Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Im 29 m.For last 1 year, im suffering from fatigue ,tiredness and weightloss, bloating ,tiredness,stomach fullness.So i went to General Physican and he advised me to do complete health checkup.Results of thyroid,Sugar,Electrolytes,Iron are in normal range.But there were some abnormalities in indirect billubirin, BUN and he referred me to Liver specialist. LFT Details: Biliburubin Total 1.27 mg/dl Biliburbin -Direct : 0.25 mg/dl Bilibubin - Indirect : 1.02 mg/dl ( is this high?) SGOT : 23.3 U/I SGPT : 15.4 Alkaline Phosphatase : 108.2 U/I GGT : 11.1 U/I Protein-total 7.63 gm/dl Albumin -Serum : 4.45 gm/dl Serum/Albumin Ratio : 1.4 Hemogram: RBC : 4.6 * 10^6/uL hemoglobin : 13.4 g/dl hematocrit :38% RDW CV 14.8 fl Platet count : 236 * 10^3/ul Erythoryte sedimentatin rate : 20 mm/hr Kidney test: Creatine:serum 0/7 mg% BUN : 7.8 mg/dl BUN/SR.creatine ratio : 11.14 Uric acid: 4.5 Calcium : 9.4 mg/dl ### REPLY: Hello, sundar230,I did go over all your blood work. Your liver enzymes are normal Randall your other blood work, like calcium, protein levels, hemoglobin, kidney tests are all normal. The serum bilirubin, the indirect fraction is very minimally elevated. Usually, Direct bilirubin is the main fraction. We see this sometime in fasting state and a very rare genetic disorder called Gilbert's Syn . Usually this is benign. Some people have jaundice, especially during stress, cold or flu, fasting, lack of sleep kind of symptoms. You mention weight loss, fatigue, and fullness of the stomach. Stress can certainly do this, but, I recommend that you get an upper Miseries, X-rays to make sure there is nothing going on in the stomach. If anything looks abnormal on x-rays, then you need endoscopy. You can discuss this with your doctor. I wish you well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor,My wife is having pain in her right cheek for the last few days recently, today its more worse. The pain is more when she wide opens her mouth and she feels the little  crackling sound around her right cheek. She also feels pain in the right teeth area. please advise what could this be related to? thanks.-Jude ### REPLY: With your query you did she had cheek bite? And any habits like smoking or pan chewing etc. Or wide opening of mouth while yawning are important to rule whether she had any TMJ problem or not? And to rule out changes in the buccal mucosa. Secondly, it is important to know the status of tooth whether is there any decay or swelling in the vestibular area or fillings and presence of any wisdom tooth where in an impacted tooth with presence of infected periodontal flap covering the tooth with limited mouth opening could also be the reason so, it is important for us to know details of which you haven't mentioned anything about it. Are there any ulcerations or white patches are seen then it could be an opportunistic infection. I would suggest you visit nearby dentist since your history is not clear. Hope this is useful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have been feeling really depressed for the last month and a half due to losing all my friends and not going out to see anyone for the past 4 weeks my brain has gone blank i cant seem to talk to anyone i dont know what to say its always a yes no answer its like my vocabulary is non existent anymore i dont think i would be able to work at the moment because i cant concentrate and take things in plese help me ### REPLY: Welcome to ! I have read your query and from that it is evident that you feel sad, blank, unable to concentrate, and there is no one you feel like or can talk to. It looks like you have developed depressive disorder due to the circumstances as almost all symptoms are seen in it. If you can, please meet a psychiatrist and get a detailed evaluation and tests done. However, from my clinical experience I can say that with sertraline 25- 100 mg, once a day you will start feeling much better and able to enjoy the life once again! Believe me!! It is very common and completely treatable condition, you donor need to worry, just start medicine. It usually takes around 10- 15 days for . Try to keep yourself busy for some time, may be by gardening, networking (internet), walking, going to market...just avoid staying alone, this will help a lot. Hope the reply is usefulness free to ask more queries ### 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 23 year old daughter has a herion addiction shes using intarvenously she hasnt used in 2 weeks she has been sick for 3 days ( not dope sick i know the difference) and her skin and whites of her eyes are yellow....what could be wrong she has hep c also ### REPLY: Assam album. Thank you for posting query at . Yellow color of eyes (sclera) indicates due to high bilirubin levels termed as "Jaundice". Jaundice can be due to hemolytic anemia, hepatitis OR gall bladder pathology. Your daughter has a diagnosis of HEPA.you need NOT worry. HepC can be cured completely now. There are . -your daughter also advice a special diet (fat free).- avoid alcohol and i/v  ### 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 run a low grade fever for the past 3 days; 100.8-101.7. I don t have a cough or any symptoms of that sort. It starts about 4:00 and is elevated until I take a couple of Extra Strength Tylenol, back to normal in a couple of hours. I do have joint aches and some chills; I m sitting with a blanket right now. I m more worried about being contagious and giving something to my family. I think it s time to make a doctor s appointment, what do you think? I just saw the cost; I ll call my doctor on Monday. Thank you ### REPLY: Hello, Welcome to ChatDoctorThanks for posting your query in . I understand your concerns. As you have only low grade fever which is not associated with sore throat and chills, most probably its of viral origin. Tab.Cronin or Tab.dolo-650 mg for three times daily will help you to suffice your symptoms. Also have plenty of hot water. If you sweat a lot, fever will come down. Take good amount of semisolid foods. Hope you are happy with the answer. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: earlier today my friend told me her little boy had taken 8 microgynon 30 (sorry if spelt wrong) contraceptives pills, she said she didn t do nothing, but Im worried, is there any problems if this is a one off or does she need to take him to get checked out tomorrow. He Is 3 possibly 4 I think. ### REPLY: Hi dear, I had gone through your question and understand your concerns. It can be poisoning. Give Charcoal 1,5 tablets to absorption of tablets and plenty of water, try to cause vomiting by making pressure on the radix of tongue. Immediately telephone your doctor or go to Accident and Emergency at the nearest hospital. It can give:-stomach pain;-headache, including migraines.-symptoms of an allergic reaction may include:-shortness of breath;-wheezing or difficulty in breathing;-swelling of the face, lips, tongue or other parts of the body;-rash, itching or hives on the skin. 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 and your son 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 son has had watery diarrhea for almost 4 wks. He can hold liquids down but any food makes him throw up or have diarrhea within ten minutes of eating. His doctor has run multiple test and cant find his problem. He diagnosed him with gilbert syndrome bc his bilirubin was 2.2 but liver was fine. all stool cultures were negative. abdominal sonar showed everything was fine.just worried and dont know what to expect, he has lost 9 lbs since dec.4, he is 16,any suggestions ### REPLY: Hello, christychambers35,Your sons' problem is not a serious one. It is a genetic disorder that shows that abnormality in the blood tests with increase in indirect bilirubin, especially during fasting, stress or infections. This does not lead to any serious liver damage or death. Sometimes, this may be associated with gallstones. Not very common. The only way to diagnose this is by a liver biopsy handsome special staining. As I said before, this will not lead Tony severe liver problems. The only reason to know about it, when the liver tests, bilirubin comes out high on testing. I would not worry about this. Get a baseline sonogram of the gallbladder. There is no special diet or treatment for this condition. I wish him well. By the way, there is no relationship between his diarrhea and vomiting with Gilbert's. It may have been a viral infection. ### 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 problem start from two year after my jaw surgery i start with sinuse problem then dizzines and ifeel my gum from inside tight and my front tooth conecting with my nose tail i saw more than twenty doctor i did root canal for my front tooth i did sinuse sergery i remove the plat from my jaw bones my age 34 please if you have answer help me ### REPLY: With your query, it looks like due to periapical infection you might have had sinusitis where chances of spread of infection is more. Normal symptoms of sinusitis ate heaviness of head with headache and other symptoms. You have mentioned you had bone surgery I think the procedure is apicoectomy are you sure that it us not numbness whatsoever best is to visit your oral surgeon for thorough examination treatment with proper history. Hope thus 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: hi my name is juliaI have 2.5 yrs old boy he had temperature at 7pm 101.4f.  