would cost you about 10-15 lakhs Indian rupee in good corporate hospital.6) Hospital will issue all the bills and invoices that you will pay for. You have to inquire with your insurance co in the USA whether they can reimburse the cost of treatment if treated in India. .  ### 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 this is buvana age-24 from chennai.Iam having sneezing while cooking and cleaning my rooms for the past 1 yr for this i have consulted the doctor and have undergone an endoscopy on my nose.and the doctor precscribed me to use the nasal spray called DUONASE,after using the spary i feel relieve in the 10min.as i have been using this spary for the last 4months.In the mean i use to have cough continously where it will goes after i take the tablets and comes again within 1 or 2 month. in between i have taken the blood test it shows me everything is normal.but last week i had severe cough and i found difficult to breathe in the night.this breething problem is happening for the first time.what should i do now?how to cure these things?is this is the symptoms for ASTHUMA?Pls advice......... Pls suggest me which nasal spray i can use ... or else can i use DUONASE which iam using currently? iam having cough with sputum. ### REPLY: Hello Bulawayo are suffering from Allergic Rhinitis and associated wheezy bronchitis. I think it is better you go for Budecort1.0 mg res pules by nebulizer regularly once a day for 15 days and take telecast daily for 1 month, if you have Duane nasal spray you continue to take, You must avoid air solution exposure. You are going to be all right soon.Otherwise, you may take forecourt 200 inhalers regularly. They are safe and effective. ### 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 female 22 years old. A few months ago I was hospitalized for kidney stones and pyelonephritis. Since then I have had terrible lower back pain and recently I have had off coloured urine, dark flakes in my urine, and a low grade fever. I have a crippling fear of doctors so I only go in when I absolutely have to. Should I be concerned? ### REPLY: HelloThanks for query. Sever pain lower back, high grade fever off colored urine are strongly suggestive of UTI secondary to stone impacted in Ureter. Please consult qualified Urologist for clinical assessment and get following basic tests done to confirm the diagnosis 1) Urine Routine and Urine culture 2) Ultrasound Scanning of abdomen 3) Renal function tests. Neglecting to see doctor may result in permanent damage to the kidney. Further treatment will depend upon the results of these tests as regards degree of obstruction due to stone, back pressure changes in kidney and final diagnosis, .  ### 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 ll be meeting my boyfriend on july this yer. Because we are not yet ready, he was suggesting me to take POSNOR2 for precaution. and he said he both me 2 tablet already. this is my first time to hear about this so i check it here. what is this all about and how and when to take this posnor2? thanks a lot! ### REPLY: Hi, It is an emergency contraceptive pill which is used to prevent an unwanted pregnancy following an unprotected sex or if a contraceptive method has failed. Each pack contains two round, white tablets. Each tablet contains 750 micrograms of levonorgestrel, which is the active ingredient. First tablet should be taken within 72 hours of having unprotected sex it will be more effective if taken as soon as possible after unprotected sex. The second tablet should be taken 12 hours after the first. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, for the last couple months, my fiance has been experiencing burning sensations the moment he inserts his penis inside me. After sex he has smal cuts on the outside of his penis and it looks very red and sore. It does NOT itch however. During erection and oral sex, he is fine, but the moment he inserts, the pain begins. The pain has become so intense recently, that he has stopped sex immediately. He tells me that he feels something csmall on the walls of my vagina that is hurting him and causing this burning sensation. I however, dont feel any pain and i am well lubricated naturally.. Please help! Thanks!!! ### REPLY: Hello,It might be that you have done rough sex with your girlfriend. There can be injury to the soft tissues of penis and urethra. This can cause small lacerations in the wall of urethra. When more force is exerted due to continued sex, this will cause burning and pain during passing urine as the soft tissues are engorged with blood and blood vessels are dilated and the lining or urethra might have suffered small amount of damage. Please avoid sex for 3 to 4 days and use lubrication while doing it gently. Apply enough lubrication jelly on your penis before penetration. Have a relaxed sex session with long foreplay and create a good emotional bond with your wife. This will also help in avoiding friction injury to your penis during intercourse. 