Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , my name is lisa. I have been very sick,nausea vomitting , abdominal pain. I had a abdominal ct scan done and they found multiple liver cysts a 2,5 cm cyst on the only ovary I have and multple tiny cyst on my rt kidney. I have been sweating profusely and spike fevers and my wbc has been up to 16,00 for months . What do you think is the problem? ### REPLY: Hello! Thank you for the query. Liver cyst, kidney cyst is very common finding. Cyst is just an empty space in the organ filled with clear fluid. If most of your kidney is healthy (I do not know what do you mean by tiny cyst and how many of them is there), cysts are completely harmless and should not give any symptoms at all. You should have them under observation. Your WBC level can indicate an inflammation process or blood issue (like leukemia). It's really hard to tell about the source of infection not being able to perform physical examination. Stomach infection rather does not give symptoms for so long time. I suggest you to consult hematologist with your results. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello my name is lisa and my granddaughter has a red rash that i thought might be related to a allergic reaction because i have changed my laundry detergent, but i have also found out that measles is also going around so i am concerened what does measels look like and what are the signs of measels that i should be looking for . my email is YYYY@YYYY ### REPLY: Dear FriendWelcome to . I am . I have read your query in detail. Furthermore, I understand your cancer. Measles usually occurs with Fever, running nose, itchy and red as, cough and Cory associated with rash. If only rash is there that is itchy it might be allergic reaction. But if she has fever and other symptoms it might be a Measles. I would advise you to send us photograph of the rash for a better help. This is my best advise for you based on available details. If you have any further query, please ask me. Stay Healthy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 gums appeared normal, but right after brushing and then rinsing with listerine whitening mouthwas, a small white patch appeared under one tooth.  Like I said, everything looked fine prior.  The spot didnt go away with brushing, but was able to scrape it off with a floss pick.I am panicking because I chew tobacco ### REPLY: Hellooo...reading your symptoms I feel that there is nothing to worry in this case...it can be stains caused by mouthwash(long term use) .it is scrapable(extrinsic)so nothing to worry at all.go to dentist get scaling done(it can't be removed with brushing).tobacco chewing can't cause much problem to tooth...it can cause problem to the gums or cheek.(best is stop that chewing habit slowly).be cool...hope your benefitted something from this reply.have a healthy day!!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a burning sensation across from the center of my back on the right side of my back in just one spot.it feels as if someone is putting fire on it or someone scrapping it with a knife or something. it feels so miserable. what can i do to stop it or ease it? ### REPLY: Hi, Welcome to . After going through your query I THINK IT CAN BE muscular pain with tender spot. You can visit orthopedic surgeon for local injection of escort 40 mg at the point of spot to relieve it. Analgesics (diclofenac) can be taken to pain receive. Sometimes vitamin B 12 and vitamin D deficiency is the cause so get your vitamins checked. If it is low then vitamins' supplementation can be taken. I think your query answered. Welcome to any follow-up query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 30 year old female I have been having some discomfort on the left side of my chest I did see a cardiologist and had a ekg & stress test done he thought the discomfort had nothing to do with my heart but it will not go away I also fill a fullness in that area that seems to move on its on it also seems as if Im having spasms I did have two c-sections one in 06 & another in 2010 please help what could this be it is not painful just bothersome what should I do ### REPLY: Hi, The pain may be caused either by gastrointestinal or spine problems, or it may be just a muscle pain. I would advise you to take Ibuprofen 400 mg three tomes a day after the meal along with Pantoprazole 20 mg, two times a day 30 minutes before the meal for 7-10 days. If it doesn't help, then you should see your doctor to undergo some examinations to find out the cause. Take fearsome back if you have any further questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 28 year old male with elevated liver enzymes. I have stopped smoking in the last few months. I have only drank alcohol on rare occasions this year. I have been using various Nicotene replacement products. My ALT levels have reached 300 and are now at around 150 but seem to be stuck at that level. My AST levels were within the normal range and have now slightly increased to a level of 52. I have had a vast array of blood tests to check almost everything and nothing significant has been found. I am suffering from chronic fatigue. Could my use of Nicotene products be affecting my liver? Or do you have any other suggestions for possible causes? ### REPLY: Hi thanks for contacting ... You are given nicotine replacement product in which low dose nicotine given for preventing with . ... It is for smoking cessation.... It is not well documented whether nicotine in low dose can affect liver.... Investigate with first USG abdomen to rule out fatty liver or gall stone like condition.... Then if history of suspected sexual history or blood transfusion. Bag ruled out by ELISA..... Take low fat diet and fruits more. Use less oil in cooking.... Besides liver if you have muscular or heart problem history then also liver enzymes can be high. Follow your nicotine replacement program to stop smoking. You can consult physician or gastroenterologist for your work up. 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 SIR, DOCTOR HAD SUGGESTED ME YOUR CREAM FOR USING IT ON DARK CIRCLES i.e(depiwhite under eye gel) BUT DUE TO CERTAIN MISTAKE CHEMIST HAD GIVEN ME DEPIWHITE CREAM..I HAD APPILIED IT ON MY DARK CIRCLES FOR DAYS REGULARLY WHICH HAD CAUSED A REACTION (REDNESS ON DARK CIRCLES,IRRITATION )AND WHEN I HAD SHOWN IT TO MY DOCTOR HE SAID TO USE DEPIWHITE UNDER EYE GEL .. BUT THERE ARE SOME FOLLOWING QUERIES WHICH ARE AS FOLLOWS 1 IS IT A REACTION ? 2 IF IT IS A REACTION HOW MUCH TIME IT WILL TAKE IT TO OVERCOME ? 3 FROM WHEN TO APPLY DEPIWHITE UNDER EYE GEL AFTER REACTION IS TREATED OR I CAN APPLY IT ON THAT REDNESS PART OF DARK CIRCLES. ### REPLY: Hello, It appears you may have a chemical hypersensitivity to one of the recipients of the cream, and it is important that you see a dermatologist with interest in chemical sensitivity to get a patch test done to exclude this. You can apply a local antihistamine cream or take an antihistamine tablet for a few days to treat the present reaction. It normally takes a few days (less than a week typically) to overcome this reaction. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 11 months old daughter is suffering from high tem. since yesterday, we have given percetomol drops thrice again today temp is 102. 15 days back she was treated for cough/cold/fever wit antibiotics(5days). Pls suggest most of doctors are not available today ### REPLY: Hello, Usually a fever will last 2-4 days.  The acetaminophen (Paracetamol) will only last about 4-6 hours.  So you will have to give it again and again - but no more often than every 4-6 hours and no more than 5 doses in a 24-hour time period.  At 11 mos, you could also try Ibuprofen, which often lasts longer, more like 6-8 hours.  You should dose it based on weight to get the best effect.  Hope I have answered your queries. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 650 on my Eosin blood test. What kind of diagnoses could this be? I am 71 years old and am taking Gabapintin a nerve- blocker med. for a spinal condition. Lots of burning in my stomach and burning for 2 yrs. across my shoulders. I have only been taking this med for 6 months. ### REPLY: Hello, Eosinophilic is a condition related to increased eosinophils in a blood test. Those values indicate mild eosinophilic. Eosinophils are found elevated in blood in cases of parasitic infection and in cases of allergic reactions, autoimmune diseases, etc. Only increased eosinophils are not sufficient to get a correct diagnosis and more evaluation is necessary to find the correct cause of increased eosinophils in your case. Discuss with your Doctor for these issues. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have like a tingling sensation in my scalp , which when I touch my scalp it s sore. I have no sores at all. I had a dull pain behind my right eye and was seen in opthomology and everything looked normal. I m scared their may be something wrong in my brain ### REPLY: Hi, Thanks for writing in. The scalp and face are supplied by the branches of trigeminal nerve and facial nerve. Tingling sensation can be felt in the scalp due to irritation of the branches of these nerves along their course. There are certain conditions which might cause tingling of the scalp region and needs to be examined by your doctor and evaluated in detail. This includes conditions like shingles which can cause a tingling sensation in the scalp for a long time before rashes start appearing. There are other causes like pinching of nerves. Since you are having dull pain behind the right eye, getting it checked is important. Pain behind the eye can also originate from irritation of nerves. Please consult a neurologist and get examined in detail. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am have b12 deficiency and have injections every three months but keep getting told every now and then that my iron levels are low and then have to be put on iron tablets i also have a skin condition phoriasis but always had it.Just want to now why my iron levels keep falling? Thank you? ### REPLY: Hi, there are many causes for low iron. It may be due to diet deficiency of iron, or may be due to increase demands and your body can not cope up with that increase demand. You may have some chronic bleeding from external or hidden site. It may lead to iron deficiency. You should go to find the cause. Go for PS examination and if needed go for USG. First try to find the cause and then take treatment accordingly. Thanks for using . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 7 year old daughter fell very hard on her back 4 days ago.  Since then, she complains of back pain about mid way up in the center of the back.  It hurts when standing for a while and when she coughs or sneezes.  Today, she says her stomach and top of hips hurt as well as her back.  Do you think she is just sore or are these symptoms of something else?  Thank you for your help! ### REPLY: Hi there. Firstly I would advise you to get an X-ray of the back done to rule out any fracture. Till then I would advise complete bed rest on a firm bed. Take a good analgesic and muscle relaxant. Do not heat the tender area as it might increase the inflammation.....although you can apply local analgesic gel. Pain while sneezing is due to the stress caused on the injured sea. Pain in hip and stomach is referred pain from back. Final treatment will depend on X-ray result. I hope my advice has helped. Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i had unprotected sex with my girlfriend 2 weeks ago ... she is on the pill though but she had just went back on it that night after having her period and i am just wondering would that pill work for that night .... and would it be possible is she pregnant cause a bit of sperm went in .. we are always really carefull apart for that time ### REPLY: Hello, Thanks for asking at  ! I have gone through your query and I can understand your concerns. Birth control pills are highly effective, and failure rate is very low. The failure rate is very low, and it is approximately one in a thousand. The chance for pregnancy is quite low and you don't need to worry much regarding this. You can do a UPT(urine pregnancy test) for your own reassurance. 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 meningitis and encephalitis due to the West Nile virus a year and three months ago. At first Dr.s told me to give myself time to fully recover. I am suffering from chronic headaches, fatigue muscle weakness and strange pains in the extremities.  I am no longer willing to believe that this is not connected to the result of my illness. I am 36 yrs old female and married mother of four. I have no reason to invent symptoms or fake me current condition. Is there any type of treatment or therapies to try? ### REPLY: Hi, Sorry to hear that you are still unwell. I would like to know how is your mood of late? Especially over last 2 weeks or so how much you rate yourself in terms of mood on a scale of 10? Do you enjoy talking with family members, relatives & doing activities like watching TV, shopping etc. which are normally termed as pleasurable activities? How is your sleep of late? Lastly are you having regular menstrual cycles? Is there any fluctuation of symptom severity in relation to your menstrual cycles? Based on your given description I think you are suffering from fibromyalgia or chronic fatigue syn .  You need to consult your doctor & discuss option of medications like milnacipran, fluoxetine which work very well in this condition. Also do answer my queries frankly to aid in your further evaluation. Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr. Gupta, Im 21, female. I had iron deficiency anemia since August 2006. However, I started treatment (1 tablet/day of Gyno-tardyferon) since September 25, 2010. My blood test results for this month show that I have no anemia. Tests from low to normal range:HematocritHemoglobinHemoglobin amount per red blood cell (MCH)Average red blood cell size  (MCV)Serum iron Test from high range to normal range:Lymphocytes  Test from normal range to (slightly) high range:Folic acid  So do I continue with my current medicine? Or should I change it to one with less or no folic acid? Gyno-tardyferon (my current medicine) composition: 80 mg ferrous sulfate, 0.35 folic acid. My pharmacist advised me to take a medicine with ferrous (because that medicine has no folic acid) instead of ferrous sulfate. Whats the difference between those two? And would ferrous alone prevent my anemia from coming back? How long should I continue my iron intake? For life or just a couple of months? And what is the recommended dosage? Thank you. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. If you have purely iron deficiency anemia then there is no need of folic acid supplements.  You can go for iron tablets life ferrous fumarate or ferrous sulfate.  However, if you have mixed folic acid deficiency also then there is chance that anemia can back due to low folate.  You should take iron rich food like dates, green leafy vegetables, .  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: I am a 16 year old male and i think that i have an infection in my genital area, it has been like this for quite some time now and is sometimes inflamed. It is concerning me a lot because I have never had sex before and I am worried as to how i got it.I am nervous to tell my parents, what can i do about it? ### REPLY: Hi, It is not clear that what type of infection is present on your genital area. This might be some local causes like yeast infection, dermatitis or ingrown hair follicle infection. This is normal if there is lack of personal hygiene and do not hesitate telling your parents. Consult your doctor and get examined. After proper diagnosis he will go for treatment accordingly. Keep local hygiene clean, well shaved and . Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my name is jen chen . i had back injured 2001 and back sore all that years, I am very healthy person 51 and 105pounds. i alway did joging every day for 1 hours . suddently last year 2010 i just did jogging  and i start had pain on my low back down to buttock, tailbone,thigh,calf and ankle. now i cant above to seat or walk for long period of time . my felt weakness and short breathing ,dizzy and my nail bed turn purple. but when i lay down they feel much better. I being went to emergency alot of times and they test all my blood test are normal and they also did ultra sound and blood test for blood clot came out normal. my concern right now does lumbar spinal stenosis can cause me no energy and weakness? I being went to chiropractic,accuputure,physical therapy and being seen orthopedic ,neurosurgeon and they just give me pain killer,patch,muscle relaxer,and nerve pain and none of them work and i had steriod injection back 2001 and current i am waiting for epidural injection. well i had took MRI on 01/2011  that show I just took MRI 1/2011 showed L5-S1  there is a broad-based left paracental disc protrusion which measures approximately 6mm in AP diameter which effaces the anterior thecal sac and impinges the descending left S1 nerve root. Resulting mild impingement of the exiting left L5 nerve root. the right neural foramen is mildly narrowed.also May 2011 i had took nerve conduction test and they confirm I had nerve pinched on L5-S1. being try to active by doing some walking but i cant above do for two block walking. i feel no energy,short breathing,dizzy,blur vision . and i feel want to pass out . i cant above to seat for 15-20min. how can i get my normal life back. please give me some advise. ### REPLY: Dear patient You're having lumbar canal stenosis with disc prolapse at l5s1 level.  Normal spinal canal diameter is 12 to 14 mm, and you are having only 6 mm with almost 50% reduction in spinal canal space due to which passing nerves get compressed, and you get pain in both legs with weakness after walking certain distance and relieved by rest. Since it is mechanical compression epidural steroid injection would not help much. You require surgical procedures in form of l5s1 discectomy and spinal canal decompression.  Procedure cam be done with minimal access and endoscope. Since your MRI is 3 yrs old fresh MRI is needed.  Consult expert spine surgeon, and he will guide you with proper treatment. All the best ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 24. I had a miscarriage last year in July. Since then my husband and I have been trying to get pregnant. To make my period regular, I decided to get on birth control. First Loestrin and then the Nuva Ring. Both birth controls had horrible side effects for me and my husband and decided that I get off them. I got off the Nuva Ring in June of this year. I had a period then. Skipped July and had a period August 23rd. I was experiencing pregnancy like symptoms for the last 2 months with no period. I have taken 8 home tests and they have all come back negative. So yesterday, almost at my 3 month mark of no period, my period starts and I get a few severe cramps that I subside with Motrin. I am still having heartburn, headaches and fatigue. Im starting to lean towards a thyroid problem. Is there any advice you can offer me? ### REPLY: HI, I understand your concern, To get pregnant, It's essential to have regular periods with ovulation.  -I would advise you to get examined by a gynecologist followed by investigations as per her advice. (Blood CBC/ thyroid function tests/ USG lower abdomen to exclude or diagnose POD, ovarian problems, fibroid uterus/ blood sugar ) . Followed by specific treatment - Get your husbands' semen analysis done to confirm it to be normal.  - have a healthy lifestyle & diet to be in excellent health & thereafter try for pregnancy as follows.  - Take Tablet folic acid/ vitamin E three months before planning the pregnancy.  - Avoid any health problem in these 3 months. Let HBO be > 12 GMS %.  * test for ovulation day by LH surge test.  - have unprotected sex after LH test +ve for 5-6 days regularly / at least alternate days.  * confirm pregnancy after 8 days delay in periods(by HPT) & consult doctor soon after the pregnancy test is + ve.  Wish you good luck.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a history of pericarditis, pericardial effusion, pleurisy, pleural effusion all of that within 3 1/2 months starting in 2007. Sed rate at it s highest was 200, wbc at it highest 24500, positive for anemia, pos protein in urine, neg ana. Never diagnosed with anything and ruled out fmf, cancers, all the usual suspects. Was told probably inflammatory process likely due to autoimmune. I am still having symptoms, severe joint pain in knees which just started 3 months ago, still difficulity breathing a couple times per week (but lungs are clear) last anywhere from 20 minutes to 4 hours, now smelly foamy urine. Any ideas? ### REPLY: Respected Sir, hi I evaluated your query thoroughly. This relates to the decline in inherent respiratory effort . *Joint pains are different related to articular surfaces erosion or frictions or calcium and other elemental disorders.*Smelly foamy urine is directly indicating urinary tract infection. All measures you have to carry out at home are :-- maintain He level by high iron diet with Iron capsules or syrup.-- maintain your HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 symptoms started two days ago i was very tired then had a runny nose, now its on my chest and when i cough mucus comes up also my voice start going last night and its still like it today, i dont know if its the flu or cold or should i see about it thks ### REPLY: Hi thanks for contacting . Noted you have cough, runny nose with voice also affected. So here you could have viral flu or viral infection of respiratory tract... There are also chance of viral laryngitis as voice affected... So you can consult ENT surgeon for laryngoscope examination... Here symptomatic management done with decongestant use... Steam inhalation also useful. Humidifier can be used. If no improvement then short term steroid can be used.... Azelestine nasal spray also useful.... . . Fruit juices taken more.... Avoid excess spicy food.... If no improvement and condition worsening then chest x-ray done for further work up. Hope your concern solved. 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 good morning! please help me what cream will help me cure my skin rashes. i experience this rashes since college (17yo) only during my menstruation.. only in my lower buttocks, the area where we sit. but during the time even a cheap cream, the rashes will heal. but this time,, my rashes started july first week, until now it is still ichy and red. pls help, thanks ### REPLY: Hi. As per your case history my advice is-1. You're maybe having a fungal infection as per your complaints.2. Using regularly cheap creams (mostly containing topical steroids) will only cause temporary relief. So avoid using it.3. You can apply topical clotrimazole cream twice daily. Take tab.levocetrizine 5 mg twice daily for itching.4. Further treatment options include oral fluconazole, itraconazole, topical terminating only after consulting a dermatologist. 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: started as burning pain high on right side, under ribs. I have had a hida scan and abd u/s....both neg. (although my gallbladder took a very long time to show up on the hida scan). I swear I can feel something inside when I bend to the right side. The burning has somewhat subsided but now I notice more of a dull pain running straight down, mid right side. It is also tender to the touch. My pcp wants to do a endoscopy/colonoscopy next but I think and CT of the abd might be a better idea. Your thoughts? ### REPLY: Hello, Several features of pain can be helpful in clarifying what is going on and the next steps for diagnosis and treatment. Type of pain:Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain. Location of pain:There is a lot to this. First, if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might be going on. Obviously if there was an injury to the area and then there was pain outward from it "hit a nerve" would be a possibility. Sick nerves are multiple areas and tend to be the TIPS of the nerve not the whole nerve. So, a localized irritated nerve often can be treated. But often the cause is not found if it is not trauma. It can be Lyme disease or lupus or autoimmune disease, but these are rarely the cause. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have two very large growths in my liver. The largest of which is 11cm by 9cm by 7 cm and have grown 2 cm in each direction in the last year. I am being referred to a general surgeon because one growth is pushing on my hepatic artery. What kind of surgery should I expect? I have also developed a large amount of food intolerances that lead to bloating, constipation, and pain and wonder if these are related. I am a 28 year old female. ### REPLY: Good morning I am sorry to hear about illhealthMasses in liver which are large and causing symptoms need to be surgically removed before doing that it's very important to know the cause and nature of these masses. This is done by a procedure called biopsy involving putting a needle in the liver mass. Commonly they may be cysts (simple or parasitic), mass containing a lot of blood vessels, rarely cancer. Your symptoms of bloating, constipation and pain could be from the mass pressing on your stomach and colons if I were your doctor I would exactly know what is this mass and then venture upon further treatment Hope this would answer your questions you a speedy recovery ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have crohns and had a bad reaction to imuran after taking it for about six months, Ihad skin rash .swollen face glands , sore eyes and blepharitis and stomack pains . Iwas told to stop the imuran which I did . I started to feel a lot better but it has been a long road , Ifeel there is something else wrong with me , but all my blood test are fine could all this have happened just because Iwas taking imuran ### REPLY: Hello, I read carefully your query and understand your concern. The symptoms seem to be related to an allergic reaction to Imran. I suggest taking an antihistamine to relieve the symptoms. I also suggest using a steroid cream for local application. If the symptoms continue, I suggest consulting your doctor about an alternative treatment. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards! .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I just took my husbands blood pressure and it is 74/41. It has been low all day. He feels cold and clammy, sick to his stomach, tired, and his color is pale with a grayish color to it. Nurse was here at noon and his bp was 70/50, and then at 5pm it was 86/55. Dr was notified but didn t seem concerned. He is a diabetic and just got out of the hospital 5 days ago. He had kidney failure, liver failure, congested heart failure. He also had a virol infection with ecoli in his urine and another infection in his urine also. He is also type 2 diabetis, and now is on dialisys. ### REPLY: Dear, thanks for taking the time to ask your questions to us. First, a patient with congestive heart pressure needs to have a low blood pressure to avoid that the heart will work more. Another situation is that when a patient is in dialysis, he/she lose a lot of volume of water and that can create low blood pressure. It is very important to check if he has any symptoms, as dizziness and weakness. It this is not the case, just keep monitoring his BP and keep record of any changes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, am a 29 yr old female. Had severe lower abdomen pain on the right side. Suspected it to be appendicitis , but ultrasound scans were negative for it. Diagnosis- questionable PID. Blood profile indicates creatinine of. 1.1, I ve had swelling in my ankles n feet for olds a year now. Apart from general tiredness n pain in the abdomen and cramps that r severe during menstrual cycles, I ve no other symptoms. No fever, no nausea. No pain urination. I want to know what could be wrong. ### REPLY: Hi ! Appendicitis is more of a clinical diagnosis by your doctor, and ultrasound examination can not confirming exclude it. What are the findings in the pelvis for which they leveled it as questionable PID ? What are the reports of routine blood tests like complete blood count and urine test. Even a silent urinary tract infection can give rise to such pain abdomen. If you are having increased intensity of pain during your periods, then it goes more towards pelvic inflammatory disease (PID) or to a condition called endometriosis. This can be excluded or diagnosed by a gynecologist. I would suggest you to discuss with your family physician and get reviewed on these aspects. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Day before yesterday, my father had gallbladder removal with kind of big stones inside.Next day he had mild pain after surgery and was discharged from the hospital.Today in the morning he didnt"b"feel good at all cause of having nausea, with really  distended abdomen. And with too high blood pressure.And after all, his pulse was more than 100 bits a minute with some atrial fibrillation. He is under IV now  to improve all of this situation. But what is your opinion and advice on this? ### REPLY: Hello, Although slight nausea, bloating,gas, pain is common after surgery and is called as post cholecystectomy syn . Although sucChatDoctorplications are few but they can be . Internal bleedingBile leak Injury to liverInjury to cystic or common bile duct etc. Since he is having high blood pressure and high pulse rate, it is better to be in the hospital under the watch of your doctor, where proper monitoring can be done. 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: RCT was done on my left 2nd molar and 3 roots were treated about 4-5 weeks back. Since 2-3 weeks I am getting severe pain in same tooth which is relieved by cold water. I have been advise ipobrufen 600mg  TDS with amoxicillin and metronidazole which I took for 6 days without any improvement. I suspect the detist failed to see the possible 4th root of the tooth which is now giving problem. I am suffering from gaseous necrosis in the possible 4th root or what? If the dentist is unable to see the 4th root  with naked eye, do dentist use magnifying instrument to see minute roots? A followup xray and OPG was unremarkable. Pls advise what should be done. The pain is unbearble even with ipobrufen. Thank for sending reply to  YYYY@YYYY Naqeeb Khalid ### REPLY: Hello, thank you for consulting with . If there is pain present in the same tooth after the root canal treatment also, it means that either the RCT is incomplete or it has not been done properly. I think you should visit another dentist to get a complete examination of the tooth done with x-ray, as without x-ray it can not be diagnosed properly. And if needed get it retreated. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor Im Tomas Encarnacion I fiill up a form for excuse dury duty . Because every time i went there i feel an tromatic Enxity because of my fast divorce court, Last year I really cannot control my self my tears fail in front of the judges. so they let me excuse n send home. hope you do under stand my situation. YYYY@YYYY ### REPLY: Dear serve understand your concerns went through your details. Anxiety disorders are a category of mental disorders characterized by feelings of anxiety and fear, where anxiety is a worry about future events and fear is a reaction to current events. These feelings may cause physical symptoms, such as a racing heart and shakiness. There are a number of anxiety disorders: including generalized anxiety disorder, a specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, and panic disorder among others.  While each has its own characteristics and symptoms, they all include symptoms of anxiety. Anxiety medicines alone cannot cure anxiety disorders mainly because medicines do not alter behavior. Behavior change and Continuous practice of the changed behavior cure anxiety. I suggest anxiety education, progressive counseling and progressive psychotherapy. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a molar (right side bottom, 2nd from rear) that has broken off on an angle & i alredy seen the dentist also he told me i m having a hole. & done the X ray. In X ray report doc told 1/8 tooth is missing. The wisdom tooth is noted. There is a little horizontal bone loss suggesting early periodontal disease but no other bony abnormality is seen in the mandible or maxillae. What happen next now? ### REPLY: Thanks for your query, I have gone through your query. The broken tooth can be restored with root canal treatment and crown, if sufficient tooth structure is left. If the tooth structure is not sufficient, then the tooth has to be removed. Regarding the wisdom tooth, if there is no space for the tooth to erupt then it has to be removed. If sufficient space is there then we can remove the overlying gums to make way for the tooth to erupt. 