Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 16 year old son was bitten three weeks ago on the bottom of his left foot by a water moccasin. He was treated with 5 vials of  Crofab and stayed in the hospital for six days. He seems to have recovered very well but says he has loss of feeling on the left side of his foot. Will the feeling loss be permanent of will the feeling gradually return over a period of time? If so, any idea how long a period of time? ### REPLY: Hello I have gone through your question and understand your concern. Post treatment with antivenin, temporary and/or permanent tissue and muscle damage can occur. Water moccasins venom is cytotoxic in nature therefore tissue of the affected area shows poor circulation and tissue regeneration is not possible on its own. If sensation does not return over a period of few weeks, it means no regeneration of tissue and the loss is permanent. Good luck. Hope your concern is answered. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have this pain right below my chest in the stomach area for like 3 days now its not a burning pain, it feels like it moves around some times. i ate some burnt toast and it kind a made it feel better. i don t know what it is . help ### REPLY: Hi..... Mr. Eric., Thanks for choosing .,1) Stomach pain in right side, and it moves around means ....it could be Pyloric stenosis .it is due to steno sing of pyloric canal...............one type of duodenal ulcer.,2) Early morning...cap. Omeprazole 20 mg before breakfast for 20 days3) Tab Norman 2 times daily for 20 days....4) Antacid syrup..... Mucaine gel 2 spoonfuls for 3 times daily ...... If not responding .........consult Physician further follow up and evaluation..., goodluck., ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 nine year old daughter that had a blood test on Wednesday and the doctor call me and said she has Glandular Fever. Since then she had had very high temps arount 40 c and gets the sweats and chills through out the day and night. She gets very pale and shivers for hours unless she has some form of medication to reduce the temp.  Can you tell me if this is normal for glandular fever or it sounds like there might be a baterial infection and I should go to the emerg dept. ### REPLY: Hellos you mentioned that your daughter is having very high temperature with chills and rigor. Glandular fever often starts with a sudden onset of FEVER, CHILLS, HEADACHE & GENERALIZED MYALGIC & ARTHRALGIAS. So high fever and chills are common symptoms of glandular fever. In my opinion at present no need of any emergency dept. Tylenol 10 mg / kg body according to necessity. Glandular fever has the following symptoms and signs. Lymphadenopathyfever, ulcer or pa pule (at the site)myalgic arthralgias, cough , pharyngitis, diarrhea . Incubation period is 2 to 10 days. There are a variety of . Ciprofloxacin 10 mg /kg body weight twice in day for 10 days. Others are chloramphenicol, ceftazidime, doxycycline. So consult your primary care physician and get his opinion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey I m really in a bad spot right now with every passing day its harder and harder and harder to do anything I cant function anymore I don t see the point anymore my memory , focus basically all of mental health isn t there I feel like a slow retard and I very rarely consume any mind altering substances also I have very little energy to do anything. When I m not depressed I don t care about anything and the things that I should care about and feel happy about them. I can feel how my brain or my whole self is just degrading with weeks,months and years passing, I have been trying to resolve it for years now, I ve taken antidepressants for 1.5 years altogether and the result I have is even worse mental function and weak emotions, more like ignore everything around me type of mentality, I respond very little to social activity (i.e. talk very little, don t know what to say, don t get the jokes or not find them funny). I feel like the end is near. I ve spent loads of money on supplements , herbal remedies to try and get more energy and fix my mental health but no big results came from that. I m so sensitive to everything and even the slightest things can upset me so much that if something really bad happens I think I might just end my life because from inside it s too much to handle. And I have another problem, I don t feel anything when having sex no joy or nothing and I can t reach orgasm s, I ve started my sex life when I just turned 17 and I m 23 now, male. If I don t get help and get better I think it s gonna be the end of me soon. I m sorry to pour all of this self pity on you but I m lost for hope and I can t talk to anyone about this because its pointless it s not gonna change anything if I do. Steve. ### REPLY: Dear Steve, I don't know what were the medicines you tried. But there are a lot of them (around 35) if one antidepressant did not suit you some other will be helpful. Maybe you are having Bipolar Disorder ad presently in a depressed statePsychotherapies will not be of great help at this stage. Electro Convulsive Therapy (ECT) is a safe and effective treatment for severe depression. More effective than any other treatment. It is a painless procedure with proven safety. Unfortunately it is a treatment which most misunderstood (due to propaganda by antipsychiatry groups). In spite of having long years of experience and good scientific evidence supporting it, the treatment is not popular due to these misconceptions. I think you should consult a psychiatrist and discuss this option. Also watch this videotape://youtu.be/oEZrAGdZ1i8 ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So, my question is...After being kicked in the nose in a upward and inward motion there is swelling along the bridge. No blood out of nostril and or down the throat, no discoloration yet, and moderate pain as well as headache while resting and severe pain when laughing, not crooked, some difficulty breathing possibly from swelling, I think that s all. Anyway, at what point is it necessary to see a doctor and is there anything I should be looking for or doing at this point? ### REPLY: Hello, I can understand your concern. The swelling on the nose bridge after an injury indicates towards possibility of a fractured nasal bone or cartilage. I would advise not to wait and go to an ENT specialist or oral and maxillofacial surgeon who can examine the area physically, take an x-ray and can look for any fractures or cracks in the area. Based on the x-ray examination, any treatment can be decided. If you are in pain right now, you can take an Acetaminophen 500 mg or Ibuprofen 400 mg that is available over-the-counter. You can take 3 tablets a day, if needed. In addition, do not rub any gel, cream or lotion and refrain from heat application until you see a doctor. You can apply ice over the area to have reduction in swelling. I hope this information helps you. Thank you for choosing . I wish you feel better soon. 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 chocked on milk this morning why eating cereal. Coughed it up and then all of of sudden I got this unbearable burning in my chest and back for like 30 sec and went away but not feeling to well just tired I sneezed a little bit ago and same thing burning for like 40 sec never felt that before now my left ear hurts ### REPLY: Thanks for your question on . In my opinion you are having acute gastritis. Points in favor of this diagnosis are vomiting after eating and sudden acute burning pain in stomach. All are due to hyperacidity. So better to follow these for symptomatic relief.1. Avoid hot and spicy food.2. Avoid stress and anxiety .3. Avoid large meals, take frequent small meals.4. Start proton pump inhibitor and antiemetic combination.5. Keep 2-3 pillows in bed to prevent acid reflux.6. Lose weight if you are obese.7. Quit smoking and alcohol if you are taking. You will be alright after doing these lifestyle modifications. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi!I have been coughing for a month, initially it was dry then became chesty, No any cold symptoms but severe cough with mucus especially at night time in bed.Since last Friday I have been experiencing sharping pain on the left side of the upper abdomen, initially it was only when I was coughing, now it is painful when I breath, laugh, bend down or if I touch that area,Went to my GP twice, 2 courses of antibiotic (Amoxicillin 250 and now still on Klaricid 500) Cough is better now but the pain not.2 xrays which the last one shows a bit of shadowing on the left costophrenic angle.Conclusion is to wait until I finish the antibiotics and if no better I have to see a specialist.Now, I am worried and my question is if it the case to wait or to act asap, plus I want to know what is happening.Thank you very muchRegardsLuisa ### REPLY: HI, thanks for using  The cough associated with upper respiratory tract infections can sometimes last up to 6 weeks. Persistent coughing can sometimes lead to chest pain. Pain can also occur due to inflammation of the pleura (the lining of the lung). This pain is worse on taking a deep breath or laughing. In addition to your other medication, you may want to consider the use of an anti-inflammatory agent such as ibuprofen, Catalan, naproxen. One of these would help with the chest pain. You can consider completely your medication before another assessment. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is Pagnarith from Cambodia. I have a friend who had an accident few years ago and after the accident his leg getting blacker and blacker, swelling with yaws . I brought him Singapore and the doctor there told him that his vein in his leg detached and the blood keep flowing in his leg. I would like to know if you can do anything about that? Can we send report to you for evaluation? Please get by YYYY@YYYY +0000. I am looking forward to hearing from you. With best regards, Pagnarith ### REPLY: thanks for your query can feel your concerns if leg is swollen, and its color is changing, then you need to consult a surgeon immediately. Your friend may need incision in leg to decrease pressure and to remove blood. If condition deteriorates and leg is whole blacken, then amputation is the only option. I advise consulting a doctor and have a properly clinical examination. Wishing him 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 had a partial hysterectomy in September of 2014. I have only 1 ovary on my right side. I ad adhesions so severe that my bladder was knicked in the process of a vaginal assisted with laparoscopic and ended up being cut on my csection inscion. In the last couple months I have pain during sex that lasts for days after. This entire week I have had increasing abdominal pain that becomes worse when I eat and wraps around my back but it s on my left side! I m also passing mucus if I bear down to go to bathroom. The pain is severe sometimes and let s up sometimes. It feels better if I put pressure on it and lean forward but as soon as I move it comes back. My son is currently in the hospital for a round of chemo so I am wondering if it is something I can let go for awhile or if I need to try to find time for an appt and if so who do I call? My general physican or OB/Gyn? Thanks! Brooke ### REPLY: Hi! Good evening. I am  answering your query. From your history, it seems that you might be developing a subacute intestinal obstruction resulting in pain after ingestion of food. Even though it might not be an emergent situation, I would advise you to find time and get it clinically assessed by your operating surgeon to have a proper diagnosis and appropriate treatment. Till then, you might go for some anti-spasmodic along with a proton pump inhibitor . I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: "confused state of mind in a female aged 32 years; depressed state of health and mind; being possessive about child; suicidal tendencies. how to treat these conditions and what are the causes and remedies; medication required. also having prolapse state of uterus. ### REPLY: Hi dear, depression and suicidal tendencies is an alarming situation, and you should consult psychiatrist as early as possible. If suicidal tendencies are very then admit in psychiatric nursing home and start electroconvulsive therapy. Also medication helpful but ECT helps in faster relief. There is no worry with prolapse of uterus. And have you suffered first time with sucChatDoctorplain?any family history of psychiatric illness? Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am planing to undergo a  master health checkup this Saturday . i am 40 years old male. what is the procedure and which place  i should go ? .  My main problem is stress and depression due to family problem. What kind of treatment  would help  me?.  I tried different treatements...like ayuervedic ,  counselling...physio therapy...please help me to decide ### REPLY: Hi dear, you must consult psychiatrist for stress and depression. Sometimes due to family problem you have excessive stress so due to that you have depression. What are the symptoms you have?detail history and mental status examination is must before doing anything. There are many treatments like medication, psychotherapy, Electron convulsive therapy.in medication SSRI, SARI, NASA group of medication helps you a lot. 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: Respected Doctor,I am a psychiatry patent of National Institute of Mental Health and Neuro Sciences, BANGALORE and i take Maxgalin 150mg twice daily, Naxito 10mg twice daily and Zolfresh 10mg in night since last 2009 but from last few days i feel my fear factor is devloped and head reeling sweating and feel very uneasy , when i thought about train or plane journey uneasyness is too much. ### REPLY: Hello are currently on Pregabalin, Escitalopram and Collided since 2009. For last few days you have developed sweating, headache, uneasiness and restlessness. The problem increases on thinking about train or plane journey. Most likely the problem is due to anxiety. Non-specific fear can develop in anxiety. I would advise you to visit your psychiatrist again for any increase in doses of medicines if required. For quick relief of symptoms you can try relaxation methods like Breathing Exercises or Progressive Muscle Relaxation Exercises or yoga. These methods will help to increase your confidence. Thanks, hope this helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Recently noticed lump in left carotid artery. It sticks out and can be seen beating....does not hurt. What else could it be, carotid artery aneurysm? I m healthy as far as I know, eat relatively healthy, non-smoker, active and exercises. What else can this be. ### REPLY: Thanks for your question on . Yes, this can be aneurysm of carotid artery. Another possibility is carotid artery tumor. Common benign tumor is hematoma. So better to get done ultrasound examination of neck, MR Angiography for the confirmation diagnosis of this vascular mass. Also get done blood pressure monitoring as hypertension is common association with this. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: XXXXX I have been diagnosed with Ehlers-Danlos hypermobility type (at age 64). My major features fall within this class. I also have some vascular (blow blood vessels in palms of hands and soles of feet, no philtrim, thin upper lip, thin velvety skin, high palate and very small blood vessels in the medulla oblongata. Don t have other bleeding issues. (Need a 22 butterfly for blood draws and IV s). My genetist glossed over stroke risk. I am guessing it is significantly increased - if so, any idea how much?. ( I have limited info on biological family.) email: ### REPLY: Hello, The type of Enters Carlos syn .  