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 Doc , I am planning for a IVF preganancy, my TSH is 18 uIU/ml. What are the consequences of this. Should I go for IVF or wait for TSH to be controlled with medication. My age is 33 years. The IVF specialist has prescribed me Eltroxin 50mcg. Do I need to consult and Endocrinologist. Thanks - Prerna ### REPLY: Hi arena, Welcome to  . Normal TSH should be between 0.5 to 5 mini/ml. Yours is on higher side. You need to wait till your thyroid profile comes to normal range. Because if ts his high it will affect implantation of embryo by inhibiting normal endometrium growth.Also, if you conceive chances of baby getting hypothyroidism is more. So its always advice to control thyroid levels and plan for pregnancy.  Ya it's better if it is possible for you to consult an endocrinologist. Hope I have been helpful. 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: So my dr says I have laryengitis since I am losing my voice and have a sore throat but now I see what appears to be swollen taste buds towards the back of my tongue. Are the two things connected and how long till I am back to normal I also started coughing a lot today and had a runny nose is this a sign I am getting worse? ### REPLY: Hi, Relax, Laryngitis is pretty common and easy to deal with! Symptoms for laryngitis include 1. Cold2. Cough3. Sore throat4. Fever5. Swollen glands in the neck6. Pain with swallowing7. A feeling of fullness in the throat or neck8. Runny nose9. Loss of voiceSwollen taste buds (but an actual throat examination may show this to be congested larynx/ swollen glands) may be associated with this. I would recommend you to have it checked again with your doctor to confirm the same. It usually takes 3-7 days to be back to normal. You can try salt water gargling thrice daily in the meantime. Take Marrakesh ### 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: doctor,  i am having a swelling in the middle of my back for more than 3 years. No pain or problems. But if pressed on the swelling, pus with bad smell comes out and swelling reduces. Again it swells in 2 or 3 months. if not disturbed, the swelling breaks it self and pus comes out. The cycle is repeating. please let me know the remedy.Thank you! ### REPLY: Welcome to . My name is Doctor Salem Your Lehman and I will answer your questionSwelling with pus is usually caused by an abscess formed due to infection. Since your swelling is persistent, it seems that u have a resistant strain of bacteria. If I were you doctor, I would examine the swelling and order a culture and sensitivity test of the pus to isolate the strain of bacteria causing your problem. Until the results come back u would have been put on antibiotics empirically. It is therefore recommended that you meet a doctor in person for further investigation and treatment. Wishing you a Healthy Life ### 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 what look like bug bite but there is a rash-like ring around them with tiny blisters, and there are about 5 of those on my leg, arm and stomach and then my nose is covered in scabs and it leaks fluid when i wipe my nose and when blowing my nose it is yellow and rock like. ### REPLY: Hello. Thanks for writing to us at  From your description it seems like you have a condition known as Erythema Multiform (EM). In EM there are targeted lesions with central necrosis, edema and peripheral red rim. There may be fluid filled lesions if inflammation is intense. The lesions are commonly distributed on arms, legs and face. It is a type of hypersensitivity reaction to various triggers, most commonly Herpes Simplex Virus in people who have a history of cold sores. Treatment is with topical steroid+antibiotic cream combination and once daily Oral antihistamine e.g. cetirizine 10 mg once daily. In those cases who are preceded by an episode of cold sores, a course of an antiviral is also warranted. Since the lesson on your nose is also discharging yellowish fluid and had crusted lesions therefore likely it has developed secondary bacterial infection. In view of that I would also suggest a week of an oral antibacterial for a week e.g. either flucloxacillin Or cephalexin. I would suggest that you visit a dermatologist in your region for a confirmatory diagnosis as well as appropriate treatment. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a pain in my chest for 10 weeks now. I am only 19 years old and would have been able to do exercise all day if I wanted! But now for some reason I find it hard to walk up the stairs, I am light headed, very weak and sometimes find it hard to breath! I have been to my local gp and a cardiac specialist and they say everything is fine but no one has given me a diagnosis! I have done the treadmill test ,echocardiogram, ct scan, chest x ray and bloods and everything is coming back clear. There is no tenderness on the ribcage and the pain is sharp and only lasts for a few seconds but happens about 8 to 10 times a day! As well it feels as if my rib cage is hollow and all thats there is the heart thumping away! So can you tell me what the problem is? ### REPLY: Hello, I need to know more about the symptoms, like precipitating factors, factors that increase pain etc. Mostly it's a gastritis and reflux disease. Do you upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, if yes it further supports the diagnosis? You should avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. You can get prescribed tab Pan DSR 40 mg before breakfast once a day for 2 weeks.  Does this pain increase on deep breathing and coughing etc. if yes it a pain arising from lining of lungs and needs NSAIDs treatment and evaluation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Recently I ve had lower back pain and am now, on occasion, suffering from simultaneous electric shock like pain in both my inner hip/groin along with sharp electric shock like pain in the back of my foot. The pain only lasts a few seconds but is quite unbearable. Any ideas? ### REPLY: Here you have told about symptoms like back pain and shock like pain or sensation in inner hip as well the back of the foot. This kind of pain is usually related to back pain(spinal issue related with disc and nerve) only, and rarely it may also be related to vitamin B deficiency along with less water intake. I suggest visiting an orthopedic and get your self examine properly, if needed go for x-ray and then do take blood report to know about vitamin B level in body. As per the report and evaluation doctor will suggest for the precautionary treatment with medication. I suggest also visit a physio for postural correction, advice on back and leg strengthening and stretching exercises. And also do follow it. You can also use a hot bag at your back for some relief in pain. As per your symptoms what you have given nothing looks major, so I have given you simple guideline and I am sure you will feel better once you start taking steps on it. 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: Dear Dr ,my dad has been diagonised as having problems with the heart, i.e some fluid in the heart and the lungs as well. for a long time he had a prolonged caugh as a result of T.B and heavy smoking. T.b got cured long time ago about 30yrs.He is on inhaler salbutamol but no change at all.  please help which drug will help him. ### REPLY: Thanks for your question on . I can understand your concern. He is having pericardial effusion (fluid on heart) and pleural effusion (fluid in the lung). Since he is chronic smoker and past history of tuberculosis, possibility of right sided heart failure and cor pulmonale is more. This can cause fluid retention in the body. Hence, fluid accumulate in lungs and heart. So better to get done 2d echo for the diagnosis of right sided heart failure and cor pulmonale. He may need diuretic .  ### 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 5 yo, presented two nights @0100 ago w/ acute onset n/v and abd discomfort, her abd was - for point tenderness, rebound pain, or regidity, that continued thru the day, she was afebrile until about 1600 at which point she spiked to 103, I gave her tylenol, the following morning she was afebrile and seemed to be cleared of the n/v. Last night my 4 yo son started w/ the same sx also afebrile, now the female is c/o abd pain and nausea again, she remains afebrile. I suspect a viral etiology with the delayed onset of the sibling. Since her sx have now reached a 3 day point, do I need to take her to the ped for eval or continue to treat her at home, thanks, RN ### REPLY: Hi, By what you say I feel that both the kids are having viral illness as it spread in two members of the same family. I will explain to you how a viral illness behaves so that you can be more confident. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day.  If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. 