Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doc i have problems with my back my spine crooked and it hurts real bad the doctors where i live dont give me the meds i need my back hurts all the time its hard its hard to deal with i just wanted to know if you can write me the prescription i need ### REPLY: Dear patient If you are having back pain for many months it may be due to 1. Disc prolapse 2. Instability 3. Minor fracture.  So you need to be investigated and not to be taken casually. I would advise X-ray of lumbosacral spine anteroposterior and lateral views to rule out bony abnormalities.  Also, MRI of lumbosacral spine is required as it gives detail information about disc and nerves. Both are helpful in confirming diagnosis and planning further treatment.  Meanwhile, start tab diclofenac plus thiocolchicoside combination twice a day for pain relief. Take tab attract one at bedtime. Wear lumbar support. Visit expert spine surgeon with report. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 3 yr old had tonsils and adnoids removed and grommetts in both ears 10 days ago. ears and everthing have recovered ok but we have noticed that when the weather gets colder at night he starts crying from pain. since he had the surgery he has refused all pain meds, ### REPLY: Thanks for your contact to . We should increase her immunity:- give to her diet enriched proteins, iron and vitamin C, fresh juices;- Tulsa juice for boosting immunity 5 ml once a day for 14 days;- she can resolve Lozenges, Stalin 1 tablet 4 times like as candies;- Multivitamins -Zirconia 5 ml once for 1 month;- tea with ginger, lemon,turmeric powder;- apply pastoral ointment by finger around gurgle;- rinse gurgle every day with salty and soda water;- compress witChatDoctorphor on the neck for night. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 using Femilon. After taking pills of 21 complete days, my doc has advised me to start the new pack after waiting of 7 days. in this 7 days, I will get my withdrawl bleeding. I want to know, in these 7 days, does my husband will have to use extra precaution (condom) or can we have unprotected sex?? ### REPLY: Hi, Welcome to . If you are taking the pills consistently and regularly, these last 7 days are safe. Having unprotected sex during this period does not result in pregnancy. So your husband need not use extra precaution during this period. But it is extremely important to start the new pack on the 8th day. If you delay it then you will not be protected during the week which follows. So donor delay in starting the next pack. I hope I have answered to your satisfaction. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi.iam trying to conceive.and i used prolifen cap during my last menstraul cycle.which was on 4 feb2014.i used 1 cap from 5 feb which was my scnd day.now i feel menstural cramps like feelings some sterching, in lower abdomin and weight.i urineate more often now dys.am i pregnant ? ? ?should i go for check up ? ? ? ?is it norml.rep me plz. Soon as soon possible. plz.thnks. ### REPLY: Hi there, I will suggest you the best possible treatment options. As you might be aware that a missing period is the most important sign of pregnancy. If you have history of regular cycles, then I will suggest you to wait for the expected date of the cycle and if you happen to cross your dates then please get mornings first sample of urine tested for pregnancy. In case of any doubt blood beta  test and USG will be of help. 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: Hi, I am wondering if I may have kidney stone/s.  The vague symptoms started 2 days ago.  My first symptom was extreme thirst, which I still have.  I woke yesterday feeling very unwell with chills and vomited later in the day.  I had severe lower back pain which is now concentrated just under my ribs on the right side.  I still feel very sick and the pain is a constant throb which becomes worse when I walk.  I am going to the toilet a lot even though may times I cannot pass any/much urine.  I do not appear to have any blood in my urine. ### REPLY: Helots type of chills and vomiting with severe back may be due to as.1 Urinary tract infection, diagnosis can be confirmed by urine examination in lab.2 Right renal colic may be the nest reason, but symptoms are not an indication of renal stone, because in renal stone pain present with vomiting and blood in urine (usually). Diagnosis can be confirmed by ultrasound of kidneys.3 As you mentioned that there is extreme thirst so all these symptoms may be due to renal failure but least chance due to short duration of history of illness.Anyhow consult a physician and get his consultation as physical examination is important. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 13 month old baby gained a temperature of almost 40c last night in the matter of secounds and was breathing funny, i took her to the hospital and they did a urine test, blood work, ex rays, and a few other tests and all that came back was she had a viral infection in her blood and a little bit of imflamation in the ear, but they couldnt tell me what exactly was wrong, any chance you could tell me? her temperature keeps going up and down and right now its sitting at 37 ### REPLY: Hi, Sudden onset fever without any other associated symptoms is suggestive of viral fever. During peak temperature, it is common to have fast breathing (physiological response). If breathing becomes normal once fever is controlled with paracetamol, we need not worry. If he is active in between fevers and taking feeds, just continue paracetamol and any other .  He will be alright in 2-3 days. Get back to you doctor if fever is not coming down by then, or he becomes lethargic and not feeding. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was cleaning & mixed toilet bowl cleaner and scrubbing bubbles with bleach. the aroma took my breath away. I did a breathing treatment which helped , but still cant take real deep breathes and continue to cough. Any suggestions on what else to try or do? ### REPLY: HI, thanks for using  Inhalation of certain cleaners can affect possibly significantly affect the respiratory system with chest pain, shortness of breath. If the symptoms are severe then it would be best to visit your doctor as soon as possible in case oxygen supplementation is needed. If they are not severe, then this may not be needed, and you can continue to monitor. In addition to monitoring your symptoms and placing yourself in a well ventilated area, there is no other home management unless you are an asthmatic and need to use your inhalers. 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: I have a pain on my left side of my back. I got a sonography done. It should enlarged liver with 14.0cm diameter and small polyps of .7cm adherent to the anterior wall. The report also shows hetergenous pancreas. Is it a matter of concern ? What needs to be avoided ? ### REPLY: Hi and welcome to . Thanks for the query. It OS not ok, but these are still nonspecific symptoms and it isn't indicating any serious disease. Enlarged liver is seen in any liver disorder or some blood hemolysis. You should evaluate it more detailed. Polyp is benign tumor which already can become malignant and requires only frequent follow up. Heterogenous pancreas can be sign of chronic pancreatitis. You need to avoid alcohol, fatty food and eat more vegetables. Wish you good health. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Yes, my daughter injured her finger and it was swollen around the finger nail.  It went down some but now it has swollen again and a little farther back.  Is there anything I can do at home? ### REPLY: Hi ! Good morning. I am  answering your query. If I were your doctor, I would advise your daughter to keep her injured hand elevated to reduce the swelling due to inflammation. I would also advise her for an anti-inflammatory .  With this, both the pain and swelling would get reduced. However, if the swelling and pain increases in intensity, I would refer you to an orthopedic surgeon to rule out a fracture of the bone in the region and for further management. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im in a fairly new relationship w/ a man who tells me that 5 yrs ago he had an accident and fell into a hold and totally destroyed his testicles.  He says he now cannot get an erection.  I accept that this is permanent for him.  what Im wondering is:  does this mean he also has no testosterone production?  And if so, does that mean when he looks at me he isnt even physically attracted to me in the normal male/female way?  He seems to not look at me as regular men do, and has no desire to even touch me.  Does he look at me and want to be able to have sex but just cant or has he lost all sense of what that even feels like if he has no testosterone?  He doesnt even want to sleep in the same bed, so we sleep in different rooms.  Im trying to decide how I want to respond to this.  I love him a lot.  We are older--in our 50s and I realize sex isnt everything, but touching and holding is very important to me.  But, more than this, if he only can look at me as say, Id look at some 8 yr old kid, well, I dont know if I want to be in a relationship like this.   Lots of questions. ### REPLY: Hello, I have gone through your query and here is my advice. As per your history it may be due to strain and stress. For further assessment he may require complete hologram, lipid profile and electrocardiogram, after physician consultation. For that he may require tablet sildenafil 1 hour before the sexual act. Avoid smoking and alcohol. Avoid stress. Hope I have answered your query, let me know if I can assist you further.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr. Henry.first i want to apologize in advance for the questions Im about to ask merely because i see how often you must get asked about problems pertaining to lymph nodes. i really am at a dead end though and feel helpless about it. i want to know whats going on with me :(diagnosed march 2010 though Im sure i got well before that. been on haart (atripla) since April. numbers have been perfect since. high cd4 800-1000 range. and UD viral load. had some issues with my lymph nodes that required biopsy of 2 of them on separate occasions. all benign.  since march 2011 started having intestinal complications, constant constant diarrhea blood in about 6+ bowel movements a week very thick white blobs of mucous in my stool. attached to the stool as well as being passed by its self. mucous was thick compared to the diarrhea. stool sample turned up blood in my stool and confirmed mucous but nothing else no disease or parasites or what not.  ALL OF MY LYMPH NODES literally every single one you could think to feel you can feel. are not only large but 90% of them all are solid. rock hard. not like they used to be... (large but still squishy.) most alarming for me are the ones in my  left groin. though last yr i had the ones on my right groin biopsied. my biggest concern with these are i not only feel the node its self but the entire lymphatic structure in my groin to be enlarged and very solid. i feel the stem system of one leading to the other. and they have only grown larger never do they shrink..ever. i read that most people vary depending on how their body responds to it, but should mine still be responding like this? i know it sounds as though Ive begun obsessing over my lymph nodes but i assure you believe it or not i really dont. for the most part i pay no mind to them at all except for public/social situations they come to mind only because they are quite visible on my neck when having a conversation with me. lately Ive been experiencing a random burning sensation at different times throughout the course of a day which feels like someone placing the head of a match on my skin. tolerable in pain but a very awkward sensation i can only describe as a burning.  could the colon problem and the lymph nodes be related? should my nodes have gone down? should haart have made any difference by now? what could be going on with my butt :( lol ? is this common? should i really go for another biopsy again? am i just one of the unfortunate who will always suffer from enlarged lymph nodes even ones obvious to other people looking at me? my numbers are fine what else can i do to not look sick? sorry for all the questions my infectious disease doctor is awful with answers.  they attempted to do a colonoscopy but my insurance denied the first request, its been resubmitted... what could the mucous be i havent had sex in ages... dont know how i ever could :(please.. give me your answers... i need them. im going nuts. thanks in advance,S- ### REPLY: Thanks for asking at . I read your question and I understand your concern. Enlarged lymph nodes, hard in consistency has two possibilities 1.lymphoma as non Hodgkin lymphoma is common in your case which has very slow growth2. Immunological reaction to ART. It will be differentiated by biopsy. Mucous in stool means infection as in your case cryptosporidiasis is common that May be the culprit. Just check your CD4 count and liaise with your doctor. Take Nitazoxanide 500 mg Two times a Day for three days.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 30 years old my semen test is :quantity: 6.0 mlviscosity : viscouscolour : normalPH :7.8 sperm count :20.2 millions/ml motility :       Active : 25%       sluggish : 30%      Nonmotile: 45%abnormal forms : about 20%pus cells 0-2 / HPFmy wife was pregnant since 7 months but after that she aborted, so dose the test ok, and if not can the sperm change in 7 month? ### REPLY: Hi ... According to your report your sperm motility is less. Active motile sperm 25% which should be at least 50% .that is rapid plus slowly progressive active sperm both....Non-motile sperm should less than 10 their it is 45%. So abnormal... Only active sperm can fertilize ova. In 7 month sperm motility can only be affected if underlying cause present like ... Smoking and alcoholic habit, vitamin and mineral deficiency, excess stress and steroid intake.... Still there are chance you can fertilize ova .... If conception not cured then cause searched and treated accordingly. Antioxidants, coenzyme Q10, L carnitine can give for increase motility... Take spinach, citrus fruits, red peppers and broccoli more. Take care ... If still conception not achieved consult an .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently hurt my knee 5 days ago by diving after a ball in a volleyball game. The knee swole immediately & turned red. It was sore & swollen for about 2 days. The swelling went down & pain went away. However when that happened I noticed a lot of black brusing under the knee down to my ankle is black & blue. Now I feel tension & more soreness in my knee. Please advise. ### REPLY: Hi, your mechanism of injury explained looks like a sports injury. I recommend you to try hot water fermentation and post that lying on your back with the legs elevated over the pillow for 10-15 minutes. During this time try doing ankle toe movements. Post this keep lying on your back and do some straight leg raise and post that some static qua .  