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: Hi my son is two years and 5 months old. I live in Mumbai India. He has been complaining of tummy ache and he has been going potty three or more times a day since past three days.stools are formed but weird. Can I give him nor met or taximo?and what dosage.thank you.. ### REPLY: Hello, It seems your kid having viral diarrhea. Once it starts, it will take 5-7 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 and 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: Hi! My name is Skylar and I am 12 years old and I have an urgent and important question for you. For the past 6 months I have been having severe abdominal pain and back pain, chest pain, nausea, fatigue, sweating alot, night sweats, and really bad muscle spasms. At first the doctors thought I had pulled a muscle, then they thought I had appendicitis, and then kidney stones. But they ruled all that out and so we figures it was something to do with my ovaries. I ve had 4 ultrasounds done and its all clear. They said I have endometriosis but thats not causing all my other pain so she decided to send me back to my primary doctor. She thinks I might could have ulcers but I don t know. My appointment for a gastro doctor ain t till August, and I can t wait that long. My pain is continuous and I have gained 20 pounds in the past month which is not normal for me at all. There is no medicine that helps and I need your help. What do you think is wrong with me? ### REPLY: Hi. Thanks for your query. Read your history carefully. It says severe abdominal pain and back pain, chest pain, nausea, fatigue, sweating a lot, night sweats, and awful muscle spasms. All the symptoms can be attributed to anxiety or psychological imbalance- if all the tests are negative. On a safer side you can undergo additional tests of : blood culture, CT scan of spine and abdomen. And a course of broad spectrum antibiotics for a week. Take symptomatic treatment under care of your Primary care Doctor. He may add antianxiety medicines also and may help you fully. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Can the Mirena IUD make yeast infections more likely and also can the IUD create the urge to urinate frequently?  My urine is clear and ultrasound is normal.. It doesnt feel like bladder fullness, just more of a urethral twinge/burning.  NO STDs either. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes IRENA for long duration can cause candida infection. Once the candida infection is established it can cause you frequent urination and UTI. As IRENA is foreign body it can cause reaction on long period stay. It is advice to replace the IRENA after some times. Frequent changing of IRENA can prevent nation of candida. Nation is first step of establishing candida infection. This time you can take the treatment for candida e.g. clotrimazole vaginal pessary. But please take this pessary inserted under doctors guidance and advice. Avoid sexual intercourse until whole of your infection is treated. Otherwise, it will transmit to your partner also and continuous cycle of infection will be maintained. Please maintain local hygiene because it will also take care of half of your infection. I will be happy to answer your further concern on bit.ly/ . Please hit thank you for me if you are helped. Thank you, ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. Im not on any contraception at the moment but i had one shot of the depo when my son was 4 wks old now he is 20mnths old and i was not on anything else since then. My period only came back May last year and has been normal since then. Now im wanting another baby and started on elevit last month and it seem like my period is now stopped. Didnt come at all. My last one was 18/01/2014 then i got brownish spotting on the 1st of Feb which i believed it was ovulation and nothing else since then..I took 2 urine test so far and results came bck negative. Can u tell me if there is a hope for me! ### REPLY: Dear member, Thanks for writing to . If your pregnancy test is negative then you can consult a doctor to induce a period.Don't worry. As you have had a baby and your cycles are regular there is no need to worry. Try home ovulation detection kits and time intercourse.  If after 1 year of this there is no pregnancy then you can consult for further investigation and 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 sir actually i got serious penile infection after getting homosex with someone.Doctor prescribed me and treated continue.But now i had oral sex since yesterday that time my penis had been cut a few blood would flow.Moreover, my penis is not erected properly.whwn i shaking it get erected and it loosed as soon.So im such scared about these so please give me advice what i do???? ### REPLY: Degree understand your concerns went through your details. You are too much thinking about the problems related to sex and sexual organs. Because of that, it is quite natural that you get anxious and obsessive. Anxiety and obsession about sexual organs and sex makes you feel weak. Your present symptoms are psychological and are due to your anxiety and obsessive thinking. Please consult a psychologist for counseling. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently gave blood where they took my BP, it was 130/820 (pulse 82). A week prior I had it checked and it was 120/82 and a week prior to that it was 115/78. The person at the donation site told me that digestion (I had just eaten) may have caused the high BP. Can that be true? ### REPLY: Hello, I really appreciate your concern. You are having minor changes in blood pressure which is quite normal phenomenon. Change in BP can be triggered by several factors like change in body postures, change in pulse rate, time of day (day or night), fluid intake, salt intake, some minor illnesses etc. So there is nothing to worry about in your case. There may be rise in heart rate and blood pressure after meals which is normal activity of heart to provide excess blood supply to stomach. Hope my answer has solved your query. Take Care. 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: when i was a kid my front left tooth got chip my mother took me to dentist they drilled a hole in the back of my teeth and killed the nerves, however my mother never followed up on this procedure to fix my tooth the older i got my tooth rotted and fell out i still have the hole they drilled in my mouth plus my tooth missing im 39 years old today and the hole just pushed gums up and remain open is there any danger that i should be worried about, went to clear choich they said i need 0000 dollars worth of work done to fix my mouth that have been killing my confidence since i was a kid ### REPLY: Hi, Thank you for the query. According to the history given by you, it suggests that root canal treatment was started by . If the teeth which was primary fell off then a permanent teeth should erupt in that place, as there was no teeth found it suggests the permanent teeth is absent or missing leaving a space in between the teeth. Your dentist must have suggested you for a replacement of teeth, which could be either an implant - which is a surgical procedure or a bridge where you will be taking a support of the abutment teeth i.e. adjacent teeth present on both the sides of the missing teeth and placing a ceramic bridge. Hope this information helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was speaking with my best friend about some bad things that were happening, and him asking questions like "why do i do this". he has aspergers syndrome, and was "officially" diagnosed by a doctor. he told me that i have a whole lot of the same symptoms that he does, and that i might possibly have AS as well.the symptoms we share are things like--difficulty understanding certain types of sarcasm and jokes, difficulty reading people/understanding body language, apparently odd gait/posture, intense and limited interests, and social anxiety.do you think he is right? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Asperger's syn .  Poor social interactions, obsessions, odd speech patterns, difficulty in reading, fewer facial expressions, unusual sensitivity to stimuli etc. are common symptoms. Because of the vividness of this problem, there is no specific methods of treatment. The following are usually applied.  