Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 been advised to take fertyl super 100 mg from starting from day 2 of my period till the day 10. is it correct ? my age is 32. ### REPLY: Hi Welcome to  Ferry super 100 is camphene citrate 100 mg tablet and dosage schedule given to you is extended camphene citrate regimen. Extended camphene citrate regimen is therapy for the management of clomiphene-resistant women with polycystic ovary syn .  The extended camphene citrate regimen result in modest ovulation and pregnancy rates with no side effects. This therapy seems to offer economic, efficacy and safety advantages, and it is worth undergoing before starting more expensive or sophisticated alternatives. So your doctor is trying best for you, going step by step. Keep faith and keep trying. All the very best. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctors.I m suffering from allergic cough since eight years.I had too much medicine but it comes back.now recently I m having again much cough nd running nose.I have pft test which shows small aiway pass.Now I am taking telekast f,momeflo and combihale from past fifteen days but didnt recover fully.plz advice me best medicine and precaution...and also wat should eat. Thanx alot ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. I would agree with your current medications - Monteluakst-Fexofenadine (Telecast), Model (Mometasone nasal spray) and Combinable (I would like to know strength of medications within).2. First, I would suggest you to make sure that your technique of using the inhaler is perfect. If it is not perfect, there are chances that adequate amount of . 3. If despite correcting your technique, you are not experiencing relief, I would like to increase dose of Combinable (at present I don't know what dose you are taking)4. I would also suggest you allergy testing as it will help you identify the substances causing symptoms to you as well as the measures to avoid them.5. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works like a vaccine to improve your allergy symptoms.6. I would also suggest you a healthy diet and regular breathing exercises to improve your immunity and lung capacity in a long run.7. As you have specifically asked about diet, I would suggest you as follows:a. Please avoid the foods you are allergic to.b. I would suggest you to avoid too much eating. Please do not eat up to full stomach.c. In general, I would suggest you to avoid too cold foods such as cold  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I do very intense Zumba classes at least 3 times a week. Usually in the middle of the class I feel strong, sharp pain in my left back area. I never had those pains before. It s not the usual pain from intense workout that you may have in your side. Should I be concerned? ### REPLY: Hello, I have studied your case. Most probable reason for your symptoms could be postural problem. When such patient comes to my hospital we usually take x-ray spine to see for any nerve compression. Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor. Some exercises which can be done after pain has reduced include-Spine extension exercises, Lying on your stomach flat lift leg 6 inches from ground, do it for other leg. Now lift both hand and leg simultaneously, 6 inches off the ground and supposition for around 10 breathes. Core stabilizing spine exercises will help. You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case. I will advise checking your it B12 and it D3 level. Hope this helps. Wish you speedy recovery.  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 fell the other day when I was going down a flight of stairs. I hit 2 or 3 steps on my right side lower backside. When it happened it felt like someone had hit me with a bat. Seam to have knocked then wind out of me but not really. The pain was not sharp but much more subtle. I almost blacked out from the overall pain but didnt. Now my lower back is super sensitive and when I cough or laugh it hurts. If I pull or twist to the right it hurts really bad. Could I have injured a rib? It feels like a big lump in me when I lay on my side now and hurts. Im 53 and in good shape! ### REPLY: HiT hanks for your thereafter going through your query I came to know that you had right side back and chest injury as you have pain during cough or laugh. It seems to me soft tissue injury. But X-ray should be done to exclude rib fracture. No need to worry. These injuries are slow to heal, may take 2-3 weeks time to heal. Its treatment assuming soft tissue injury is rest to part. Breathing exercises are of use to reduce pulmonary congestion. You can take analgesic such as ibuprofen. You can take vitamin B-complex and C to promote healing. Furthermore, you can discuss with your Doctor about it. Hope your query get answered. If you have any further questions then don't hesitate to writing to us. I will be happy to help you. You can also write to me directly on below link:https://www.bit.ly/ask . Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my liver function test is ok except bilirubingindirect  is high i.e. 1.09 and alkaline phosphate 148.30 as per the technlogies used BILD-BILT-BILI-SGOT-IFCC* SGPT-IFCC* ALKP-Alp IFCC* GGT-Ifcc* PROT SLAB  which is ready or medicine and treatment to bring the above two items on normal parameter ### REPLY: Hi welcome to  .... Noted you have conjugate hyperbilirubinemia.... So obstructive jaundice has to be ruled out like by cholestatsis or gall stone.....USG done witChatDoctorplete LFT profile and liver enzymes......Meanwhile, urine for urobilunogen also done. Udiliv tablet might be needed.... If hepatitis is present viral marker study also done.....Meanwhile, fruits more and fat taken less. Clinical follow-up necessary.... Hope your concern solved.... Take care.... .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am having stomach pain and i can not stand up straight without it hurting. i went to the er room on monday 12/24/12 and i was diagnose with immflamate bladder and they also said i have count of white blood cells, this has been going on for about a month. and also my stomach is big as well but i am not pregnant nor do i have tumor .. can you please help me out ### REPLY: Dear madam, reinfection can cause symptoms you're describing but if it is prolonged and antibiotics aren't helpful then you should try to find another causes. You need to do US or CT scan of abdomen and pelvis to rule out some intra-abdominal disorder. Also, you should do monoculture and repeat blood tests. Inflamed bladder usually doesn't go with such kind of pain. After u do tests i ve mentioned everything should be clear. Wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daugher has a bad cold, severe fatigue, moderate temp. nausea and vomiting, cough with pain in back ( lower) tthey said she had plus four ketones, and respiratory infection. and needed treatment ,liter of IV fluids zofran ( pres) and zpac. they could not get vein for IV and on discharge no antibiotic because doc said if would have interaction with zofran. the nurse said sorry, you are the only iv i have ever missed. my God should they send someone home with a plus four ketone my daughter is still so sick, I am very disappointed in ### REPLY: Thanks for posting on . I am sorry to hear about your daughter. During illness when the child does not eat properly, the body has to manage nutrition from elsewhere and converts fats to ketones which act as the food for brain. That is probably the reason for your child to have 4+ ketones. All that has to be done is to give her feed properly. I would also insist giving her ORS to help her regain salt and water imbalance. At times, it is extremely difficult to find the vein in small child .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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...  I have GERD and have pain in the mid chest as well.  Pressure applied to the chest is painful.  The pain is almost constant.  Can this be costochondritis or could it be related to GERD?  