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 32 yrs old and my wife is 33yrs old. i had torsion surgery in 2010 and i got infected with (Staphylococcus Aureus. my wife got pregnant this year and after a month she had a miscarriage. i want to know if (Staphylococcus Aureus could be responsible for the miscarriage since the spermatozoa is believed to be infected ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No staphylococcus infection won't cause abortion. But if you are infected with staphylococcus infection in the semen you won't be pregnant. So there is no question of pregnancy. But you should test for staphylococcus bacteria again at nearby laboratory particularly MRSA which is more resistant and dangerous bug. If you are having the bug in your system than you should treat it immediately, so you should not have any complication. Please maintain good hygiene by frequent cleaning up and good handwashing this will help keep such a bug away from us. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a male and take 4 pegs daily, however me and my wife are planning for pregnancy, could you please help me in understanding, what is the effect of my alcohol intake on my sperms and their quality, and how many days before i should avoid alcohol to have a healthy baby ### REPLY: Degree understand your concerns went through your details. Alcohol can reduce a men testosterone levels, leading to loss of libido. It can also damage the quality, structure and movement of sperm by stopping the liver functions. A new study published in BMJ Open suggests that even a moderate weekly alcohol intake of five units could be linked to lower sperm quality and thereby low chances of fertility. BMJ Open study of 1,200 men found that the higher the tally of weekly alcohol units, the lower the sperm quality. Therefore, I suggest you to refrain from alcohol consumption. 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. 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 31 years old diagnosed with Pcod and Hypothyroid. I was prescribed fertly 100 and during follicular monitoring it was observed that I ovulate on day 23-24 of the cycle.Will this pose a problem for conception? My husbands tests are normal. Thyroid levels are normal (TSH -1.57).We have been trying for 1 year now, what else could the problem be. ### REPLY: Madam, From your history I understand that you have POD (polycystic ovarian disease). This has not become the syn .  So Your hypothyroidism is under control with tab. For ovulation to occur other than estrogen and progesterone, follicle stimulating hormone (FSH) and luteinizing hormone LH) are needed. If even one of these hormones is not produced and released when it should be, ovulation may not occur when expected. Fortunately you are ovulating. You have not mentioned your menstrual cycle. If your menstrual cycle is not regular, for example once in 40 days, then 23rd day is normal. A healthy ovum can come from a healthy follicle only. Regarding the treatment, if you are obese, reduce the weight by whatever means available - keep your thyroid profile normal, periodical hormone analysis of LH and FSH, get relieved of your stress and tension, reducing insulin resistance by improving insulin sensitivity through medications such as metformin, and the newer thiazolidinedione - glitazones (with consultation of gynecologist), - are advised. Continue Tab. Ferry for few more cycle. Regarding insemination and IVF consult Infertility specialist. Madam, as you are ovulating, the chance for pregnancy is there. Be optimistic and don't lose hope Best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is suffering from a) mild fever, body ache - first fever 10 days back but had disappeared and have again started last 4 days, b) blood count was all normal 10 days back when fever started, but platelet counts has declined to 85 (last 10 days) from 125  but has inched up to 95 last 24 hrs, c) ESR is ~32. Dengue Serology test was indeterminate. Doc suspected dengue but now starting to think it could be some thing else. Any suggestions/ possibility? ### REPLY: HelloYour father is having fever from 15 days with a gap of 4 days. Serology test for dengue is negative (indeterminate) . The counts of platelets is not a parameter for dengue. However, you didn't mention the other symptoms and type of fever, but may be due to these possibilities, these include:1 Typhoid fever, diagnosis can be confirmed by Tidal test, serology and stool test .2 Tuberculosis, is another most common cause of such fever (long-standing fever, low grade) . ESR is further an indication of tuberculosis or any other chronic infection.3 Jaundice, this is the most common cause beside above-mentioned reasons for fever. Get in blood for HBase for hepatitis. However, there are so many other reasons of such fever, like UTI, bronchitis, sore throat. But in my opinion consult a physician and get his opinion. 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: Woke up two nights to feeling like my left hand was on fire. Unable to fall back asleep it hurt so bad....took a bunch of ibuprofen and eventually fell back asleep. When I woke up in the morning my hand feels like it had fallen asleep and tingled for quit awhile before going away. What is causing this? ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to:1. Para spinal spasm & compression of nerve fibers at the Cervico-dorsal region or due to compression of nerve secondary to improper sleeping posture.2. Inadequate HY .  Dietary deficiencies of certain nutrients like Iron, Calcium, vitamin D, Vitamin B12, Folic acid, etc. which help in blood formation & nerve conduction.4. Peripheral neuropathy caused due to any fluctuation in blood pressure or blood sugar level. Symptomatic relief can be obtained by intake of cervicogenic agents (like Vitamin B6, Vitamin B12, Folic acid) as well as multivitamin & multimineral supplements including iron, calcium & vitamin D needs to be added in your diet. If symptoms still persist, kindly consult a Neurologist & get a complete Neurological examination done. Certain investigations like complete blood count, serum electrolyte estimation, fresh estimation of blood pressure & blood sugar levels & nerve conduction studies will be helpful to rule out any pathological cause for the symptoms. Wishing you a Good Health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 32 yr old female, experiencing a bit of stress. I am mostly concern about feeling extremely tired even tho I sleep at least 8 hrs per day I still feel tired throughout the day, also Ive been getting mood swings and I become easily irritated or sad. Wondering if its all just stress related? ### REPLY: Hithanks for using  I think u r in depression. Easy navigability, irritability, low mood, excessive sleep, etc. all are symptoms of depression. U need some antidepressant that would help u. Consult a psychiatrist and discuss your issue with psychiatrist. According to your severity of disorder, u can get treatment. U can also do some relaxation exercise, that would help u to stay calm. 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 4 year old daughter just received a root canal to one of her molars. Today is day 3 and her jaw where the procedure was done is swollen and very visible. What could be the cause and how can we treat this? Will this be permanent or will it go away? ### REPLY: according to me the chances is more of restoration/filling which is done is high, because child won't be able to judge the high point in the restoration during the procedure, you have to visit the dentist and get it corrected. Secondly, it can be due to RCT procedure is not done properly, the root canal filling material is either short in they canal or flown out of the canal. Ask your child not to eat or chew from that side, till its corrected. Give the child lukewarm saline mouth rinse 3-4 times/daily. Give the child soft diet.Don't give hot compression from outside.Don't let the child sleep from the side where is swelling. If the child has unbearable pain, give a painkiller tablet. Swelling is temporary it will go away, not to worry. ### 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 is 2 year old and she is suffering from the rickets.She started walking at the age of 1 and currently she is not finding any difficulty in walk but her legs are like curve shaped.We have consulate many allopathic doctors and they suggested to give the calcium supplement. They told me that it will become ok after some years.Now, I do not want to give her any allopathy medicine  and want to give her the homeopathy medicine .This is because I believe that homeopathy is best medicine. So, Can you please suggest me some homeopathy medicine for rickets. ### REPLY: Hi Welcome to  I have gone through your query. It shows she is only breastfed so she has acquired deficiency of vitamins social It D. I want to know about her food intake by now ? Did her teetChatDoctore in time or were late ?  