Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I have a question in regards to a lump I found on the left side of the testicle. I have a hard lump on the side of my testicle. The lump is not beneath the skin I can actually see it and feel it. The lump does not hurt but I do have a consistent discomfort/ache in my left testicle. Also I notice that my testicles hardly hang anymore in the sac. Also recently over the last week or so I notice a constant ache in my lower back and groin area. I have research testicular cancer lumps but I get a lot of different information. I am currently away from home and will not be able to see my doctor until next month. What could this be? ### REPLY: Welcome to  .1. Testicular lump what you feel could be the collection in the sac, Cysts and mass.2. The inguinal hernia also seems like a mass, it does not give pain until it is strangulated. 3. All these questions can be solved by getting an ultrasound scan done - gives complete information and non-invasive and cheap investigation.(even if its just skin thickness also evaluated.4.Don't be afraid as it is not painful you can book an appointment with your doctor and get the scan done as soon as you can.5. Hope it helps. Anything to ask ? Do not hesitate. 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 have tiny red bumps a few inside my mouth on the side on one on the roof of my mouth I felt one of them which led me to look inside my mouthThen I noticed I have bumps under my toungeNot pus looking but white.Us this oral herpes I may haveAnd if so is there some kind of rinse I can use? ### REPLY: Hi, Thanks for posting the query, Bumps on the floor and roof of the mouth could be an infection like bacterial, herpes, it could also be an ulceration, allergic reaction. I would suggest you to consult to a Dentist and get a checkup done. Take a course of multivitamin supplements for 30 days OD daily. At home take antiseptic mouthwash rinses like Chloe twice daily. Avoid hot spicy, foodstuffs, allergic beverages. Hope you find this as helpful, Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor I am doing excercise and eating regular food but i have some problem like breathing.While i am breathing it stuck near right side of my chest and i feel like getting uneasy.Once I make my gas come out from my stomach it will be easy to breathe.I am struggling with this frequently.So can u suggest me any Idea What to do with these problem? ### REPLY: Hello dear, welcome to .come have evaluated your query thoroughly.* This seems in relation with psychosomatic manifestation of underlying stress and anxiety issue.* Guidelines for better recovery-Focus on deep breathing exercises, YOGA, regular walking in fresh air-Avoid smoking, alcohol if using.- No exposure to house dust, pollen, polluted environments.- Once get x-ray chest with your physician. Hope this clears your query. Regards dear take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 36 and have had a fever up to 103 for the past 4 days, doc said it was a upper respitory infection but i had a rash under my arms he said was from the fever.  he gave me a steroid for the rash and today it has came up in my groin area as well.  any answers??? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. This rash is surely because of the respiratory infection you have. If your respiratory infection is treated than there is no need to worry. Steroid will suffice to take care of your rash. Cetirizine can help cure the itching associated with the rash. You can continue the low dose steroid like prednisolone under your doctors' guidance. Fever should be avoided, high fever should be immediately treated with the paracetamol. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have noticed that I have a hard lump on my sternum.  It doesnt hurt but it seems to be getting larger. Also, I have arthritis that is getting worse and I am having pain in most of my joints, including hands, arm, hips and shoulders. I am taking tramidol and hydrocodone for pain. ### REPLY: Respected user, thanks for using .come have evaluated your query thoroughly.* Seems sebaceous cyst or lipoma over sternum region Needs confirmation by clinical examination or at least high resolution clinical photograph of the same to evaluate it in depth with further treatment guidelines.* Till then continue painkillers. Hope this clears your query. Welcome for further assistance. 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 son aged 25 yr had small size of testies. he has been treated by a endocrologist in shifa international hospital islamabad pakistn. doctor treated him abt 2yr and rest him on testoviron injection. but nothing improved. his testy size 2.7 and 1.8 cm each. we want marry him but he is reluctant. he fed up by injection and desire alternate remedy either homeopthy or alopathy. pl advise ### REPLY: Hello and. As a Urologist, i can understand your concern. The testis is reduced in size on both sides. Home doesn't help in this. He needs certain tests to know if he can marry and be able to plan a family.1. Blood routine, FSH,LH, PRL,testosterone, creatinine,RBS and LFT.2. Semen analysis.3. Scrotal Doppler ultrasound scan. If there are no sperms in the semen, will he be able to father a child If you've any doubts, you can send it as a direct question to me. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently had a brief relapse on meth after being clean almost a year due to some major life changes and stress . I am now back on the road to recovery. I was diagnosed one year ago with HIV and I am on Stribild, and since I have quit using again I am feeling electric type shocks that go thru my body. Its more frequent at night. I do have mental health issues that I currently take meds for PTSD military related, and some other issues that I am working thru. What could these shock like feelings come from, and can they be fatal? ### REPLY: Hello and welcome to . Thanks for your query. There could be a few possibilities for the electric shock-like sensations which you are experiencing:1) Anxiety-related: anxiety can manifest with a variety of physical symptoms and such strange sensations are fairly commonly reported.2) Due to the with . 3) Due to some other medical problem - like a peripheral neuropathy. These sensations are not fatal, but it would be a good idea to see a doctor to have an evaluation, to find out the likely cause. Since you say that you also have other stress related issues and possibly underlying anxiety, I would also suggest that you try relaxation exercises like deep breathing, progressive muscle relaxation, yoga, etc. Wish you all the best.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, I recently suffered from Jaundice (Hepatitis A) was under treatment from 26 August 2014 to 4 September 2014. The SGPT count was increased to 10.25 now it has reduced to 2.8(tested on 13 September 2014). I rejoined my office from 11 September 2014. Although I feel I am recovered from Jaundice but from 14 September 2014 I am experiencing pains in my right side of abdominal below ribs and the pain extends till back. Now the intensity of pain has increased. One more point to note is the pain is not continues, the pain occurs only when I make movements especially after driving bike Is it due to lack of rest or is it some other problem? ### REPLY: It could be related to your previous hepatitis. Although hepatitis A doesn't lead to chronicity, but incomplete recovery or reinfection cannot be ruled out. You should get a ct scan of abdomen to check around the hepatobiliary system as well as repeat all the liver function tests required for evaluation. But foremost thing, do not delay and visit your doctor. Certain pain relievers like .  You should have a complete work up done. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I m a 21 year old female and for the last few months I ve had bad hair loss , heart palpitations, breathlessness on slight exertion sleepless nights, I m always tired and I ve had headaches and lower back pain . Could it be some form of iron deficiency and even though I ve been taking multi vitamins my hair loss is still pretty bad. ### REPLY: Hello welcome to  In the query you didn't mention the menses,is there any overflow that is more bleeding.in general females have low hemoglobin and low iron level because of monthly losses due to menses. Regarding the above said symptoms they are symptoms of iron deficiency... Take a routine blood test in that hemoglobin levels are mentioned. Also take hologram,it will tell you the cause of low hemoglobin . Consult gynecologist(if you have heavy periods)/physician, and he will prescribe iron tab.,Meanwhile take good diet which is rich in iron like Jagger, nuts,meat etc. Regarding hair loss,it might be but to stress, genetic issues or doe to iron deficiency also.consult trichologist. Hope you understand my suggestion and 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: Hi Doctor(s). I m Eric and I m 24 years old. I had my right wisdom tooth removed as it was growing horizontally at 90 degree. my left wisdom is also to be removed as it is also growing at 45 degree. as of now i dont feel any pain as such. so with both my wisdom teeth removed , I l be left with 30 teeth. but the tooth just above the right wisdom tooth is gone. doc said its half dead. so it has to be removed. my teeth are crowded n doc said four teeth has to be removed for putting braces. That leaves me with 25 teeth. are there any side effects of removing so many teeth and that too at this age. Please help and suggest. ### REPLY: Hi, Thanks for asking the query, Wisdom tooth removal is often associated with side effects like post-operative pain, swelling, nausea, dizziness you don't worry about the symptoms as they will subside after sometimes. You follow the post-operative instructions given to you properly. Take lukewarm saline ad antiseptic mouthwash rinses. Take the full course of antibiotics and analgesics prescribed to you. 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: hi iam 25 years old and its coming 1 and half year to my marriage but we have never tried for a baby .till now i had a regular periods but since this 2 monts i had a irregular periods. and iam getting to hear that periods can give problems in concieving .please suggest me some remedies ### REPLY: Hallow Dear,Most of the time, irregular periods are associated with or are the result of failure to release eggs. You need to get evaluated for egg release function (ovulation). Along with it better get complete profile of the reproductive capability of both of you: 1. Ultrasonography, FSH, LH and Prolactin in blood will assess the ovulation.2. Laparoscopy and Hysterosalpingography will assess the patency of your genital tract.3. Semen examination of the husband. Depending up on the reports, further management will have to be planned. Wishing you best luck, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother is suffering with spinal cord pain since last 6 months. If she take rest, she feels better, once she started working in kitchen continuously then again she gets the pain. If she take rest and sleep for 2 hours she feels better. What kind of treatment she need? ### REPLY: Hello, I will ask you a few questions. What age is your mother? How is her sun exposure and intake of food rich in calcium and vitamin-D, like fish milk eggs? In old age, you must get an X-ray done of exactly the point at which she points for pain. Also, do her calcium, phosphate, alkaline phosphatase and vitamin D levels checked.  She should at moment take some light analgesic like paracetamol with orphan . Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a chest infection 5 weeks ago where I had a course of antibiotics. I ve had a slight cough ever since not through the night only every now and again of a day. If I have any coffe or cereal with milk I m worse! Do you think I still have a slight infection or my airways are still touchy? If I breathe in a gust of cold air conditioning this will make me cough! Today I feel like I have dust in my chest. ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you are having post infectious bronchitis. It is common after pneumonia due to inflammatory process. So better to consult pulmonologist and get done1. Repeat chest x ray2. PUT (pulmonary function test)Repeat chest x-ray is needed to rule out worsening of infection.PFT is needed to rule out bronchitis. It will also tell you about severity of the bronchitis. And treatment is based on severity only. So PFT is must. So consult pulmonologist, first diagnose yourself and then start appropriate treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My daughter who is 30 years is digionesed with sarcadoisie. The doctor mentioned something abouth ear infections. She had grommits implanted three months ago I amnow wondering is there some reasion why she got this dease as it is not in the family history. Thanking you Mary ### REPLY: Welcome to . Thank you for posting your question. I can understand your concern for your daughter. SARCOIDOSIS is multi-system disease involving the lungs (>95% cases), skin, lymph nodes, eye, spleen or heart.  Ear infection is not associated with acidosis. The clinical symptoms are usually cough and breathlessness. Fatigue, fever, night sweats to start with. It is often due to lack of symptoms that ACIDOSIS is late to pick up. You are lucky that the diagnosis is made early. It can be diagnosed with a chest X-ray, PET scans and bronchoscopy. With proper treatment, it can be kept controlled. I would suggest you to consult a pulmonologist immediately and get your daughter examined. Do not worry. Post any other question. We will be happy to help. 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: My Father in law is in a rehab-nursing care facility in Worthington MN. He has developed a case of Thrush in his mouth and throat. How does one contract Thrush at 86? How is Thrush treated in the elderly? My mother in law has stated that they have given him medicated sponges??? ### REPLY: Hi. Thanks for the query. Well, at such an elderly age with medical history which he already has, Thrush can occur due to poor immunity and reduced resistance of the body to diseases. So it seems to be the most probable cause. As yeast is an opportunistic organism and overgrows in individuals who have poor immunity therefore it can be a cause for him to get Oral Thrush. Do not worry with proper maintenance of oral hygiene, gargling with Statin mouthwash and using Candid mouth paint will resolve the symptoms. If he can eat then probiotics like Yogurt and garlic can help. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Me and my gf were fooling around i had gotten cum on my to stop from cuming in her after i pulled out. After i washed my hands with soap and water. About an our later we fooled around again. Could she get pregnant even after i washed the cum my hands? ### REPLY: Hi their have understood your concern. If you had this unprotected sex act in the fertile period of her cycle then she should take emergency contraceptive pills within 72 hours of unprotected sex act. As you might be aware that pre ejaculation fluid contains sperms enough to cause pregnancy. And it gets deposited without you noticing it. So even if you pull out before ejaculation, it is not a safe sex. It is not due to washed hands but due to pull out method, she stands chance to get pregnant. I hope this answer helps you. Thansk. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 26 yrs married girl suffering from underweight problems..i m also a mother..but after pregnency nd before it also my body weight sick to 45 kg.i can not overcome this big problem.eating plenty of food..pls suggest some medicine to overcome this issue..i m very much eager about to know it..i m going to depression nd many time feel insulted among people..plz give some remedies............................sananda ### REPLY: Hi, Welcome to  Public Frumpiest you should get investigated for cause of low weight as many illnesses may lead to weight loss. Apart from that depression itself, can lead to poor appetite and weight loss. Vice versa low weight lead to decrease self-esteem and depression. You should also go thyroid function test as its dysfunction may lead to both depression and weight loss. It is also more common in middle-aged female. I hope this information has been both informative and helpful for you. Wish you Good Health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend has extreme lower back pains. She has had plenty of xrays, medications, and physical therapy. All that have barely temporarily lesson the pain and no conclusion as to what it is or what it is caused by. Recently, they had thought it was kidney infection, but tested by urine it was not. She said it was because she was swelling on her lower back? and so they though it was kidney infection. Her symptoms are lower back pains (RADIATING PAIN), hurts all the time whens shes standing up and sitting down. It sometimes makes her legs and butt hurt (that or it may be from running). She has been getting mini fevers lately. Im not sure if thats due to the pain or to weak immune system?PLEASE HELP HER TO KNOW WHAT COULD BE AFFECTING HER. ### REPLY: Welcome to ChatDoctorAfter going through your query I concluded that you there are having chronic backache. It can be due to disc problem. Lately she also got fever in the evening, so you may be having some infection such as tuberculosis .MRI report will be helpful. You can discuss with your Doctor about it. Hope your query get answered. If you have any further questions then don't hesitate to writing to us. I will be happy to help you. You can also write to me directly on below link:https://www.bit.ly/ask . Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been biting my tongue and inside of my left cheek.  This is involuntary and only happens when I talk.My tongue goes to the left and then the biting occurs.  A CT Scan and MRI of the brain and both were clear.My dentist, primary care physician and neurologist think it is neurological but nothing shows up on the CT Scan nor the MRI. ### REPLY: Hello, As per your query, you have symptoms of cheek bite which seems to be due to improper dentition, increased stress levels and odd chewing habits. This occurs very commonly. Need not worry about it. I would suggest you to visit oral and maxillofacial surgeon once and get it examined and start treatment as per cause. When dentition have excess gaps or very less gap than it causes flap of cheek to come in between the teeth, so dentition needs to be corrected in that case. .  Chew on sugar-free gums. 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 chronic sinusitus pain behind and above my eyes.  I have been to two ENT doctors, have had allergy testing, sinus CT scan, accupuncture, several rounds of antibiotics, take an anti-yeast remedy to rid any possible candida yeast and have yet to be able to get much relief.  I do smoke menthol cigarettes and am to the point of deciding to quit so I can be relieved of this terrible pain.  Do you think this might be what is causing my sinusitus pain? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have chronic sinusitis pain which is due to impaired immunity of body and leftover respiratory tract infection. Need not worry. I would suggest you to visit ENT specialist once and get it examined and start treatment as per that. You should get CT scan of sinuses and Chest done again with contrast to get an exact diagnosis of the lung disease. You should avoid taking outside food. Sip on warm saline gargles. Continue antibiotic course and avoid taking oily and spicy food and cold beverages. Probably you are suffering from an allergic problem or fibrotic diseases, so you should start treatment after proper examination. 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: My name is Dwayne. I have a lump below my armpit and above my breast that I have had for 5 years. Now it has gotten bigger and red, with irritation and ocassional itchiness so I want to know if it could be cancerious or what else it possible is. Thank you. ### REPLY: Welcome to  .1. The history suggest long-standing breast lesion followed by the axillary / armpit lesion / lump.2. The axillary lump according to the description seems like infective collection - hair follicle infection.3. Lymph nodal pathology can not be ruled out as there is lesion in breast next to in with symptoms.4. An ultrasound examination is advised for both breast lump and axillary lesion-that will help to find out the nature of the lesion and its source and extensions.5. An FNAC - fine needle aspiration cytology will be helpful for definitive diagnosis.6. Folowing that for breast lesion a mammogram might be need depending on the age, followed by treatment. Good luck. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. 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: hello about two days ago i discovered a rather large bump on the exact center of my spine that was pretty sensitive. i put ointment on it once and it came to a "head" and burst on its own this morning. shortly after erupting  i noticed that i now have a very bad pain on my right side near my ribs with it being very sore. please please help ### REPLY: Hi, Based on your history it seems that you had soft swelling over upper dorsal spine which had ruptured, and now you have neuralgic pain along the ribs (dorsal radiculopathy).you need to visit Neurologist and require MRI dorsal spine to rule out structural lesion there (e.g. Potts spine any access) . Also requires complete blood picture with ESR for further help of etiology to present problem. You need painkiller, with neuralgic .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 12 year old son has a lump under is right nipple, he says it is sore I am concerned because it is bigger than a quarter. What should I do? My first thought is it is probably puberty but I am thinking now I should make an appt. With his pediatrician ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your son may have gynecomastia.  It is common at pubertal age.  You should go for examination.  If needed go for fine needle aspiration cytology of that lump.  It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been hoping to get pregnant for about 6 months now and nothing. I started really tracking periods and temps. According to my calendar I should have started my peroid on Tues (7/23). I had a super light pink when I wiped on Monday first thing monday morning so I figured I was starting. But nothing for the rest of the day, and nothing at all the next day. This morning again light pink with first urination but nothing since. Should I take a hpt? I just hate to get my hopes up. Do you HAVE to do it first thing in the AM? ### REPLY: Hi, For confirmation of pregnancy with a HPT, a fresh early morning sample of urine is the best and this is ideally done 3-7 days after a missed period. As you have been spotting on and off, it could be either an implantation bleed or a disturbed cycle. For better confirmation, you may get the serum beta-ChatDoctor assay along with a trans-vaginal sonogram and see your specialist for further advice. Hope you find this information useful. 