Thank you. ### REPLY: Cellophane you for asking. GERD is one of the main causes for chest pain. According to the history you already suffered from HERD. I do not think that is Costco . You have to take some medications for HERD like antacids in the dose the specialist prescribe them to you. The diet is very important too. No smoking no alcohol, no spicy food the dinner will be early, you have to use two pillows during the sleep. If you will be careful I am sure you will feel better shortly. Take care. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im a lactating mother to a 6month old child. i have been diagnosed w/ amoebiasis and was prescribed with Metronidazole. My child wont accept bottled milk so i am forced to let her still feed through me. Is it risky for my child? what other medicine can replaced Metronidazole that can be good for my child? ### REPLY: Hi, Welcome to . I have read your question in detail and I know that you are very concerned about your child. Metronidazole doesn't pass through breast milk and will have no effect on baby. You can continue taking metronidazole, and also you should continue breastfeeding the baby. There is no need to replace metronidazole. I hope this will help you. Wishing your child good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I seem to be getting a sore throat more often recently. I am 63, live in Vermont, have problems with depression, high blood pressure, type 2 diabetes, and more. Is there anything that would be causing me to have a sore throat every 2 or 3 months now that did not seem to cause problems before? ### REPLY: Hello! Thank you for asking on ! I understand your concern, and would like to explain that your sore throat needs a comprehensive medical investigation to identify the exact cause of your complaints. Several factors, like inflammatory diseases, adverse . First, a careful physical exam is necessary to rule in/out possible signs of infection, or alternative disorders. Some lab tests, like complete blood count, PCR, ESR, AS (antistreptolysin liters), fasting glucose, should be done to differentiate between possible causes. A thorough investigation of current therapy and underlying health disorders is helpful too. You need to discuss with your internist about above-mentioned options. Hope to have been helpful! Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lymph nodes have been swollen for quite some time now. i figured it was because of my allergies that i have badly. about 4 days ago i noticed a lump/knot on the back of my head and behind my ears. is this caused by a sinus infection from my allergies or from sonething else. also my scalp has been very itchy and tender to the touch at times. i also notice that i have lost some hair at the top center of my head. will penicillin help fight this infection off ### REPLY: Hello, Allergies do NOT usually cause swollen lymph nodes, but infections. You are either prone for recurrent sore throat, tonsillitis etc. that causes the lymph nodes to swell up. Rhinosinusitis (bacterial) can be very troublesome and difficult to treat, and a CT scan is the best modality of investigation in this setting. Penicillin can decrease lymph node swelling in infections, but not recommended for sinusitis or for hair loss. If recurrent lymph node enlargement and hair loss is a feature, suggest you get the following tests done and seen by a physician or Rheumatologist if any of them are abnormal: CBC, fasting glucose and lipid profile, Lots, creatinine, ANA, TSH (thyroid profile). 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 am 26  and my height id 165 cm and wt:59. I had been suffering form hirsutism and now i m fine. However my skin has excess of hair and i want to reduce them . i had tried laser treatment before but that affected my skin texture and also resulted in acnes. I am not sure if bleach or any other thing any help. Is there any natural way of reducing facial hair? ### REPLY: Hi Natural way of losing facial hairs which is being traditionally followed by our ancestors mainly include Turmeric. Turmeric can be alone applied on the skin, keep it for half an hour and wash it with pain water. Turmeric can be also mixed with equal amount of began (gram flour) with or without milk cream. This gives good results. If this doesn't help simple threading or bleaching skin in tone with your skin color shall really work. Do let me know for any additional information anytime. Take care. 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: had my mirena taken out on march 7th had unprotected sex the day before and everday since. The night of the 10th i unexpectedly was bleeding and a couple small clots. Woke up the next day with very little brown spotting that lasted two days now i have light pink discharge but in small amounts for two days along with nausea snd vomiting that comes out of no where,cramping, hot flashes, smell everything. Took a pregnancy test and it came out negative. In 2007 i got pregnant right after my mirena came out ### REPLY: Hi, thank you for your question, i read your problem carefully, since you have removed IRENA and having unprotected sex without any other birth control method chances are high that you can be pregnant urinary pregnancy test can give false result in early stage, It's not very reliable beta  level of blood will be more confirmatory, USG abdomen and pelvis will also be very reliable. Consult gynecologist for these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 uterus size 66x38x35 mmrt overy 33x30x21 mmlt overy 33x24x23 mmboth overies enlarged and show multiple peripherally placed folicles with increased central echogenic stroma.16th day of folicular study rt overy contains 12x10 mm & E.T. 6.7 mmIt is possible can I conceive? ### REPLY: Hi, I think your follicles' growth is a little slow as you have pod.  So, you may need some medicines like camphene for the growth of your follicles and track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for 2 to 3 days after injection.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 months.  Hope I have answered your question. 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 husband is taking Amiodorine and recently the Dr. Increased his dose to 200 mg. even before the increase he was feeling very tired, short of breath, and just not feeling right. He went to see his cardiologist on Monday and he said everything looks ok. Since he was short of breath I went out and bought a pulse/oximeter and his oxygen level was 92. At what point should we go see a dr. I made appt with pulmonary dr but can t get in until Wednesday of next week. Is 92 too low? Should that number fluctuate? ### REPLY: Thanks for your question on . In my opinion your husband is having arrhythmia as amiodarone is anti arrhythmic . And normal oxygen level is above 90. So no need to worry about oxygen Level of 92. And I also think that his breathlessness is due to cardiac cause only. But better to consult pulmonologist get evaluated for lung cause. So no need to worry about oxygen level 92. Its normal. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently came in contact with poison oak. It is on her neck and face and she now has a fever of 102 for the past 3 days and she feels like her throat is swollen/ closing. Is it possible she ingested some of the poison oak and this is a symptom/ reaction? ### REPLY: HI, thanks for using  The closure of her throat implies that the reaction is very severe. Closure of the throat is a symptom that is seen in severe allergic reactions. It requires immediate emergency treatment. It can be accompanied by problems with breathing. It does not mean that any of the poison oak was ingested. She needs to avoid any contact with this in the future. 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, may I answer your health queries right now ?  Please type your query here...48 yr old white male having pain in one breast, it is tenderness on and around the nipple when prodded, having one lyphoma in the breast about the diameter of a quarter, had mammogram which was stated to me that there was no indicated problems. any ideas? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have gynecomastia or lymphoma or other breast lesion.  You should go for fine needle aspiration cytology or biopsy of that lump.  