Does she sweat on her forehead ? Is her try out ? You can give her Homeopathic treatment , but her intake of food intake has to be taken care.without that medicines also don't work. Child need to be given some solid foods after age of 4 + months. Now she is 2 yrs , Take care all ingredients of balanced diet proper carbs, minerals, vitamins fats , water in paper quantity are supplied to her Lack of vitamin D makes it impossible for a children body to absorb calcium Sun rays in the morning provide sufficient it D .  Give her massage with olive oil and let her sit in the sun 10 -15 min, Give her vitamin D rich foods-cod liver oil; whole eggs (egg yolk has vitamin D in it); and yogurt. You may also have foods fortified with vitamin D like orange juice, milk, butter and breakfast cereals, leafy green veges like carrot, locally, cabbage all are good for children proper growth provided she is given good caregiver her 2-3 pills of Homeopathic Cascara Pros thrice a day, for a month. Hope this solves your query. TAE care All the Westmont hesitate to get back if you have any further query, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi this is ahmed from doha. actually still i a didnt get married. i am so expecting to get married. even i got engagement also. my question is about masterbute. usually i keep masterbute per 3 days..is  it will be spoil my life because of masterbution ? sometimes i am using masterbute one day thrice time.. ### REPLY: Degree understand your concerns went through your details. Masturbation usually cannot harm your health if you masturbate in moderation. You have not mentioned your age here. For a teenager, once or twice daily masturbation is OK. But when you grow older, you usually have other priorities than masturbation, like education, career, stress and physical activities. During that masturbation practice comes down to thrice or four times a week. You should reduce your masturbation to thrice or four times a week. Past frequent masturbation habit cannot have any negative impact on your married sexual life. Stop being anxious. 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: I suffer from leg and ankle cramps which will wake me up with a distressful twisting feeling relieved only by standing up (although sometimes this still doesn t ease it) so I take an oral dose of magnesium but recently I have heard that it may be Calcium which is my problem but, I have had kidney stones in the past 12 years and know that I have a high incidence of calcium in my urine. So this makes me wonder what to do and would a calcium intake add to my chances of creating kidney stones? I have a family history of kidney stones but am the only female who has had them. Thank you, Shelley ### REPLY: Welcome to  I have gone through your query and understand your concern. You may be deficiency of vitamin D. So you can get your vitamin D level. If found low you can take supplements of vitamin D3. You can take vitamin and trace elements supplements. Higher calcium intake doesn't lead to kidney stones as body tend to regulate calcium absorption according to need. Excess calcium will not be absorbed. It will only be absorbed if you are deficiency. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter 17month is suffering from cold and running nose.she was given Augmentin 475twice daily for 7 days.today is her 4th day and tonight she started vomiting. She is not vomiting continuously but just a banana that was given to her. Along with it some sticky substance which seems like phlegm. She has severe chest congestion also. Does this happen?she is very active and playing full time. Is Thanks ### REPLY: HI, thanks for using  The vomiting may be related to the illness or a side effect of the antibiotic. Antibiotics are associated with gastrointestinal symptoms such as nausea, vomiting, abdominal pain and diarrhea. The use of probiotics would reduce these symptoms. The probiotics can be used on their own or in yogurt. The sticky substance is likely mucus from her infection. It is not usual to see this in the vomits. If she is active and playing that is good. You can continue the medication as prescribed, add the probiotics and monitor for any other vomiting episodes. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HelloA recent blood test showed I have elevated levels of gamma gt. The results were provided to me by my doctor on the phone. He said it was likely due to alcohol but would not require retesting for 12 months. I am not an alcoholic. I didnt think to ask what the reading was. What are the health risks if the reading continues to be the same or higher? Are there any other causes apart from alcohol?Thanking you in advance of your advice.Alison ### REPLY: Hi and welcome to . The most common cause of this is alcohol abuse, but it can be due to any kind of hepatitis, viral or autoimmune. So check your viral markers. Also, some heart disease and some .  The main question is there significant liver damage but if ultrasounds is fine and the is no other liver enzymes or bilirubin elevation the is nothing serious. You should just follow some hepatoprotective diet and do frequent check-ups. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am a 25 yrs old female. i am experiencing hair fall since quite some time. have taken biotin tablets for the past 3 months.. but not sure if its helping in hair growth or not. can u kindly suggest me what i should do to get healthy hair and fr rgrowth of hair? ### REPLY: Hi, You seem to have halogen effluvium. Kindly consult the dermatologist for the perfect diagnosis and proper treatment. There are many causes of TE. Exact cause is to find out to improve the hair growth. Anemia, thyroid dysfunction, nutritional deficiencies, stress,depression, other internal diseases, dan . . etc. may be the major diseases leading to hair fall. I would suggest...- apply mild steroid lotion on the scalp-biotin 10 mg tablet daily-vitamins and high protein diet-avoid worries and tension - reduce stress level-yoga and meditation - exercise - oiling the scalp hairs with almond oil - treatment of diseasesTake long term treatment and have patience. 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 had a Septal Myocardial Infarction in early 2008. I also have LBBB that was found in 1986. Of what I read from the hand written report of my doctor at the time it states...septal myocardial infarction, EF 40%, LV dilator 7.0 can. I am a 57 yr old female 197 lbs. What after treatment should I be doing? ### REPLY: Hello, Thanks for posting your query on  ...* Brief Answer: adhere to anti-ischemic medications, healthy diet and regular follow up with your cardiologist.*Explanation: My opinion is that ischemic heart disease is an important condition that needs good plan of management first of all anti-ischemic medications such as antiplatelet and antihyperlipidemics are crucial. Then regular follow up with a cardiologist is a must to modify your treatment and see if any new findings in patient heart condition exist. Of course health diet with low salt and fat content and regular exercising do help in such conditions. Avoiding stressful conditions and smoking is nonnegotiable. If any new chest pain develops or symptoms or signs of heart failure or even palpitations present then coronary angiography plus or minus stenting may be needed then. I suggest my patients the following :new echocardiography and electrocardiogram is important to reassess heart dimensions and ischemic changes if their any. The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about height and other comorbidities present.