I gave him 4cc chilren tylenolthen I gave him another dose at 9.15pm 4cc his temperature droped to96.7f and last one at12 midnight and his temp now is 96.4 ist ok he had a case of ceasure at age 1 ### REPLY: You can safely use Tylenol in the prescribed dose 4-5 times a day for a child who is running fever. However, it seems that you are using it even when there is no fever. Stop using it by the clock, and use it only if there is fever above 99.5 degrees F. Why did the fever occur? Most likely a virus, but it is safer to go to his pediatrician in routine hours within a day if possible. Use sponging as a tool to reduce fever - as your child had a fit in the past, don't allow the fever to rise beyond 100 F. I hope that helps. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 19 and 6 foot. Six months ago a small bump appeared near my temple. I considered this to be a swollen lymph node since I fought off an ear infection two months after it appearance. The ear infection has been long gone and it is still there. It is small and painless yet sometimes it is the clear reason for my headaches. It typically get larger when I am agitataed and it starting to become worrisome. What is this and what should I do? I did some research and apperantly a lymph node not suppose to stay swallowen for a month. ### REPLY: Thanks for contacting . Painless bumps at temple region that may be lymph node swelling. But lyphnode swelling is suicide within 2 or 3 months. Keloid may rule out because that one painless growth. Malignant growth may cause this type of problems. You don't mention size, color,and texture of growth. Sebaceous cyst may rule out. Lipoma may present at temple region. Ultrasonography is helpful for further diagnosis. Fine needle aspiration biopsy is also helpful if lesion is cystic. As soon as possible meet the ENT surgeon for diagnosis. Take care. 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: my niece had her thyroid removed due to having a tumor inside the thyroid gland, but thank God the tumor was benign. What worries me is that during the surgery the surgeon noticed some swollen ganglions and he tested them and they were cancerous. The doctor removed so many. My question is is there a posibility that she can develop more cancerous ganglions? And what is the prognosis for this situation. As far as I know he is gonna start her on a radiation pill within 3 weeks ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She has thyroid removal but it is benign. Maybe she may have some lymph nodes which are positive for cancer. It can be due to occult papillary carcinoma of thyroid or some other malignancy spread to lymph nodes. Please send me histopathology report of that cancerous ganglion so that I know the type of cancer and I can help you further. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband had a vasectomy 4 years ago for the past 2 weeks I have had pregnancy symptoms including urinating a lot, tender and enlarged breasts, feeling nauseous and now my period is 2 days late. I took a test last week it was negative.  I have a slight white discharge. Could I be pregnant? ### REPLY: Hello, and I hope I can help you today. Pregnancy symptoms vary widely between women, and the symptoms of irregular hormones (which can also delay your period) are very similar to the symptoms of pregnancy.  Women sometimes don't ovulate at the same time as usual, and other factors, such as weight changes, travel, and stress, can also make your cycle abnormal. Furthermore, in your particular case, your husband has been sterilized.  And you had a pregnancy test that was negative, which is just as accurate as the ones in a doctor's office. So I think you do not have to worry about being pregnant. To be totally secure about your husbands' sterility, he could get a sperm count done to make sure the vasectomy worked, if you would find that reassuring. I hope I was able to adequately answer your question today and that my advice was helpful. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Ive been noticing that every once in awhile I get these sharp, piercing pain in my lower abdomen and a little to the right. It hurts so much, it comes by surprise and lasts a good minute or so. I cant move or breathe while it happens because it just makes it hurt more. Im looking for some answers please & thank you. ### REPLY: Hello! Thank you for the query. Lower abdominal pain can be caused by urinary tract infection, urinary tract stones, ovaries cyst, inguinal hernia. If you have also frequent urinating, burning while urinating, back pain. Lower abdominal pain can radiate to the leg. Hernia usually gives a lump in the groin. The pain is more intense the standing, coughing or lifting heavy objects. I suggest you to visit your doctor. Urinalysis, blood work, abdominal ultrasound should be done at first. If you are female, gynecologist consult and transvaginal ultrasound should be also done. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi - am concerned as 4 year old is vomiting and there was talk of Norwalk virus at preschool (although how do they know it was Norwalk in particular), and I am 7 weeks pregnant. What are the risks to the fetus? I miscarried once before at 4 weeks with gastro virus. ### REPLY: Hi, I understand your concern.  Nor walk virus mostly causes spread of infection in society(a sort of epidemic). Its diagnosis is done by history of consumption of polluted food, symptoms of gastroenteritis, absence of any bacteria, amoebae, parasites in stools. Other blood tests like antigen tests are usually not needed. As the infection is controlled in 1-3 days.  The virus is not known to cause any bad side3 effects on baby. Still its contact must be prevented . As deny . . Which may create problem in pregnancy.  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: Im having anxiety issues that i can not get a handle on mostly its in social situations and I lose my train of thought and get hot and sweaty hands. I always get a huge pit in my stomach prior to these situations. Also it keeps me up at night frequently and screws me up more the next day. Not sure if there is a way to treat this but it makes it hard for me to work when im claming up from anxiety all the time if feel like a fool. ### REPLY: Hi, I read you query and can understand the trouble that you are facing. Going by what you have mentioned, you have social anxiety and can be more than that in form of generalized anxiety disorder. However, the good news is that your condition is amenable to treatment. I would recommend you to visit a psychiatrist at the earliest. Had I been your psychiatrist, I would have offered you combination treatment in form of medications with behavior therapy. The initial choice of medications would be from one of the SSRIs like sertraline. Behavior therapy would include relaxation training and strategies to overcome situation specific anxiety for which regular weekly sessions would be required. Hope this information was useful. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been experiencing dizziness, nausea and blurred vision for several years. It is worse around 3 am  best in evening. Getting incapacitating. Had MRI to rule out MS. Lesions in brain  but not spine. Neurologist thought it was normal 52 yr old brain. Saw an ENT, did all the tests. No answer. Quality of life terrible.   Have tried every anti nausea med, Serc, ..   I also have very labile BP. Diastolic from 40-110.Suggestions? ### REPLY: Hello! Thank you for asking on ! I carefully read your question and understand your concern. You should know that blood pressure fluctuation can cause these lesions in the brain. They are related to low blood flow to the brain and damage to the small vessels. Migraine can also cause similar troubles. For this reason, I would recommend consulting with a cardiologist to help you maintain stable blood pressure values. I would recommend taking flunarizine for your troubles. Sertraline can also help. It is also necessary taking aspirin 80-100 mg daily to help prevent future strokes. Hope to have been helpful! Wishing all the best,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has got a Medtronic Spinal Stimulator Implant. He needs to have a MRI of the brain to see if he might have MS. He had a CT Scan , of the brain, but it revealed nothing. Only a MRI will reveal MS. I was told there is a new MRI machine that could be used if you have the stimulator. Is this true and if it is where might i go to get one for him. I live in Missouri about 100 miles south of St. Louis. ### REPLY: Hello, It is true that only an MRI scan will reveal MS in most patients. Coming to the Medtronic spinal stimulator implant, I would suggest you to collect details of the stimulator and make sure the implant is MRI compatible and also take surgeons advise on the same. On the other hand you could please contact your nearest MRI center and have a talk with the attending Radiologist. Please note that MRI machines vary only in their magnetic field strength and the patient bore (closed or open).MS can be diagnosed in all MRI machines. 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: Yesterday my 61 yr old sister had itching on her scalp on the left side and later in the day a small bump appeared and in this morning she woke up with a terrible headache and there was a large lump on the side of her head. She went to the emergency room at Intermountain Medical Center in Salt lake City, Utah and was told she was having a migraine headache and was given Keflex and sent home with a prescription for more Keflex. The lump has gone down some and her headache is better. So what is the lump from I never heard of a migraine with a lump on the head. They told her it was on the outside of the skull. ### REPLY: Hi, Thanks for writing in. From the description of the lump on the head, it appears that it might be a scalp swelling, There are many kinds of swelling involving the head and scalp. Some of these remain inactive for a long time and then get infected and become enlarged in size with development of pain. These are commonly cysts like sebaceous cysts and can have a central opening when looked at closely. If doctors at ER have examined your sister then it is certainly not a tumor that is growing from within. As lump has gone down after taking reflex therefore there is an infection that is now under control. Migraine cannot be the result of a lump and cannot cause one. Migraine is a different medical entity and not related to the lump. ### 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 Doctor,My SGOT Level is 59 u/lt and my Alkaline Phosphatase is 188 u/lt. I need to bring these to normal levels within a weeks time since i have to join a ship. please advise me what should i do. I have stopped drinking a couple of days ago. i am also going for walking regularly. ### REPLY: Thank you for posting your query.GOT (AST) and SGPT (ALT) are liver enzymes located inside the liver cell and some other tissues. These enzymes play an important role in the metabolic processes. An increase in the level of these enzymes reflect an INJURY to the Liver. Medically, the condition is known as Hepatitis. Lab results reveal MILD hepatitis. If all causes of hepatitis are ruled out, then abstinence from "Alcohol and . Wish you good health. Further queries are welcomed. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health. 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  am vinod,my semen report is excellent swift progressive activity grade   [4] 00%moderate progressive        activity grade [3]  02%struggling progressive        activity grade [2] 08%poor sluggish non progressive activity grade [1] 30%sperm count is 17.oo millions /mlvolume 3.50ml ,this is normal ? please suggest me ,thank you. ### REPLY: HelloThanks for uploading your semen analysis report which reveals that you have what is called as Oligoasthenozoospermia meaning there by that your sperm count and sperm motility are very low as compared to accepted WHO normal range. Truly speaking there are no medications that can increase sperm count and sperm motility however following general measure followed for 6-8 months will help you to increase sperm count and sperm motility to certain extent. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc 3)Take anti oxidants like Almonds 5-6 everyday4) Avoid alcohol and smoking. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband just fell from the top of a ladder when it slid out from under him and fell on his buttocks. His bottom and right leg hurt pretty bad but he doesnt think going to the ER will do him any good. He is able to walk but very painful. Also experienced being very cold and shivering. Looking for any advise on how to treat this at home or signs to be aware of that would prompt us to go to doctor or ER. ### REPLY: Hello, I read carefully your query and understand your concern. The symptoms of your husband seem to be related to the injury. I suggest using anti-inflammatory medications such as Ibuprofen to relieve the pain. I also suggest to use cold compresses for a local application. If the symptoms continue you should do a X-ray for further evaluation. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards!  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 11 year old grandson has been experiencing pain in his abdomen, not specifically the lower right quadrant, along with vomiting all day and night up to the present.  The last few times he has vomited, it is bright green.  Is this bile from an empty stomach or should I be concerned about something more serious? ### REPLY: Hello. As u said constant abdominal pain and coming may not be a usual cause... might be he have gastroenteritis or inflammation of gallbladder or may be something else... and constant coming may lead to deny . ...which may because intestine to be paralyzed... For better evaluation kindly get done x-ray of abdomen ABD USG abdomen to rule out the oz...ND along with routine blood work up and electrolyte.... will guide us for supportive treatment ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Fell on hard packed dirt at horse show deep anterior knee wound, 10 days later can t walk at all red and extremely swollen. 3 days in hospital with IV antibiotics and pic line now at home. Torn anterior meniscus. Will I eventually have to have knee surgery? ### REPLY: Hi, Thank you for providing the brief history of you. A thorough musculoskeletal assessment is advised followed by an MRI of the knee. As you have a torn the anterior meniscus, it is very difficult to say whether you need surgery or you do not need it. Because, surgery is totally dependable on the extent of the ligament injured, if the ligament is intact with the body of the rest surgery may not be required but if the ligament is detached from the rest of the ligament than surgery may be planned. In the majority of cases, surgery is avoided as the healing takes place. Also, undergoing physical therapy should give excellent results and better performance of the knee joint. In my clinical practice, cases with meniscus injuries are treated initially with physical therapy and majority responds well. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My doctor has just advised me that I have Gleason 4 prostate cancer cells from a recent biopsy. My question is this. The Urologist explained a 5 point scale from 1-5 therefore 4 cells being very serious however when I have checked out websites the Gleason scale is 1-10. What should I understand? ### REPLY: Hi, dairy have gone through your question. I cannunderstand your concern. Gleason score is useful in prostate cancer.  