The type of Enters Carlos that has a risk for blood vessel wall weakness leading to aneurysms and strokes is the Type IV and Type VI according to the current evidence base. Therefore, you are not at increased risk for these conditions. Your risk for aneurysms or stroke is the same as for any individual. Risk factors for stroke include smoking, increased blood pressure called hypertension, abnormal blood lipids and blood sugar. So rest assured, your type of Enters Carlos does not put you at increased risk of blood vessel related problems and the overall quality of life and general life span are not affected. However, do remember to protect your joints and ligaments from injury. Should you require more information on your condition you may post your queries here. Best regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear doctor, my mother is 50+ in age and she is suffering from rashes appearing all over her body recently. the rashes appear in  clusters, look like mosquito bites and cause itching. The general physician suggested its "Arctic area allergy" and has something to do with the blood, also that it has no cure. My mother is very stressed due to this. Please help ### REPLY: Hello, Thank you for asking at . I went through your mothers history and would like to make suggestions for her as follows:1. I would like to know more details about her like - a. Since when she has itching & rashes? b. Any day/night or seasonal variation? c. What is the frequency? d. How long they last? e. Does she have any allergies? f. Does she have any other medical conditions? g. Does she take any medications frequently/regularly? Above details would help me to know your mothers complaints better and therefore to make more specific suggestions. At present, I would suggest her as follows, from your given information:2. I usually prescribe my such patients levocetirizine or cetirizine in morning and HY . 3. I would also suggest her application of calamine lotion or moisturizing lotion/cream over the rashes and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor, I was diagnosed with follicular lymphoma in 2008. I also came +ve for TB at that time. I preferred not to have Chemotherapy.  Since then, Ive been on alternate medications. Now, I have a lump adjacent to my Adams apple. It has no pain at all. What could be this? ### REPLY: Hi, Dear,Good Morning. Thanks for the query to my  Clinic. I studied your query in depth. I am concerned about the worries you have. In my opinion, you have -Relapsed Follicular Lymphoma /? Could be thyroid CLT . I would advise not to depend on Alternative treatment-which you may -support with the advice and consultation of ER -Oncologists- who would treat it with-low toxicity-Rituxan-Radio-immunoassay treats would fix the problem you had. This is the remedy for your lump. Hope with this you would be relieved of your worrisome query. Wellcome again to . Have a good Day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir, I have some raised black spots on my body like left ankle, left knee, left and right thighs, right pointing finger, right elbow. I am 30 years of age. I have a lot of itching sensation and when I scratch it a liquid is coming out. Initially this was on my left ankle but now it is distributed all over the body. When I use the tablets or ointments it is vanished but again it is appearing. when I consulted the doctor one says it is eczema and the other says it is psoriasis. please confirm me as what to do now ### REPLY: Hello, I can understand your concern for itchy raised black spots almost all over the body. There can be multiple possibilities of the condition, and it requires a personal physical examination of the area by a dermatologist to see the area. I suggest you to either meet a dermatologist or can send few good resolution pictures at:bit.ly/ . Do not scratch as it causes further aggravation of the condition. Hope it helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter 17 yrs old in good health, had a chair pulled out from under her by a guy at school and now she says her tailbone is starting to bother her a lot when she has to sit in school, should I take her to the Doctor, she is on Heath Choice, her Doc retired and I haven t found a new one yet. ### REPLY: Hi there. Thanks for your question at . Pain at the base of Spine is literally a pain for both treating physician and patient. It is known to come back again and again if rest and care is ignored initially. One of the most helpful ways to reduce pain is to use coccyx cushion which is horse shoe shaped and helps relive pressure on tail bone when seated. Make sure it is used every time u sit irrespective of the social situation. I suggest you to use it religiously irrespective of where you are sitting over at least 6 weeks to get any meaningful benefit from it. Also lying down on the sides can help reduce the pressure. Injections help when pain cycle is on the peak, otherwise painkiller medicines should help. Tail bone pain responds best to offloading the pressure over it. Relieving the pressure over the tail bone is the most important step in relieving your pain. You can use any painkiller over initial few days.  Hope this helps. All the best Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hellow doctor, i am stomach pain patient in last one year i have taken so many medince(rekool20,domstal,vitazyme etc ) but it is not stoping pain, the stomacChatDoctore in night only not for day (9 night after 10 pm and 1 day in early moring) i have check the stomach in endoscopy & sonagrapy but the result is normal(oseophages is larger). now i have taken Neopride total &Iladay 10 medince. why the stomach pain come again & again please guide me ### REPLY: Hi. The frequent stomach pains can be due to irritable bowel syn .  Another causes should be found out. I would advise you to undergo:: -Blood tests - Complete blood counts, Quantifier gold test for tuberculosis, ESR, blood sugar, liver function tests, thyroid function tests.-Urine tests. -Stool tests-CT scan with enterocolitis. This will help to rule out Tuberculosis, Stomach cancers, Gastrointestinal Cancers These tests along with a consultation of a Gastroenterologist should get you the proper diagnosis 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. About three weeks ago, my husband found a nickel sized lump on top of my right collar bone. It is hard, slightly tender (when I wear my purse on that side or get bear hugged by husband) but no discoloration. It moves a little bit. Not sure what it could be. ### REPLY: Hi Hope this message finds you in good health. I have gone through your complaints and understand your concern. I guess it might be some part of soft tissue particle, or a cartilage /bony piece, usually due to scaling out of bony surface. It can be confirmed on a X-ray. But, whatever it is, it should heal-up eventually by analgesics, anti-inflammatory tablets, hot fomentation. Nothing to worry about. I hope your question has been answered. If you have any follow-up queries, feel free to consult me anytime. Thanks, Take care, God bless. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. This is xxxx here. I have been suffering from chronic backpain from 2007. It started with the neckpain and gradually to middle and lower back pain. I have suffered from knee and leg pain in 2011. My X-Ray and MRI reports are normal. I have got some other tests done : Vitamin B12 , 25-OH Vitamin D3- RIA , calcium, haemoglobin. This backpain has been effecting my day to day life activities. I would appreciate your advice and help here on what steps/ treatment should be taken to cure it. ### REPLY: Welcome to . Chronic back pain is quite disabling. Most common reason is muscle fatigue and spasm. Need to find out the risk factors contributing to the problem.  Common risks factors are prolonged sitting job, long travels and overweight. Long term solution to the problem is physiotherapy with back muscle stretching and exercise with modification of the risks factors if present. Coming to the Treatment options. Initially we always treat with medicine and physio. If problem persist then we need to investigate further to find out the pain generator. 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 am a 76 yr old woman with PD.....some cognetive problems....slight depression..periodicaly...   I find my self singing-humming 85percent of the time.   Nearlly uncontrolable......Is this a mental health thing.....I live alone, have never been a singer...... ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. In your case, self humming of songs are not at all a mental health thing. Instead, it is clearly healthy. We often ask people with mental problems to sing or hum songs which they like. Such an exercise keeps their mind away from unnecessary thinking and thereby other related mental troubles. Means, you are healthy otherwise and do not relate the humming with mental illness. Actually it is entertaining. Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I need to find a neurologist, who is also a psychiatrist specializing in the side effects of a number of medications. I currently take medications Hwith the approval of a psychiatrist and a primary physician. My location is Northwest Chicago. City or suburbs of Chicago on the near Northwest side are a good commute. ### REPLY: Welcome to  Have you tried contacting the Rush Medical Center at 8883527874? I did a search for "psychiatric neurologists in northwest Chicago Ill" and came up with a list of names. It is unfortunate that many psychiatrists s do not place neurology in their listings, but many psychiatrists s are also neurologists. One thing you can do is to contact Rush and if this place is not a good fit for you, ask them for names of NW psychiatrist neurologists. Other options are .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ve been working with Xylene for 6 years. During this time (within first year) I developed Fibromyelgia, Chronic Fatigue, Anxiety, a feeling that I ve lost some sensation and co-ordination in my hands and patches of skin that occasionally become supersensitive. I used to feel intoxicated while working in the lab but by the time I got home was super aggressive and angry. I no longer feel intoxicated when working with it. After 4 years I noticed when working with Xylene my face began to burn/itch. In the last two weeks I have developed irritation in the Trachea immediately after commencing a major project with Xylene. It settles down when I go home but immediately on entering the lab the trachea gets irritated and I cough. How do I know if it is the Xylene causing me problems? ### REPLY: Xylene is a pretty toxic organic solvent. It certainly affects the liver, and liver function tests are necessary. Likely also to affect nerves. A nerve conduction test can show if the nerves are sick BUT, there isn't good treatment for it except stop exposure and hope. It would take months for the nerves to correct themselves. Then lung exposure to xylene can cause lung fibrosis. This is testable with lung function tests (x-ray, spirometry, but mainly diffusion testing). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I m a bit frustrated and am not sure what to do. I suffer from constant tinnitus which has gotten much worse over the past several months. I do suffer from neck pain that often radiates into my shoulders. I have done therapy however it continues to get worse. Last Monday I had a rather scary incident in the middle of the night. I got up to use the restroom when my heart started racing, I became dizzy and the vision in my left eye became blurry. When I laid down my chest started hurting and my cheek under my right eye became numb. My doctor ran a CBC, metabolic panel, an EKG, and a brain CT all of whicChatDoctore back normal. Could this have been caused by nerve issues in my neck? I was told several years ago that I do have arthritis in each of my cervical vertebrae and at least one if not two protruding discs. I would greatly appreciate any help you can offer. ### REPLY: Hi, Thank you for posting your query. These symptoms are most likely due to transient lack of blood flow to the brain. So, you should undergo an MRI scan of brain along with MR angiogram.  The vascular risk factors such as diabetes, high BP, cholesterol, etc. should also be investigated for (if not done already).  Cervical disc prolapse usually causes neck pain, radiating pain in the arms, weakness of arms, etc. Wishing you good health, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Have a 3 yr old grandson who hit the top of his head on my lower lip pretty hard yesterday while goofing around. Since then, he did not eat well at dinner, has had a cough and flem coming out for a month or so, mother took him to er and to family dr. says cant find anything wrong just had a cold. since yesterday has been hot, at times slight, high grade fever from time to time and is complaining eyes hurt (which are red and glassy) andat times complains of head aches...? ### REPLY: Thanks for consulting at . In child . g., pharyngitis, ear infection etc.) and allergies. Nasal congestion can cause headache. Eye congestion can also occur in viral infection. As doctor has examined your grandson after head trauma and found no significant clinical problem then you need worry regarding head trauma. Give paracetamol for fever, decongestants for reliving nasal congestion. If no relief consult ENT specialist for detailed clinical examination of hypopharynx, throat and ear to detect infections of upper respiratory tract and ear. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: if my last period was sept 7,2009..and my due date is june 14,2010 iam 30 weeks pregnant i most likely conceived from sept 18,2009 to sept 23,2009.. i did it with guy A on Sept 11,12,15,16,17,21,22,23,24,27,28,30 and i did it with guy B october 8 only who has the most chances of being the father? and to help october 7 i had already missed my 1st period.. i found out i was pregnant october 16,2009i really want it to be guy A ### REPLY: Hallow dear, you had your menses on 7 Sept. so your next expected menses were somewhere around 7 Oct. considering your cycle of 30 days. The egg is released 30 days. The egg is released 14 days prior to next expected menses which in this case would be on 23 Sept. Egg has life of 24 hours while sperms are active for 72 hours. Hence, a period of about one week around the day of egg release (ovulation) is considered as fertile period; which in this case would be from 19 Sept to 27 Sept. Even considering your due date as 14 June, the date of ovulation would be 21Sept. So by any calculation, the intercourse on 8 October would be most unlikely to cause pregnancy. You had many intercourses with person A during the period between 19 and 27 Sept. So person A seems to be the father of this child, not person B.Moreover, if you want an authentic proof of paternity for legal purpose, you may opt for DNA test. I am sure, this will serve the purpose for you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been taking toprol Xl 37.5 mg for over 5 years daily For both tachycardia and elevated BP my age is 76 yesterday while standing and talking I experienced a quick loss of balance lightheaded ? The last 2 days I have been extremely tired . My hands and feet are cold . After returning home 1/2 hour my pulse rate 60 normal 80 and had difficulty raising it on exercise. The episode occurred about 3 hours after taking the med ### REPLY: Howell come to ChatDoctorI really appreciate your concern, with the history of hypertension and some cardiac elements if patient experience lightheaded then it could be developing of ischemic area in cerebral region later on the full developed ischemia cause the TIA (Transient Ischemic Attack) and to rule this out CT brain is must, the symptoms has to be taken seriously, certain things' area there that needs to be taken care like high blood pressure, endocrine system, renal function, it is advisable to see the physician on regular basis, hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I ve been having pain in my lower left rib cage area under my left breast. At times I get shortness of breath, heaviness feeling and also feels like I m almost paralyzed for a minute where I can t move or breath properly . It scares me! Any idea what this could be? ### REPLY: Thanks for your question on . I can understand your situation and problem. By your history and description, we should first rule out cardiac diseases in your case. So better to consult doctor and get done blood pressure monitoring, ECG and 2d echo. If all these are normal than no need to worry about cardiac diseases. Stress and anxiety can cause similar symptoms. So better to consult psychiatrist and get done counseling sessions, try to identify stressor in your life and start working on its solution. You may need anxiolytic .  So avoid stress and tension, be relaxed and calm. Don't worry, you will be alright. First rule out cardiac diseases. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i think i have a compressed nerve, i had a neck pain because of my extended positioning of the neck in one position during playing games or working laptops. But that reduced after controlling and medication. how ever i get a wave of pain some times in my tooth,jaws ,in my head or in the eye upper portion of the eye when i cross my legs and sit or sleep. what could be the problem since yesterday i have pain at my left jaw ### REPLY: Hello, I have studied your case. Due to compression of cervical nerve root there can be pain. This can lead to articular jaw pain. I will advise you to MRI cervical spine for better diagnosis. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 17 yrs.+ age, is suffering from enteric fever (typhoid). The doctor has prescribed Tab. Cetil 500 mg twice daily for 10 days. Is the drug is appropriate ? He has taken the above tab. for 3 days and the fever has gone. Now temp. is 98 degree ferhenhite. ### REPLY: Hello, Thank you for your contact to . I understand your concern. If I am your doctor I suggest you that Cecil us good .  It is infection caused by S. type, there are chances of relapse if you do not take completed treatment. Do not eat heavily as there is probability of having intestinal ulcer, which are likely get perforated. I will be happy to answer your further concerned can contact me. . Infectious disease specialist. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here.. my dad has hemochromatosis since a long time and I actually was born with it. he is 78 and was in the hospital for 3 weeks and now he can not dress or wash himself. sometimes he is up and ready to go for lunch, which my mom does, but most of the time he is in bed with no energy. how long can that  go on? ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Hemochromatosis affects the liver mainly, but can affect multiple organs including thyroid.2. Evaluation of hypothyroidism, and anemia is necessary. Thyroid hormone profile and hologram will be helpful in ruling out the cause.3. Good HY .  Mild exercises, involvement in social activities, family support and good partaking is necessary. Positive reinforcement necessary. Meet your doctor to get the tests done. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my daughter who is 12 now has had stomach ache/pain for at least 6 years and has had a blood test, and they did not find anything. I believe her. I also had this pain when I was little and still get it too. A lot of times its the food and drinks I might have and was wondering if that could be her problem too. Thank you. ### REPLY: Cellophane you for asking question. I am .  By stomach pain, I presume that you mean pain in epigastric region, that is center of the upper abdomen. Epigastric pain also has the number of causes. If I see a patient who has epigastric pain for such a long time. I would order baseline tests that is, blood CP, liver and renal function test and more importantly an upper GI endoscopy and abdominal ultrasound and will also look for H-pylori antibodies to completely rule out some common causes. The above-mentioned test should be done and the reports of these tests will aid in making a comment and final decision. I hope you have understood my point. You may ask me more questions anytime. If you have already done these tests, feel free to share their reports. Regards.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: about a year ago I was diagnosed with CIS by a neurologist.   I went for a second opinion who said I did not have MS.  Since, I have had shingles and now have post whatever they call it pain.  My question is....I still have a lot of the original symptoms like- a cuff like feeling around my left arm occasionally, severe migraines on my left eye, tired, and it all started with some tingling on my left cheek 10 years ago, which occasionally will pop up now and then.  am I crazy? ### REPLY: Hi, Thank you for posting your query. I have noted your symptoms and agree with your neurologist that you do not have features suggestive of multiple sclerosis. The most likely cause for your symptoms is post-herpetic neuralgia, whicChatDoctormonly causes pain and burning in the affected body part. You would benefit from medications such as carbamazepine tablets. For migraine headaches, you could take beta blockers or topiramate tablets. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 27 5ft 5 and 7st 10. I was exercising (pilates) and as i stretched i had the urge to cough and there was phlem with blood in it. I have had radiotherapy in the past could it be a weak area in my chest caused by the treatment and i over did the exercise? ### REPLY: Hi, Thanks for writing in. It will be important to know why you were given radiotherapy treatment earlier. If this was for a cancer in head and neck or chest region then repeat detailed evaluation with CT scan or MRI scan is required. It is possible that your cancer might have had a recurrence if you have recovered from cancer recently. Another possibility is that your immunity is low after taking the radiotherapy, and therefore you might get infections easily. There are many infections which will not affect the normal adult at your age but those having a low immunity might develop these infections and its complications. Please have your chest and throat evaluated in detail by your doctor and also get CT scan or MRI scan to investigate the origin of blood in the phlegm. Exercise rarely can cause this problem. 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: Hello. I have recently developed a pulse rate of between 54-56. I had back surgery 3 weeks ago and immediately post op, for about 3 days it was as low as 44. I take tablets for high blood pressure. Can you tell me what this may be, and is it normal? Thank you ### REPLY: Hi, Surgery includes giving of anesthesia which can temporarily cause your Heart rate to slow down, but it comes back normal after some time.  As you still have a heart rate of 54-55, it can be because of a BP medicine you could be taking (beta blocker or calcium channel blocker). Please check on your medicine whether there is any medication with content - Metoprolol, bisoprolol or diltiazem. If there is any such .  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 am 53 years female.i got angioplasty done on 25th sep 2010.one stent is inserted in my left anterior descending artery (2.75x23mm cypher),due to 56% blockage.3 weeks have been passed,i feel a little irritation right on the place of stent.and a little haviness upper to heart.i want to ask what type of exercise can i do and how much.i had habit of 30 minutes moderate walk before angiopalsty.can i return now to my previous routine.how much walk i should do daily in terms of duration and speed? ### REPLY: Hi there After going through your query I understand your concern. I would like to tell you that physical activity is important to all the cardiac patients and brisk walk can be done if you don't have any symptoms on exertion. But if you are experiencing a chest pain then it should be evaluated first. So It's recommended for you to get an ECG and Echocardiography done and consult with your cardiologist with reports. Kind Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am a regular user of cetirizine , if i stop it allergy will recover again .Now i am going to study in banglore . At the time of allergy i have asthmatic problems,skin problems,eye and nose will runing given me a solution ? i am 18 years old women,weight 40 kg,with A+ve blood group . ### REPLY: Hellos you mentioned that you are a patient of allergy and using cetirizine tablets for this purpose. Since diagnosis is established so avoid certain predisposing factors causing allergy, these are :Dust, mite, pollen, hay, fodder, fine dusting powder, sudden fall and rise of temperature (change in temperature), mold., pests (cockroaches) . If possible avoid these factors. When such type of patient visit my clinic I advise them to take Montelukast+ fexofenadine combination according to need (whenever require). Hot coffee and steam inhalation also provide relief. Hope this information will be helpful for 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 daughter who is 13 had a fever of 103, a sore throat, and horrible cough about a week ago and now shes been fever free for about 4 day and now has a horrible rash thats patchy all over and swelling in knees, feet, and hands. We dont know what she had and are curious shes on penicillin and is taking benidrill regularly. ### REPLY: Hi, Thanks for consulting. I have carefully worked through your case, and I can realize your health worries. Being your physician, I assure you not to worry as I will take care all of your medical concerns. The rashes present all over the body indicates allergy to any one of the .  