*Conclusion: I suggest you follow up with your cardiologist and until that happen, stick to your medications.  If you have any further questions I will be happy to help, If not, you can close the discussion and rate the answer. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been in Hospital for took Chest Xray, I had been twice chest Xray because in my skin test is positive result but, my X- ray negative, Im not sick I cant feel any symtoms on my body..What should I do? Do I need take medicines? Best Regards Janice ### REPLY: Hi welcome to ... You have positive tuberculin test but chest x-ray negative .... So you are confused whether to start AKT or not .... Let me know you mere skin test positive doesn't always mean you have TB ... False positive result can be from if you have prior vaccination history or having infection with atypical mycobacteria other than TB bacilli..... Clinincal correlation necessary in your case ... You are also asymptomatic ... So as such just now no need for starting AKT .... Regular follow up done ... Take care ..... Hope your concern solved. . Consult pulmonologist for examination . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...Hi, I am a 54 year old female, and in the last 18 months about a quarter has fallen out.  I do not really think stress is a factor here and it continues to fall but has slowed, very slightly, in about the last month, what do you think the story is? ### REPLY: Hello, Thank you for posting on . I appreciate your concern regarding hair fall. Hair fall is usually ascribed to multiple factors like diet and nutrition, hormones, stress, acute or chronic medical conditions, . From your description, it seems you might be having Halogen Effluvium, which is hairball secondary to stress. If I were your dermatologist/trichologist, I would like to take through history including family history, history of recent major trauma/illness/stress/medications etc. and recommend some basic investigations like CBC, blood sugar, Thyroid function test. Some other special investigations like pictogram and endoscopy and further aid in diagnosis and prognosis. I would suggest you a course of oral tablets containing biotin and other essential vitamins and minerals for minimum 3 months. Also, would put you on solution containing 5%/10% minoxidil once a day and a hair serum containing peptides for hair growth at night.(Q era etc.). I would advise use of gentle shampoo and conditioner on regular basis and use of coconut oil twice a week. Also inquire from your dermatologist about upcoming treatment options like monotherapy and platelet-rich plasma. Avoid combing in wet hair and let them  ### 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 18 yr boy ,wen i was 16 at hom we had a house maid n therre always evry nyt she commes on my room n i fuck her til morning there fore i go off to school nw days she z gone n i am addictd to it n i mustbt even 4 tymz a day  wat should i do to stopp dis ### REPLY: Hi, The masturbation for four times a day can cause social fatigue and groin discomfort like side effects. To get rid of this habit you need to decrease porn watching if having a habit of it. It's advisable to set short term and long term goals in life and focus on study. With firm determination, you can decrease the frequency of masturbation.  Yoga, meditation also will be beneficial. You can take the help of psychiatrist if needed.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a kidney stone I know Im ready to pass. ive had them now for the past 3 years. my fathers gets them as well. i am in pain and need something for this but i dont want to go to an ER and get all the testing and $1000.00 s in costs when I know what is wrong. I am afraid if I go to a walk in they will tell me to go to an ER or think Im just drug seeking. ### REPLY: There are good remedies in Ayurveda for stone formation in kidney urethra etc.;the touch me not plant (Patanjali in Sanskrit language)whole part is a good remedy. Alkaline oriented foodstuff is helping out clear crystal stones.(tributes terrestrial (a plant in Ayurveda if used as decoction would relieve your immediate pain. If not available ...please consult an Indian Ayurveda Physician who will help you out. ### 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 years now at times i suffer awful stomach pain high up in the tummy. i find it happens sometimes if i lie down short time after food..my tummy swells up and pain becomes severe i have to curl up and after some 15 minutes or more with the releasement of wind the pain eases a bit. it is also sore to touch if i press in . can u help please ### REPLY: Dear. It sounds to me like typical stomach disorders such as gastritis, HERD or hiatal hernia. It causes abdominal bloating and distension, especially after meal. So if you want to find it out then do gastrostomy and stomach biopsy. Till that you need to change your dietary, eat more fruit and green, less alcohol smoking and fast food. Also, after meal don't lay or sit. Just walk or stand for a while, until food pass through the stomach and duodenum. When you lay try to be on your right side. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 21 yo daughter is 5 days post op from a reduction of a telescopic small bowel that had no lead point. When she stands up she has a small protrusion right above the mid line surgical incision. She is having small bowel movements and had a GI xray with contrast to ensure there was no further obstruction post op. This area is tender to touch. She has no vomiting and no fever. Should I be concerned about this swollen area? It developed yesterday and seems a bit larger today. ### REPLY: Hello! I really appreciate your concern. But such swellings are common after surgical procedures due to inflammation of the site. If there is pain, tenderness and redness at the swelling then you should concern about it and have an appointment with the surgeon. Otherwise, there is nothing to worry about the swelling. It will be minimized as the days past. Hope my answer has solved your query. Take Care. Thank you. Best Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a very small, nonpainful, slightly moveable lump on the bottom of my elbow, on the olecranon, I think. Its just odd, and, as with anything involving a lump of sorts, it makes me slightly worried. When I straighten my arm, you can see it a bit more than when I flex. But you can feel it more when I flew. ### REPLY: Hi ! Good afternoon. I am  answering your query. From your history, it seems that you have got an olecranal bursitis, a benign condition which occurs due to repeated friction on the olecranal bursa normally placed in the elbow just above the olecranal bone. If I were your doctor, I would advise you to avoid pressure on the elbow repeatedly to avoid accumulation of more fluid in the normally present olecranal bursa. In case of need, some patients might have to change their profession if need be to achieve this. Apart from this, I might advise you for a RA factor test and a serum uric acid test to rule out Rheumatoid Arthritis and high uric acid levels in the blood. On the management part, I would treat any abnormality detected on the blood tests, and would give an anti-inflammatory and an antibiotic .  In case of no relief, I would suggest you to visit a general surgeon/orthopedic surgeon in your area, who after a physical examination, might go for an FNAC, or an excisional biopsy both for diagnostic and therapeutic purposes. 