It is based on histological features and architectural criteria.  Score is start from 1+1, so minimum score is 2 and maximum score is 5+ 5. You have score of 4. Any score less than 7 suggest good prognosis.  So you have good prognosis.  Treatment options are radiotherapy and chemotherapy.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my daughter is 5yr old .forlast 10 to 12 days she is passing very hard motion.and when i wipe i find blood in the paper.but today the stool is soft but that was bloody.i m very scared what it is.she drinks very less waterannd its very tough to feed her fruits and vegetable ### REPLY: Hi, She basically had severe constipation, and the hard pellets of stools caused mucosal wound in anal area, leading to bleeding. Now even if stool is soft, some bleeding can be there until the wound is healed. In such cases, after reloading rectum with suppositories like bisacodyl, I used to give oral laxatives for 5 days and reassess. Some kids need laxatives to be increased / continued for few weeks if no adequate response. Meanwhile, let her .  Also give paracetamol/ibuprofen for pain relief to avoid voluntary bowel holding fearing pain, which can further aggravate the situation. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor my age is 29 years,I got married 2 years back. we are not conceving yet,Q.1 my penis is 2 inches when it is normal & when it is erected it is 4-5 inches.Q.2 my penis is little bit curve and i get little pain during inter course.Q.3 Is this the reason for my wife not conceving.Q.4 my sperm count is 35millions ### REPLY: As you are 29 years old, your penis size is normal, your sperm count is normal. In semen analysis other points are also important like liquidification time, active sperms, motility. As you have complained of pain during intercourse that doesn't interfere in pregnancy. For conceiving, both partner should have normal reports. Your wife should have normal tubes, ovaries. And ovaries must have ovulating. So u should do some reports of your wife like ultrasound. So consult a gynecologist and he/she will guide you properly. ### 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 pcos and recently have been on my period for several months. My dr put me on birth control for 1 month and then started me on tamoxifen and dexamethason. My period is getting heavier instead of stopping and now I am really concerned because when I changed my tampon and wiped I had a large clot that was dark brown about 1cm thick and 2 inches long. It was also about the consistency of a wet cotton ball and had a secondary clot inside of it that was about half the length and a little thicker. I am having severe cramping that is getting worse. I cant get in touch with my dr at the moment so any info would really help. ### REPLY: Hello, I have gone through your query and understood the concern. I would like to know why your doctor suggested Tamoxifen and steroid. Your symptoms suggest that you are experiencing neuropathic cycle. The clot could be a discharge of endometrium as a whole. You need further evaluation which includes coagulation profile, blood counts, hormone profile, urinalysis and sonogram of the pelvis preferably in the trans-vaginal route. Maintenance of a normal BMI and regular exercise is also important. Supplementary therapy is also needed to aid in the treatment. Styptics are needed to control the bleeding; hormone courses may be necessary to check the bleeding and set the cycles on track. Metformin is of help if insulin resistance is detected. Hope your query has been answered. 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: This is confusing.  Ive needed an extraction or a root canal for close to a year.  This past weekend the tooth really started to hurt.  I went to a new dentist on Sunday because they were open (I really needed immediate help with the pain).  He gave me an option to have it pulled or he could do the root canal.  Well we both decided for the root canal.  He gave me Metronidale 500 antibiotic.  The rest of the day and the next day I was in even worse pain, and my right side of my face started to swell up.  Tuesday morning my face had really gotten swollen, so I decided to go back to him.  He told me that he was hoping to be able to save the tooth, but he then mentioned something about an abscess and that the tooth was infected and he showed me an x-ray with the infection.  He removed the tooth and made an incision to help drain fluid.  He now has me on 2 antibiotics (Amoxycillin 500, and Metronidale 500).  My question is: Today the swelling is 70% better, but I feel a hard lump on my cheek that is very sensitive to touch.  Is this normal, my concern is that the infection has reached the jaw bone.  I realize I waited too long to get my tooth worked on, but Im hoping that its not going to be too serious.  Thanks in advance for any information you can give me.  Tom ### REPLY: Hi, Thanks for asking the query, According to your clinical symptoms I suppose that you have developed severe infection in the tooth that had spread to the periapical tissues leading to pain and swelling of the surrounding structures. As you have done with the extraction of the tooth the swelling has receded up to 70%. I would advise you to take the antibiotics and analgesics prescribed to you. Take lukewarm saline rinses. Take antiseptic mouthwash gargles. It will take some time for the swelling and pain to subside. Maintain a good oral hygiene. If the systems persists or worsen, visit to the concerned Dentist and get the checkup done. Hope this helps out, 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 lump that swells on the outer side of my knee after excercising . I have played very strenuous basketball for several days a week for the last 5 years. Did this contribute to the lump? Hopefully you can diagnose my problem through my description. Thanks ### REPLY: Hello! Thank you for the query. This lump is most likely a Becker's cyst. This is a kind of lump filled with clear fluid. It has a connection with knee joint. Exercises can make it larger and more painful. The cyst is not something you should be worried, however as it causes pain, should be removed. Please consult orthopedist, have an ultrasound of this area and consider surgery. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been ill on and of for a year now lower back pain bad lower stomach cant move my bowls and fells like thers a heart beat in my stomach i am lucky if i open my bowls twice a week but only little and the pain is getting worst i have lost a lot of wheight but now very bloted ### REPLY: Hi there, I had gone through your query and understand your concern. Mutiple problems like Low back pain, bowel disturbances with losing weight are usually related to Stress in your lifestyle. Pain in the stomach may be related stomach ulcers but losing weight rapidly need to be evaluated with a complete examination. I suggest consulting an Internal Medicine specialist or General Physician at the earliest ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife hemoglobin level, at 24 weeks pregnancy is 8.2.she gone through the thalassemia profile but report is normal. How to increase the hemoglobin levels from now. Is it require any injections to increase the hemoglobin level? Please suggest me thanks in advance. ### REPLY: Hello, THX to contact us. If I am your treating doctor I would like to advice you that having a hemoglobin 8.2 at 24 weeks is very low. It is advice that before she conceives you should start with the iron tablet to increase the hemoglobin. Pregnancy is the condition of the demodulation. So always there is some decrease in the hemoglobin as you are going to the final phase of the pregnancy I advise you to take injectable iron treatment with the guidance of the nearby physician. Some detail history is required to start the treatment. So visit the nearby physician. If you have anything else to ask please contact me. Than.