Parent education and training specialized educational interventions social skills training language therapy sensory integration training for younger kids, usually performed by an occupational therapist, in which they are desensitized to stimuli to which they're overly sensitive psychotherapy or behavioral/cognitive therapy for older kids Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MY LEGS ACHE ALMOST CONSTANTLY, SOMETIMES THE JOINTS TOO, AND ARMS ALSO.I DO HAVE ARTHRITIS IN MY LEFT KNEE AND THIS HAS PROBABLY SPREAD BUT THE ACHING AND PAIN IN MY LEGS IS FAIRLY CONSTANT AND 800 MG. IBUPROFEN DOESN T WORK LIKE IT USED TO. WHAT IS GOING ON? GETTING OLD?? ### REPLY: HelloDepending on your age and sex I would say the cause is either the arthritis or if you are a female maybe osteoporosis. It may affect the spine and this causes aches in both upper and lower extremities would suggest doing a full blood count for this two disease (Rheumatoid arthritis and osteoporosis) and radiology examinations and proper treatment by specialists. Another rare cause may buy fibromyalgia or chronic fatigue syn .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ended up having sex the last day of my period which was 2 weeks ago. I was wondering if it would be possible to get pregnant then, and if so when would I have to test. My cycles are very irregular so I m not sure how long until I ovulate again. I m having some symptoms but not too sure if its my period showing up again or just in my head. Any help is appreciated. ### REPLY: Hi Cole, i read your query, usually It's safe to have intercourse 5 days before and after your menstruation, no ovulation takes place at that time.  So, you are in safe period and nothing to worry, you won't conceive as you had your periods after intercourse, it makes the chances to zero if you further had any doubt, just do an  card test, its most reliable, i understand that your stressed and worried about being pregnant, that itself make you feel like having the symptoms of getting pregnantRegarding irregular periods, consult a gynecologist and have an expert opinion take care . Surendiran ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 50 yrs old lady.Last 3yrs some brown patches seen on my nose and on both sides of upperlip. Now its spreading to my forehead .I consulted a dematologist he did Microdermabrasion on my nose and upperlip. all came in vain.Now I am using carofit during night and a sunban lotion during night.Dr please advise me. I am so worried. Thank you ### REPLY: Been, recurrence of spots after Micro dermabrasion indicates that the triggering cause is still there. Generally these spots are triggered by hormone estrogen, melanin or sun. Plasma spot soccer due to age. Sunscreen formulations may help. Hy .  It decreases melanin production. This helps only if the pigmentation is superficial & not deep. Pigmentation may recur if it is discontinued. Oxybenzone, a derivative of HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 my wisdom teeth removed over a year ago now. But my bottom right side has always played up since but today I have woken with sever swelling and pain down to side face and my jaw and a bad headache. Could this be a infection as Iv been using warm salt water ### REPLY: Hello, thank you for consulting with . It can be possible that now the tooth which is at the back side in mouth might have been infected and creating problem, or a root of the wisdom tooth might have left after extraction, and now it is creating problem. But these both can only be confirmed by an x-ray, so better that you visit your dentist and get and the x-ray done which will clear the condition. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,my husband has chf,coronary heart disease and diabetes and basal cell cancer that has spread to the bones in the in the right shoulder,his ejection fraction of the heart is 15%,his kidneys are at 1.19,they say there is nothing more they can do for him.he currently stop taking his meds because of what the doctors are saying.one more thing he also has 3 stents put in in 2009.how much longer can he live like this?? ### REPLY: Hi welcome to  forum. Basal cell carcinoma usually doesn't spread but it is possible. Also, i don't think that he will pass away from basal cell carcinoma. Probably there will be heart failure, but it is impossible to say when. He can live for more several months or years. It is impossible to predict. You have to support his heart and kidney function as much as you can with medical therapy. 15%is very low ejection fraction, but this is enough for normal circulation. Hope I have answered your query. Wish you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a stabbing feeling approx where my gallbladder is. It hurts more when I breath in and it comes and goes. It has also sent pain down to my right testicle that almost puts me to my knees. I can pinpoint the pain and have an ultra sound, blood test, and urine test and everything looks normal is what I am being told. It will shoot to my lower right side of my back. Seen doctors and no one says anything is wrong but the pain can be unbarable at times. I have not had a good stool since the notice of the pain. Need advise t take to a doctor, something is not right. Thank you ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have cholecystitis or some intestinal colic or some muscular pain. You should go for repeat ultrasound abdomen once. Many a times cholecystitis is not diagnosed in early ultrasound. You should take dicyclomine and diclofenac tablet for pain relief. First we have to search the cause and then specific treatment should be taken. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am a 40 year old male. I got hit by a cricket ball 3 weeks back, close to left eye and am diagonised with Orbital Floor Fracture (had CT scan taken). I have numbness on my head whicChatDoctores on and off. When this numbness comes, I become very tired and am very weak. I do not know what is causing this debilitating numbness, what should I do? ### REPLY: Hello, I have studied your case and I think that you might be having nerve compression in the fracture, or it can be due to concussion to brain. I would recommend you to visit a neurosurgeon and get your complete evaluation as it can not be taken lightly.  If there is any nerve pressure then it will improve once swelling and edema will settle. Your doctor may advise you to get an MRI scan of the brain and face to confirm the diagnosis.  I hope this answer will be useful for you. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I went to an ENT for acid reflux, but a throat culture showed pseudomonas aeruginosa. I was told they tested several antibiotics on the culture, cipro being the only effective one. Im having trouble finding any information on this bacterium as it relates to the throat. Im on cipro, but wondering where this could have come from. Female nearing 40, usually in good health but flu-like symptoms for last two months. Thanks for any info. ### REPLY: Hello there, Pseudomonas aeroginosa is a different organism in the fact that it has the ability to form a biofilm. What it does is, attach to your throat then forms a slimy layer around itself which prevent the body from destroying it and then intermittently attack the throat epithelial layers. So you would have on and off fever along with a persistent sore throat over a period of time. Now that the doctors have established what it is sensitive to the antibiotic would take care of it. It is an organism present in the environment and occasionally infects us. So you do not have to worry whether you were singled out or you did something wrong. Thank you for your query. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: In a nutshell, had a cyst and bone spur removed from right middle finger 2/26/14. Became infected and had 2nd surgery 4/1/14. Bone culture taken; staph infection in bone present. IV antibiotic via 24 hr pump/oxacillin for 6 weeks, then 4 weeks of cephalexin; 500 mg twice a day. just at end of these 4 weeks, got infection in eye. Went to ER, determined not a stye or blocked tear duct; said cellulitis. Was put on IV bag and given gentamicin ointment. Got better for one day, but now today, eye seems to be a little worse. Could it be possible, in any way, that whatever is going on in my eye can be related to the past staph? infection? ### REPLY: Dear patient You have got sufficient course of antibiotics for your staphylococcus infection of bone osteomyelitis. 6 weeks of intravenous antibiotics is recommended for chronic osteomyelitis. Staphylococci are very resistant organism and can lead to Infection in any part of the body including eye. So when bacteremia occurs organism Amy lodges into eye and when body immunity is decreases it leads to clinical infection.  