You would have to ask your doctor if test dose of penicillin was given, before starting penicillin. Most importantly you need to visit her doctor, in order to stop the allergic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband began having a fast developing dementia in October, and it has gotten very bad. I would characterize his symptoms as later stage of Alzheimer s Disease. He is nearly always incohert, his cognitive abilities are practically gone, and he thinks he isn t in his own home. He knows everyone--friends and family. He has no pain, no seizures. His takes very small steps, like an old man. He s had CT scans, MRI, 2 spinal taps, Pet scan , EEG . His neurologist has rule out Alzheimer s. The MRI had a lighted area in his brain, but no cancers cells in LP. EEG showed slow brain waves, but nothing definitive. PET scan did not suggest Alzheimer s. Last spinal tap showed a high level of GAD65 antibodies (.2 titer). Five years ago, he was diagnosed with Stage IV NSCLC . He s had chemo, the last type being Tarceva, which he no longer takes. His diagnosis presently is dementia. What are the doctors missing, if anything? ### REPLY: Thanks for posting this question in ChatDoctorLet me tell you that dementia has so many causes. If the symptoms have been noticed for the last few months only, and he is rapidly progressing, a possibility of rapidly processing dementia will be likely. Other conditions that can behave in this way are autoimmune encephalitis (more so when the GAD 65 IS ELEVATED), vitamin B12 deficiency, thyroid problem, Hashimoto encephalopathy. In the background history of cancer, I will advise you to discuss the MRI and all the scans with a neurobiologist. Please note that another rare cause of this type of illness is Creutzfeldt Jacobs disease He needs to brr e-evaluated by a neurologist or cognitive expert who will synthesize all the reports and guide you. If found to have autoimmune encephalitis, he may recover with immunomodulator. Hope this clarifies ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 left jaw is in constant pain.  I cannot open my mouth all the way and its impossible to yawn without pain. The pain hurts to swallow and move tongue around mouth. Sometimes it feels so swollen that it effects my speech.  My entire left side of face and head hurt with throbbing pain at times.  Tender to touch outside of jaw joint near the ear.  My teeth are fine.  I went to urgent care he said possible infection in gland that makes sylava or TMJ.  No ear or sinus infection.  On antibiotics for 7 days with no improvement. ### REPLY: Hello, Thanks for your query. One of the most common reasons for jaw pain is stress to the temporomandibular joint, leading to temporomandibular joint disorder, or TMD. The temporomandibular joint is immediately in front of the ear on each side of your head. Visit your dentist and get the treatment accordingly. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my aunt had undergone a leg surgery for thigh bone fracture After a week of treatment doctor suspected of renal shutdown initiation for some unknown reasons. She is a diabetic and BP patient. And now doctors are kind of sure that both the kidneys have failed. Doctors are taking our consent to decide on whether to go ahead with either dialysis or kidney transplantation . I would totally appreciate if we could guide us with what is best suited for knowing she is a sugar & BP patient and had undergone thigh bone surgery. Kindly respond urgently as we are counting on the expert advice. Also suggest us if you could help us with kidney transplantation. Thank you so much. Thanking in anticipation. ### REPLY: Hello It looks your aunt had landed in acute renal failure. Since she is a patient of diabetes and hypertension, she would definitely require a renal transplant for the best outcome but the proper approach at the moment would be to go for dialysis. Let the patient settle first from the trauma of surgery and then renal transplant can be undertaken later on depending upon the situation at that time. Consultation and advise from the nephrologist would be the best thing to do at the moment as he can assess the patient properly. 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 copper T inserted in 2006 Sep and then i had it for 3 years and got it removed and inserted another one in 2009, recently in Sep 2010 i got it removed again this time to plan for the second child, but its been 4 months now and am still not pregnant, my question is will there be any delays in getting pregnancy after inserting coil for so many years and if so how long should it take to get pregant, is there any cautions i need to take? ### REPLY: Hello Welcome to , thanks for posting your question. I read your question and understood it. See, to be frank, copper T is a foreign body that prevents fertilization. Hence, I would like to tell you that, definitely a foreign body will alter physiology and also the uterus especially when you have used for long time. But there are no supporting papers published that says, it will hamper fertilization. So I suggest you not to worry and keep trying. That should be fine. For about 9 to 12 months you should be able to conceive. If not then you need further evaluation. So, don't put a lot of stress on yourself. Be happy, be confident, positive and see how things go on. In case you need any help with this, you can contact me back. 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 last week i had a heavy crushing pain in my chest i also lost my balance and have felt very tired and weak since i am taking tablets for high blood pressure and colestorole i had blood tests taken all was normal except my mpv here in turkey normal is between 7-9 mine is 9.8is this a problem ### REPLY: Thanks for your question on . I can understand your concern. No need to worry about MVP. In my opinion, you should rule out coronary artery disease (CAD) for your chest pain. You have risk factors like hypertension, high cholesterol etc. So better to rule out CAD first. So consult cardiologist and get done ECG, 2d echo, stress test. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , my bf has got pain in penis after he tried to have sex with me on my period but we couldnt as it was too messy and as i am stilla a virgin. He says its yeast infection and he is lot of pain and he blames me for it.. i tried to look up on ineternet it but i cant find anything about it.pls help. ### REPLY: Degree understand your concerns went through your details. Painful sexual intercourse, known as dyspareunia, is rare in men. The cause is usually physical, but in some cases it may be psychological. The most common cause of painful sexual intercourse in men is an infection of the genitals, the prostate gland, or the urethra. In some instances, discomfort during penetration results from skin irritation caused by an allergic reaction to a particular brand of condom or spermicide. If you think that the pain is due to an allergy to condoms or spermicide, try asking your friend to change to another brand. If the pain persists, consult your doctor. 