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 18 years old and I have been struggling with my skin for several years. Ever since I was 14 I have had itching skin after I have been in contact with water. I have asked several skin doctors about this, but they have told me there is nothing I can do about it, even though they dont ever check what it is. They more or less ignore what I try to tell them. So thats why Im asking you.It first started when I took a dip in the sea (Canary Islands). Ever since, my skin has been sensitive from water, itching a lot and becoming red, with white in the middle, as if mosquitoes has been there. However, sometimes, it wont be same. Like showering in upper Sweden (Stockholm) the itching was much less extreme, as well the water in France. (Avigon) Another detail is that if I have been in contact with water first, it will start itching and what not, but the second time (after becoming dry first, and that takes several minutes) it wont itch or anything. I will become a little red, but thats about it. My skin also reacts from sweat. It also doesnt matter matter what temperature it is.The skin doctors have told me that this would most likely disappear some years ago, but its becoming worse. At first, it was only on my chest and on my back. Now, its spreading to my stomach, arms, entire back, and thighs, and instead of just itching, it burns as well. I would be so grateful if you could help me! Swimming has always been a great passion to me, and taking relaxing baths is always something I have loved... however, its hard to enjoy water when I become like this. Its torture, and it makes me so sad I cant find help. What could this be? Is there anything I should try out? Thank you! ### REPLY: Your body seems to be allergic to something in the water. Because you're not feeling equally bad with the water at Stockholm and France, the dissolved contents in water must be troubling you. But, what is to be remembered is that we can not change the water always, so we need to change your bodies constitution and make it less sensitive like any others skin.1st - For this you need to have a proper workup of your case to find out if there is any allergic or Autoimmune process causing this in your body. You need to discuss this with your doctor.2nd - Homeopathy also can help you. There are certain remedies in Homeopathy which can change your bodies constitution and reduce your bodies sensitiveness. Consult a good Homeopath also who can understand your case and systematically analyze and treat you in the proper medical lines. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good evening: I know most ancillary exams are not diagnostic by themselves. I Ve had a chronic cough for over a yr (dry when on steroids). Three CT scans (first clear, last two show .5 cm nodule in left lower lung with bronchiectosis). All other labs, bronchoscopy normal or negative for fungus etc. Besides a sweat test, should I consider a PET scan (46 y/o female non smoker)? ### REPLY: I would like to have more info as in what is the cause for you to be on steroids. The nodule needs serial ct to observe. If in these serial ct scans the nodule is static then there is no need to worry. But if it is otherwise then it requires work up. Your cough may be related to the bronchiectasis though I am not sure of the extent of bronchiectasis. You will benefit from inhaled bronchodilator with steroid combinations. ### 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 ivebeen taking 150mg sertaline 200mg bupropion 25 trazadone for about 4 years now and sometimes I wonder if it just make things worse. I feel emotionless alot . I can t tell if its the meds are me. Can the mews I m on make me go numb from my emotions? I don t know what s worse feeling numb or crying all the time. ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. Well it's not the combination. Sertraline can cause such numbness and hence if your depression is well under control then sertraline can be better changed to venlafaxine or mirtazapine etc. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I woke up with a small circular rash looking area on my lower back toward my right side.  Laterally elongated characterized by small raised red bumbs.  Slight burning sensation occurs when rubbed otherwise no discomfort accomponies.  Wondering what it might be and what might have caused it. ### REPLY: Hello. Thank you for writing to USI will keep a most likely possibility of Tina/Fungal Infection. Patches of tines classically present as annular or circular lesions, which may be composed of red, raised bumps forming a raised margin with central clearing. The patches may grow bigger as they expand peripherally. Itching and burning are a feature of fungal infection. A KOH preparation made from the scale can be scanned under the microscope to look for fungal elements. That would be confirmatory. I suggest you to try an OTC topical antifungal e.g. clotrimazole 1% cream, twice daily for 2-4 weeks. An OTC oral antihistamine e.g. cetirizine 10 mg once daily will provide you symptomatic relief from itching and burning sensation. If the lesion does not respond as expected you must review with a dermatologist. 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: About 6 days ago I woke up and my left butt cheek was swolen triple to regular size, very painful and hard as a rock. There are no bite marks as if I was bitten by an insect nor did bring trauma to the area from a fall etc.. I went to the after hours clinic that my family doctor is associated with and the doctor took one look and he was speechless and said I am not even going to charge you, but he was adamant that I go strait to the hospital. All three doctors there were puzzled as to what was going on and even ordered me to have a CT scan to rull out a blood clot and to get some picture as to why this was happening. I am at my witts end and so are the doctors. I am needing to kknow something. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have extreme swelling of the left buttocks. Well there can be many reasons for symptoms you mention in query like infection, hematoma, scar tissue, buttock injury, colonial sinus or sebaceous gland inflammation.  I would suggest you to apply cold compresses, keep the site clean and .  If condition doesn't get better then consult dermatologist for proper examination. Doctor may order test like blood test to detect septicemia, physical examination to check tenderness and consistency , CT scan and take sample for lab test in severe case. Doctor may prescribe antibiotics like azithromycin at least for a week along with anti-inflammatory and corticosteroid ointment. Doctor may also recommend surgical excision in cases of benign tumor . 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: I have been looking around on the internet and stumbled across a procedure called jelqing. It is aimed at increasing penis length and girth while erect and some swear by it. I was wondering what a physicians opinion on the matter is. Ive googled around a bit and have read many warnings over the dangers of jelqing, which could cause damage to penile tissue. But I was curious if one were to take this slow and follow adviced routines, if this would be able to be done without any harm to my penis. I am an 21 year old male. 192 cm tall, weighing around 90 kg (fluctuates a few kilos) and my penis size is 17 cm in length and 13 cm circumference. I am not circumcised. ### REPLY: Dear user, Thank you for writing to . I read your concerns to increase penis size. In fact, penis size or circumference has no effect on sexual satisfaction of either partner by penis vaginal containment. Only lower vagina (outer 1 and half inch only) has nerve fibers. Inner vagina is largely insensitive and lacks nerve fibers. If you want to arouse the partner during vaginal containment, you should focus only on outer vagina. For this erect penis size more than 2 inches is more than enough! This might be surprising for you but its reality!! You may revise your concerns to increase the penis size by unproven, probably costly and potentially harmful techniques. Wish you good health dear. ### 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 just had a bliood test a few days back and my doctor confirmed to me that i have Hepatitis B, and its in its early stages, he recommended an HBsAg test to be conducted. can you tell me more about this test and any symptoms that i need to worry about that may affect me badly in the future and please also tell me if there is a cure available ### REPLY: Welcome to . Thank you for posting your query. I can understand your concern. Any kind of hepatitis presents with 1. Pain in right upper abdomen2. Fatigue3. Loss of apetite4. Yellowish discoloration of eyes and urine5. Nausea and vomitingWithout a blood Bag or Hepatitis B surface antigen, a diagnosis of Hepatitis B is hard to make. I would suggest you to get - blood Liver function test done- Bag uneven if it comes out to be positive, there are plenty of . Do not panic. Hope this helps. Have a nice day. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I have a small hard lump under the skin on the back of my lower leg on my calf muscle it doesnt protrude but is sore. I have beeen excercising recently and thought it may be due to this. At the beginning of the week the area that is hard seemed bigger than it is now I have no idea what this could be. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma, neurofibroma, dermatofibroma or some other mass due to trauma. You should go for examination and if needed to go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,my daughter, age 6 and haf yrs, was playing with the dog(non-owner dog)and has got accidental tooth mark just below her nose. It seems to be the superficial one (1 mm size)but has a blood dot over it. I took her to the doctor   36 hrs. after the injury and course of rabipur has started. I want to know that since the health status of the dog is unknown, will my daughter suffer any problem in future as i couldnt take her to the doctor immediately after the incidence. we had washed the affected place with soap and water and with dettol antiseptic immediately. Please answer my question. Im feeling guilty. ### REPLY: Hi, I had gone through your query and understand your concern. I want to say you thanks first because of cleaning the wound immediately with soap and water. Your daughter is safe now since the course of vaccine has been started. So please do not feel guilty yourself. People will be affected by rabies virus only when contaminated with rabies affected dog (rabid animals). It means every dog bite will not cause rabies to human. But we recommend five doses of Raipur vaccine as a post exposure prophylaxis and for safety. If you observe the dog for 10 days and find the dog alive, then 3 doses are enough. Since you will not be able to observe the dog, I would suggest your daughter to complete the five doses according to schedule. So do not worry. Everything will be okay. Wish your daughter 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: sir, My sister suffering from upper abdomen pain accompanied with vomiting since last one month. Pain last for 4-5 hours . After radiology, endoscopy and blood test and sonography   it is found that she have kidney stone. Can this pain may be due to kidney stone as kidney stone pain occur in lower abdomen ### REPLY: Hello, the pain of a kidney stone depends on the place where it is situated. We call it as referred pain. If the stone is higher up in kidneys it can cause pain in upper abdomen. Similarly, if stone is stuck in lower ureters or nearby then pain comes in lower abdomen as you said rightly.  So pain is in upper abdomen probably because stone is in kidney and causing pain. Regarding vomiting, when kidney tries to push the stone downwards it causes typical pain called as colic. Here we would call it as renal colic. In most of the colic pains, vomiting is commonly seen as there is spasm of muscular structures of body trying to reduce the causative factor of vomiting. Hence, the vomiting. I hope she must have been started on the required treatment by the treating doctors and I have helped you to answer your query. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 39 and in the last six months I went from having normal periods (Ive always been regular, like clockwork) to a really light period one month, then a heavy period the next, skipped a period, light one again, then I had two 3 week long periods.  One started normal, started getting light, then suddenly heavy again for a day, then light, then heavy again and so on.  This was the case with my last two periods.  Went to GYN and she had my blood tested and vaginal ultrasound and pelvic ultrasound done.  My results of the blood test showed .6 for progesterone, 15 for iron, and a low Vitamin D count (dont remember what number she told me)  I am now taking iron and Vitamin D supplements as well as 200 mg of progesterone daily.  Mu ultrasound showed two small fibroids on the uterus and an enlarged uterus (20cm) and a very thick lining.  She did an endometrial biopsy right then and there.  Nurse called and said biopsy shows no cancer, but Doc wants me to come in and go over the results.  What could I expect?  I am so scared. ### REPLY: Hi dear, small fibroid in the uterus are very common and would not be a matter of concern if they are not located near the uterine cavity. In that case also they will result in heavy and frequent bleeding. A history of enlarged uterus associated with thickened endometrium and amenorrhea followed by heavy bleeding goes more in favor of adenomyosis. This, at present can be taken care of by medical management but yes you have to be under constant follow up ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good Afternoon Dr. Kumar. Long story short ha. I have spinal surgery 9 years ago. Ruptured disc, splattered into my nerves, 4 hour operation. Surgeon said didn t realize how bad until he opened me up. He said he spent two hours picking fragments out of my nerves. He gave me an 80% total use of my left leg. Pain he cured, until about two years ago. More numbness, more pain, less movement. Pain in hip to toes. Also have shoulder problem . Popping noise, pain when reaching and side to side motion. Im 46 year old female. Always have pain somewhere either leg, shoulder or neck . Being treated now by doctor. Just had xrays. Waiting for my emg appointment. I haven t been able to work since 2004 because I can not stand, sit for long periods of time, I am up and down all day trying to get into a position that is comfortable. Thank you ### REPLY: Hi, Thank you for posting your query. I am glad that your surgeon did a fantastic job and your pain reduced after the surgery. The current pain suggests that your nerves in the lower back (lumbar region) are still compressed, and needs to be investigated. An MRI of the lumbar spine would help us clarify the diagnosis. As of now, you would benefit from medications such as pregabalin or gabapentin capsules. In addition, physiotherapy including IT/ultrasound, and back extension exercises would also be helpful. Please keep me informed about your progress. I hope it helps. Please get back if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a Ra patient since 1992. First doctor prescribed me sulfasalazine for 6months. then i stopped medicine . ra was under control for 9 years again started and aso is 4.56 and Ra was 617. with wyosolone 10 mg and HCQS  iRareduced to  92.5 and after stopping HCQS and only wyosolone continued RA increased to 147 . i have been taking voveran 50mg daily. do you advice me to increase medicine? or to take voveran once in two days? ### REPLY: From the question and details it appears that you have stopped or increased the dosage of medicines on your own. If you did not, and it was your doctors' advice then continue with it. If you are not advice to change the dosage, I suggest stick to what your doctor has advice you.govern is advice for pain in RA mostly and I suggest you to take the dosage as per your doctors' advice as its one of the side effects is it interferes with kidney function. I would suggest you not to increase the dose without consulting your doctor once. And do keep exercising sometimes or visit a physiotherapist to learn about exercises. It helps in management of RA usually, ### 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 sometimes have some of the symptoms some described below. Rapid heartbeat out of no where  and shortness of breath. Sometimes when I cough it make breathing easier. I can be sitting down, getting up bending down and it just happens out of no where. I know when I was pregnant with my first child, Doctors said I was anemic. Are these symptoms something I should be worried about? ### REPLY: Hello, This can be arrhythmia like PSV or atrial fibrillation, where your heart rate suddenly goes up and BP falls. You will need evaluation like ECG, thyroid test and holder monitoring. You should also get one hemoglobin levels done. So visit nearby cardiologist for this investigation. Also, to abort such episodes you should try to cough hard. Is there any stress or anxiety associated. Till the time your evaluation is complete, you can ask your local doctor for tab collar LA 20 mg once a day. If none of the above is successful then last option is of electrophysiologist studies which is invasive test which can diagnose and treat the arrhythmia permanently in most of the cases. 