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: hi i have a big problem, my face is so skinny and thin and i want it to get back chubby and full . i tried all ways collagen creams and filler and they didnt help and fillers didnt give me the result i want. can u please help me ### REPLY: Make my face look fuller and chubby:With age some people put on weight and fullness of the face. Have you lost a lot of weight recently???, then you need to see a physician to know the cause. If you are a teenager and are worried about skinny face the best way would be to go for FILLERS by a Plastic Surgeon. There are temporary and permanent fillers but in my opinion FAT as a Filler is the best, very cost-effective and permanent. ### 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 surgical wisdom teeth removal Tuesday... all 4.... beside the tooth they extracted the gum seems to be growing up and over the tooth... is that normal? Also expericing a slight pain where they were removed.. esp when I breath with my mouth open, is this the start of dry socket? ### REPLY: Hello and Welcome to Ask A Doctor service. I have reviewed your query and here is my advice. It looks like there is inflammation of the gums in the area of wisdom tooth extraction, and it is pretty normal to see inflammation and swelling of the gum and the cheek after surgical extraction of wisdom teeth. Also slight pain is normal and there is nothing to worry about it as the pain and swelling will subside gradually as the healing will proceed. If the pain is above tolerance level for you or if it is present all the time then you can take painkillers like Ibuprofen and apply Lidocaine gel over the gums. Do cool compresses over the cheek and do cool water rinses. Do warm saline gargles. 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 just prescribed apo-cefprozil 500mg and the next day I have swelling of ankles and hands,I was given this for extraction of top molar and bottom molar on right side ea. and the bottomgum did not heal properly and is squishy some puss after 14 days. Is the swelling normal and will itgo away after the 10 days I am taking this drug? ### REPLY: Swelling occurs more commonly in case of wisdom tooth extraction or in case of surgical tooth extraction.  Swelling is comparatively less in case of simple or closed tooth extraction procedures. Laceration of soft tissue, trauma to the bone, careless retraction of the flaps and irritation by fragmented bone are common causes of excessive swelling.  After 2 days of tooth extraction procedure, the swelling reaches maximum. The post-operative instructions of the dentist explain about the ways to reduce the swelling after tooth extraction. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend who is 72 years old has just been diagnosed with dyverticulitus, which she has been told there is no cure! I think that there are certain foods which aggrevate this condition. Can you suggest anything she can try. I have been using homeopathy remedies for years now with much success! thank you Jenny mcDonald ### REPLY: Hi, Diverticular disease is one of the most digestive conditions.  Not sure what causes diverticula in the colon. But that a low fiber diet may play a role, without fiber to add bulk to the stool, the colon has to work hardly than normal to push the stool forward. The pressure from this may cause pouch to form in weak spots along the colon. Diverticulitis happens when feces get trapped in the pouch. This allows bacteria to grow in the pouches. This can lead to inflammation or infection.  The treatment you need depends on how bad your symptoms are and whether you have on infection.  You may need to have only liquids at first and then return to solid food when you start feeling better.  Avoid foods containing nuts, seeds, corn and most raw fruits and vegetables.  Add water, juice, milk, soups and herbal tea contribute to your daily water requirements.  It is recommended to eat between 18 and 30 arms of fiber a day. Abdominal obesity with a greater risk of diverticulitis. ### 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 received a lower lumbar fusion 1 year ago.I currently have back spams,swelling in infusion area. Along with this I also have 10 degenerated disc. 4 on my neck which that are considering also considering fusion.Though the numbness on my legs are gone, I still have bad lower back pain, now my hips and butt cheeks hurt as if I;m getting a cramps frequently. I have developed insomnia, severe depression, which I took 8 ambiens hoping not to wake up. I get anxiety attacks 3 to 5 times a week, my head aches and loud music aggravate me. I feel alone, hopeless, sad and i find my self crying every day/ I even forget where im driving and feel confused,i cant stop cleaning, im scared. when or do i have a chance to back to work? meds given very from buspar,xanix,norcos,norflex,Quazepan,parovetine gapapentin. currently cymbalta60mg ,temazepam 30mg. ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. Insomnia and Depression are not related to Lumbar Fusion. They are separate problemsPlease consult your Neurosurgeon at the earliest Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in  at http://bit.ly/ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im a 24 year old female and yesterday I felt this sudden sharp aching feeling on the left side of my chest and its lasted all day today. It even hurts when I breath, I do not smoke or drink so there seems know reason to why I have this, Ive read various things online that points to heart problems but surely that cant be it.... While exercising today the pain seemed to go away for a while, can you be tell me what this pain may be. Thank you, my apologies if this whole paragraph doesnt make sense. ### REPLY: Thanks for your question on . I can understand your concern. Sudden onset left sided chest pain in young patient is mostly due to pulled muscle. Your chest pain was relieved by exercise. So possibility of muscular pain is more likely. No need to worry about cardiac chest pain as it won't go away with exercise. So apply warm water pad on affected areas of chest. Avoid movements causing pain. You can take simple painkiller like paracetamol or ibuprofen if pain is worrisome. Don't worry, you will be alright. 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 recently had a kidney stone and I just received the results from my blood/stone analyses. My parathyroid levels are normal, and all of my nutrients are in a normal range. I got to the stone analysis section, and it says that the stone is made of something called mucin. Can someone explain what this is, and how I can prevent future stones? Thanks. ### REPLY: Hello and welcome to .  Around 80 percent stones are made up of calcium, 20 percent of uric acid and there are mixed type of stones, consisting of a mixture of these two and some other forms. Much is not something you need to worry about. A metabolic stone testing consists of calcium, phosphorus, uric acid, oxalate,and a 24 hours urine calcium, phosphorus, uric acid. According to the reports, specific preventive advice is given. In general, take 12-15 glasses of liquids daily, which the best way to prevent stone recurrence. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im allergic to cold and slightest of cold wind gets me down with cough cold fever.This time it persisted for long and did not healed after 3-5 days medication.I then saw a specialist and after XRay of nasal passage and examination he diagnosed it a minor case of rhinosinusitis.He put me on heavy antibiotic(1000mg Clavam twice aday) with anitallergic(snizid) and vitamins for 7 days and told it will take a month of recover from the infection.I kept visiting him for a month every 8th day where he reduced the capacity of antibiotics and antiallergics and the salt.In my last visit he again got my XRay done and told to take 7 day course and no need to come.Then he prescribed Telekast L.He adviced to take onetab a day extended for 14 days when I told him I easily catch cold. Ive been regular on my medicines but a day before I came out in morning without woollen cap covering my ears and happen to catch same cough and soar throat.I have been gargling and taking steam1/2 a day. How do I cure and increase stamina against cold so I do not fall prey at slightest of exposure. ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. As an Allergist-Immunologist, I would suggest you allergy testing for common air-borne allergens such as house dust mites, molds, pollen, insect proteins, animal dander, etc. This will help you identify the substances you may be allergic to and also to know the measures to avoid them.2. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms over long duration.3. Treatment of rhinosinusitis requires a lot of patience and care. Regular steam inhalation, usually twice a day, is very helpful in rhinosinusitis.4. I also prescribe my such patients regular montelukast + Levocetirizine (Telecast L that you are using) for long periods.5. X-rays pick up changes in sinus cavity very late, so I usually do not suggest repeated X-rays to decide treatment.6. I would also suggest you regular breathing exercises like Panama which may help over a long time.7. In general, please avoid exposure to dusts, smokes and air pollution as much as possible.8. Regular healthy dietary habits like a diet rich in vitamins, minerals and antioxidants, adequate fluids during day to maintain HY . 9. Cold air does not cause "allergy", but it acts as an irritant. So it is always advisable to avoid exposure to cold air by adequate covering nose and ear openings as well as scalp by proper clothing. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead. 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: Hi doctor. My daughter s father 59 and he is in the hospital. He has hep C for over 30 years and now he has esophagus and liver bleeding and 200 level of ammonia in his blood, diabetes and ascites fluid. The doctors placed a shunt in his liver to stop the bleeding and a ballon in his esophagus. He is sedated for 6 days. The doctors tried to keep him awake, but he became very agitated, so they put him back to sleep. Would you, please, tell me if there is any chance at all for him to survive. My daughter is on denial. I m concern about my daughter. She has many emotional problems. If her father dies, she will go insane; literally. ### REPLY: Hello, based on what you said, the patient is probably suffering from chronic liver disease (liver cirrhosis) with esophageal varietal bleeding along with ascites. Such patients require urgent banding of esophagus and shunting. Such patients based on my experience in wards do not last very long I am afraid. Shunting may lead to decreased blood supply to brain and cause another complication called hepatic encephalopathy. That said life is in hands of GOD and you should support your daughter during such time. ### 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: almost 2 years ago i got out of bed and could not stand up straight without screaming with severe pain.  one dr said i had a torn fascia and another said it was a nerve in my back. the shot in the back isnt helping and therapy isnt working what do u think ### REPLY: Hello, Thanks for your query. According to the clinical history provided the back pain could be part of a mechanical back pain complex of symptoms. I suggest you to try back strengthening exercises by extension of the back muscles which can be taught by your Orthopedic or Physiotherapist. This will help to relieve the possible muscle spasm which causes the pain. One must also rule out inflammatory disorders, for which I recommend you to get an X-ray of your spine after consulting with an Orthopedic. MRI can be taken in case you have any nerve compression symptoms or as deemed necessary by your Orthopedic. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. My name is Kady I am 19 years old and have been having pain in my upper to mid back. Im active, I play basketball for a college and my job is delivering pizzas so I drive a lot. I dont know what is causing my back to ache. It is not the usual pain after a work out. I havent fallen down or lifted anything heavy. ### REPLY: Lady, playing basketball and doing a lot of .  These gradually causes back muscle fatigue. I would suggest you to start Muscle relaxant like Moral or MySpace. Also, you should take warm water shower. You should also learn back muscle strengthening exercises from physiotherapist. It will give power to your muscles, so you would not have such pain in the future. Till than you avoid pizza delivery by bike. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I wake up during the night with bilateral arm pain/numbness, not being able to move them.  At the same time there is pain radiating from my chest through to the back between the shoulder blades.  Is this a heart attack?  I am 61 year old female with hyptertension and borderline cholesterol. ### REPLY: Though atypical chest pain during a heart attack may be as what you have described, However the kind of pain and numbness particularly inability to move them points towards more like pain of cervical spondylitis.  The pain radiating from chest to in between shoulder blades is more characteristics of aortic root dissection or reflux gastritis. Because of the risk factors just a basic EKG if the pain is persistent and increase on exertion and there is associated breathlessness, palpitation, sweating, to rule out cardiac event.  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 name is manny I m 32 year old I m trying to get pregnant I had my medication from India doctor told me to use susten VT 200 for ten day.i had my period on April 17 she told me to use after intercourse . But I forget the date when I have to start using this . Can u guide me please. ### REPLY: Hi, Susten Vt contain progesterone. It should be taken after ovulation to support luteal phase. It makes uterine environment favorable for implantation and support early pregnancy. Furthermore, it should be taken from 15th to 25th day of your cycle. Furthermore, it can be available in oral and vaginal form. - Oral form: take one table 1 hour before meal or two hours after meal.- Vaginal use: Inset pill in vagina as high as you can at bedtime. Let it be there for minimum 6 hours. Avoid urination and sex after putting tablet. Avoid stress, take healthy diet, . Hope this may help you. Contact further if follow up needed. Best regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was just diagnosed with emphysema in the early stage and I have a chronic cough and get bronchitis a couple of times a year. My chest is heavy and after I eat I have trouble breathing and some kind of fluttering in my chest. What do you thinkmthis may be? ### REPLY: Thanks for your question on . I can understand your concern. You are having symptoms of acute exacerbation of emphysema. And this is sign of inappropriate treatment. This attacks actually worsen your lung function permanently. So better to consult pulmonologist and get done clinical examination of respiratory system, PUT (Pulmonary Function Test) for the diagnosis of emphysema. It will also tell you about severity of the disease and treatment of emphysema is based on severity only. You need regular inhaled bronchodilators and inhaled corticosteroid (ICS) to control symptoms and to prevent such attacks. So consult pulmonologist and discuss all these. Quit smoking if you are smoker. 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: I hard a hard painful lump on the bottom of my tongue that i can feel from the top too. It just formed yesterday and if I squeeze from both sides I feel it and it hurts. I have a sore throat right now, I m not sure if that has to do with it. Do you know what this could be? ### REPLY: Hi Dear, Welcome to . Understanding your concern. Thanks for your query. The symptoms you mention is due to viral infection. Usually the symptoms go away in few days by its own. I would suggest you to :-- Do warm saline gargles 3-4 times a day.- Maintain proper oral hygiene.- For pain and inflammation take aspirin or ibuprofen(if not allergic).- Give warm compresses externally. Consult ENT specialist (ear, nose,throat) for proper evaluation of condition and rule out causes like strep throat or acidic reflux. Doctor may order throat swab test or blood test to confirm the diagnosis. Doctor may prescribe steroid medicine, anti-viral (acyclovir) or antibiotics depending upon diagnosis. Avoid hot and spicy food. Hope your concern has been resolved. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son 3 mths old had his umbilical granuloma treated with a copper sulphate application, with the cuso4 swb in place fr 2 days.on removal of the dressing i saw 4-5 pustular eruptions on the skin the swab was in contact with.why did that occur and what should i do abt it? ### REPLY: Hi.normally there should not be any pustular eruptions occurring there after this copper sulfate treatment. Pustules mean infection and off late a bug called MRSA is on the rise in the community. I suggest doing a swab for Grams stain and culture and start using Mupirocin antibiotic as topical application. But all this requires a doctors prescription and I suggest you consult your pediatrician regarding this. 