It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have 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 had unprotected sex with my boyfriend and I am on birth control but I took the pill late that night by accident. My lower stomach hurts really bad kind of like a period and I m feeling tired and my back, legs, head, and breasts hurt. I had a clear mucus discharge the next morning . Is it possible that I am pregnant since I m on birth control but took it late that night? ### REPLY: Hello dairy understand your concernPregnancy is not possible as you are on the birth control pill. Birth control is very effective in preventing the pregnancy (just 0.5 % failure rate). Efficiency of pill dose nit affected by taking one pill at late night. Your symptoms could be due to hormonal imbalance, premenstrual symptoms. You can be symptomatic treatment for that:Take tablet metal spas, gentle breast massage with evening prime rose oil. Maintain proper pelvic hygiene, take proper rest, . If period will not come in next 7-8 days then consult the gynecologist for proper examination. Hope this may help noncontact  for further health query Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am an aml patient type m2, now receiving a consolidation flag treatment. The initial induction was a different one ,but cr was achieved. I am currently responding well,no infection, only WBC is .05.and ply is 10. My question is if the consolidation is fine,do I need a transplant. Thanks. ### REPLY: Hi, Thanks for asking. Based on your clinical history and query, my opinion is as follows:1. Consolidation is necessary before a transplant.2. Yes, you will require a transplant as there is still mutation in your cells, which are capable of starting leukemia.3. Transplant will put new cells, which will proliferate and help you in complete recovery. 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: Dear Doctor, my daughter is suffering from epilepsy for last eight years. Though the frequency of seizures are very less sometimes it did not occur for two years however, when she is in stress or have sleeping disorder, it occurs. She is taking lametac DT 50 once in the morning and two in the evening. For some time I felt some behavioural changes like missing and unresponsive. Is this the side effects of medicine or otherwise. Pl. advise. Thanks Arvind 0000 ### REPLY: Hi, welcome to our site. I am , MD. Read your query. That is a very significant question and I appreciate your problem. I will try my best to answer your everywhere are two things you need to understand.1. The medicines are weight based. That is the dose is weight adjusted. As the child grows older and gains weight, the dose has to be adjusted. Sometimes, the medicine has to be changed.2. The patient should avoid stressful conditions. Stress and lack of sleep are known triggers in seizure patients and should be actively avoided. As for the behavioral changes, they need to be assessed by an EEG. A video EEG is a better option. They may be a manifestation of -a. The seizures b. post seizure status. Sometimes medicines have the effects too. I hope this helps you. Inform the reports mentioned above/if any other, so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. You can upload them on the site. You can upload them with the query, or if you have a problem, send them to attachments@ChatDoctor .com with Sub: ATTN Your Name. Once we receive the photos or diagnostic reports, my team will send reports / pictures to me. Please do understand that some details could be extracted from a detailed history and examination. Please click on Thanks/Helpful if found useful. Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck. . MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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  19 year old daughter was hospitalized with cpk 350,000 resulting in renal failure in which she required dialysis 3 times. Her kidneys began to function again. We are awaiting to see a specialist in a neuromuscular group. Awaiting muscle biopsy for diagnosis. She recently after 2 mo from onset of it all has cpk of 298 and normal kidney function test results . In diseases such as mcardles disease does the cpk level fluctuate or does it normally remain elevated. ### REPLY: Hi there, Thank you for your question. Raised CPK can have many causes, these include injury to the muscles, high fever, inflammation of the muscles called as myositis, McArdle disease also causes high CPK levels. In any condition the levels of CPK can fluctuate and since she was dialyzed so the CPK must have been removed from the blood via dialysis so that could be the reason why it is not raised anymore. Such a high CPK does require further testing such as a muscle biopsy etc. to determine exactly what's causing it and then to treat the condition accordingly. Kindest Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 27 yrs old.I am married for 5yrs.I am trying to conceive more than 2yrs.But i am affected with irregular period and TB also.Now TB has recovered.I have also hypothyroid disease.I am taking L Toxin 100 for thyroid.i am also over weight 65kg.please please suggest me the proper treatment and the way of getting pregnant as soon as possible,because i am very upset for this infertility ..please doctor help me out..///thanks ### REPLY: Hi, Thanks for using the . You can become pregnant. Get your thyroid profile test done. Control your hormone values with in normal limit by adjusting Toxin dosage.consult an obstetrician for your infertility problem for through work up, you may need HSG, to know condition of your fallopian tubes. Hope I have answered your query. If you have any further questions I will be happy to help. Thanks get well soon.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just had an reaction to my allergy shot: Threw up, rash, redness, trouble breathing, etc. The office is now closed for a holiday party so I cant return. I am still red and itchy and wheezing a little but not life threatening. Do I need to go to an emergency room? ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. As you have only a little wheezing, I would suggest you to use a rescue inhaler like albuterol or levosalbutamol. Rescue inhaler does not improve your symptoms, then you should go to emergency room.2. I would also suggest you to take an antihistamine like cetirizine as you also have rash, redness, etc. Hope above suggestions will be helpful to you. Wish you the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have been ill for about 2 weeks with a flu, and i started having pains in my right lung, i thought it may be a chest infection so have been pon antibiotics, after 6 days though the pain is still unbearable...it feels like i have sprained a lung, or trapped some muscle in the ribs or something, when i use my left arm it hurts but it doesnt hurt to breathe - only if i take a big breathe ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of musculoskeletal pain is more likely because your pain is associated with movements of left arm and deep breathing. So better to follow these steps for better symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise.2. Avoid forward bending and sudden jerky movements of chest.3. Avoid movements causing pain.4. Apply warm water pad on affected areas of chest.5. Take simple painkiller like paracetamol or ibuprofen. Don't worry, you will be alright with all these. 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: I am 31 yrs old,66kg, and i am trying to conceive, my Gyno gave me clomid to take for 5days but nothing happened.Now he gave me Duphaston 10mg to take for 10days,then after he will give clomid but this time he said he will double the dosage(Clomid).I am worried coz Ive heard that clomid might lead to triplets or twins is it true? ### REPLY: Hi, it's true that closed can lead to twin or triplets, but the risk is not very high, around 6 to 7 percent. You can track your follicles' growth by repeated ultrasound.  If you have only one dominant follicle, then chance of twins is that of a normal pregnancy.  When follicles reach a size more than 17 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days after your injection.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that. Hope I have answered your question. If you have any other query I will be happy to help. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir,im facing problem with my dad. He at any little issue, gets tensed and when he is in tension he behaves abnormally... he speaks himself, laughs himself. we have tried to make him understood that what he is doing is not looking normal. but all goes in vain... again for some day he becomes normal. i dont know what to do. plz help. we live in kolkata, indiae-mail:  YYYY@YYYY ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. We must know what is normal and what is abnormal. You said your father behaves abnormally at certain times when he is under stress. Till this point, that is OK. Almost everyone does so. Then you said, at that abnormal period, your father talks to himself and laughs to himself. That matter is a bit troublesome. Here you must confirm, whether the self speech and laugh, are continuation of the incident or they have no connection with the incident. If in connection, just counseling and training to overcome stress may be used. Otherwise, you should take your father to a psychiatrist. If you require more of my help in this aspect, 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 further. 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: Hello!  I just had a spinal tap done. My Dr is looking for MS or another issue that could be causing my symptoms. My test results are. Glucose CSF (67), Protein CFS (31.0), Tube Number (4), Color and Clarity is Colorless and Clear, White Blood Cells CSF (3), Segmented Neutrophils CSF (1), Lymphocytes CSF (85), Monocytes (14). Everything else was a 0 so I didnt put them down. What can cause the Lymphocytes to be so high? Will MS cause this? Thanks Christine ### REPLY: I read your question, and I am sorry about your concern. Those results show an elevation of the protein and the lymphocyte count. Before continuing I must point out that the White Blood Cells (WBC) count must be mistaken because the WBC include all the neutrophils, lymphocytes, monocytes so number can't be lower than it's their sum. Regarding the question on multiple sclerosis, well yes, it can show high lymphocyte and protein numbers. On the other hand they can change from other causes as well, like from central nervous system infections. So the diagnosis is directed by the history and clinical exam.However, usually to search for the diagnosis of MS, the spinal tap is obtained more for the purpose of testing for what are called immunoglobulins and the presence of oligoclonal bands. I don't know if those have been tested, the rest doesn't help much for the diagnosis of MS. Usually the diagnosis of MS if put by MRI, and spinal tap is obtained if in doubt to search for oligoclonal bands. I hope to have been of help. Feel free to ask further questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Aslam-o-Alikum Hi. my name is Humair ali m from pakistan and my age is 23 years old. dr. before 1 year i m suffering with vertigo no one know what is this. i take my all body test all clear. like Cat scan, eeg, sinues, blood, heart echo, Ett test. ecg all clear but now before 2 days i see in my urine thick blood and take altera sound again doctor diagnose you have stone in your left kidney doctor i want to know what vertigo is related to kidney stone. ### REPLY: Hello, Vertigo is a problem that is related with problems related to inner ear. Kidney stones are calcified materials present in the kidney, ureter (tube that transports urine from kidney to urinary bladder) or urinary bladder. These two conditions are totally different, and they do not relate with each other. However, when the stone moves from one part of urinary tract to another and pinches in the ureter or flesh of the organ, you might get intense pain and may feel nauseated and dizzy, which could be misinterpreted as vertigo. If the ultrasound suggests that the stone is larger, you may have to go for lithography procedure to break the stone down in smaller parts by ultrasonic waves. Smaller stones can be removed through urine by . I wish this information helps. Thank you for choosing . 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: Hi, I am 21 years olds and for the last 2 years my wisdom teeth have slowly been coming in. The bottom 2 are almost fully out but have a flap of skin over them it is not painful and i know the importance of keeping my mouth clean to prevent food from getting stuck under the skin so the their is no pain or discomfort associated with the bottom 2. The 2 on top are also partially out but not completely but overall in this process my overbite has gotten more visible and today when my upper right wisdom pain started i was feeling around in my mouth with my tounge and i felt a hard bone like bump towards the right side of the roof of my mouth not too close to the wisdom tooth but its not painful and im not sure if it new or i just never realized it before is it just a bone over growth or is it something to do with my wisdom teeth Thank you for your time and help AAAA ### REPLY: Hello and welcome to . Thank you for your query. This bony growth that you have recently noticed could be a less exposed end of your upper jaw, now that your wisdom tooth is coming into place you could have noticed a change in your jaw. This should not be of any worry. But an oral examination would always be best, consult your dentist for the same. Also, if you do experience any other symptoms you could visit your dentist at the earliest. If you do feel discomfort with the muscle flap that is still covering your wisdom teeth, there is a small procedure that can help expose the wisdom teeth quicker and thus avoid pain and discomfort. This is done by making a small excision on that flap. It is a safe and small procedure. Discuss the possibilities with your dentist. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 7 weeks pragnent, I took 3 cytotec pills when I was 4 weeks pregnent. My doctor scan my baby is only 5 weeks big and with heart beat.I didnt tell my doctor I already ate the cytotec pills.  what should I do since I hubby already knew about my pragnency should I keep the baby. Is the baby healthy? ### REPLY: I have read and understood your query hope this will be helpful of all you should not have taken tablets for abortion without consulting doctors your baby is weak but viable what you need to do is to decide whether you want a baby or not. If you want an abortion you should meet your ob/gone doctor and discuss it properly but if you are ready to have a baby, right now you need to take care of you, eat healthy and more, take proper rest and avoid stress. Also start taking supplements containing folic acid and multi vitamins. I will be very glad to know if you find it usefulThankyouRegards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Zahra Rehmani - 24 yrs old. I got married 4 months ago and recently diagnosed with L5 -s1, L3 - L4, slipped disc issues. I am also facing a problem in my neck C4 -C5-C6 some sought of cervical prob. My left leg is continuously numb for about a month now. I think that is because of the slight nerve root compression. I am planning to get pregnant soon. Will this effect my baby or my back? My backache is unbearable and I am on bed rest for abt 3 months now. Pls suggest ### REPLY: Hi there, I will suggest you the best possible treatment options. I will suggest you to consult with an orthopedic or spine surgeon first. Take medical treatment and proper physiotherapy, once the things are under control then plan for pregnancy. As pregnancy is condition associated with weight gain, calcium consumption and laxity of joints and ligaments, please be sure of getting your present condition treated before you plan to get pregnant. As such, your present condition will not have any effect on the baby. So do not worry about it. Please start with preconception doses of vitamin B 12 and Folic acid supplementation. This will help to prevent various complications during pregnancy and delivery. 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: Male, 29 years old. Ive had a consistent dull pain in my left lower back (around kidneys) for a couple of months. On a scale of 1 to 10 for pain, its a 1 to 2. I excersize regularly, and drink mostly water all day (no coke, little juice). My urine test at my doctor didnt show any issues.  