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 was delay menstruation almost 2 weeks but in pregnancy test it s negative that s why i go to ob and prescribed me a duphaston even she s not sure if i m pregnant or not.if it s okay if i ll take it?there s no side effect if i m pregnant?and what i m going to do if I ve missed to take 1 tablet in one day.the prescribed is 2X a day.please help me.thank you ### REPLY: Hello dairy understand your concernThere is no harmful effect of the phaeton on pregnancy. If you will be pregnant then it helps to maintain the pregnancy and promote the growth of baby. But I assume that doctor gave you to induce the period. Sometime missed one dose cause spotting and starting of period occurs. But overall no major concern about missed one dose. I would suggest consulting the pregnancy by blood  test as it is more accurate than urinary pregnancy test. Avoid stress, take healthy diet, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, im on Yamini (drospirenone and ethinylesstradiol tablets- 21) from the past 5 months for treating irregular periods. I ve been facing anger irribility from the past 2 to 3 months.... Is it a side effect? Why after so many months? What can I do to safe gaurd my health? ### REPLY: Mood changes are common with contraceptive . This varies with person to person. Some women are depressed and some are anxious or angry. Consider meditation and mind relaxing techniques. Physical exercise will also be useful in elevating mood.In case of persistent mood change, considering changing to other types of contraception after consulting with your doctor. Hope I have answered your query. Let me know if I can assist you further. 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, I have a small hole in my leg that scabs over if I leave alone for weeks the problem is the scab never goes away. And when I remove there is still a hole in my leg what could be cauing it I have no diabetes nor ddo I remember injuring my leg..? ### REPLY: Hi, What you are mentioning is like a small wound which heals with a scab formation and every time you remove the scab, maybe it seems that the raw underneath tissue become visible. This could be due to an old injury which may have never healed properly or maybe some kind of skin lesion with recurrent scaling. What I advise you is to visit a dermatologist and get it examined properly and then subsequently you will have to use an ointment for regular .  Do not hesitate to contact me if you need any further assistance.  Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been been suffering with Lupus SLE and Discord and I also suffered a heart attack a year ago which a stint has been place and because of that I was seeing a phsychaitris for anxiety for fear of dying in my sleep.  My Lupus causes extreme pain that affects my joints and I have been seeing a dr. in Tampa for 2 yrs and suddendly she is no longer in practice which cause me to be hospitilize on 10/15 for 4 days at Fawcett Memorial Hospital because of the extreme pain i had, and I also thought I was having another heart attack which ended up being a very bad anxiety attack,  Im looking for a dr which can help me with my pain which I have a dr. that has referred me to pain management.  The problem is no dr can see me until the end of Dec 2013 or Jan. 2014.  What can I do? ### REPLY: HIT hank for asking to  I really understand your pain but no need to worry it will go to alright soon first thing you need to do is just relax bring your confidence back, say that it will be alright keep your moral very high, this pain won't hurt you anymore, I would advise you to start the corticosteroids start with 40 mg thrice in day and then tapered it gradually to 10 mg once in day within 12 days, you will get good result I would be happy to help you for further question or advise have nice 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 in the recent week my knee s have started produce pain when placing weight upon.My job involve s being on my feet daily mostly upon a hard floor surface.Have not had knee problems prior,it has only starting occuring this week.I have not fallen or jarred nor knocked my knee s upon anything.Any suggest s as what might be causing such a reaction to start occuring recently? ### REPLY: Hello, In the present instance if you are feeling this pain first time, then most probably, this can be due to strain over your knee.  To me at present it doesn't look to be e a case of osteoarthritis knee. I will advise you to follow to have relief at your knee pain- 1. You should avoid heavy work.2. You should take proper rest.3.  Furthermore, you may take a good analgesic like acetaminophen for relief from pain.4. Furthermore, you main apply warm fomentation to get relief from pain.5. Furthermore, you should also wear a knee cap to support your knee. Furthermore, you may have relief from this knee pain in next 5 to 7 days. 