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 throbbing, sharp pain in my left wrist. It seems to be in line with my pulse, thus making me think it s in a blood vessel. I already have carpal tunnel syndrome, so I know it isn t that. I also have lupus, and I know it s nothing like what I experience with a flare-up. I m worried about DVT s or aneurisms. ### REPLY: Hello Tenosynovitis can lead to pain in wrist. Tenosynovitis is due inflammation and swelling of tendon.swelling on tendon may not reduce with medication alone. Local steroid injection can give good results added with physiotherapy protocols of machine can reduce your pain and swelling, you can ask your physio for wax bath therapy Use ice packs to reduce swelling, inflammation and pain. Physiotherapy with ultrasound and Tens will help you, For early healing you can take Tab Colin [it C] and antioxidant with anti-inflammatory [Tab enzymic plus]. If not resolved then you may need MRI. 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. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: In May 2010 I had a perfect liver. Around that time I started take the anti depressants, Lexapro, Trazodone, and Wellbutrin starting three months ago. Ive also been taking Aderall since last may. Now I have an abnormal liver. Could any of these medications be the cause of my liver problem? Thank you. ### REPLY: Hi, I had gone through your question and understand your concerns. Yes, Wellbutrin and Trazodone are known to have some minor effect on liver enzymes, so this could because of elevated liver markers such as GOT and SGPT. If this is just slight elevation then medications should not be changed but if there are significant values then you should consider switching it to another antidepressants. Also, you should avoid alcohol, and fatty food till liver findings stabilize. All medications changes should be discussed with your doctor. If liver abnormality persist no matter of medication stop then you should look for some other causes such as fatty liver or viral hepatitis. In this cases' ultrasound should be done and viral markers as well. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Been sick for over a month. Started to feel better but it came back. Congestion, hurts to breath in my chest, weak tired, feel like Im freezing and a runny nose. Not sure if I should spend the money on a dr visit. No temerature, was wheezing last night but not now. Im a MA so I tried to listen to my chest and I dont hear anything. I have a slight couch but nothing is coming up. ### REPLY: Thanks for your question on . I can understand your concern. Chest congestion and wheezing are commonly seen in heart diseases (heart failure) and lung diseases (bronchitis). So better to consult doctor and get done 1. Clinical examination of respiratory system 2. ECG, 2d echo and stress test to rule out heart failure. 3. PUT (Pulmonary Function Test) for the diagnosis of bronchitis. You may need inhaled bronchodilators and inhaled corticosteroid (ICS) if bronchitis is there. Diuretics and cardiac isotropic .  So better to first diagnose yourself and then start appropriate treatment. 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: I had unsafe oral sex with a lady of the night Something I never do and never will I went to see a doctor and told him He suggested I take the following med to be safe doxycylclin 100mg 2 x 14 days Cirprofloxcine 500mg 2 x 10 days and Lamivudine, Nevirapine and Zidovudine table 2 x 30 days At the moment my penis is red and swelling , with tenderness. My skin has started to peal on my penis What do I do ### REPLY: HelloThanks for your query, You have developed infection of the subcutaneous tissue of the penis due to unprotected oral sex Oral cavity is full of multiple bacterial flora hence prone to get infection of genitals transmitted through unhygienic or unprotected oral sex. You need to take broad spectrum antibiotic like Čeferin along with anti-inflammatory . Along with topical antibiotic ointment like Newsprint twice daily. Ensure to wash your genitals with warm water twice dailyEnsure to avoid sexual encounters till it heals up completely. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 18 and i have a baby tooth in front of the adult one, the problem is that the adult one is not in line with the others such that it is in a vertical position while the others are in a horizontal one. when i was younger a dentist took some x-rays and told me that when the baby tooth will fall out the other one would be extracted, but now another dentist told me ( without taking an x-ray) that the baby tooth should be extracted and the adult one will be put in place with a brace, but i;m not really sure about it. what should i do? 10x ### REPLY: Thanks for your query, I have gone through your query. The deciduous tooth can be removed after taking the radiographs and confirm the presence of the permanent tooth. Once the permanent tooth is there then the deciduous tooth can be extracted and the permanent tooth can be aligned by braces or orthodontic treatment. Consult an orthodontist and take an opinion. You can get radiographs like OPG and lateral cephalogram to rule out the presence or absence of teeth and also plan the treatment. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: what s the best antidepressant for ocd/ bad anxiety and depression i am currently on Remeron 45mg 1 at bedtime and Klonopin 1mg 1 in the morning and 1 at bedtime. but my doctor also wants me to start taking Celexa 10 1 at bedtime, but is that okay to be on both antidepressant s at the same time? and how can i get my psychiatrist to up my Klonopin dose upped to 2 mg or should i get on a different antianxiety medicine? ### REPLY: Hi, It is usual for psychiatrists to combine two anti-depressants when one medication is not effective. However, it is advisable to put in place an individualized plan of management (especially for OCD and anxiety) which includes not only medicines, but also non-pharmacological methods like behavior therapy and relaxation techniques. Continuing Klonopin at high doses for long duration should be avoided as it can cause dependence. Discuss with your psychiatrist about your preferences and the most bothersome symptoms which you want him to target first. This will help in setting up priorities after which problems can be dealt with accordingly. ### 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: It feels like a have a lump or a ball in the middle of my upper chest. There is a bit of pressure there and I m a bit tight chested. While I can breath okay, I feel like I can t breath fully all the time and find myself sighing a lot. I also seem to be a little out of breath sometimes when doing things ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have lump in the middle of upper chest. Well there can be many reasons for symptoms you mention in query like infections, inflammation, tumors, trauma, boils, abscesses, hematoma, benign and malignant tumors or cysts. I would suggest you to consult general surgeon for proper examination. Doctor may order biopsy, check tenderness and consistency and order x-ray to confirm the diagnosis. Doctor may put you on antibiotics along with anti-inflammatory or may .  Doctor may also recommend surgical removal or radiotherapy.  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 doc, I am 5 ft 7 bout 145 in weight and I have developed a coughing problem while eating everything. Thought maybe something had scratched and irriatated my throat but just eating eggs make me cough like I m dying. Coughing, throat hurts and it feels extremely tight!!! I suffer from severe migraines, I had asthma when I was little but haven t had an attack in a good 10 years. I have had pleurisy and also pericidatis, I have mitral valve prolapse ....any idea what the cough could stem from ### REPLY: Hi Hillside, Is the cough productive;-brings out much sputum, I think your answer is-No! Then you have got a Hacking cough, It can be caused by many factors but because in your case eating anything precipitates a bout of cough; So I would think of a problem in upper airway rather than down it. Frequent causes are Viral/His Epiglottis, Vocal Cord Palsy, If you are an elderly then supra nuclear palsy, Some benign/malignant tumors of vocal cord region, A Singers' nodule if you are excessive user of speech. A Otorhinolaryngologist is the right person to be consulted at the earliest. 