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: hi,i have a pain in the lower left side of the chest,which i assume to be caused by alcohol and smoking.the pain is kind of uncomfortable n dull,around the pancreas,spleen area.well,stopping is an option,but may i know what exact it is.i have been smoking for 6 years and drinking so so heavily for 1 year ### REPLY: HAI.pls change your lifestyle, . So many reasons can be there in your case. It can Bede to gastritis, pancreatitis, cardiac related, pleuritic pains.pls get an ECG, Chester, ultrasound abdomen, sugar level serum amylase, lipase, cholesterol levels, liver function tests, upper gastrointestinal endoscopy done. Take antacids and pantoprazole (PPI).u had to undergo all these proposed tests. Meet physician to rule out the ca use, God 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: In anger I kicked a metal filing cabinet with my right foot. I cannot walk on that foot, though I do not see any bruising or major swelling. It is exceedingly painful and hard to bend on either side. It is especially painful on the left side of my foot. Is my foot broken? ### REPLY: Hello, As mentioned that in anger you have hit are your foot to the hard object, you forgot to mention which foot actually it is; the right or the left?  As you mentioned on the left side of the foot it still makes unclear that which left the side of which foot right or the left? But to make it simple if you are getting pain at the ankle level then there will be a ligament sprain.  Which will heal in 2-3 weeks of time provided you use a foot brace which is something like a hard sock.  In case if the pain is in the phalanges then also you need to take the brace as with just hitting the foot on the hard object we never develop a fracture.  As the intensity of the hit from outside is actually far less because we control the movements. In case if it was a non controlled movement than we could have expected a fracture. Use hot water fermentation and use the foot brace for 2-3 weeks. Later slowly follow ankle toe moments and try walking on the toes - forward and backwards. You should perform well.  On a safety note, I would advise you to take up a quick x-ray to make sure you haven't made any big injury.  In case you have any other questions please feel free to contact me. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having pain in my upper abdomen that had been getting worse for 3 days. I had my gull bladder out in May of last year, so I know this is not the issue. The pain is located right below my right ribcage and to the right and it feels like it is deep not just under the skin like a bruise. I have PVCs and they are acting up today a lot. I have had a lot of soft bowel movements over the last couple of days. More than normal for someone who does not have their gull bladder. I dont think I am running a fever. The pain seems to get better if I lay down in the fetal position or if I lean foward while sitting up. I have had elevated AST levels during my last 2 blood screenings. I think they were 57 or 67. What do you think ### REPLY: Hi. Thanks for your query. Thanks again for a good history of the pain, the relieving factors and explanation of the loose motions - the bowel movements. The most probable cause looks to be enteritis without fever and this can occur in many incidences that the infection is not severe enough to cause fever or the gram negative - a type of bacteria do not cause fever. The pain explains this. I would advise you the following:Get the blood tests : CBC, Tidal for typhoid, Blood culture and sensitivity if you have not been started on antibiotic. Tests of retests of stool, culture and sensitivityUltrasonographyThis will give us an idea. Get started with the most proper antibiotics and metronidazole, probiotic and so on I hope you will get the results in 3 days, continue the treatment till you are cured. Avoid all foods and beverages which cause such problems. Use boiled and cooled water. ### 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 sister had a tumor removed from her lung and developed crepitus when the lung did not seal around the chest tube.  It was a severe case and resulted in emergency surgery to repair the air leak.  She was on major drugs for 15 days and is now showing signs of severe depression, not eating, afraid to go to sleep, etc.  Could these be drug withdrawal side effects or could something else be going on?  She was very close to dieing when they did the 2nd surgery and is now afraid she is going to.  Is there something we(her family) should do to help her through this?  Thanks ### REPLY: His understand your concern. I admire you for positive outlook. Usually tumor is highly co morbid with depression. This kind of condition can be treated with SSRI. Escitalopram 10 mg or sertraline 50 mg is very useful among SSRI. Require motivational support and psychological support. Ensure proper sleep and routines. Mild anxiolytic before surgery can be useful to control anxiety. Support of family and friend is must. I hope I have answered your query. Wish her good health. Get well soon. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 4 year old got sick 5 says ago. Threw up only once, no stomach ache. Immediately became congested with thick green mucus and sore throat. Fever 103 for 3 1/2 says. Fever is down no sore throat strep negative. Now she has nose and chest congestion and a stomach ache with some has..not sleeping well. ### REPLY: Hi, Now I guess your child have inflammatory process in upper respiratory system. I think following combination therapy should get your baby relief:-Adolf suppositories 250 mg per rectum will helpful for very high fever;-Suprax-amoxicillin - 50 mg/kg/day in divided doses every 8 to 12 hours for 7 days;-Lozenges-Strepsils, Stalin;-Please start to since gurgle with chlorhexidine and salty, soda water 3 times a day;-KDKA syrup 5ml twice a day for .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been dx with vasovagal syncope . i have within the last 7 months fainted as many as 6-9 times in a day. i have been dealing with this for years but 7 mo ago it went from an occasional faint spell to quite often. i had a pacemaker put in 3 yrs ago for bradycardia but my cardiologist says there is nothing wrong with my pacer and that its not heart related. can u possibly tell me what i need to do to have a normal life again. i cant work, drive, be by myself and i think im going into alzheimers because my memory is bad just x 7 mo ### REPLY: Hi, Thank you for posting your query. Vast legal syncope is a common illness. Cardiac arrhythmia can be responsible for this. I noted that you had a pacemaker implanted for a possible bradycardia. This makes you quite safe, and you should be able to resume all normal activities. Regarding memory impairment, please get a check-up done. It could be related to anxiety, vitamin B 12 deficiencies, etc. A brain scan would also help in diagnosing any underlying brain disease such as ischemia (less blood flow). 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 two year old son received a third degree burn on his index finger. A piece of melted plastic stuck to the top of his finger from the fingernail to the first joint, and covered the finger from side to side. It has since continued to reveal it s severity, as the subcutaneous layer turned white and has stopped leaking plasma. My question is, could he lose the function of his cuticle, and what kind of procedure can we expect at the E.R. ### REPLY: Hi, Thank you for asking question on . Third degree burn of your children index finger needs immediate attention of burns and plastic surgery specialist. Antibiotics to prevent sepsis in addition pain relieving . Skin grafting and physiotherapy may be required once the wound heals. It is difficult to pronounce prognosis right now. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake 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: Ok, so i had sex for the first time today unprotected, but we made sure that my partner did not ejacuate inside of me, or at all. Is it still possible that i can become pregnant? I have also been having many stomach cramps and my legs are sore, but that may just be from recent workouts. I also found a red blood spot in my underwear. I just finished my period today, the day  had sex, but Im unsure if it was from my period or a sign that i may be pregnant. help!!! ### REPLY: Hello madam and welcome to ... Thank you for posting your query. I read your question completely and have understood it well.  Well, you say that you are sure that the semen did not enter you. If that is the case, I can tell with certainty that you need not worry about getting pregnant. Definitely, there are failure rates in the practice of with .  Most often it is due to non-compliance. But once you are sure that, to ejaculate did not enter inside you, then there's absolutely no need to worry. You will get your cycles as per your period cycle. And, don't unnecessarily worry about this. It happens, when practicing with ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 70 year old white female with a soft firm pink bump size of a small green pea that suddenly erupted 4 months ago on top of my knuckle ( second knuckle back from the fingernail) on left hand, middle finger. It is not causing pain or restriction of movement. Another 2nd one of same description is starting up now , but still very smaller, on the next finger ( pointing finger) in the same location as of the first bump. Is this arthritis? Thankyou, Carol. YYYY@YYYY ### REPLY: HI, Dear,Carol MDM. Very Good NOON from India. Thanks for your query. I understand your concerns. I studied your query in depth.-I would advise you not to worry still. In my opinion the painful lump in the 2nd and 3rd middle-knuckles is -mostly Rheumatoid Arthritis- /or could be due to digital mucous cysts of the small joints common at this age? Or Granuloma annular cell granulomas around small joints.-Treatment-would be -Consult an ER Physician/ Rheumatologist doctor-who treat it as per the cause of the digital lumps.-Hope this reliefs your worry-some query. Welcome for any more queries in time to come. Have a Good Day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have some sort lump on my left testicle. More like a thick tube that is swollen that start at my left testicle and leads up to my penis. It s painful, as if I had blue balls. I have experienced blue balls but never had a lump like this. Is it something I should be worried about? Is it possibly testicular cancer? ### REPLY: Hi.testicular cancers usually occur at 20 to 40 age groups.mostly they will be painless testicular swelling.hard in consistency.u may be having non-malignant conditions too like varicocele that is enlarged veins of testes, epididymoorchitis i.e. infection or inflammation, even hernia too. Kindly consult a surgeon and get ultrasound of scrotum done. Never go for a needle biopsy even when a doctor advises. If someone advice biopsy consult an oncologist before biopsy as biopsy upstages cancer from 1st to last stage. ### 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, Im having teeth problems.. One of my top front teeth is pushed back inside my mouth, causing a 95% overbite.. I get severe migraines.. Will extraction/ implant be more beneficial than braces/ jaw realignment..?? I know its hard to say without actually seeing them, but I cant find any info anywhere.. ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have one tooth misaligned in jaw for this you can go for orthodontic appliance or braces if you have front tooth as it is good in aesthetic view. Extraction is preferred mostly of posterior tooth not of front tooth. I will suggest you to consult orthodontist for visual facial profile examination for good opinion. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a pain in my lower back about 3 days now. Lower right side of spine. Gets worse when sitting still. Hurts to lay back. Now....it just traveled up higher to lower back right waist area. If I go to the bathroom it was helping but today, I have to stay on here. ### REPLY: Hi thanks for using ChatDoctorIn my opinion you should stop worrying. For immediate relief have some painkiller along with a muscle relaxant and do some back strengthening exercises. Do not lie down on soft mattress use hard one instead, do not sit for longer durations and do not travel long distance for 2 weeks. Take complete bed rest and you will be fine. If the pain increases do some hot fermentation locally ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. My name is David. I have several conditions, concerning my spine. Recently, the specialist that I am seeing, explained to me that I am about out of options, as far as improving my condition, relieving pain. A spinal cord stimulator is suggested. Any thoughts? ### 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. Another Alternative is Intrathecal Morphine Pump 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: hiii mam...am hvng pcod frm last three years...frm last 4months i didnt got my periods..on last 27 th 1am i hd a intrcorse wth ma bf...it was a protected one..he spurt out in condmn outside my vagina ...for a double protectioni hd a ipil on 28th...what effect ipill on iregullar periods..?? wat should i do for get periods?am afraid of gettng pergnancy as he just rubbed pennis before d intercouse..?? whether i hv to take any medicines for gettng periods..i ws so tnsd.plz help me doc ### REPLY: HelloThanks for your query. I pill can cause slight alteration of the menstrual pattern, but since you are already having POD, that causes the main effect on periods. You should definitely consult a gynecologist, as POD needs detailed investigation and treatment, even if you do not want a pregnancy. Morevoer, Pill also has a slight failure rate (5 % if taken within 24 hours), so please see a gynecologist for the same too. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife has constant pain in her chest and has recently developed a small bruise approximately where the 2 parts of the sternum meet. The last time she was in this much pain we went to the hospital and she was told that she had low oxygen and low iron. She was diagnosed with PAVM and ended up having the lower lob removed. She is 54 years old, non smoker for +2 years, not very active and a bit over weight. Any suggestions? Tx ### REPLY: Thanks for your question on . I can understand your concern.PALM (Pulmonary arteriovenous malformation) are recurrent in nature. So we should definitely rule out PALM in your wives case. So get done CT pulmonary angiography. If this is normal then no need to worry much. But if it shows ruptured PALM then she will need surgical removal. Hope I have solved your query. I will be happy to help you further. Wishing good health to your wife. 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 had bilateral femur fractures. One side I have nearly no pain but the other side is complete opposite. I cannot weight bear on it and also the titanium rod has moved down and snapped the bottom nail. I ve been told that this is good but I cannot do any rehab to get stronger. What do I do? Its been 9 months since the injury. ### REPLY: Hi, 9 months post injury and fixation, and still tender and painful means some problem with union of fracture, I would suggest you to get fresh X-Rays of your both limbs and send to me so that I can see the level of union that has been attained yet. Also, sometimes subtle infection can be the culprit, which will need blood investigations, CBC, ESR,CRP and sometimes IL6. If you can furnish details we can proceed further on advise on what could be the right course of treatment now. Thanks ### END