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: Our 33 year old son, has been taking sodium valproate (Epilim) for several years now for night epilepsy - but also helps as a mood stabiliser. However after a very nasty burst of violent behaviour 9 months ago in the home he has finally gone to see a psychiatrist and has been taking Citalopram. Recently he ran out of his meds (though he didn t tell us) and his behaviour suddenly became angry and extremely aggressive; taking it out verbally on us all. Later he told us he needed money to purchase his meds and his behaviour is good again. Can you please comment about the need to stay compliant on prescribed medication. ### REPLY: Hi, Thank you for posting your query. I have noted your sons symptoms and the list of current medications. His epilepsy seems to be well controlled on Emilia (sodium valproate). He should be compliant on this medication to prevent any recurrence of seizures in the future. Regarding his mood disorder, he is on citalopram- an antidepressant and Emilia, a mood stabilizer. He needs to continue these two medications to prevent any mood disturbances. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell and hit my two front teeth 5 months ago. The left front has healed, the right front remains wobbly. I have been under the care of a dentist since it happened. Recently my blood pressure has risen to 190/90 and dispite medication cannot be controlled. Is there a corrilations between the two events? ### REPLY: HelloThanks for posting at . Your BP is definitely on the higher side. BP can be higher after stress either mental or physical. However since it had been five months since your trauma and teeth extraction, it is unlikely that the BP would be high because of the trauma. So there is no correlation between teeth extraction or wobbly teeth and high BP. You should record your no regularly and if still readings are persistently higher on the different days, you need to be started on BP medications. Wishing 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: My 6 yr old son is complaining that his bottom hurts. The pain seems to come an go, but is certainly worse when he sits down. He points to an area more towards the center of his cheek and says this is where is hurts (on both sides). He spent the weekend with his Grandparents, and no one is sure when he last had a BM. Earlier today he passes gas and had a small amount of loose stool come out in his underware. I just asked to look to see if there were anything on the outside that looked wrong. When he bent over, there was a small amount of stool around his rectum and I know we cleaned him up when he had his accident earlier. Should I seek medical attention tonight or is this something simple that I can care for at home? ### REPLY: Hi... Thank you for consulting in . It seems your kid is having bacterial dysentery. Once it starts it will take 5 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a red lump like area on the underside of my breast that has now turned to look like a blood blister.  This morning I woke to find a red line heading upwards from it.  Should I get to an ER or just call my doc which is closed for lunch for another hour. ### REPLY: Hi.it is best if you consult with a doctor for clinical evaluation. It is not an emergency case, so you could wait and do it on out-patient consult. Based from your description it could be an infectious process (such as dermatome herpes) or it could be any of those benign lesions (such as sebaceous or gelatinous cyst). It is best that you are examined personally. Further diagnostics and management will be directed accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Age 41, Height 5ft 4in, weight 59 and currently no any health problem.I facing dental bone loss problem, Dr. suggested to remove teeth and use teeth cap. But my question is that, any ayrvedic / homeopatChatDoctoredicine available to increase teeth bone? ### REPLY: Hi Welcome to ChatDoctorThis is .  I have come to know that you are keen to enhance the bone of your teeth . Dear i don't think it is possible in any therapy not to say only of homeopathy or ayurvedic medicine . It may be possible in cosmetic surgery. I suggest you to consult some good dental who can help you All The best Don't hesitate to come back if you have any query. We will be happy to help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 58 yo female. 5 9 181 lbs African American with family hx of diabetes. My fasting glucose was 129 although I was not fasting and my doctor told me to go ahead and take the test anyway. So the results are more accurate as an after meal result. I did a true fasting test today and I await the result. Should I be concerned. My Dr said I m pre-diabetic. ### REPLY: Hello have gone through your question and understood your concern. Fasting blood sugar (FBS) measures blood glucose after you have not eaten for at least 8 hours. It is the first test done to check for prediabetes and diabetes. If you were not fasting, then the result can not be taken in consideration for the diagnosis of pre-diabetes or diabetes. In my opinion, This result can be considerate like a random blood sugar (RBS) and measures blood glucose regardless of when you last ate. Random testing is useful because glucose levels in healthy people do not vary widely throughout the day and Blood glucose levels that vary widely may mean a problem. This test is also called a casual blood glucose test. It is true that your age, positive family history and being African American are RISC factors for Diabetes. But the test result can not be taken in consideration for the diagnosis because it is not fasting. A fasting blood sugar level from 100 to 125 mg/DL is considered prediabetes. If its 126 mg/DL or higher or a random blood sugar level of 200 mg/DL or higher ; on two separate tests, you have diabetes.(Actually, if you were fasting, 129 mg/DL can be suggestive of diabetes not prediabetes and the next step will be to repeat the test for the confirmation of the diagnosis)In my opinion you don't have reason to be concerned because the test result is not a fasting but a random measurement, and we can not reach the diagnosis only with this test. So, be patient because the true fasting test will give the exact information about your situation. Hope this is helpful. If you have other debts, feel free and ask. Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i have a bursitis in my shoulder, had a steriod injection the other day, but it doesnt seem to have helped?? mine isnt extremely painful unless im using it... im 33 years old and go to the gym, but i havent been in about 2 to 3months because of this shoulder pain...wats a good natural remedy to help with this? ### REPLY: Greetings Sir. As for as bursitis is concerned, definitely pain will be more and since you were going to a gym it would have made the condition still worse. So in order to get relieved from pain due to a shoulder bursitis, as a home remedy you can only have a Cold ice compress for 15-20 minutes over the painful area, and it will surely remove/make less of your pain if at all it's not severe. Take an anti-inflammatory with a pain medication after consulting your doctor. Hope I helped you in bringing down your sufferings. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For the past couple months or so, Ive noticed this lump on my forearm, just below my elbow. It feels hard but when I touch it but it doesnt seem to be attached to the bone. On top of the lump, on the skin, there are always little lump bumps all over. Im not sure what it could be. ### REPLY: Welcome to  .1. The history given by you suggest me- the most possible cause could be ganglion cystic structure arising from tendon, bursae, nerve sheet. 2. They are generally pained less lumps adjacent to joint space.3. Your further step should be got an ultrasound lesion / lump done.4. Ultrasound will evaluate the source of the lesion, its content and where it is extending. 5. But best investigation of choice is MRI joint - good tool for evaluation of nerve, tendon, bursae, nerve. And content of the lump. Good luck. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. 