I am sure your query for pain and swelling will come down and later in future if you keep doing this exercises will help you avoid sport injuries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 abdominal pain,neaseua,no appetite,sharp pain in my upper back,and lower back,this has been going on for several months,i have talked to my doctor about this with no solution i have also been tothe emergency room wand not getting any answererscan you make a suggestion? ### REPLY: Hi. Thanks for your query. The problem is for several months, this means it needs to be investigated, diagnosed so that a proper treatment can be instituted. I would suggest you the following for the symptoms of pain in abdomen, loss of appetite, back-pain:Investigations of blood: to rule out diabetes and to rule out any other general diseases like Typhoid, Tuberculosis and so on. Urine and stool. Ultrasonography. To start the symptomatic treatment with the following:PPI or reinitiating. Domperidone Intravenous fluids and antibiotics, Upper GI Endoscopy to rule out any gastric ulcer If you require CT scan of the abdomen if USG is suggestive pancreatitis and so on. A proper investigation are normal, we can think of a probable diagnosis and plan a proper treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i have mild fever since last 2 months it is coming like 2 days it is there then relief for next 2 days then again it comes. I had a liver test having my SGOT = 55IU/L and SGPT = 68 IU/L, and i had platelets count = 1.1 lacs.i had fever along with fever. i had IBS also. Please suggest me some advise to control my SGOT and SGPT and platelets count. As i am worried that it may cause of Dengue. ### REPLY: Thanks for choosing . You are advised to go for further investigations like CBC, qbc, urine,RBS, s.bilirubin, dengue egg/IGM to reach the diagnosis. Only low platelet count suggests some viral fever. You can take paracetamol round the clock to subside the fever, cold sponging will be helpful during episodes of fever. Increase liquid intake is the remedy for any viral fever. . Avoid spicy, oily food. Simple high fiber diet is ideal for IBS. Take b12,vitamins, minerals to boost up your immunity. You will get recovery within 7 to 10 days after proper management under guidance of your physician. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 semen test, can you analyze it doc if its normal.. if its abnormal what will i do to make it normal, like motility is 20 only, non progressive is 50 and 30 non motile, PUS is 1-3, RBC is 0-2, Spermatogenic cell is 2-3 and morphology is normal 70 and abnormal is 30. ### REPLY: Hello Thanks for writing to ChatDoctorYou are suffering from semen infection and low sperm motility. Infection is indicated by the presence of pus cells and occasional RBC in semen. Normally there shouldn't be any pus cells in semen. Infection may be due to prostatitis, UTI etc. You need antibiotics for infection. You need few more investigations like routine hologram, Semen culture and sensitivity, RBS,Ultrasound of pelvis should be done. Trans rectal sonography of prostate can be done if needed. Proper antibiotics should be prescribed after culture and sensitivity report. Normal sperm motility should be at least 55%. You should do exercise and take nutritious food. You shouldn't wear tight underpants. Even if low sperm motility persists then you may need assisted fertilization techniques like GUI. Hope I have answered your query. Get well soon. 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 got out of the bath last night and went bed to watch a movie about 1hour later a felt a pain in my groin i felt around and i came across a lump under the skin it hurts to touch bit like a bruse. then  got up this morning its still there and when i walk i can feel discomfart feels like its getting worse wot can it be ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some enlarged lymph node due to reactive hyperplasia, tuberculosis or lymphoma. Or it can be some soft tissue tumor. 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: Hi, I  am 32yrs and need some urgent help to understand my semen report. After confirming that my wife has PCOD, her gynaec also suggested my tests.Please let me know if this is a problem? Is it curable? Will it impact conception as we are eagerly planning a baby? SEMEN ANALYSISMacroscopicVolume:2.0 mlColour: Pearly WhiteReaction / pH: AlkalineViscocity: NormalLiquefaction time: 30 MinutesMicroscopic Sperm Count: 70 Millions/mlMotility *Active: 60%Slugglish: 10%Non motile: 30%MorphologyNormal forms: 80%Abnormal forms: 20%Other FindingsPus Cells: 6-8/HPFRBC: 1-2/HPFImpression: NORMOSPERMIA------SEMEN CULTURE AND SENSITIVITY (VITEK)IDENTIFICATION INFORMATIONSelected Organism: Enterococcus faecalis (Plenty growth)Benzylpenicillin: SENSITIVE (4)Ampicillin: SENSITIVE (Gentamicin: SENSITIVE (SYN-S)Ciprofloxacin: RESISTANT (>=8)Levofloxacin: RESISTANT (>=8)Erythromycin: INTERMEDIATE (4)Nitrofurantoin: SENSITIVE (Tetracycline: RESISTANT (>=16)Tigecycline: SENSITIVE (Vancomycin: SENSITIVE (1)Linezolid: SENSITIVE (2)Quinupristin/Dalfopristin: RESISTANT (8)Please let me know how serious is this problem of mine? Thanks. ### REPLY: Hi, I will suggest you the best possible treatment options. I have gone through your semen analysis report, it shows normal sperms count. But presence of pus cells is a matter of concern. Please seek prescription support from your treating doctor for suitable antibiotics to get rid of the infection. For your wife, I will suggest that she should opt for a healthy diet and regular exercise regimen. Include more portions of fruits, salads and vegetables in daily diet. Start on Folic acid, vitamin B 12 and Omega-3 supplements at least 3 months before you plan to get pregnant. This helps to prevent many problems during pregnancy and delivery. I hope this answer helps you. Let me know if I can assist you further. Thanks, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor,I had a small growth like in my thigh near anal part.  It was first observed in year 2010 and was slightly increasing its size very slowly.  But it was soft in nature.  Now it is about 1.8 cms in diameter. Today suddenly I felt that it became slightly harder as if it is pressure filled.  I have Piles.  But no treatment has been taken till now.  Is it dangerous that tonight itself should I visit the hospital.  Advise please.  I have high blood pressure also normally. ### REPLY: Hi. This looks to be a prolapsed pile which has gone into thrombosis. No need to worry. Take some painkillers. Have site bath in warm water. It is a good idea to visit a hospital to see the blood pressure. If you have a history of high blood pressure you have to take a regular treatment under the care of a Physician so that if the surgery is required you can be for surgery. Also, you will be checked to see the lump and confirm a diagnosis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a housewife, i have taken 1 tablet of mifepristone yesterday and i forget how to take further dose which my doctor told something like after 48 hours take misoprostol 4 tablet. please guide should i take all 4 tablets together after 48 hours of taking 1st tablet of mifepristone. ### REPLY: Hello dear. Understand your concern. You take abortion kit which contain 5 tablets after confirming intrauterine pregnancy by USG scan. It should be used under the advice and observation of gynecologist.1 tab of mifepristone 600 mg which taken orally. After 48 hours, you he to take another 4 tab. Of misprision 200mcg each. Place 4 tablets of misprision in vagina one by one under the observation gynecologist. Do not take as self-medication at home as it cause serious complication like excessive bleeding, incomplete abortion, and abnormal development of pregnancy in case of failure. Follow up at 7th day and USG should be done to confirm the compete process of medical termination of pregnancy. After this take some healthy diet, . Meftalspas for pain etc. This kit is only applicable for 9 week intrauterine pregnancy, so do it under observation of your doctor, its more safe. Hope this will guide you. Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My 6 year old son has small lumps at the back of his bottom teeth. He is on penicillin as we went to the doctor who could see pus on this tonsils and tongue ulcers.  