You need to consult eye specialist asap and get yourself examined.  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 when I cough my upper spine pops hard I also have pretty bad pain in my upper back enough it s hard Sometimes to sleep And my lower back hurts constantly but to go With that my legs hurt sometimes pretty bad I feel my feet like they are burning and when walking sometimes I have no problems but other times I get a sharp numbing pain in my Left and right hip and have to sit down for a few minutes then I can go again this is especially when walking on a uphill incline ### REPLY: Hi, I had gone through your question and understand your concerns I were your treating Doctor for this case, I would come up with two possibilities, these include: Upper back pain musculoskeletal spasm in the upper back and this could be relieved by skeletal muscle relaxant. Lower back pain with articular pain in both hips and numbness with walking is mostly nerve root compression due to back problem as lumbar disc prolapse mostly. SO you should do MRI lumbosacral spine to assess the cause well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! I am 67 years old, and I too have a probable lipoma (MRI 2 days ago--no answers yet)Its large, hardened and to the left of my LS spine, at waist level.  It doesnt cause pain, but does interfere with the fit of my pants.An X-ray of my LS spine revealed nothing in the area, so its not ossified. I have a H/O spinal fusion L3-5, but that was in 2001...... Could that be a factor, 10 yrs later? I have had a lipoma in my breast (1988), and had excisional biopsy for this--no other personal or family history.I had lost 70 lbs, and am just about at normal weight.  This started to develop over a year ago--before my weight loss-- as a thick pad of soft tissue in the area, and now is definitely hardened. Any advice you can give me would be appreciated! :)Jan W. ### REPLY: Hi, Thanks for writing in. A lipoma is a benign fat containing tumor usually found under the skin but might occur in any place. Lipomas are soft swellings that slip under the skin when palpated with fingers. It will help to get an ultrasound scan of the area and if possible then a CT scan or MRI scan which will confirm a lipoma. If it is a slow growing swelling and soft such that it slips under skin then it is most likely a lipoma. However, it will help to consult a surgeon to confirm it and then get treated if required. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My daughter 2yrs and 1 month old had stomach infection two weeks back. The doctor prescribed Zeprox. After one week, now she is suffering from serere Cold, and high fever. Also her motion is becoming lose from today. The doctor assumes some urinary infection but have not prescribed any antibiotics yet. I m not satisfied as she is really ill for past two weeks. Is Augmentin safe to start with? ### REPLY: Thank you for asking quarry. As for stomach infection zero is good choice. But now you are saying she is having urinary tract infection, and you must treat it. What are the urine reports if any, and also get one USG done if urine reports are suggestive. Though augmenting is not good choice for urinary tract infection. Start antibiotics only after urine report of microscopy and culture. Hope this is helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 2 1/2 year old boy has been sneezing, coughing (wet cough) and has a runny nose. When he is breathing there is a bubbling noise in his lungs. Yeterday he coughed all night to the point he was unable to get any sleep and he vomited once. He has in the past suffred from mild ashma and was prescribed with Salbutamol Sulphate reliever. We are currently in Ethiopia which is a very hot country and the pollen count is low. I never had to use his inhaler previously in this country. My question is I m not entirely sure if his current condition is caused by an allargy, pollen etc. His cousin who has been staying with us was recovering from a bad cold with simlar sympoms mentioned above. She recovered fully in just a few days. The runny nosie she had was clear in the begning but trurned yellowsih after a few days which indicates that her conditon was caused by cold? I think he might have caught cold from her? Today he had a mild fever 37.4 and I give calpol for this. The coughing, runny nose and sneezing persisted throughout the day. I m not too sure how to treat my son shall I give him the Salbutamol reliver? Is this an infection or common cold, allergy or a combination of all three? please advise. Many thanks ### REPLY: Hello dear. As per your symptoms, its chest infection that he caught through his cousin.Also, he is prone to allergies AA he caught asthma last year. I would like to ask if there is any exposure to dust, mites,carpets or stuff toys on which there is fur??? If yes then please avoid such stuff. I would recommend antipyretic like paracetamol 120 mg/5ml (5 ml 4-6 hourly for fever) and Mobil syrup 125 mg/5ml 5 ml three times a day for 1 week along with some bronchodilator syrup like terbutaline 0.3 mg/ml (5 ml thrice a day for 1 week) and anti histamines like Ben . You should also try some home remedies like 1 teaspoon of honey in Luke warm water daily along with avoidance of cold  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 would like to know of a doctor who specializes in pedriatrics of muscle diseases-I guess a neurologist-in the Middletown NY area? My 11 year old niece has been diagnosed with myotonic dsyphropy (not sure of the correct spelling, sorry). Any help you can give me would certainly be appreciated. Thank you. ### REPLY: Hi, Thank you for asking question on . Myotonic dystrophy is a complex disorder involving multiple systems. Neurologist, Physiotherapist, rehabilitation specialist, or tho pelican, ophthalmologist Cardiac physician and a pulmonologist to function in coordination for better outcome. Patients survive full and successful life if treated in a correct institute. Inability to relax muscles bet rated with . Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a enlarged heart, I am diabetic, I have really high blood pressure, and was told I have angina. I have a very hard time breathing when I lay down. Sometimes so bad, I wake up covered in sweat and feel like im gasping for air, and its not hot, so I know im not sweating because of that....what could it be? Im supposed to have a stress test done, and the heart test to check for blockage...im 23 years old. ### REPLY: Having diabetes and enlarged heart with high BP along with sweating and breath difficulties suggest heart failure. And you may also have kidney dysfunction. These may be the complications of Diabetes or high BP or both. I think you are required to limit your liquid intake specially at night along with salt. Keep your head end elevated position while sleep. Take diuretics to control congestion. And better consult with cardiologist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So i am a Male 24 years old living in burlington ontario for the last past week i have had redness around the eye(making it itchy) one more than and small red bumps on the forearm(itchy) ...aswell it goes away for a day and came back starting to worry... i am looking for a creme or soemthing to treat this please help me Thanks Nick ### REPLY: Hello there, You seem to be having an allergy to some component in your environment. It could be pollen or the fabric with which your bedspread is made of. You can have tabbed Allegra 180 mg once a day for 3 days and also apply calamine lotion on the itchy forearm. This will reduce the itching, but you will have to identify what you are allergic to. This can be done by keeping a chart of on what days your itchiness flares up and relate it to any change in your environment. Hope this helps, Please feel free to ad .