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 have been eating yogurt sweetened with splenda for a very long time, i also drink splenda in my coffee, and drink diet sodas (not very often) but whenever  i drink soda its diet. I have low platelets count, i was told that it is ITP.  I would like to know if splanda contributed to this thank you ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  Your low platelet count has no relation with your upland or diet. You are suffering from ITP. Its immune thrombocytopenic purpura.  Your body produces antibodies against your own platelet and causes destruction of platelets. So your platelets count is low. You should take immunosuppressive .  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: Hello, I think I got a problem with my lungs. I ve been coughing for nearly 6 month. I start feeling a bit dizzy when I cough. I cough at random times & it starts off like a spasm. If I cough I can t stop for some time, could be 5-20 min in a row. I can breathe while coughing so I don t think it s asthma or something. I think it s something chronic but I m still scared if it s something worse. I got no other symptoms or chronic deceases. Age is 20. Male. When I use cough syrups like codeine it really helps for a while but sometimes meds don t help at all. What do you think it could be? ### REPLY: Hello! Have you ever noticed any particular precipitating factor for your cough ? Does it happen on exposure to dust or cold ? Any increase in cough before or after meals ? Do you have any problem with digesting the food you take ? Any symptoms of upper abdominal pain or regurgitation of food? Do you have running nose, facial pain or feeling of mucus tricking down your throat ? Cough does not necessarily mean it should be a problem with your lungs. Sometimes inflammation of your nose / throat and even reflux disease can cause cough. Sometimes cough can be the only presentation in asthmatics too.  So kindly get yourself checked by a physician and a chest ray if needed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was with my boyfriend on saturday and the condom broke but he didn t realize until we were done. I am on birth control and Ive never missed a pill, but i haven t been on it long (today will be my 29th pill) Should i get plan b? Im hitting that 72 hour mark in about 2 hours ### REPLY: Hello dear, I understand your concern. In my opinion the plan B is needed in case of emergency situations like slippage or breakage of condom, missing a birth control pill etc. As you have regular intake of birth control pills there might be no need of plan B. But if you have missed any pill then the plan B can be taken. The plan B is effective in 95% of cases of taken within 72 hours of unprotected intercourse. The plan B effects the timing and bleeding of periods. So they might get delayed or come early, and the bleeding can be scanty or heavy or irregular. Hope this helps. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have COPD and have not been feeling well for several days.  Today I have taken my b/p and when lyingdown the diastolic was 41. That was over an hour ago. I have been sitting in a chair for approx 1 hour andnow my b/p reads 108/46. Should I be concerned? ### REPLY: Thanks for your question on . I can understand your concern. Your diastolic pressure is very low. Normal diastolic pressure is between 70-90mmhg. So you are having diastolic hypotension. And it is common in COPD patients due to right sided heart failure. So possibility of right sided heart failure is more in your case. So consult your doctor and get done 2d echo to rule out heart failure. You may need diuretic and cardiac isotropic .  Better control of COPD is also important. So take your inhalers timely. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there. I m not exactly sure if a real doctor will answer this- let alone the fact it will be answered. I have a world of questions to ask... but I guess I ll ask this one, well maybe two. Is it possible for an individual s intelligence to fluctuate? When I was younger it appeared that I was simply average, IQ wise... in my family it was just an unspoken truth that I was the least intelligent. But as I got older, around 17 I began paying attention more in school and trying more and found that I achieved top marks. Not just slightly above average but far exceeding that of my peers. In most classes I had the highest mark. It led me to wonder whether I became smarter with age? I don t know, is this possible? And if so, is it possible for me to become less smart? They say the brain is like a muscle and it needs to be used but I ve also heard that no one can actually alter their natural intelligence? Thanks! --Branden ### REPLY: Hello, I believe you're hard on yourself! There are so many aspects of intelligence and nobody can be perfect. You're right... it's not a strictly medical question, it's more like one for a psychology expert. But I can give you a direction. Ill start with some examples. Some people can be very good at interacting with others in social gatherings but may be the worst students. Others can be great students but can experience trouble when socializing. Some have great talent in sports, others can't even run without stumbling. All of them can get better with practice. You've seen it in yourself. Trying hard got you better marks. You probably can't really alter you natural intelligence, but you can get better results with trial and experience. Use a step-by-step approach to achieve more and more. Getting the best marks proves you've got potential! Best of luck in your endeavors. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Dr. My son is having problem with his spine , I m giving the MRI report in short: At the L4-L5 there is a large large disc extrusion, this extends 1.2 cm to lie posterior of the superior part of L5 and 7mm from the posterior margin of the vertebral body and is compressing on the thecal sac . There is broad-based Disc protusion on the left of L5-S1 disc. Impression : Multilevel degenerative disease . The most severe is at L4-L5 level with a large disc herniation. Less severe changes r seen at L3-L4 and L5-S1 levels. I gave him Arn 1000, Hyper 1000 & Ruta for pain. Please advice. ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras, and I am here to help you. I have read your question with care and understand your concerns.  The report says "At the L4-L5 there is a large disc extrusion, this extends 1.2 cm to lie posterior of the superior part of L5 and 7 mm from the posterior margin of the vertebral body and is compressing on the thecal sac. " This condition may be treated with rest, physiotherapy and exercises for some time, but eventually, he will require surgery. Disc Bulge where Annulus is not torn can be managed by conservative treatment Disc Extrusion, where Nucleus Pulposus is extruded and is pressing on the neural components require surgery sooner or later 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. Best Wishes for Speedy Recovery Let me know if I can assist you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is it better to wait to have permanat filling after root canal treatment till the preganancy is over? I m 23 weeks pregenant! I just had my root canal treatment done a week ago. ### REPLY: Hi Fiona, if your doctor is sure about the treatment given, he should give you the permanent filling only. Temporary filling as the name suggest is only for short time. If it gets dislodged again you will get the infection in that tooth. If you need any further treatment in the same tooth, we can remove that permanent filling also. So I suggest take safe and sound treatment by getting the permanent filling only. 