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 detail 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: doctor my pallet is paining every morning I wake up. The ENT Surgeon has prescribed me Antoxid-HC for a month. She has also prescribed Amoxycillin (MPX-CV 625) for my problem. My problem is going on for the last 3 weeks. I want to know of Antoxid-HC why is it prescribed in my case and in what way will it help. ### REPLY: Hi Dear, Understanding your concern. As per your query pain on palate occurs because of infection of oral cavity. Antonio HC capsule contain multiple vitamins and antioxidants in it which are quite beneficial for the over all maintenance of the body as a whole. Though not directly but indirectly these are helpful for effective functioning of the immune system also. So it can be also taken for the purpose of improving the immune system as a whole. Also, as a multivitamin they will help in quick healing of palate and help in fighting the infection. I would suggest you to properly complete the medicine course as prescribed by your doctor. Avoid eating hot and acidic food, also do warm saline rinses. Hope your concern has been resolved. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i was at martial arts training todat and kicked someone in the elbow, 8 hours after and it has grown into a missive painful lump, it hasn t gone blue with bruising yet which seems odd.... can you give me any suggestions of what this may be and how to treat it? ### REPLY: Hello, I recommend using cold compress or ice pack application for 20 to 30 minutes for the 48 hours following injury to reduce swelling. I also suggest elevating your elbow higher than your heart. I suggest a light compression with a wrapped bandage. In case of pain I suggest to use pain medication such as acetaminophen (Tylenol).  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i had a chronic sinusitis 2 month ago but untill now i still have some headaches that come and go. i feel pressure in my head and wheezing in my ears. is this normal , antibiotics and steroids did not seem to help.should i fear something more serious? thank you ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have sinusitis. You should go for ct scan. It will give exact idea whether it is sinusitis or something else. For sinusitis antibiotics like among clan or cephalosporins can be used. Antihistamines .  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have found a small hard pee size lump next to my shin bone that slightly moves. is it something I should get looked at or worry about? Im 31 year old female, my height is 5ft 3in, weight is 8.5 stone. i have a clear medical history. i am not on any medication and have no allegies ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some skin adnexal tumor or soft tissue tumor like neurofibroma or dermatofibroma.  You should go for excision biopsy and histopathological examination. Then you should take further treatment accordingly. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 5cm solid mass on my left ovary and my Doctor recommends getting the left and possibly right tube removed as well. She said the current information points toward Ovarian Cancer starting in the tubes? We are hoping, of course, that the mass is not malignant but will not know until it is sent the pathology. Also is it better to try to save the ovary or go ahead and remove it to ensure no cells are spilled or left if it is cancer. I am 44 with a healthy lifestyle. I am scheduled for surgery on Wed. Thank you for your time. ### REPLY: Hello, Thanks for your query. You said that you were diagnosed with a solid mass in the left ovary. You are 44 years old, and you have solid mass in your ovary. Ovarian cancers are common at this age. I guess by this time you might have completed your family. So I feel you should undergo bilateral salting oophorectomy (removal of both tubes and ovaries). You can get a CA-125 level in your blood. Usually its level will rise in ovarian cancers. Also, it serves as an important tool in your follow-up period. You can discuss with your surgeon and get the test done. 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 10 yr old has been having headaches (back of his head), neck pain and some eye pain for a few weeks. At its worst it brings tears and has missed some school. We tried alleve morning and night, good diet and proper hydration for 5 days. It never went away. He has an upper and lower wire in his mouth. I removed both prior to a dentist visit (for 5 days) to see if that would help. It got better but didn t go away. The dentist asked if he had fallen. I had forgotten that he had. He missed the soccer ball and landed on the asphalt, back, head and tailbone. He kept the wire out and sent us to an Osteopath that we have been to before. He worked on his pelvis,neck and head. He immediately felt great but after a day it all came back and a few days later he was in tears again. I intend to call his pediatrician again on Monday. I guess I m wondering if we should wait out the treatments with the osteopath to see if they start to help (he had a lot of tension in his neck), go to the eye doctor or a neurologist. Thoughts, ideas? - Jenny ### REPLY: Thanks for your query. From your history your child has a chronic headache which is not episodic and not associated with nose and vomiting. It may be referred pain from teethes or neck or may be due to refraction errors in eyes. I suggest you to visit an ophthalmologist for eye testing first and if it is normal consider a neck X-ray to find out any problem in neck. Also remember that these all problem may be due to orthodontic treatment going on his teethes. 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 had baby he is 4wks old and i am having toothache,and i think they have to do a root canal. i just wanted to ask you that is it safe to have a root canal done after 4 weeks or should i wait another 2 weeks.(i had a c-section) some body told me that i have to wait 6 weeks after delivery for any dental work but i don t know. thank you ### REPLY: Thanks for your query, I have gone through your query. The root canal treatment can be carried out after 4 weeks of the delivery. There is no contraindication as such to carry out the root canal treatment. You can get it done, no problem. The main reason after 4 weeks is for the wound healing after delivery. It is a non-surgical procedure, so it can be carried out anytime. The only thing what you need to take care is the medicines prescribed during treatment. You need to take after feeding the baby. 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, I ve had a copper IUD fitter for around 5 years now. It has caused me some problems with my periods as they are usually extremely heavy and smelly (before I had it fitted they were really light). I do have poly cystic ovaries so occasionally get tummy pains. I ve noticed over the last few months I ve had a potent smell from my vagina. It is really bad that people notice it but I notice it, sometimes in my discharge. I ve read online it could be BV but people symptoms seem worse than mine & it isn t fishy, it s more like an ammonia coppery smell. Could this be from the coil? Would you advise to have it removed? ### REPLY: HelloChatDoctor user I understood your concern and My opinion is that IUD does not cause foul smelling discharge, you must be having vaginal infection/pelvic infection that's why you are having foul smelling discharge, please take following tablet for 7 days T Doxycycline 100 mg 1-1 T Metro 400 mg 1-1-1 Clinger vaginal pessary for 6 days If your discharge doesn't reduce than I will advise you to remove IUD after doing ultrasonography hope my answers help you Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Someone was on top of me and had all their body weight from their palm on my chest right below my left clavicle and now there is a golf ball size lump. I have super sharp pain in my back and it hurts to breathe deep and coughing is almost unbearable. Its been about a week and a half and I need to see if this is dangerous to not see a doctor. It feels like a muscle strain in my back though. even though it was caused in the front from being pressed on way to hard. Any advice? ### REPLY: Respected user, thanks for using .come have evaluated your query thoroughly.* Seems hematoma formation most likely with referred neuritic pain over back side.* Should immediately seek medical attention without delay as the symptoms' severity is much more according to the narration, take tab. Tylenol (500)mg stat dose for instant relief. Hope this clears your query. Welcome for further assistance. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been taking .05 Clozapine twice a day for a year to treat Vertigo which was quite severe 3 years ago. Meclizine did not help but Clozapine does. In addition to that, I take Ambien 2-3 times a week for sleep. I was also drinking 2-3 ounces of Vodka nightly which I have discontinued. My plan is to wean myself off Ambien but am not sure about Clozapine because when I don t take it, my head starts spinning again. ### REPLY: Hello, If you have vertigo that has never been evaluated as to underlying then, I suggest you see a neurologist or if possible a NEUROBIOLOGIST.  There must be a reasonable explanation for why you have such symptoms that can only be cured with clozapine.  You should be screened for what is known as VERTEBROBASILAR INSUFFICIENCY which is a reduction or lack of good perfusion into the vascular tree of the brain stem which could be critical.  It should not be masked by something like clozapine but rather identified and ad .  Perhaps, it is something simple such as BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) which can also be quieted down by something like clozapine but never cured as well as either the Brandt-Daroff exercises or an Ella Maneuver.  Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My brother goes angioplasty at the age of 33 years at May-2010. Now he is feeling pain now after 5 month. He consult with doctor, he is saying nothing to worry. Please advice how we can know how much he has block edge know...pls suggest, this is urgent. ### REPLY: Hello! Welcome and thank you for asking on ! I passed carefully through your question and would explain that considering his past medical history, it is important to investigate for possible coronary artery disease. For this reason, I recommend consulting with his cardiologist and performing some tests: - a cardiac stress echo-cardiac enzymes- a resting You should discuss with your doctor on the above issues. 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 have ingrow toe nail that seem to have created inflammation and pain to the point I could not touch the sensitive area. When the pain eased it would slightly itch. The doc prescribed fucicort 15g cream Leo which definitely helped reduce the pain and inflammation, however it has created skin scab that s reddish and it itches a lot. Is this normal ### REPLY: Hello, Ingrowing toenail is a frustrating problem, and it can cause inflammation many times. So I would suggest you to take surgeon s opinion and remove this toenail because till then you will continue to have these scabs.  If you are not willing for surgery then you need to avoid wearing shoes, do not keep this place wet and apply this cream. I hope you are not a Diabetic. I hope this answer will be useful for you. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my daughter has type 1 diabetes, uncontrolled as yet. on the weekend she had severe pain lhs abdominal and shoulder, she was given gas and air and eventually it went next day just pain with pressure. what could have caused this. she previously to the pain, vomited, thanks alison ### REPLY: Hi Alison ! Good morning. I am  answering your query. In case of Diabetics, with this kind of symptoms, one has to exclude calculus cholecystitis, and so I would suggest for an ultrasound abdomen. This would also rule out possibility of any stone disease in causing the pain. Management would differ depending on the results of a physical examination and related investigations. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had an indwelling catheter in for about 3 weeks. The catheter is completely painless but the catheter tube goes up inside my penis there is an ongoing, terrible pain when ever I sit down or stand up I ve found that if I skin my foreskin back from the head of my penis the pain is considerably less. ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have indwelling catheter and getting severe pain in penis. This is mostly due to spasm of the bladder and your foreskin (which is very sensitive) has been infected due to friction of the catheter. You need to take broad spectrum antibiotic like Čeferin along with anti-inflammatory . Ensure to clean the catheter and your genitals with warm water twice daily. Ensure to  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: doctor,I am 31 years old lady married for 2 years 6 months.  Small pcos was detected. All other investigations were norm.  I was on infertility treatment for 2 months.but could not  concieve. I was taking loprin ,folic acid ,glycomet, siphen ( for 5 days from day 2 of my cycle). i was given humog injection, lutigen injection and duphaston...since i was under stress and due to personal problem i could not continue the treatment  in mid of second cycle and i am in 7th day of my third cycle..do i need to continue taking glycomet  and folic acid and start the treatment in next cycle. what are the chances of conceving......is there any ayurvedic trreatment ### REPLY: Hi, I welcome you to  VIRTUAL CLINIC. I have understood your concern. PCs is a lifestyle disorder, and I will suggest you to indulge in a healthy diet and regular exercise regimen. Avoid deep-fried foods, and bakery products and refined sugars. Folic acid and metformin can be taken without any harm. Folic acid taken 3 months before conception helps to protect pregnancy in many ways. Metformin helps to reduce PCs effect and help on egg formation. I hope this answer helps you. Thanks .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister is having sever nose bleeds she had to have a vessel tied off through her groin area a few days ago went into her nose twice to pack but the bleeding started back to day she has lypmphemda can that be the problem the doc cant find the answer ### REPLY: Most commonly, trauma to the nose triggers a nose bleed. Trauma to the outside of the nose, such as a blow to the face, or trauma inside the nose, such as nose picking or repeated irritation from a cold, can cause a nose bleed. Less commonly, an underlying disease process, such as an inability of the blood to clot, may contribute to the bleeding. Inability of the blood to clot is most often due to blood-thinning .  Liver disease can also interfere with blood clotting. Abnormal blood vessels or cancers in the nose are rare causes of nosebleeds. High blood pressure may contribute to bleeding but is almost never the only reason for a nose bleed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr I have pcos problem and I conceived with clomid but that pregnancy end up in miscarriage in 6th week .now i am taking dophaston 10mg bid n baby aspirin n metformine . Can I try for this month for pregnancy . My LMP was 12 august . And I started dophaston 14th day of cycle when I should stop this . I am 25 years old ### REPLY: Hello dairy understand your concerned have PCs and miscarriage history. You can take phaeton for 10 days form the 14th day if cycled. Aspirin should be given in coagulation abnormality that cause miscarriage. But it should be started at 4th to 5th week of pregnancy once heart activity of baby appear in USG. You can again take clonidine, ova care plus,  shot, FSH injection to become pregnant. If you have regular period then you can try for baby in this cycle also. Duphaston help in conceiving and support early pregnancy. All treatment should be taken under advise of gynecologist and regular monitoring by USG scan should require. Hope this may help noncontact further if follow up needed Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mouths been half closed for months every now and then i get a sharp pain in the back of head and my mouth closes and my speech is slurred also i feel tired and i cant move sometimes i cant open my eyes i have noticed if i have my telly on my eyes flicker and cant move ### REPLY: Thanks for using . Read your query. Along with the difficulty in mouth opening what other signs and symptoms you have? Do you have the habit of chewing tobacco and associated products? I would advise you to visit the oral and maxillofacial surgeon at the earliest and have it checked. If the difficulty in mouth opening is due the erupting and impacted third molar, have it removed. Continue doing with simple mouth opening exercises. Consult a speech therapist for slurred speech. Hope this was helpful. Thanks and regards ### END