He has had temperatures. On one side the lump has increased in the last day & is very painful. Could this be an abscess or something to do with molars coming through ? Many thanks. ### REPLY: Thanks for your query, I have gone through your query. The lumps and pus discharge could be because of the infected tooth or infected gums causing periapical abscess or periodontal abscess from an erupting tooth. Consult your oral physician and take a radiograph to rule out all these things. You can take metronidazole 400 mg along with penicillin after consulting physician. This is effective in abscess or pus producing infections. Do saline gargling. I hope my answer will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I was using a squeeze bottle to flush my nose and I squeezed to hard which cause air and water to shoot up and cause my ears to pop. Every since then my ear has been feeling like I was on an airplane and my head feels like it is going to explode due to pressure. Four days ago prior to this i was diagnosed with strep throat and also a sinus infection. Please help. I am really nervous about maybe pushing too much air into my head through my nose. ### REPLY: Hello! Thank you for asking on ! I carefully read your question and would explain that your symptoms seem to be related to the sinus infection and an inner ear infection. You should know that there is no direct way to the brain, so do not worry about any air pushed into the brain. The nasal (and throat) cavity is closely related to the sinuses and the inner ear cavities. So an inner ear infection could be related you headache, besides the sinus infection. I recommend consulting with the ENT specialist for a careful physical examination, a sinus X-ray study, a sinus discharge bacterial culture and discuss the proper antibiotic therapy to be started. Hope to have been of help! 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 have a skin lesion near the edge of my ear (near the middle fold). I suspect it is squamous cell and have an appt. with a doctor - but not until June 23rd. This patch of irregular and scaly skin with a bump is actually painful - especially if I lie on the side of the lesion, at other times it intermittently is painful without any contact with a hard surface or pillow. Are skin cancers painful? Thanks so much. ### REPLY: Thanks for your question on . Most of skin cancers are painless. Skin infection is painful. In my opinion you are having skin infection with involvement of supplying lymph nodes by infection. This is known as Scrofuloderma. It is skin infection with enlarged lymph node beneath TH skin lesion. Most commonly seen in TB infection but can be seen in other bacterial infection too. Biopsy of the swelling is the needed to rule out infection and malignancy.  So better to consult ENT surgeon and get done biopsy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 feel a prickly sensation on the left side of my chest. below my armpit and upper left side of chest aches and center of abdominal pains especially when i eat. weird electric like pains on the left side of my arm from forearm to twitching in my left eye at times. Is this an indication of heart problem or just anxiety. i also feel adrenaline in my stomach. ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. In my opinion you are having mostly anxiety related symptoms. But better to rule out cardiac cause first. So get done ECG. If ECG is normal then no need to worry much for cardiac cause. Anxiety must be the cause for your symptoms. Anxiety can cause HERD (gastroesophageal reflux disease).  And your central abdominal pain after eating is mostly due to HERD.  So control of anxiety should be done to relieve all your symptoms. Better to consult psychiatrist and get done counselling sessions, try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Avoid stress and tension, be relaxed and calm. For HERD, Start Proton pump inhibitors and avoid hot and spicy food. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 young, and a high level athlete. I swim and play water polo multiple times a day, yet when I m not working out I find myself getting chest pain. It s been going for about a year and my pediatric ion said it was just part of being a teenager but I m concerned it could be more. ### REPLY: Hello, You are having chronic chest pain. So, it is better to first get done ECG and 2d echo to rule out heart diseases. If both of these are normal, then no need to worry about heart diseases. Sometimes musculoskeletal pain due to an active lifestyle can also cause a similar kind of chronic pain. So avoid all kind of sports for a few days. Apply warm water pad on affected areas of the chest. Take a simple painkiller and anti-inflammatory .  Avoid sudden jerky movements of the chest. You will mostly improve with all these in 1 to 2 weeks. 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: This question is for my mother.  She is 75 and they recently detected high protein in her urine. She does not have diabetes.  Her appointment with a nephrologist is not until January but she is wondering whether it would help to reduce her protein intake in the meantime until they find out the cause.  Thank you. ### REPLY: Hi, thank you for posting your query in . I had gone through your question I understand your concerns. High protein in urine is a sign of kidney disease. Damaged kidneys let proteins leak from the blood into urine. Medications, trauma, toxins, infections, obesity, diabetes, hypertension, above 65 are the risk factors. Treatment of proteinuria depends on identifying and managing its underlying cause. Untreated kidney disease would lead to kidney failure. Hope I have answered your question, if you have further questions I will be happy to help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been feeling nauseus for the past week, but yesterday I was really sick and feverish and my left gland has swollen up. Today is much the same, my body is aching, my head is sore, my glands are swollen, and Im incredibly nauseus. What could it be? ### REPLY: Dear Friend. Welcome to . I am . I have read your query in detail. Furthermore, I understand your concern. You might have developed an acute viral infection supersede by secondary bacterial infection. I would advise you to get examined by a doctor and take appropriate treatment. Till you get a medical help, observe following:1. Tab Paracetamol as on when required basis.2. Warm saline gargles3. Anti-allergic like Levocetrizine once a day. This is my best opinion for you based on available details. If you have any further query please ask me. Stay Healthy. ChatDoctor, MD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Arun, My kid is 7 months old, she is having loose stools for the past 14 to 15 days.  Doctor has advised to give sporolac, but after sporolac, she passes formed stools, but by another 2 to 3 days, same process of loose stool continues.  Is it safe to give Ofloxacin and ornidazole..... ### REPLY: Hi... Thank you for consulting in . It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics like Ofloxacin or Ornidazole. Antibiotics are not indicated unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir my period had started on second jan and ended on eleventh jan than on 15th jan doctor had provided me duphaston for seventeen days I have eaten that medicine my next period started on 29th jan as iam a fibriod patient but its only few drops now doctor has given me folinz for 60 dy want to is there chance of getting pregnant ### REPLY: Hi, I guess your concern is about getting pregnant after spotting of taking Duphastone and in spite of having fibroid. Right my straight forward answer is - YES. THERE are CHANCES OF GETTING PREGNANT. Firstly, I want to tell you that in case of fibroid usually there is excessive or prolong bleeding during menses as you had. For that your treating doctor gave you duphastone for 17 days to regulate the menses, which is usually given. Spotting usually occurs after this medication. Its no big deal. Secondly, let us discuss you fibroid. Fibroid have a role in infertility but its depends on its size, number, its position in uterus. You didn't give information regarding this, so It's difficult for me to comment on this. With above information you can try out my suggestions:1. Try to do coitus during fertile period (its from 10th to 16th day of sense cycle), during this period ovum is rupture and fertilization occurs when sperm meet the ovum. So try to do more coitus during this period.2. Usually spotting occurs after stopping the Duphastone. So KEEP PATIENCE.3. If you are in hurry then visit nearby infertility specialist. He/she can help you. 