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 fell down the stairs about 6yrs ago nd hit my buttocks really hard on the stairs. I noticed a swelling couple of days afterward but did nothing about it.now it has formed a big painless nd stiff bump on d upper part of my buttocks. Im now conscious of the type of clothes I wear so that it doesnt show. Please what can I do about it, need an urgent answer ### REPLY: Hi, Welcome to  Clinic. You seem to have Calcified/fibrous after the healed hematoma which you had 6 years back on the buttocks. Remedy-Consult a Surgeon. Get the USG to study its depth and nature of Lump. Who would plan Surgical planned Excision Biopsy with plastic repair. HPR report of the Biopsy would confirm its cause. Hope this would help you to plan your treatment with your doctor and resolve this problem at the earliest. Hit Thanks and Write Review if this reply helps and satisfies you, for the benefit of the needy patients at  like you. . N. Senior Surgical Specialist ### 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 switched from pristiq to zoloft this is day 3 and im really light headed when wi it go away.. was on zoloft 100mg before and was switched to pristiq 100 last wweek reduced to 50 with 25 zoloft and then stopped pristiq 3 days ago.. Bernard light headed for 5 days when will it end ### REPLY: Hello, Zoloft may cause dizziness and light headache in few patients. It is a side effect of the .  The side effects may go away with in one or two weeks. But other causes of headache like migraine headache or tension headache or sinus headache treated separately. If headache not improved please consult with your physician, he will examine and treat you accordingly. Take care. 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: I was masturbating about 2 days ago with shampoo in the shower. It was all fine but now yesterday and today my testicals are dry, red, and very wrinkly (they also have a strange odor). I wonder If it was some of the shampoo that didn tt get washed off or what. I know it is not an std because I m a virgin. ### REPLY: Thanks for asking in  forum In short: Scrotal skin is very delicate, your shampoo might have caused allergy. Explanation: Usually scrotal skin has abundant sebaceous glands which secrete sebum and keeps skin moist and in a good condition. So, if you use soap/shampoo excessively it may wash all the sebum and cause .  So, for now you can apply coconut/Vaseline locally to keep it moist and by time it will be ok.  If not subsided after 2 days visit a doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son has PMF.He is 34 yrs old. It was detected during a routine blood test for severe cough. His HB was 7.4 and platelet 83000. His spleen was 20.3 cms This was before two months. Now he has no cough,the spleen has shrunk, no symptoms of IBS, eats well and sleep is ok. But he is perpetually tired. He keeps lying dowN and does not move around. my question is how to reduce his problem of FATIGUE ### REPLY: Thanks for your question on . I can understand your concern. Your son was having severe anemia (hemoglobin 7.4). His platelets are also reduced. So possibility of megaloblastic anemia is more. Megaloblastic anemia if not treated can cause lethargy, fatigue, Tiredness etc. So start iron and vitamin B12 supplements. Once his hemoglobin level is increased, he will be alright with lethargy and fatigue. Hope I have solved your query. I will be happy to help you further. Wishing good health to your son. 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: Yes. I m 66 male - started having dizzy spells on Sun. Took Sudafed in case it was sinus and electrolyte drink in some water... Seemed to help. Monday dizzy again. Took Mucinex. And dr. had me begin a round of generic Cipro for Prostate infection. Also took more electyrolyte. Tues, slight dizzy, two Cipros and a mucinex at bed time. today very dizzy, another Cipro and took a mucinex and electrolyte drink.... ### REPLY: HelloWelcome to . I have gone through your question understand your concern regarding dizziness you are getting. Dizziness in your case may be because of diabetes mellitus/orthostatic hypotension. If the dizziness increases with movements of head, it can be due to inner ear problems. In that case, you may need to get your inner ears examined by ENT specialist. Also, would like to know are you on any long term medications as certain medications may predispose to dizziness. I advise you to get your fasting blood glucose level and blood pressure, sitting and standing, checked. You need to maintain adequate body HY . Avoid sudden standing from sitting position or change in posture. Mintain adequate nutrition. Further management depends upon the cause. Hope this information helps. Will be glad to solve any further query. 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 had a bad dust allergy,symptoms-running nose, watery eyes, sneezing and heaviness in chest, with slight feverish feelthats gone now,with sem medicinesbut i have a heaviness in my chest, slight running nose and watery eyes sometimes still, nose is blocked during sleep what medicines can i take, this happens with the onset of Oct and stays longi am from Mumbai and the pollution is too bad suggest a medicine pl ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to Allergic rhino-tracheo-bronchitis. Presented with similar complaints, I usually treat my patients with:1. Tablet Allegra 60 mg twice a day or Tablet Levocetrizine 10 mg in the evening.2. Tablet Montelukast 10 mg in the evening.3. Linctus syrup 5 ml to be taken 3 times a day.4. Voice rest-avoid talking in loud voice & for a long time.5. Stay protected from exposure to cold, dust & other allergens.6. Steam inhalation.7. Avoid smoking, cold food & .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son has a very persistent dry hacking cough..yet his nose is runny..he has no fever..he had a tonsil infection with a fever..about six days ago which cleared up on it s own..however as soon as his tonsils cleared and te fever left the cough started..what should I give him ### REPLY: Hi... Thank you for consulting in . Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15 mg/kg/dose (max ceiling dose 500 mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetirizine at 0.25 mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I have a bump in my gums and a red vein? Wierd but on my upper front tooth I have 2 bumps very small. And I also have veins through it. Like. Little red lines. I also have 2 more bumps above another tooth. Its smaller but when I press it, its a bit painful. ### REPLY: Thanks for your query, I have gone through your query. The bumps on the gums could be multiple periodontal abscesses because of the gum infection. Or it can be multiple excessive bony growths(exocytoses). Consult your oral physician and get yourself examined and get your teeth cleaned and take a course of antibiotics if it is of gum infection. Do saline gargling. I hope my answer will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed as Hepatitis B Carrier and according to my physician, its already chronic.. but what is the purpose of the test required SGPT & SGOT inspite of their confirmation that I was already a carrier of the virus. the results of SGPT is ALT (Kinetic)12.28 U/L and SGOT is AST (Kinetic) 20.40 U/L... do i still have the chance to get cured? and what is the result affected to my hepatitis B? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Hepatitis B virus as name suggests infects the liver cells. It causes damage to the liver cells. With resultant damage caused by virus they release the enzyme GOT and SGPT from the liver cells. So by measuring the liver enzymes it gives us idea that how much damage occurred and what is the likely prognosis of the condition. You do not have damaged much of your liver, so there is good prognosis. Please do not . I will be happy to answer your further concern on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son recently died of Blastomycosis. I just found out that another person who lives in the same apartment complex contracted it the same time and both died on the same date. My question is. Does this spore land on hard surfaces such as vehicles, furniture as we will be moving his stuff out and don t want to endanger anyone. Please advise ### REPLY: Hello, Blastomycosis does not spread from person to person. A person is at highest risk of becoming infected by this fungus if they often visit places where the fungus that causes blastomycosis grows such as moist soil, leaves, and rotting wood. You may wipe the furniture and inside any vehicle with a washcloth moistened in soapy water as I doubt that a standard disinfectant will be effective against the spores. What a special person you must be. While you are suffering from such a personal tragedy to be concerned about the well-being of others. I hope the happy memories you have of your son will be a comfort for you. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, i have tightness in my lower belly almost like a contraction..and my lower back as well...i have 2 kids im on birth control..2 mnths ago they tested me to see if i was preg and i came out negative..my tummy looks like theres a bump..can maybe the birth control pills affect the reult? its feels like i ate too much but its been a few days.. ### REPLY: Hallow Dear, Birth control pills contain Estrogen and Progesterone preparations. They are known to cause stomach irritation, nausea and sometimes vomiting too. Also, these pills do put on weight. So the pain in your abdomen and increased waistline could both be due to birth control pills. To avoid gastrointestinal upsets, please take these pills after dinner at bedtime. In addition, you may take one tablet of Pantoprazole daily in the morning on empty stomach. High protein, low fat and low carboy .  I hope this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i hav a very thin hair bt density was fine earlier .bt since last 3 years its density is decreasing ...i m applyin coconut oil with methi and neem once a week and dove shampoo..bt aftr applyin oil n when i comb my hair i get a lot of hair loss..please suggest me some remedies n how to control my hair loss and maintain my hair density gud enough ### REPLY: Hello, Thank you for posting on . I appreciate your concern regarding hair fall. Hair fall is usually ascribed to multiple factors like diet and nutrition, hormones, stress, acute or chronic medical conditions, . Since you have not mentioned relevant history and description like sex, pattern of hair loss(patchy/diffuse), family history etc., It's difficult to put a definitive diagnosis. Still, it seems you are suffering from either An ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i went to the dr for originally what i thought i still had a blood clot in my lung due to my c section when i went they decided to do a chest radiograph and they suggested for me to go to a cardiologist and do a cardio echo and cardio mri are there cardiologist that do both or do i need to go to a specific dr for one then go to another i have no clue what i am doing ### REPLY: Hello, Your Cesarean section was probably done under spinal anesthesia and any blood clot formed should have been around the sectioned area. If you are talking about a thrombus (blood clot) formation inside the blood vessel which has moved to the lungs (embolism), then the chances are very rare. Usually thrombus occurs in surgeries in long post-operative immobilization or prolonged bed rest. Even if it has occurred it usually dissolves over days. If the thrombus were to have been big, it would have caused obstruction symptoms resulting in difficulty in breathing. Your complaint of blood clot to the cardiologist must have made them to suggest and echo and MRI. However, if you want to get it done, it is done by a radiologist in most of developed scan centers. You can make an appointment and meet. I would usually suggest to wait and watch as the possibility of blood clot in lungs is low, if you do not have any breathlessness. Hope I have answered your query. If you want to ask any further questions, will be happy to help again. ### 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 want to get advise on liver functions Im 43 years old. I had jaundice in 1986. I got herbal medicines that time to cure this disease. After that I had no trouble until now. I got blood tests including liver functions in 2011& 2012. But that time very thing was normal. This year also, I got my liver functions test but now after one year there is too much changes on liver functions. I have blood reports but there some test which are higher than the normal. The reports show the following: T-BIL : 24 (normal range 4-20), GGT 94 (5-50), ALT 1133 (5-40), AST 624 (10-40), LDH 393 (120-250), Iron 38 (5-30) TRF 3.8 (2-3.2). I want to know about the results, how this can be treated? I feel well and been working as normal, exept I dont feel hungry these days. ### REPLY: Hello and welcome to , Your liver function tests are deranged. The levels of bilirubin, GOT, LDH, alkaline phosphatase and GGT are raised. The levels of bilirubin, GOT and LDH are raised in damage to liver parenchymal cells. The levels of alkaline phosphatase and GGT are raised in case of any disease process in the extra-hepatic biliary tree. Thus, the report of liver function suggests that a disease process is damaging the liver cells as well as causing deleterious effect on the extra-hepatic biliary tree. Are you alcoholic since alcohol is known to affect the biliary tree as well the liver cells? In case no risk factor is present for liver dysfunction, a liver biopsy may be required for exact diagnosis of liver dysfunction. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi I am 29 years old, I have tendency or can say nature of taking lot more pressure and stress over me, specially when I was starting up my career as Programmer. It s because of my nature while working I undergoes stress and nervousness , I start feeling hit on my ears and finger tips . I think because of this nature of mine, I have caused some skin problems to me, at this stage I have psoriasis spots around neck, one near the forehead , edge of ears and on my right leg. I am working on my mental ability to cope with things and not to take pressure on me but would you be able to suggest me any solution for such problem? ### REPLY: Hi friendWelcome to  How did you conclude it is Psoriasis? It has an inherited basis.  It has no relation to your nature.  You have to seek the help of a Psychiatrist.  The changes of modifying your behavior and return to near normalcy are excellent.  There are medicines and counselling techniques.  A dermatologist must see your skin.  He will be able to diagnose correctly.  A proper diagnosis is a prerequisite for proper treatment.  You have two different issues.  Both of them are easily manageable Relax / see the doctor... Take tarnishing you speedy recovery God bless 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 scrotum itches It does not bother me at day but when I go to bed it starts to itch. I have to use an old hair brush to relieve the itch at night when I take my clothes off. I does not bother me all day and I only notice it when I go to bed. I was just wondering what causes the itch and what I can do to get rid of it ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. Your problem can be due to .  Avoid use soaps to wash that area. You can use saline or warm water. If you want to use soap then use hypoallergic soaps. Use some moisturizers. Creams with aloe vera and vitamin E is helpful. If that is not helping then creams with antifungal like fluconazole and corticosteroid like dexamethasone will be helpful. Use loose cotton underwear. Also use mild detergents for washing undergarments. Hope this may help you. Let me know if anything is not clear. Thanks. ### END