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 am sufferng from dhat syndrome for past 4 years ad my sperm count is also very low. due to masterbation i am suffering from premature ejaculation. i am lean and gets tired. i am 28 years old and i want to marry now but i am afraid of marrying because of the above reasons. plz help me. ### REPLY: Hello appreciate your concerns will definitely help you in the best possible way if you can answer my these questions' presence of any medical or metabolic disease Do you smoke or consume liquors, you can be got married and be a father of child first it needs to rule out any organic cause for low sperm count and non-motile sperms, by treating the underlying cause, healthy sperms can be improved it fails to increase, than artificial insemination and other artificial reproductive techniques can be used. Ask him to have good balanced food multivitamin and minerals supplements you should avoid smoking and alcohol exercise regularly Hope this answers your question 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 been suffering from fever for last one week or so. It goes with the effect of mediande and comes back after the effect is over. Its a normal fever with body pain no other issues but its been time I m facing all this. Please suggest some medicines and is it a symptoms of typhoide or malaria please suggest what should I do. Thank you ### REPLY: Hi, Welcome to , Fever with body ache since 7 days could be due to acute viral fever or upper respiratory infection. You will have to go for routine blood testing, urinalysis,ESR, preipheral smear for malaria, widal test for thyroid. You will have to take antibiotics(quinolones or accolades group preferred) with antipyretic, analgesics and antacids for 3 to 4 days course. If certain cause is found out then treatment is depended upon the underlying cause. Consult physician for further treatment. Thanks and  ### 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 doc i am on 16 day but still not ovulated. My right overy size is 24 n letf is 16. ET is 9.6. Right now i am on my way to get injection to rupture my overy. Can u plz tell me Post injection how long it takes to actual rupture n when should i have inetercourse ### REPLY: Hi, Thanks for writing to . Once you take injection for rupture of follicle it takes average time between 6 to 36hrs to rupture.  So I generally suggest having intercourse from 12 hrs after injection to 48hrs later. This is the ideal period. And the sperms have the capacity to survive in uterus for 2 to 3 days. So no need to have very frequent intercourse. Instead, you can plan once in 12 hrs. This increases chances of conception. Hope I have been helpful. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had a surgery done on a right hydrocele about a year ago, and recently the scar has developed a red lump under it. I am worried about this because I leave for basic training in about 2 weeks and I dont want it to make me fail my physical. It doesnt really hurt unless I put pressure on it. ### REPLY: Hello! Thank you for the query. A lump in the scar area after such long time usually indicates some tissues' irritation due to stitches which were left under the skin. This stitches usually get absorbed after 2-3 months. However, in some patients stitches can trigger inflammatory reaction. This results with lump creation. Other possibility is that your scar is growing and creating a keloid. Both conditions are not serious. But you should consult a surgeon with it. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi dr.for the last 3 weeks i developed a strange thing that i never usedcto experience,that at night i feel breathless such that sometimes i feel like i am not getting oxygen,am 22 and non of my relatives hav cases of asthma what could be the problem and what is the uses of Bifilac and Azithromycin-500. ### REPLY: Thanks for your question on . I can understand your concern. Breathlessness are commonly seen in bronchitis. Get a chest x-ray done. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). The other possibility is anxiety or stress.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. 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: Just had 2nd kidney transplant..first one lasted 34 years.  The surgeon attached my donated kidney ureter to my existing ureter of my native born kidney and not the ureter is scarred and narrowed.  they put in nephrostomy tube and creatinine is rising.  I dont understand why they didnt attach the transplanted ureter directly to my bladder.  What do you think? ### REPLY: Hello and welcome to . As a Urologist and transplant surgeon, i can understand your anxiety. Your doubt is very genuine. That corrective surgery can be done even now. The main reason for nephrology, is to relieve obstruction to the kidney. The cause for the obstruction, is the narrowing in the ureter below. Creatinine starts rising, when the obstruction and failure becomes severe. This could be avoided, by placing ureter to bladder, as is done routinely. As to why it was not done, only the surgeon can answer. Discuss with him. .  Manga. ### END