I occansionally have very mile flutters in the same lower back area. Not sure if I should have additional testing done, or if it could simply be back/muscle pain from an older mattress? ### REPLY: Thank you for sharing your complaint, dear friend your pain seems mostly muscular type but if radiates from back to pelvic area or associated symptoms like burning/difficulty/frequent urination you should keep in mind possibility of renal stone also. Your pain is from at least last 2 months so I think once you should go for sonography of abdomen to rule out other possibilities. If reports are normal no need to worry. For pain you can take analgesic like ibuprofen or for severe pain take muscle relaxant medicine like combination of diclofenac+paracetamol+chlorzoxazon.for muscular back pain exercise and physiotherapy will be much helpful to you.-exercise for low back pain-raise your lower extremity straight from hip joint without bending from knee after sleeping on back and then put down slowly. Same exercise for other lower extremity and then raise both lower extremity simultaneously. Sleep on abdomen and raise your head and chest backward. Do all these exercise daily by increasing every day. Hope this answer will be helpful to you. For more queries please don't hesitate to ask. Get well soon dear friend ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor, i am raju and suffering from alopecia areata disease beacuse of this i have been having loss of hair and patches on scull. i consulted doctor last month he has given some tablets like BIOTEE-PLUS 10MG and ANDROMIN TAB AND GROCAPIX GEL. by using these i did not stop my hairloss and patches on scull. could you please suggest me...should i continue with this treatment.how can i reduce patches on scull. will get hair that on that patches. ### REPLY: Hello AJU and welcome to ChatDoctorAlopecia errata is a condition where the body reacts against the hair, causing it to fall off. You will need more specific treatments for the same. You can continue with the tablets and gel application, they help give nutrition for hair growth, but will not treat the reaction in your body. For that you will need stronger medication like steroids. I would advise you to see a dermatologist regarding steroid injections in the bald areas. This will stop the reaction from spreading and slowly stop the hairball. It also gives faster hair growth. In many cases it gives a good permanent resolution. But since it is an allergic or immunity related disease, it can happen again in new areas. You will need to follow up regularly and take proper treatment. You may also have to check for other diseases like thyroid disorders, white patches(vitiligo) or anemia which have similar causes. There are also newer options which can be tried along with your present medications. Do consult a dermatosurgeon for further opinion regarding what is best for you. Keep in mind that it will take time, and also to take good nutritious diet, avoid harsh chemicals or anything you might be allergic to, avoid stress. 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. As of the last few weeks, I ve been having a problem with my teeth becoming very cold sensitive. This is becoming worse everyday. At first it was just the teeth. Now I have electrical sensations in my teeth and my gums - left and right, upper and lower. ALL my teeth are effected. I have not noticed any kind of changes with my teeth or my gums at all before or during this whole time frame. I can push on my teeth, push on my gums, or bite down hard - and no pain. So it does not appear to be a dental problem. It seems to me the nerves in my gums leading to my teeth have suddenly become over active. What could have caused this? By the way I am a 47-year-old white male. ### REPLY: Hello and welcome to , Sensitivity of teeth may be due to-Regressive changes like attrition, abrasion or erosion of teeth. Periapical infection of teeth. Exposed tooth portion has to be restored with tooth-coloured filling material. Use soft-bristled toothbrush and clean your teeth in back-forth, up-down motion. Avoid intake of carbonated . Avoid tooth grinding habits. 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: A couple of days ago I noticed that my lymph gland on my right groin is a little swollen and tender. Just that one gland. I have no fever and other than a little discomfort when Im sitting it does not bother me. When looking at my groin you cannot see the swelling only when a little pressure is applied you can notice a little swelling. A couple of months ago I had done a CBC and my white blood count was in the normal range. Could an ovarian cyst that ruptured be the cause of the inflammation of the node? Also I am trying to conceive and my husband was taking tetracycline which I am allergic to, can that have an effect on the inflammation. I am a little worried I,ve never experienced this before. Aside from 3 thyroid nodules and a low iron level I am in good health. Should I get any testing done? Thank you for your time. ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  You have reactive hyperplasia of lymph node most likely.  It can be due to some infection.  Youfoovarian cyst rupture, tetracycline sensitivity or thyroid nodule has no relation with that.  You should take a course of antibiotics.  If it doesn't respond to treatment then biopsy diagnosis is advisable to rule out tuberculosis or lymphoma. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It is been a week iv got a little bmp filled with puss on just below my left elbow, since 2 days the area was swollen and was paining as i moved my arms but the pain and swelling is reduced but the bump filled with puss is still there. What is it?? How can i get rid of it?? plz help ### REPLY: Hi ! Good morning. I am  answering your query. If I were your doctor, I would advise you against leaning on the table with your elbow which might aggravate your symptoms. Pus anywhere have to be evacuated. Same is the case here and so you should report to your family physician or to the ER of your nearest hospital for a proper . 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 went to the ER last night bc I was having a Sharp pain and a burning sensation in the mid chest area and back I was also nauseous and weak and very dizzy... when my results came in they said I had an inflamed liver, pancreatitis, and urinary tract infection, what does that mean and how did I get  all of that? ### REPLY: Thanks for your question on . I can understand your concern. Inflammed liver (hepatitis) and pancreatitis are almost always from secondary septicemia. Since you are having urinary tract infection (UTI), this caused release of inflammatory mediators in blood which is causing hepatitis and pancreatitis. Pancreatitis in any infection is considered as severe infection. So better to start Intravenous antibiotics for UTI, Intravenous fluids for pancreatitis and hepatitis. Usual time for recovery is 15 days. 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: Every 3-4 days, a raised, itchy rash will appear somewhere on my 12 year-old s body. Never in the same place. First it was on buttocks, then hands, forearms another day, shins a few days later. Yesterday it appeared on his wrists, knees and cheeks. It is alleviated in a matter of minutes after administering separate dosages of prednisolone, Zyrtec and Zantac. The hives first appeared May 10 after a day spent in the woods with friends. He may have rubbed a Bounce dryer sheet on his body to deter insects. But the rash will not completely go away and we are almost out of the prescription. Any thoughts? ### REPLY: Hi, The ideal management of hives is to find the cause for the hives. Hives (urticaria) is usually caused by food, .  Antihistamine and steroid can give a temporary relief. The ideal treatment is to avoid yourself from the causative agent. I request you to consult your Dermatologist who will help you in managing the condition. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a scope inserted into my stomach through my mouth a few weeks ago, I was diagnosed with a hernia and something wrong with my oesophagus. I was prescribed medication and have been fine, no more sickness. However I have just received a letter advising me they want to insert the scope again. What could this mean? ### REPLY: Thanks for posting your query to . I didn't understand why your clinician want to do endoscopic examination again. As if they had done examination once no need to repeat the test. So first you confirm for what purpose they want to repeat the test. Sometimes it can be repeated to take some biopsy material if not taken during first time. However, there are different type of hernia and require surgical management.review AFER complete information for repeating the test then I would suggest what to do. Feel free for any further query. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My cousin has diabetes. She had a sore on her foot and now is hospitalized. I understand she has a flesh eating bacteria and the doctors have said they have to amputate the leg. Can you tell me the name of the bacteria and if we should seek another opinion ### REPLY: Hi I can understand your concern it's not all a bacterium that is eating the foot or leg it's all a called a diabetic foot profile of a patent that result in necrosis of that body part so these no bacteria that causes it except supers added infections be sure that the part of leg that changes the color and have no sensation need an urgent amputation to save the rest of the foot so just a good glycemic control and a good antibiotic coverage serve the purpose thanks and 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: Yes, my period was irregular last month for the first time and this month I was suppose to be getting my period on the 17th as I did last month but last week I took a pregnancy test it was posistive, how far along am I ? Or could I be? Was last months period statin I was already pregnnt? ### REPLY: Hello, I have gone through your query and understood the concern. If you have always had regular cycles, your age of pregnancy can be approximately calculated even though you had a recent irregular period excluding the number of days your period got delayed. The ideal way to estimate the gestation age in the current scenario, however, is to get a trans-vaginal sonogram. This gives you the location of the gestation sac, the fetal pole, cardiac activity and so on with more accuracy. Follow-up gives you good concurrence. 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. Recently while showering (after sitting on the pot) I noticed that there was a lump inside my buttocks, very close to where the anal opening is. It is quite hard and initially only hurt when I apply some pressure on it, but now while not very painful is noticeable throughout. I can also feel some bony or veiny structures around it. I dont think its anal or colorectal cancer as Im only 22, with no direct family history of cancer and show none of the symptoms, but Im worried that it might be skin cancer or something else thats serious. I dont smoke or drink (but admittedly do have a lot of chocolate and fizzy drinks, and not much fruit except fruit juices) and I dont have beef regularly. There are no signs of bleeding and my bowel movements dont seem to be much different. I have no idea how long its been there, but I only noticed it yesterday. Is this something that will go away or is it necessary to see a doctor (Im currently job-seeking and am not insured). Please advise. Thanks ### REPLY: Thanks for your question on . I can understand your concern. Possibility of skin cancer is less likely in your case. Common symptoms of skin cancer are chronic skin ulcers, not improving with .  These ulcers are usually painless and mostly on the sun exposed parts of the body like face, neck, hands, foot etc. So no need to worry about your gluteal swelling, it is not cancer. Possibility of gluteal abscess is more in your case. So better to consult doctor and get done clinical examination and ultrasound examination. You may need surgical removal of this swelling. Also check for diabetes as diabetics are common to develop gluteal abscess. 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: Please type your query here. Since this query is directed to our panel of specialists and super-specialists, pleaRESPECTED SIR/ MADAM,      WHICH THINGS TO CONSIDER REGARDING BLOOD GROUP MATCHING BEFORE MY DAUGHTER MARRIAGE?se mention your problem in as much detail as possible. Do not forget to highlight your Age, Gender, Medical History and Treatment History of the problem you are facing. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Blood group matching is not necessary at all for purpose of marriage. She should go for thalassemia test. If she is thalassemia minor then she should not marry the boy with thalassemia minor. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Should I be concern if I have a t-score of-0.2 lunar l1 l4 it has decreased 13.8 since my last scan in2010 and my hip score is-1.7 decreased 10.9% I am 55 postmenopausel have had herniated disc in my back and neck both corrected with surgery is there any connection? ### REPLY: Hello, There is no connection between herniated discs and low bone density except that both are more likely as we get older. What you have is osteopenia. A T-score less than 2.5 is osteoporosis. Treatment is not needed usually for osteopenia, but there is a calculation your doctor can do called a FAX score. This is a calculation that estimates risk of major fracture and when your doctor calculates the FAX score, if you are at high risk he/she may recommend a medication to increase bone density. 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, may I answer your health queries right now ? Please type your query here...My granddaughter is 12 and started her period this summer and is on vyvance. Recently she has become more impulsive, sassing and just not being herself should her meds be changed?I can t afford to pay ### REPLY: Hello, With the beginning of the adolescent age, personality changes also begin. A child may behave in a totally opposite way as he or she has been. Just wait and watch, and be patient with her. Try to understand her turmoil bad mood swings. There does not seem any need for medication for monarch. Reconsider any medication if she has regular menses. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a niece that is 1 year old, she has had a rash for the past month, it comes and goes. The rash starts out as a red bump under the skin and then presents itself with a hard raised bump similar to a chicken pox, she has a low grade fever, fatigue, and is very miserable. We have been to the doctor but no one can figure it out. I am a nurse and I have never seen anything like it. The fever is what concerns me low grade but its there, any suggestions? ### REPLY: Hello, Fever and skin rash is not a good combination, and usually viral infections are the cause. If however the skin red areas do not blanch on pressing with a glass (glass test) then you need to consult a doctor to exclude meningitis. If doctors do not think it is meningitis, and blood counts are normal (exclude low platelet count), then this is urticaria that is quite common at this age. Piriton syrup 5ml three times a day should keep it under control and ensure there is Dermal lotion to apply on the areas. The low grade fever may be due to the urticaria itself that happens due to histamine release. This will settle down soon but requires a good course of antihistamines. Do NOT avoid vaccines if this is just urticaria. Best Wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last summer I had a crown put in my back upper molar due to the dentist repeatedly messing up my tooth.  It triggered a strange pain in my jaw, headache and a constant sharp pain in the back of my skull when I swallow, laugh, cough, chew...pretty much any time.  I went to local medical clinic and they gave me an antibiotic and anti-inflamatory.  It went away about 10 days later.  It is now back as of last Monday.  Not sure what to do, where to go, etc...  