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 doctor.I just received my blood test and i have a sgpt level of 63.This is the first time i get a high level. I am currently on depakine, crestor and magnesium daily. My valporic acid levels are also low despite a 1g a day dosage. My tsh level is low as well. My cholesterol, despite the medication is also 203 and have an elevated ldl level.Any thoughts? ### REPLY: Hi thanks for using . Low TSH suggests you are hypothyroid patient. Put the value of TSH for further discussion on it. Elevated cholesterol and LDL may come to normal gradually if you take treatment regularly and daily 30 min exercises. Valproic level low may be due to increased metabolism as there is liver enzyme abnormality. I advise you to get evaluated by your board certified doctor once for your management. Hope this helps you. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: bout once per yr, I have what I call sinus with discharge of phelm from mouth and nose. I experienced  an eposide where I found it difficult to stand or  coordinate, room spinning, sweatinf, nauseaetc. I had to throw up. After about 45 minutes, except for a bad taste in my mouth, I was back to normal. ### REPLY: Hi. For sinus headaches, treatment starts with decongestants, pain relievers, and nasal irrigation to ease sinus pressure and congestion and help . Antibiotics or nasal steroids are often used as a second line of attack to treat the underlying infection or chronic disease. A sinus headache caused by an infection should go away soon after starting treatment. Migraine treatment isn't just about stopping a migraine once it starts. It's also about preventing them and reducing their frequency, severity, and duration. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an upper resp. infection a few weeks ago which seems to have improved.  Now I have a deep cough (meaning that I have to keep coughing and pretty hard for the sensation to stop) that gets really bad when I lie down.  Now my head is beginning to hurt when I cough as well.  I dont have any more congestion or a runny nose.  I do still cough up gunk though. ### REPLY: Hello rearward welcome to .come have evaluated your query thoroughly.* This is in relation with respiratory congestion from bacterial or viral infection.* Suggestions for better recovery.- . - Gargles with salted lukewarm water and added peppermint oil 3 times a day.- Avoid exposure to pollen or dusty environment.- Use face mask liberally when needed.- Lesson pearls, tab. Tylenol (500) mg for symptomatic relief.- Avoid smoking in any form. Hope this will help you for sure. Welcome for further queries. Regards dear take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Okay so every day for the past month i have felt nauseous, having lower back pain, feeling dizzy, peeing a lot and over all not just feeling good at all. And I dont know if I am crazy or what but it sometimes feels like I feel fluttering in my belly. I am on implanon and already have 3 kids and I am on vistaril for anixety. ### REPLY: Hello You have complaints of nausea, backaches, dizziness, frequent urination, fluttering or butterflies in stomach most of the time a day. Most likely these symptoms are part of anxiety disorder or more specifically generalized anxiety disorder. Try to control the symptoms by relaxation exercises as Progressive Muscle Relaxation Exercises, Breathing Exercises, Yoga etc. methods. If symptoms cause a lot of dysfunction in social and personal domains then visit a Psychiatrist. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had a missed abortion on august.on 10th month pregnency.bcoz babys foetal pole is not seen.after 3month we are trying for pregnency.i want to know after happening that is it possible,same thing will be happen again with me?what is the reason that foetal pole is not seen in baby? ### REPLY: Hallow Dear, When gestational sac is present without fetal pole, it is called as Blighted ovum. You seem to have such pregnancy in the past. Most of the time, such pregnancy is due to unhealthy ovum. The possibility of recurrence of such pregnancy is about 10%. Normal healthy pregnancies are noted after Blighted ovum. You may report to a Fetal Medicine consultant for evaluating both of you for any chromosomal issues. This might help you in planning a healthy pregnancy. Please start consuming Folic acid daily much before you are attempting the pregnancy. This will increase the possibilities of healthy pregnancy. I hope this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MY BABY IS 5 MONTH OLD, SHE LOOK HEALTY, BUT THE LAST WEEK SHE DONT DRINK THE MILK LIKE THE WAY BEFORE, AND NOW SHE DRINK SOMETIME AND SOMETIME VOMIT, I TRY TO SEE IF IS HAVE UTI, BECAUSE COULD BE THAT THE ONLY SIMPTOM, BUT IS HARD FOR ME COLECT THE URINE SAMPLE, IM THE DOCTOR AND I THINK TO TRY ANY ANTIBIOTIC PROFILACTIC BUT I KNOW THAT IS NOT THE CORRECT, ALSO I KNOW CCOULD BE DIGESTIVE PROBLEMS, PLEASE TO ADVISE ME...THANK YOU DR PEDRO FROM GUYANA... ### REPLY: Hi, I am .  It may just simple viral or digestive problem. If otherwise baby is active, passing urine near normal as before, a slight less intake of milk may be due to viral or digestive, which will resolve in 3-5 days.  A gross idea of urine infection can be made by examination of urine collected in an adhesive, sealed, sterile collection bag after disinfection of the skin of the genitals but can be useful only if the culture is negative or if a single pathogen is identified. Alternately one may go for suprapubic aspiration. At least microscopic examination can be done to get some idea of infection. 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 questionsTake 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 16th month old daugther has excessive coughing and runny nose. Last wednesday the docter said she had tonsilitis and prescribed tylenol and an antibiotic. I believe she has been getting better, her temperature has been down fr the most part, but i cant explain the excessive coughing. the runny nose i had assumed she gt from me because i am just recovering from the flu. ### REPLY: Hello rearward welcome to .come have evaluated your query thoroughly.* This is due to respiratory tract infection through some bacteria or virus.* Suggestions for better recovery-Continue current antibiotics.- Maintain HY . - Avoid excess sugar , oily, dairy fat, chocolates, ice cream or candies.- Take care of hygiene of the nose , mouth.- Balanced nutritious diet to combat the infection. Hope this will help you. Welcome for further assistance. Regards 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, i m from currently working as a research scientist in panacea biotech ltd. My youngest sister is having a skin disease known as vitiligo. She has some white patches on her body. She is getting the treatment from army doctors, as my father is in defense, for the last 3 yrs. She still have the same. Is there any treatment for this disease. My sister is 14 yrs old. Regards ### REPLY: We think you might have gathered some information about Vitiligo. We can understand the changes in your sisters skin can result in stress and worries about the appearance. Vitiligo is a condition in which your skin loses melanin, the pigment that determines the color of your skin, hair and eyes. Vitiligo occurs when the cells that produce melanin die or no longer form melanin causing slowly enlarging white patches of irregular shapes to appear on your skin. The goal of treatment is to stop or slow the progression of pigment loss and, if you desire, attempt to return some color to your skin. The latest advances are included at this link which includes Morale, PVA and Narrow band Ultra Violet. https://urldefense.com/v3/__http://mayoclinic.com/health/vitiligo/DS00586/DSECTION=treatments-and- .  If the patches are small the distressing color can be camouflaged with melanocyte transfer and re growing the skin over it. Lot of research is pending in the treatment but yet there is no complete cure for vitiligo at treating the cause. We can help you to get the Grafting over patches or Melanocyte Transfer procedures and re-growing the skin done if you are in Bangalore or take time to get it done here. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: kindly Dear Dr tell me mother age 65 is dying due to heavy increase of bilirubin which 25 mg/dl and she is also having liver tumor but her life sake kindly let us know soon she is taking her last breaths and I am tearing while writing you this. waiting for your reply its my mobile 0000 its my email YYYY@YYYY ### REPLY: Hi, I am sorry to hear this bad news. Unfortunately if the liver tumor is too large, there is not much to do to prolong her life. So everything depends on the size of the tumor, the number of tumors, if it is invading other organs or vessels, and if it is a primary liver tumor or if it is a metastasis from another organ. Bilirrubin is inevitably going to go up as the liver gets invaded by the tumor. This will cause liver failure, and ultimately death. If doctors have told you there is nothing else to do, then I would recommend you to keep her comfortable without suffering or pain on whatever time left she has. Let me know if you have further questions or concerns. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 work in a residential home and hav gone and caught scabbies I have been to the doctors and have bern put on Dac m liquid went by the instructions plus on anti itching tablets too but hav noticed more reds spots still appear on my legs is this normal ### REPLY: Hello, Welcome to , Scabies is caused by small parasitic mites burrowing under the skin. The bumpy rash you can see on your children skin is an allergic reaction to the eggs of the mites. Permethrin cream is the most common cream that is used in treatment of scabies. You need to spread over every inch of your body, from neck down. Even parts of his body that don't seem to be infected must be treated, so don't skip them.Don't forget to put the cream between your toes and fingers, under arms, in navel, and the genitals. Leave the cream on his skin for 12 hours and then wash it off. Other . 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 have a lump on my back that feels like a large air pocket, it isn t swollen nor does it hurt, no crackling sound when touched, and is about the area of a tennis ball or smaller. the lump doesn t feel like it contains a fluid, just air like. i do have pain to the left of the lump or swollen area, but it feels like a tight muscle. any ideas? ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in full details updated from you. I understood your health concerns. Based on your query data, In my opinion, Dear You seem to suffer from Back Lipoma mostly as its non-tender and is common site for Big Lipoma. Sebaceous Cyst needs to be ruled out by USG study of the lump and by a Second Opinion from Surgeon. If the lump is on the heels as said in the heading, which exposes the confusion by oversight/or typing mistake. Still if it is in the back of heel, TendoAchilles Bursa needs to be ruled out, from or tho Surgeon. Treatment-Would vary depending on the cause of the lump on the back or on the back of the heels. Surgical excision if it troubles you is advisable. Else it is a benign tumor and need not worry unless its of cosmetic or pressure symptoms, for which I would suggest you. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. . N.M.S. Genl-CVTS -Senior Surgical Consultant ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 HUSBANDS HANDS HAVE BEEN DRAWING UP AND HURTING HIM REALLY BAD. HE HASNT BEEN ABLE TO SLEEP LATLEY BECAUSE OF THE PAIN. SOME TIME BACK HE WAS HAVING NUMBNESS IN HIS HAND WHERE HE JUST COULDNT FEEL ANYTHING. HE IS ONLY 26 YEARS OLD WHAT COULD BE GOING ON? ### REPLY: Hi, Thank you for posting your query. I have noted your husbands symptoms. The most likely diagnosis could be carpal tunnel syn . This can give rise to pain and numbness in the hand, usually worse at nights. The diagnosis can be confirmed by doing nerve conduction studies. Initial treatment consists of pregabalin or gabapentin capsules. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just came back from my Doctor who performed laproscopic surgery on my inguinal hernia . He said it either went around the mesh or there is a second one. I have two swollen areas one his hard above my left testicle and the other is bigger where the original hernia right above the first area. He now wants to operate. What are the dangers should I seek a second opinion is this normal. I am in perfect health and ride a stationary recumbent bike every day for almost two hours. no other obvious problems thanks in advance for you help. Have aetna Medicare Hmo Ins and live in smithtown NY. ### REPLY: Hi, I can understand your concern for the Swollen areas on testicles. It appears from your query that after hernia operation you have developed herniation of some part of momentum which is covering of intestine which is giving small lump like appearance of the area. This area is quite common to get strangulated and intestinal obstruction because of narrow passage. Do not try to even touch or pinch the area as can cause more aggravation of the problem and spread of the infection. For time being period you can take painkiller tablets such diclofenac or paracetamol. You must meet a surgeon or any family physician and get a proper treatment without delay. 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 six year old son has a fever and body aches and unfortunately store is closed and I only have children allergy meds and Nyquil cold and flu. Is it safe to give him a small dose to break his fever and if so how much. He is fourth pounds and takes 20mg vyvanse in the am along with his inhaler diligent Flovent ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have had a rash which started around four weeks ago originally thought they where bites started on my back travelled to legs and arms stomach an chest doc first of all said chicken pox then said scabies used treatment for this and stil not cured not as bad as it first was jus getting random ones here and there instead of groups I got one on sole of my foot an two in between my toes which have turned into what look like water blisters and the palms of my hands are itchy and have come out in tiny lumps any idea of what this is ### REPLY: Hi, It could be edematous dermatitis, specifically pompholyx or Delhi .  This condition usually presents as itchy, grouped, vesicles which may coalesce to form blisters.  The fingers of hands and toes are favored sites.  I suggest you to use a potent topical steroid and antibiotic combination e.g. clobetasol propionate and Aureomycin combination cream, twice daily for a few days.  In addition, I suggest you take an oral antihistamine e.g. Tab cetirizine 10 mg once a day for symptomatic relief from itching.  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: While lifting something heavy friday evening I hurt my back I have almost unbearable pain on left side of my back just above the buttock. When I move or try to walk the pain travels down my left leg as far as back of my knee. I have never felt pain like it before. ### REPLY: Hello, I have studied your case. Due to compression of this nerve root there is pain in your leg. Another possibility of acute muscle sprain will advise you to do MRI spinor these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had major oral surgery on saturday. it was an emergency. a fractured tootChatDoctorented to a bridge was removed, and the tooth on the other side of bridge was almost gone but still cememted with a metal bar wedged in my gum. still in so much pain, he gave me 12 percocets, 10 mgs...will he give me more on tuesday? cant take the pain ### REPLY: Thanks for your query, I have gone through your query. The pain could be because of the wound created during extraction. Nothing to be panic. PERCO CET is a combination of paracetamol and oxycodone. It works nicely, you can take it. But along with this you have to take a course of antibiotics like penicillin. Do saline gargling. If the pain does not subside consult your dentist or oral physician. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have a hole in one of my tooth and there has been grown something like gum full of blood and a little white thing. The size is a bit bigger than tootChatDoctoring from inside of the hole. Sometimes when Im touching it with my tongue is bleeding. Ive read that can be a gum polyp, I have taken ibuprofen for it but seems not helpful. Is there a treatment for it or the tooth should be taken out? Can be only the polyp taken out or cut, and keeping the tooth? ### REPLY: Hi, Thanks for asking the query, According to your clinical history I suspect that you have developed a gingival polyp, I would suggest you to visit the Dentist and get the checkup done, take an x-ray of the tooth. The tooth can be treated with root canal treatment and the polyp can be removed either surgically or with the use of certain chemicals. Take complete course of antibiotics and analgesics. Take lukewarm saline and antiseptic mouthwash rinses. Maintain a good oral hygiene. 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: My concern is that I had a wisdom tooth extracted three months ago. Since that time in the exact same spot mu jaw line has been visiably swollen. There was a root and a root left after the extraction. I am now seeing an oral surgeon, who says he doesnt know why my face is swollen. This oral surgeon has thirty years of experience and is also a MD, with a stellar background. He is going to romove the bone that was left but has no plans to address swoolen jaw line. I am very concerned about this and appreciate any information you can provide. Thank You CD Scott ### REPLY: Hi and welcome, After reading your history I suspect the extraction of the wisdom tooth was traumatic, and the root piece was left extracted in the socket or the bony prominence of the socket was not cleared which has lead to formation of swelling along the jaw line.I would suggest you to get an OPG radiograph done which will show you the exact cause of the swelling, accordingly the leftover root or the bone remnant can be removed surgically.I hope this helps you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,sir my baby has 4 year she is suffering with mild hepatomegaly .In ultrasound scan of abdomen reported that measures 12cm enlarged in size and normal in echotexture .No e/o IHBD/focal lesions noted.portal vein and CBD appear normal.please suggest what is the condition of my baby and which treatment should be better for her ### REPLY: Dear Madam, you shouldn't be worried because in most cases liver enlargement doesn't mean anything at this age and this is only mildly enlarged liver. Also US is an operator depending on test. You should do lab tests, especially bilirubin and liver enzymes parameters to rule out some serious disorder. What about gays growth and development? If you didn't notice anything serious then it is probably something benign. Not only liver pathology can be associated with this finding, also every hemolytic anemia and some infections cause hepatomegaly. So red blood count and inflammation parameters should also be done. Depending on these findings you can plan further tests such as liver biopsy and genetic testing. But as I said go step by step and don't worry. Wish you good health,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I checked my 22 month olds blood sugar about 2-3 hours after she ate breakfast. I can t be exact on the time because she eats pretty slow so it takes her a while. She had 2 eggos, a quarter of a banana, a cup of milk and a half cup of orange juice for breakfast. 2-3 hours later her blood sugar was 135 is that too high? ### REPLY: Hello, Please don't get panic. This is called Random Blood sugar level. And its in the normal range.  Up to 140 mg/DL is considered normal RBS (random blood sugar) level.  In case of family history of diabetes. One can monitor blood sugar levels like: FBS (Fasting blood sugar), PUBS (Post Radial blood sugar). But in such a small kid.  It's not required as such in general.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My brother is in the hospital after beginning to have frequent falls and slurred speech. His Blood pressure is unstable. He is abusing alcohol. Could his problems be linked to some type of encephalopathy? My sister in-law was a nurse, as am I. Would it be wise of me to ask if thiamine was tested, or what would reveal if WE or a hepatic condition is the underlying cause of these symptoms of falling and slurred speech? ### REPLY: Hello! Welcome and thank you for asking on ! I passed carefully through your question and would explain that your brother symptoms could be related to possible repeated TIA (transient ischemic attacks) or seizures. For this reason, I would recommend performing some tests to investigate for the possible causes: - a brain MRI- an EEG to investigate for seizures- an ambulatory 24-48 hours ECG monitoring to investigate for cardiac arrhythmia- a cardiac ultrasound-vitamin B1 levels are needed, considering the fact that he abuses with alcohol. You should discuss with his doctor on the above issues. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed as Bi-polar. My age is 31 years, height 5 feet 3 inches and weight 78 kg. I have been prescribed Sizodon 1 MG 1 tablet daily. I am gaining weight significantly and also previously I had no pschiznphrenic episode off late I started experiencing hearing sounds and severe stress on mind. Does Sizodon causes all these side effects? Is sizodon a right treatment for me ### REPLY: Hi there, thanks for asking. Iodine can help for decreasing the sounds you are hearing sometimes. You are true about the side effect since it changes the metabolism and causes weight gain. The best way to deal with this issue is to have more physical activity. You may also change your diet a little. The dose that you mentioned is very low, however and has the minimal side effect. You can ask your doctor to add some medication which does not change your weight, like the medications from the class of new antiepileptics. Then your mood will be better under control. Wish you the best 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: Hello sir, Iam anand, age 25 yrs my sperm count is 105 M/ml active motility is 10% moderate motility is 42% sluggish motility is 24% Immotile is 24% Normal form is 5% head defects is 75% neck defects is 12% tail defects is 8% i am not able to became a father after 1.5 yrs of marriage. Pls guide me what I had to do? Thanks. ### REPLY: Hi, I have gone through your question and understand your concerns. Your semen examination shows normal sperm counts but the motility and morphology of the sperms are not normal. Such situation occurs when there is infection in the genital tract or there is some obstruction in the genital tract. Abnormalities in morphology and motility of the sperms are a major cause of infertility would suggest you to consult a urologist and get properly examined, investigated and treated accordingly. Hope you found the answer helpful. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in my teeth back upper jaw from yesterday, Today I visit the doctor he did clining and polishing and tell everything is fine in teeth. It might be sinus problem and he advise for X-RAY, and written OFLOX OZ , Flexon and Vevoran. Does it sinus issue or anything else ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have pain in upper teeth and jaw region don't worry, yes it can be due to sinus problem or due to carious tooth, erupting third molar, impacted tooth also.  Do warm saline gargle two - three times a day Do chlorhexidine mouthwash twice daily Consult physician check up for sinus, if won't get relief then consult dentist for investigations. Hope this will help you. Wishing you good health. ### END