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 having what i thought were muscles spasams--which start under my right breast and follow my rib cage up to below my arm pit and around my back to about the middle of my back. It feels like I ve slept wrong or pulled a muscle. But now I m breaking out in a rash in this same area. Seems like too much of a coincidence to me. I a 54 woman in good shape; 5 6 inches, 130 pounds. ### REPLY: Hi, I understand your concern. The muscle spasms under your right breast following your rib cage below your armpit associated with rash break out, are suggestive of herpetic rash. Please contact your doctor as you might need prescription antivirals. Please send a photo to me of the affected area, so I can analyze it further. Topical anti-viral cream is suggested to apply locally. Do not squeeze or touch the rash as it will make it worst and spread to other parts. Wash your hands well with warm water and soap after medicating the rash area. Take ibuprofen or paracetamol for the pain. Wish fast recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my husband and me are trying to have a baby for some time. I have polycystic ovaries and estradiol level 15. I had bleeding between 2 period 2 times. Once in August, it lasted for 5-6 days. Second time in October, it lasted fo 5-6 days...first 3 days it was brown and a little, for the next 3 days it was like regular period. Can you please let me know why I had bleeding and if estradiol level and polycystics ovaries can make problem for pregnancy? ### REPLY: Yes your law steroidal level and PCs make a problem for pregnancy. Because of these things you get problem of ovulation. If a person comes to me with PCs we suggest them Ayurveda treatment of panchkarma especially uttarbasti treatment. And also I suggest them to do some changes in their lifestyle, do exercises regularly, lose body weight, eat plants of vegetables and fruits. I would presided her Kumar ashram 4 spoons before food 2 times. Since this is prescription base medicine I would suggest you to meet the Ayurveda doctor for proper panchkarma. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a question but do not know what kind of doctor you are, I need to talk to a psychiatrist, this question is for them I suffer from Depression and having a hard time right now with school work, I have no motivation at all, keep putting things off, not eating, sleeping too much, feeling really really low. This is something that I have been living with since young age. I have been hospitalized over 25 times since age 17 and I am not 40 yrs old. I am scared that I am heading to hospital soon, I do not want to go back there but I wonder if it may help me to get a break from school and other things. I do not know what to do. All I want to do is sleep and escape. This is not good, I know that I am depressed, anything I do to try to help myself such as talking to others, going for walks, going to school, hanging around people during the day, I just do not know what to do anymore, I think I need to see my family doctor, just need some advice. I do have people in my life professionals to talk too but just need to know what someone else would tell me. Sorry if this is not the right doctor to ask for advice. i know what to do if this gets worse like go to the hospital i do know what i am supposed to do if things get worse just need some advice right now to figure out what i should do. ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. From what you have stated it is quite clear that you are having a depressive episode. Depression can occur with regular stress, and it can also occur biologically without any stress as well. You need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or Escitalopram, and they are all very effective and mostly safe. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep.  If you are averse to the .  This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my girlfriend has been in acute kidney failure since about March. She is horrible wiht going to dialysis and following ehr diet. She bleeds for longer than the average person when cut and recently she discovered blood in her stool . I am in nursing school and know about kidney failure and what not but is there somethign I can tell her that will really wake her up? ### REPLY: Hello budding nurse. Compliance with meds and medical advice is a problem in anyone suffering from any chronic disease and CKD 5 patients are no exception. Your GF bleeds longer since she is not getting adequate dialysis which causes platelet dysfunction. However, make sure she is not getting excessive heparin on dialysis. Bleeding from rectum needs definite assessment by a gastroenterologist. Educating your GF about kidneys, their function and effects of kidney failure on health is key to get her to comply better. Best wishes. RB ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, it s more than a year that my face complexion is getting darker and browner day by day my face skin pores got large (larger) during last year , it s really like a ghost skin. my complexion got brown. i used peels and oxygenation but nothing changed at all. i don t even recognize myself when i look at the mirror. help please. ### REPLY: Hello, First you should know about for skin type. The best way to prevent hyperpigmentation is to limit skin exposure to the sun. If you go out in the sun, take these preventive measures:1)Wear a hat with a brim to shade and protect your face.2)Apply sun block (such as zinc oxide or titanium dioxide) to vulnerable areas.3)Use sunscreen that protects against both ultraviolet A and ultraviolet B radiation. The sunscreen should have a sun protection factor (SPF) of at least 30. Kind regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir i,m guljeet my 1yrs 3mth son is suffering from regular convulsion he has suffered from 2 attack & today he is having a high fever .as i,m giving him regular sponging on his fore head chest stomach legs & hands with ice cold water . i,m giving him drug name 1.megaclav ds ,anti biotic 2.5ml thrice a day 2.acolate containg paracetamol &pain killer 5mlthrice a day 3.p125paracetamole 5 ml thrice a day.& 4.valparin as advice by pediatics 2.5ml twice a day regularly since 1 mth .today his fever is not lowering his temprature sometimes it lowers but again reachs high wat preventions shal i take during nght so that he remains fine ...plz advise me some .. ### REPLY: Thanks to ChatDoctorI CAN UNDERSTAND YOUR SON PROBLEM It is terrible situations when small child who unable to speak and tell their problems.Don't worry, what you are doing right now like cold sponging during high temperature is correct method of bringing the temperature .child . Try to avoid journeys with child, take care of diet, avoid exposure to cool weather, air cooler MAC in child room.,please monitor the temperature over 24 hours which gives clue to diagnosis along with other lab reports normally after usage of syrup it takes to control the temperature, but in emergency we can use paracetamol injection according to age and weight prescribed by a pediatrician .so don't be tense during such situations, try to find the cause of fever .ok ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor we are trying to concieve from last 20 months but not succesd. After taking ovulation induction course (letrozole 4 months and fertyl super 3 months) and done some medical tests like HSG-Normal, Semen test-normal. What could be the reason? I have done blood hormon test also like TSH ,Prolactin and others all the have normal value and we have done the test two times both results have normal value. but LH:FSH test have imbulance value like (18.21 miu/ml and fsh is 5.85 miu/ml) but it could be LH Surge because i have done these test on 13th day of my period. and secondly i have also done sonography and results tiny cystic areas are found in both overies size (3.15*2.35cms in RO) and (LO 2.69*2.33cms) Impression-Bilateral polycystic overies When she was on ovulation induction course we had done follicale study and result was some folicle 15mm was found. now doctor suggest IUI. Pls give your valuable comments. What is the problem she has? Why she is unable to get pregnent? is there is any other option except IUI? Pls explain in detail? wife age is 26 ### REPLY: Hi Hem ant;The problem with your wife is that there is no ovulation as you mentioned in your report that the follicle is only 15 mm. It should go up to 20-22 mm & rupture to release the egg. Egg formation is very important because egg & sperm have to meet together to have a baby. If there is egg then only GUI is possible if it becomes necessary. Polycystic ovary can be a cause why there is no egg formation as she is on medicines but still there is no egg formed. So first the polycystic ovaries need to be treated please consult your GAEC doctor for further management/treatment. All the Bethinks ### END