Pharmacist says possible triad facial neuropathy. ### REPLY: Hi! Welcome to . I read your query. Did this pain start only after placing the crown or was it there before too? And was RCT of the tootChatDoctorplete before placing crown? If this started after crown, I would suggest you go to your dentist and get the high points of that crown checked. At times disturbed occlusion level of crown leads to pain (more while chewing). In case there are none, get the crown removed and check if pain goes. If it persists, do get a radiograph of the tooth done to rule out any infection there. And if the pain is still there, I would suggest you to consult a neurologist for further tests. Hope the answer helps. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother had a CT scan of the abdomen showing a retroperitoneal mass which was displacing the pancreas. It also showed a mass on the left lobe of the liver. She had needle biopsy done on friday on the retroperitoneal mass.  I have not gotten the full report as of yet but was told it looks suspicious and their were rare epithelial cells seen.  Can you tell me a little more? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some malignant mass in the retro peritoneum. Your FNAC report of rare epithelial cell does not indicate anything. You should go for Ultrasound guided biopsy of that lesion. It will give you some idea about diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes doctor if one had an operation (spine lower) is it true our bodies heals from inside out so a little discomfort at times maybe too much lifting bending etc. operation was done my name is pay I never received an answer from a few days ago the money was taken from my account but three emails to my pc opened but was blank thank you Dr Andrew I saw your name and photo so this is a another attempt ### REPLY: Hello! Welcome on  ! Regarding your concern, I would explain that after back surgery you may experience some pain and discomfort in this region. Besides, healing is a long process. It is not really important if the body heals inside out or the contrary, but you should know that the inflammation in this area may persist for a month. Physiotherapy is needed to help improve the posture and reinforce the back muscles. I would also recommend avoiding heavy weight lifting. Surgery can not give you a new vertebral column. The chronic degeneration permit. It just helps improve the pain and movements.  Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother (53 y,o.) has always been emotional, but lately her emtional irregularity has been very extreme. Last night after a heated arguement with the family, she burst into tears and began expressioning symptoms of psychosis. Bizarre behavior (not understanding what the function of furniture was, blank expressions), and then she may have had a hallucination of her deceased mother. When she snapped out of it, she could not remember what happened, but just remembers that she felt she was in darkness with voices around her. 30 minutes later I assesed to see if she oriented x3, but she failed. An hour later she was oriented x3, and was slowly returning to baseline. She currently is doing better, but not 100% herself. She may be in the early stages of menopause, and has no other psychiatric history. Is this common in menopausal women? ### REPLY: Hello She is 53 years old and after a major argument she has developed abnormal behavior, expressionless face, complaints of seeing her dead mother, forgetfulness. She was not responding to interactions. As per my opinion though acute psychosis can be possibility, but she might be having severe anxiety and acute stress reaction. There is positive history of major fight at home which was followed by symptoms. She has not shown other behaviors of psychosis like auspiciousness, fearfulness, irrelevant talking. In severe anxiety or in dissociative disorder individuals may stop to interact, may show abnormal behavior. I would advise you to consult a Psychiatrist to differentiate between these complaints. Medicines like low dose benzodiazepine can be given in her situation to calm her. Clonazepam, Lorazepam are commonly used. Visit a psychiatrist for proper diagnosis. 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 FATHER HAS A SEVEN NURVES PROBLEM...HAVE U GIVE ME GUIDELINE ABOUT THIS...THIS PBLM OCUURS IN SEVERAL 3 YEARS..AND ALSO BOOTEK INJECTION INJECTED TO MY FATHER BUT HAS NO ANY RRELASE FROM THIS DEACES.....PLS SUGGEST ME... FROM ; MANTU KUMAR GUPTA ### REPLY: Dear patient I think you are suggesting involvement of facial nerve with spasms in face. This may be bells palsy which is idiopathic and relieves itself in few months. Since your father is suffering form last 6l3 years cause of facial nerve palsy should be searched. MRI of the brain should be done from radiology center nearby you. Nerve conduction studies of the both facial nerves should be done. You need to consult expert neurophyysician for detailed assessment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell off my bike and landed hard on my hip. I think i have a groin pull but need confirmation. Groin hurts. Hip flexor hurts. Under right buttcheek hurts. What do you think? Its been 10 days. Still limping. Getting better with range of motion but feeling more. ### REPLY: Hello, As you fell from a bike I suspect you have a muscle and ligament injury at the hip joint due to which the healing is getting delayed and most muscles around the hip joint are painful.  I will advise you to take maximum bed rest where the muscle and ligament can heal. Post 2 weeks of rest you can slowly start exercising the hip muscles in static exercises and core stability exercise for the abdomen.  Post which range of motion will be advised and then later the strengthening exercises. Balance board training should be a part of the exercise program to improve muscle Imbalance and joint stability. In my clinical practice of over 12 years, most cases respond well to the above-mentioned procedure under a guided physiotherapist. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, Im being treated for Veridians Streptococcus. Have been for over a month now. At first I was given 5 days of Amikacin in injection form 1gr/per day. I had no signs of improvement and was then prescribed Cefalotin for 5 days, injectable 1gr per day. I completed three days of this and went back to the doctor because this also had no beneficial effects whatsoever and I was prescribed 10 days of 750mg tabs of levofloxacin. Im five days into treatment and yet again no signs at all of improvement. I went to another doctor today to get a second opinion and he told me to discontinue use of levofloxacin and start with a 5 day treatment of ceftriaxone injections at 1gr (which I havent done yet) At this point Idont know what to do or who to believe.... My symptoms are not severe or very discomforting in terms of pain, difficulty swallowing etc.... In fact if I hadnt looked in my throat about a month ago and seen the white lump on the side of my throat I would of never suspected I had Strep, as it only tingles a bit here and there. During this time it has niether spread, or become bigger/smaller. The only new symptom recently is a sporadic wheezing cough. I would l really appreciate any input that could lead to finally getting rid of this. ### REPLY: Thanks for posting your query to ChatDoctor.no need to be worried I can understand your concern and guide you about treatment as I understand it is an upper respiratory tract infection (URI).white lump is not always a Streptococcal infection it could be due to some other infection or may be tonsillitis.first you need to do :Culture and sensitivity examination of your throat swab to microbiology lab . It will guide you about exact cause for your URI.presently you should satrt1. Gurgling with Provide iodine gurgle 3 times per day .2. Take vitamin C 500 mg daily.3. Multivitamin and zinc tablet.presently stop taking antibiotic. Along with this can consult to ENT surgeon for examination undergo examination .hope this information will be sufficient for your query .rate me if you are satisfied with my answer .feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i got my periods in 7th dec and had unprotected sex on the 6th day last day on my periodsi took emkit 0.75 together 12 hours later. then 11 days later i took cyotec am i still pregnant my urine test show negative i have taken 8 tablets of cyotec till now ### REPLY: Hello, Thanks for sharing your health concern with us. I have gone through your query. Firstly, I would like to know why you took the medical abortion kit without confirming pregnancy clinically. Secondly, you had the intercourse during the safe period of your cycle and in addition, you took the emergency contraception soon after which rendered you safe. In the current scenario, since your hormone status would be disturbed, you may experience menstrual irregularities. I would ask you to see a specialist, get a proper clinical evaluation followed by a trans-vaginal sonogram to know the status of the pelvic organs and plan further management. 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: What is a normal blood pressure for an 87 year old female?  Paramedics were called earlier today and it was recommended that she go to hospital because part of her blood pressure reading was 220. She signed a piece of paper opting out of getting medical attention. Im concerned for my friend. She is not currently on any blood pressure meds. She has been in bed sleeping most of the day and has only had a few sips of juice... ### REPLY: Hi, I understand your concern and would explain that these blood pressure values are extremely high. At her age, blood pressure values below 140/90 mm Hg would be recommended. You should know that these blood pressure values (220mmgHg) can lead to increased risk for brain hemorrhage or stroke, besides seizures. So, considering her clinical situation, I would recommend bringing her to the nearest ER service for a physical exam and some tests: - a resting ECG- a chest X-ray study-kidney and liver function tests-fasting glucose-blood electrolytes- a brain CT scan to exclude stroke or hemorrhage Hope to have been helpful. Let me know if I can assist you further. 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 having strange sensation of a constant minor head rush. I get a feint pulsing sound that constantly heard in my ears its gets more intense as i am active. when i sit not so much but again when i try to lay down at night to sleep, during the day when i am active i don t notice it as much. i do take b12 shots every 2 weeks. i have had low blood sugar and other minor symptoms from that but this is really new like the past couple of weeks so i don t know if its related. i also get minor dizzy spells and light headedness as well....... should i be concerned? ### REPLY: Along with headache and tinnitus(ringing sound in the ear) do you have any difficulty/ swaying while walking? Do you hear that ringing sound in the ear along with your pulse if so you should suspect some tumor in the brain(CP angle lesion/ gloves tumor)? Along with this tinnitus do you have any vertigo(reeling sensation) if so suggests ear pathology. Any reason for taking vitamin B12 every 2 weeks? Kindly check your hemoglobin once as anemia also causes tinnitus. Do you have any ear discharge?. Kindly consult an ENT surgeon and take 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: I am currently being tested for mono. I had already been diagnosed with low platelets but do not know the number for certain. I think 500. My spleen may also be enlarged. I awoke itching so bad all over with a possible small rash all over. Is this possibly another symptom for mono or the enlarged spleen? ### REPLY: Hilo platelet count indicates reduced production of platelets or raised breakdown of platelets. Platelets can also be trapped in greater numbers by a belly organ called the spleen. This can happen when the spleen is bigger than usual, which can occur due to of a number of conditions. Platelets are produced by the bone marrow and travel in the blood for around 7 to 10 days before being destroyed. The medication and other causes above lead to lower bone marrow production of platelets. Other causes affecting production include:Leukemia and other cancers that can replace the bone marrow, so fewer platelets are awesome types of a blood condition called anemiaInfections with viruses, including HIV and hepatitis CSepsisAcute respiratory distress syn .  This condition is usually mild enough not to need treatment and returns to normal in time. If platelet counts are not very low and there are no symptoms, the condition may be left untreated. For platelet counts that are low enough to cause concern, the problem behind it may be treated. The range of possible causes is wide. Treatment could be to stop taking a  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 this tightness in my chest on the left that shoots into my left elbow for like two days now.. it doesnt hurt as much when it started yesterday, but today is a new day and its still there. the pain is wierd like some one squeesing me and sabbing me at the same time, i dont want to make a big deal out of nothing ### REPLY: Hello Chest tightness shooting to left elbow need proper evaluation. It is important to rule out cardiac reasons. It is important to know your age and about illness like hypertension, diabetes mellitus. You need proper clinical examination and routine investigations. Investigations include routine hologram, random blood sugar, lipid profile, liver function test, renal function test, chest X-ray (PA view)ECG in all leads, TMT,ECHO. Further investigations can be done if needed. It is also important to exclude musculoskeletal causes of pain. Proper treatment depend upon findings. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: what is the difference in coating, contents, of Reddy Laboratories Olanzapine 15 mg. pill Blue & Teva Pharmaceutical s Olanzapine 15 mg. blue Pill vs. Brand Zyprexa 15 mg. (?) Blue Reddy Laboratories & Teva Pharmaceutical s Brand Zyprexa 15 mg. ? Also how toxic is it to the Brain to give Halidol Shot with a Prolixin Shot? Will that cause a Brain Fire? ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. There is no difference between the medications that you have stated. They are all the same except for the manufacturer is different. The color won't make any difference. It's not advisable to give Hall shots with that of prolix in as they may increase the chances of patient developing extrapyramidal side effects. It's better to avoid sucChatDoctorbinations and better to wait until the benefits are apparent. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 14, and I hit myself, and harm myself. I have been doing this for about 4, nearly 5 years, and it all started after the death of my mother. When ever I do something wrong, just little things, I feel the need to get back at myself and I do this by punching my forehead , and biting my wrists. I cry hysterically, so much that I can hardly breath. I haven t spoke to my family about it (because they won t believe me, they don t believe anything I say). I don t care for myself at all, I drink, I smoke , I do some drugs, just to get it off my mind, and get as far away for reality as possible.I honestly don t know what to do. ### REPLY: Hi smith, you might be developing a personality disorder especially cluster B personality. It might be possible that you may be having very few friends, and you may not express your feeling to anybody else who is close to you. Its advisable that you have to develop social relations and better to spend time with people of your age with good nature. Concentrate on your studies. Contacting a psychiatrist would help you, you might need some behavioral modification therapy also along with medications ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has fibroadenoma.  She had a mammogram and the doctor says that one of the lumps has developed "roots" that are wrapping around the milk ducts and blood vessels.  Do you have an image that I could see to get an idea of what it looks like?  Also, how extensive will this surgery be?  She had a biopsy.  What are the odds that it can be cancerous? ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  It may be fibroadenoma. Fibroadenoma is the benign lump in breast.  It is firm to hard and movable mass and mostly painless. You should go for biopsy or fine needle aspiration cytology of that lump.  It will give you exact diagnosis.  If is fibroadenoma then there is no need to worry.  It needs lumpectomy which is a minor surgery. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END