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: My daughter is 10 her dr head puunomia (sp) yj her left lower lung 3 weeks ago she tooK a 5 day Z pak now she on Ceftin because a week ago the dr said her lungs sound crackly.  My main issue is her cough is no better than it was 3 weeks ago and now when she coughs she has to gasp to breathe and then she devolops a headache.  Should her recovery take so long?  Whooping Cough?  Any ideas.  I am trying to not be neurotic. ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for her as follows:1. As she has cough along with headache, I would first like to know about her nose symptoms, whether she has running nose, nose congestion, mouth breathing, sneezing, etc. If any of above symptoms are present, I usually prescribe my such patients' levocetirizine + montelukast for 7-14 days depending upon response. Regular steam inhalation will also help.2. Whooping cough with pneumonia is unusual presentation. So I would not first suspect whooping cough in her, unless she has been in contact with a patient with whooping cough.3. Viral infections can sometimes be prolonged, may be up to 4-6 weeks. Also, cough takes long time to respond to medications. So I would personally think of viral infection first.4. Regular warm saline gargles will help to soothe throat and hence may help early recovery.5. Please avoid exposure to dusts, smokes and air pollution as much as possible.6. Please have a nutritious diet with adequate warm fluids during days maintain HY . Hope above suggestions will be helpful to your daughter. Should you have any further query, please feel free to ask at . Wish your daughter a quick recovery and 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: i m 34 yrs old ,smokoing from last 14 yrs. from last 1 year i have a persistance pain in my chest (left side),back,left hand and shoulder. i ve got my medical check up by a Dr. in last august ,he has done my chest X-ray,E.C.G and blode pressure etc.but nothing has been findout,he said it must be a muscular pain or something like gas. but, its not setteledown yet. please help me . ### REPLY: Hello, I would explain that considering all your performed tests, there is no reason to worry about.  I would like to know more about your chest pain. Is it triggered by deep breathing or shoulder movements? Is it related to food intake? Coming to this point, I would recommend performing an exercise cardiac stress test in order to exclude a possible cardiac issue. Taking an antacid or PPI (omeprazole, pantoprazole, etc.) would help in case of acid reflux.  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 m a 54 year old male with stage 5 kidney disease and high blood pressure Just had AV fistula surgery last week for hemodialysis . Will I be able to keep my night shift job? How hard is it to get a kidney and what is the waiting period.I m in NC. In your opinion which dialysis do you think is the better option at home or in a clinic?I m having gout a lot and swelling in my right ankle. What is my life span on dialysis and with a kidney transplant? I am scared and been vomiting a little now and then urine output is good, just tired all the time? Dr. said it would take 3 months for the fistula to mature. What symptoms do I need to look for if I need dialysis sooner? What questions do I need to ask my nephrologist my next visit is Oct.17th? When sick how will I know when to go to the emergency room? What is recovery time for a kidney transplant ? What health requirements does a donor need to meet from the health aspect? ### REPLY: Hi, Thank for choosing CHI can understand your problem well, you need not worry every thing will be okay, I here with your answers and questions, you can not do any night shift right now, It is really hard to get the kidney donor for this you will have to see the concern person or department frequently and criteria of this is varies from country to country, you can not do a dialysis at home you need to hospitalize anyhow for this Hemodialysis would be a choice, Even if you have renal problem with right treatment you will get alright, if the urine out put becomes very low it is indication for dialysis, you need not ask any question to your doctor, doctor taking good care of their patients, you just take extra care of your self and enjoy the life Have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It s been 5 days i m getting a pain in my lower abdomen.I ve also had 2 weeks medicine for kidney stones.The pain is severe when i try to poop and pee.The pain comes in very sharp and twisted and then goes away.It pains when i walk,move,laugh and cough and i can t evrn pass out gas.My tummy has grown bigger.The doctor said i ve got bladder infection and i m having antiobiotics.It s been 3 days now but still the pain hasn t gone.Please help me.... ### REPLY: HelloThanks for query. Intermittent severe pain in abdomen is mostly due to presence of impacted stone either in kidney or ureter and needs to be investigated. Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis In the meanwhile take broad spectrum antibiotics like Definite along with urinary antiseptic like Nitrofurantoin twice daily and urine alkalizer thrice daily. Later on switch on to appropriate antibiotics as per culture report. Get the prescription of medicines from your family Physician. Ensure to . To keep your urine dilute This will help to control dysuria. Further treatment will depend upon result of these tests and final diagnosis as regard size of the stone, site of the stone and degree of obstruction it has caused. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I m 16 years old I ve been dipping tobacco for maybe about a month now I ve noticed I have a small painless lump below my ear lobe that is kind of going away now. Also noticed that it s a little harder for me to swallow but not really and it isn t painful. Also today I noticed I have little bumps on the top and bottom of my lips it kind of feels like a rash almost. Today is my first day quitting I haven t put a lip in at all today. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. Your lump in the ear lobe is not related to quitting smoking.  It may be sebaceous cyst. You just need excision biopsy of that lump.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am currently taking the pill levlen and I m having side effects like vomiting diorreah major bloating, red spotting and also head aches.Is it my body adjusting? Because I don t have access to any other type of pill At the moment and it s my first time being on it. Thanks ### REPLY: Hello, Some side effects of Even are the symptoms that you have mentioned like: headache, bloating, diarrhea swelling in your hands, ankles, or feet or weight change may occur. Vaginal bleeding between periods (spotting) or missed/irregular periods may occur, especially during the first few months of use. I think you should take an appointment with your doctor because of the side effects and another reason is that the Even doesn't work properly when you have vomiting or diarrhea, so you have to take something else for birth control. 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: Dear doctor this is for a ckd patient. Our scan report says right kidney size 10 .2 x 3.6 centimetres and left left kidney sizes 8.9 x 3. 3 centimetres both kidneys are normal in size and shape and position no calculus in the kidneys and cortico medullary differenciation poorly decreased. can it be treated? and how? And also says no as cities, no pleural effusion. ### REPLY: Hello, I have gone through your query and understand your concern. In Ultrasound, the cortex (outer portion of the kidney) and medulla (inner portion) can be differentiated due to specific cellular and tissue structures. But due to any long-standing medical conditions which caused chronic kidney disease, can result in tissue changes, with reduced renal function, and this results in appearance of both the cortex and medulla as similar zones and cannot be separately identified. This is called decreased Cortico-medullary differentiation. Treatment in such a condition, would be to treat or control the underlying cause like Hypertension, diabetes etc. For the chronic kidney disease. Take all the medications prescribed by your treating nephrologist, Reduce your sodium intake. Exercise regularly. Do not smoke or use tobacco. Do not . Hope this helps. Please write back for further queries. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am having severe pain onthe very low abdomen, right where the legs begin on both sides. It comes along with a pain on butt (tailbone). It feels like I am going to explode, when going to bathroom, when sneeze, when moves, when walks. Literarelly I have to put my hands over to relieve it a little. Ihad the same kind of pain last year without the pain on the tailbone, went to GYN but he did not find any GYN problems, he said maybe a problem with colon. Is that possible, I am hurting really bad.  Thanks ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You had pain lower abdomen, where the legs meet on both sides, pain on tail bone, increases while going to bathroom, sneezing, moving or walking. Last year you had the same problem.  It appears to be the urinary tract infection, or stone in the ureters, or in the bladder(conceal pain usually suggests this)Other causes are infection of the colon or rectum. Repeating in every summer, means it might be secondary to the less fluid in the body due to sweating.  I advise you to consult a surgeon for diagnosis and treatment. You may need to have M.R.I. besides other routine tests for confirmation.  Wishing for a quick and complete recovery.  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 just changed my birth control this month and am now on microgestin. Halfway through the month I had light bleeding . This week is my period week, and I have been experiencing the normal cramps and pains, however, my period is very light almost like spotting. I took two pregnancy tests and botChatDoctore back negative. Is this normal for microgestin to have this effect? ### REPLY: Hi, I have gone through your query and understood the concern. Whenever there is a changeover of hormone medication, it is natural to experience menstrual disturbances. This is the most likely cause for the mid-cycle bleed you had experienced. Also, you should use additional protection similar to the initial cycle. In the current scenario, you can have a pelvic/trans-vaginal sonogram to know the status of the pelvic organs and also to confirm/exclude pregnancy. If negative, please go ahead with the pill as things usually settle down in a month or two. 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 last monday I broke my jaw and I have stitches in my mouth from the operation, its been over a week now and Ive been washing my mouth with mouthwash which I was given, I went on Tuesday and the doctor said everything was fine. Last night I was suddenly in a lot of pain and this morning have experienced yellow puss liquid coming out near the stitch , what could be the matter? ### REPLY: Hello dear user! I have gone through your query and understood your concerns! Thank you for sharing them on . It seems that your surgical wound has got infected. Yellow puss is indicative for a bacterial infection. Stitches are one of the causes of the infection of wounds. Mouth is an organ which is invaded by too many bacteria in the same time and when its tissues are damaged, the infection is more likely. I would recommend you to go to your healthcare center immediately and see your surgeon because the puss inside must be .  You need a cure with antibiotics after that. I hope this answer was helpful to you! Please kindly rate it and write a short review about your experience with me! Thank you and 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 went the er Sunday due to being thrown into a pipe fence from my horse. They did xrays and a ct scan nothing broke. But I have a huge jiggly lump on my thigh. It is the size of a pineapple and is turning purple around the edges. The skin is numb but it hurts to touch. I have been icing it. When should I see another doctor about it. Not taking any meds. ### REPLY: Hi welcome to . This large sized lump on your thigh could be post-traumatic concussion lead to the formation of hematoma. Its strongly recommended not to have any needle procedures as it can result in profuse bleeding. It's advisable to have an MRI scan if it seems to expand rapidly. Ointment Thromboprobe can be applied daily to resolve the lump. In most cases the lump resolves by itself. In cases if it does not resolve, the risk of being infected is high. In all such cases, it has to be opened and explored under general anesthesia. Aspiration of the blood material will help to improve the condition. Consult your surgeon for further assistance. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I have a patient with me who, according to Chennai Apolo hospital diagonesis suffering from Cancer (throat-early stage), so I took the patient to mumbai to meet Dr. S K Advani of Sushrut hospital. But unfortunetly he is out of mumbai and currently I dont know what to do. Pls help me.Thanks,Shirsendu ### REPLY: Hi, Thanks for writing in. It is good that cancer of throat has been diagnosed at early stage. The chances for cure and post treatment survival are high in that case. If you have been unable to meet your known doctor then it will be best to take the patient to a tertiary cancer center like Tata memorial hospital and get him evaluated in the head and neck cancer services. Surgery is the choice treatment in stage 1 throat cancer. You also have to get detailed investigations like CT scan or MRI scan and if possible PET scan after consulting the concerned doctor. This will help in accurate staging and planning of surgery. The surgery is done with removal of cancer area with a margin of normal tissue. After surgery the patient might also have to be treated with chemotherapy and radiation for a better treatment result. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve recently had a stomach bug (3 days ago). I was throwing up for a period of an hour. I did NOT have diarrhea . The days following the throwing up I was very nauseous, light headed, and weak. I also had a terrible headache . I didn t eat much all weekend but continued to drink plenty of fluids. Last night, I had a weird feeling in my stomach when I touched it. It felt like something poked me on the skin. After looking, nothing was there. While sleeping I felt a pain in the exact spot every time i would bend or twist my torso. Now in the same spot, if I laugh or cough or sneeze (or hold a baby on that side) I have a burning sensation that is slightly painful. Can you explain what is going on?? ### REPLY: Hi ! You have not mentioned the site of pain in your stomach/abdomen. However, the way you have described your symptoms and signs, possibly you have a sub acute attack of appendicitis, where you got nausea with mild fever which caused you a headache. You did not have a diarrhea, which is not favoring a food poisoning. With all probabilities, the sub acute attack has caused the momentum to seal it off with a localized inflammation of peritoneal cavity and an appendix mass formation, which gave you a Ward feeling on touching. This can give rise to pain and tenderness on moving, coughing or sneezing or any work where intro abdominal is altered and the inflamed parietal peritoneum is disturbed. In my opinion, you should take the opinion of a general surgeon by getting clinically examined in person, who may also advise you for some blood and radiological investigations like ultrasound abdomen. If it proves to be appendix mass, then you may have to be admitted in the hospital for IV .  Get yourself seen and investigated by your doctor at the earliest possible. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife was taken allout liquid a little bit of drinking few minutes back and I was given a salt water and she is doing wamting now she is in conses so what I wood give prewantion method and whatever she drinking water and she is look good but please tell me there is any problem in wife ### REPLY: Hello dear, All out mosquito repellant contains prallethrin, a parathyroid compound. Depending on the amount consumed, its ingestion causes sore throat, nausea, vomiting, abdominal pain, headache, dizziness, convulsions, etc. which can be appreciated within minutes to up to 48 hrs of consumption. So, it is advisable to immediately shift her to Emergency for Stomach wash/ Gastric lavage. Once the contents has been removed, further management will be based on the symptoms. Wishing her a 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 have a smal lump near my bellybutton at the right side wich feels hard and round. something it will become bigger and little bit painfull but after pooping it will return to smaller lump and pain will dissapear. Then only sometimes it will tikkle and burn but that s all. Can you tell me what s the matter with me? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have umbilical or para umbilical hernia.  You should go for physical examination and ultrasound study. 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: my boy is 6. 20kg. Suffers from childhood asthma. Now improving. But during weather changes gets periods of fever upto 103 if unchecked. Shivers. And losses appetite. He is again has fever. 102F. No apparent symptoms of anything. No cough, no wheeze, no runny nose. Pl suggest. ### REPLY: Hellos you mentioned that your son is a patient of childhood asthma. Triggering factors of asthma are, hay, pollen, dust, mite, sudden fall & rise of temperature, fins dusting powder, so if possible try to avoid these. Usually the cause of fever in such cases may be due to INFECTION or also due to allergy. When such type of patient visit in my clinic (usually a very common disease)I at once advise my patient to take "montelukast +albuterol" combo pack tablet once or twice in day, till complete relief (very, very effective). Above-mentioned dose is only for adults. Since your son is 6 years, weight is 20 kg so 1/2 tablet will be sufficient once or twice in day. If fever occurs then take levofloxacin 10 mg / kg body weight in a single dose. Once symptoms are in control, stop all medicine, if recurs, start medicine. Once your child will attain the age 15-16 years these attacks will subside. Hot coffee also helps in such cases. Hope this information will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I am 24 years old and for the past three days I have lost my appetite . I don t get hungry or thirsty. When I do eat something because I know I have to I either get nauseous or get a really bad upper gastrointestinal pain that comes and goes as if it were cramping. Aside from that the rest of the day I feel totally normal. ### REPLY: Hi thanks for your question. Nausea and abdomen pain following eating could lead to loss of appetite. Most probably nausea and vomiting could be due gastritis that is inflammation of stomach. I would suggest you to consult a physician who may examine you and may perform upper G I endoscopy on you to establish cause of, nausea, pain abdomen and loss of appetite. You may need antacid and proton pump blocker like pantoprazole for management of your symptoms. Hope this answers your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was diagonised with hepatitise B for the last seven months back, my first doctor has put me on antivairal drugs lemuvudine but later i was advise by the second doctor to stop taking the medicine becouse the vairal load was low and it doesn t qualified me for treatment and later liver biospy was done but i don t have the varius in my liver but since then my liver enzyems keep on elevating especially the alt , alkaline, billrubin, total protein , ggt & at times the mentions ones also reduce though HIV B varial load was done later and it was below 25mm in DNA . What could be the problem am so scared of liver concer and chriosis. Secondly can someone grow up with hepatitise B from child hood up to the age of 60s? if so what is the life span of the person having a chronic HIV B? ### REPLY: If you have elevated liver enzymes and hepatitis B you should probably get treatment, but it also depends on the results of your liver biopsy (if there is active inflammation or not). Also getting treated will prevent your chances of getting liver cancer. If you are coinfected with HIV, then you should definitely control the hepatitis B with medications since the risk of liver cancer is higher if you have both HIV and hepatitis B. Keep in mind that some HIV medications also work against Hepatitis B (such as tenofovir, also known as Arvada) reasons why your doctor may have stopped lamivudine. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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  a heart attack Tuesday at the age of 59 year old female  received one stent in rca   medicines making me  tired  and  hot  is this normal   and  I like to have a few cocktails on the  weekends   is this  okay and how soon  ? I am a active person and do not feel my  age or look it ### REPLY: Hi. Thank you for asking us. My opinion is that you should do a full recovery which is 2-6 weeks. These may be some mild side effects that any medication has the probability to exert. You should take your therapy regularly. As about the alcohol consumption, you are allowed to take the allowed daily dosage, which is up to 30 g ethanol/day (e.g. two beers, a glass of wine). I recommend that you perform a stress test 1, 3 and 6 months after the stent replacement, and an echocardiogram 3-6 months after discharge. Take care. I wish you a good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i had fungal infection last 1 year my doctor started my treatment azithromysin 1 time 3 days fluconazole 150 mg 1 in a week for 4 weeks and a cream banbact aftar complete this course situation was much better but not fully cure then my doctor given me some medicine of tetracycline group but still infection not fully cure. now what should i do my blood sugar level is normal . ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion you should undergo culture, sensitivity and Grams staining from the infection site. This test will tell you about the exact pathogen in it and its sensitivity status. Once you have report exact treatment is possible. Complete treatment can cure your infection. I will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 2yr old daughter has had bad bowels last 3 days, yesterday was dark green and frothy and today was dark burgundy red in colour and loose, quite worried, otherwise she is well though apart from being overly fussy with eating last 2 days? Pls can you advise what this might be? ### REPLY: His ve gone through your query. I can understand your anxiety. Frothy Green stools often results from 1. Green leafy vegetables 2.iron supplements 3. Food coloring 4.Breastfeeding (sensitivity to some mothers diet e.g : cows milk) 5. Bacterial or parasitic Infections. 6. Medications that turn stool green Based on the deny .  Let me know if I can assist you further. Hope for speedy recovery of your baby.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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..its LeAnne..I wrote to you last week about having an issue with my right calf..that when I push on it on the outer side of the calf muscle ..that I get strong pins and needles in the bottom of my foot ...You had suggested this could be Peripheral Neuritis..and suggested I see my doctor but that the condition was not serious...I saw my doctor today and he called it Peripheral Neuropathy ...Is this the same thing that your suggested?? And,,I thought Neuropathy was a serious condition..My blood levels were checked and were all normal...He told me it was from crossing my legs right over left and said the nerve was irritated...but I m a little scared as I have read alot about neuropathy in the past for my job...Can you please clarify any of this for me...I m nervous ...Is this permanent?? He didnt suggest me seeing a neuro or taking any meds..only told me to stretch my calves regularly and to apply some heat and to bulk up my calves a bit...Help ? ### REPLY: Hi, Thank you for posting your query.First, I would like to reassure you that you do not have a serious neurological illness and there is no need to worry. Yes, peripheral neuritis is same as peripheral neuropathy, and this is not going to cause any permanent damage or disability in your case. In your case, the neuropathy is due to mechanical pressure over the nerves in the legs, so, avoiding putting pressure would make your nerve better, and you would recover. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi this is Rajendra. im suffering with psoriasis on the scalp and body. I am using now Propysalic Nf Ointment. please suggest me this ointment will cure my problem or not.Also can i apply this cream on the scalp or not.Im waiting for your reply.. because im facing so much itching. ### REPLY: Hello and welcome to  Psoriasis is a chronic immune mediated disease characterized by scaly erythematous plaques over the extensors like scalp, elbows, knees, lower back etc. Treatment options for plaque psoriasis are:-Topical steroids+salicylic acid ointments-Topical vitamin D analogues(calcitriol, calcitriol)-Topical coal tar+salicylic acid ointmentPropysalic ointment contains clobetasol propionate+salicylic acid and is a good choice for localized plaque psoriasis. While you can use this ointment, twice daily for the psoriasis plaques on your body but for scalp psoriasis, it is preferable to use a lotion formulation because ointment would be messy to be used on the scalp.Besides, you could also use a coal tar + salicylic acid based shampoo for scalp psoriasis. 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 daughter had to put down a horse that her vet told her was infected with rabies. THis means that she has been exposed to the virus. They are supposed to go get a series of shots, i guess, on tuesday. she has an 18 month old daughter, whom i have with me, my question is if my daughter has been exposed, can she give it to my grand baby ### REPLY: Hello want to tell you that your daughter is on risk, as due to post exposure. But your grand baby is not at risk because rabies don't spread through touching, inhalation because saliva, however contains rabies virus, but person can't get rabies until and unless this virus don't ENTER into blood, so you didn't worry about that. I myself came into contact with so many patients having HY . But once thing I want to tell you that take full post exposure course anti rabies vaccination for your daughter. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son of 8YRS 6 MONTHS having asthmatic problem allergic to change in season, dust and cold is contineously coughing now almost 10 hrs. He is taking Montair-LC, Theo Asthaline, Nebulize using duolin , Puff- Budecot, Asthaline . He is having asthma problem when he was 3 years..... Is their any permanent solution to this.. ### REPLY: Hi, I had gone through your query and understand your concern. Asthma is chronic inflammatory disorder of the airway. There is no permanent cure of it. But the good news is that if asthma symptoms are only in relation to viral infection and there is no history of atop, there is a good chance that symptoms will resolve as the child gets older. If a patient follows physicians advice properly and take medicines regularly, there is more chance of having good asthma control even patient may remain symptoms free without medications. It is difficult to confirm the diagnosis of asthma during childhood since there is difficulty in preforming objective test. If I were the treating physician, I would confirm the diagnosis first by objective test and then advise your son to>Avoid triggers (e.g.dust, cold etc.)>Steroid inhaler twice daily>Bronchodilator (albuterol) inhaler as required>Add other medications according to symptoms control status my suggestion is :please consult with a respiratory medicine specialist to perform objective test and confirm the diagnosis. Hope this helps you. Wish your son good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 7 yr old son had a bad toothache, went to Dentist, dx with a cavity and was put on antibiotics. Several days after antibiotics, he was playing and jumping and he fell and his knee came up and  hit him on the same side as the bad tooth (upper) Now it has a pea size lump there. What to do?? Been there about 4-5 days now. He says does not hurt now. ### REPLY: Hello! Thank you for posting here. This can be an abscess formed there. A x-ray must be taken to assess if the tooth can be saved with a root canal. Extraction of the tooth or a root canal may be necessary. I suggest you to see your dentist immediately to prevent any further spread of the infection. Excessive usage of antibiotics is also not recommended. Antibiotics only subside the infection. A complete treatment is necessary to eliminate infection. Also, the age and exfoliation of the concerned tooth must be considered. A clinical and radiological examination is necessary. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been making a horrible whezzing cough it occurs when i tried to talk, pain in my back lower back and now i have just notice i am bleeding but not bad bleed, i am been having stomach pains i havent been able to eat sometimes.. feel nausa sometimes too ### REPLY: Thanks for your question on . I can understand your situation and problem. By your history and description, possibility of bronchitis is more. Your stomach problems are mostly due to HERD. HERD can cause worsening of bronchitis. So we need to treat HERD and bronchitis both simultaneously. For bronchitis, consult pulmonologist and get done clinical examination of respiratory system, PUT (Pulmonary Function Test). You may need inhaled bronchodilators and inhaled corticosteroid. For HERD, start proton pump inhibitors and prokinetic .  Avoid hot and spicy food.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HELLO,MY NEPHEW OF 1, 1/2 YEAR GOT FEVER LAST WEEK,IT WAS 103 F, WE TOOK HIM TO DOCTOR,WHO GAVE MEDICINES,ON THE THIRD DAY OF FEVER HE WAS SLEEPING WE TRIED TO WAKE HIM UP BUT HE IS AGAIN SLEEPING,WE IMMEDIATELY TOOK HIM TO HOSPITAL WE THE DOCTORS CONDUCTED CT SCAN,IT SHOWED SOME SWELLING ON THE BRAIN,AGAIN THEY TOOK FLUID FROM HIS BACK BONE THE RESULT OF WHICH WAS NEGATIVE, THEN THEY CONDUCTED MRI ON HIS BRAIN IT SHOWED LOT OF SWELLINGS ON THE RIGHT SIDE,IMMEDIATELY AFTER MRI HE GOT FITS SINCE THEN HE IS UNCONCIOUS THE DOCTORS PUT HIM ON A VENTILATOR SO THAT HE CAN BREADTH EASILY,THE CAUSE OF DAMAGE TO THE BRAIN IS STILL UNKNOWN,TODAY THEY REMOVED VENTILATOR AT ABOUT 1400 HRS AND KEPT HIM UNDER OBSERVATION WITHOUT VENTILATOR.NOW THE DOCTORS CALLED ME AND INFORMED THAT AGAIN HE GOT FITS AND THEY ARE PUTTING HIM ON VENTILTOR. I AM STILL CONFUSED WHAT HAPPENED TO MY NEPHEW.KINDLY ADVICE. ### REPLY: Hello I have gone through your complaints. I am sorry for your child. Actually your child is having some brain lesions. Brain is the organ which controls all systems. If any lesions are present in brain, it will present to us as fits. While during fits, the child can't breathe, and they will go into respiratory arrest. It is the condition where the child won't breathe for minutes together and if it prolongs, the heart also stops. So while during fits your child needs respiratory support which will be provided by a ventilator. So please follow your doctors advice and doings. Thank you. Good day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey there Im a 29 year old male, healthy and eat well. Ive lost the feeling in my penis and teaticles, the testicles are also very warm when they used to be cold. I find it hard to get erect and hold an erection. Whats going on? Im not sleeping well and am not waking up with an erection anymore. ### REPLY: Degree understand your concerns went through your details. Why do you want to wake up with an erection? You are 29. I hope you are married and is having good sexual life. In any case, the description sheds light on your obsession and anxiety towards your sexual organ and sexual life and associated perceived obsessive compulsive problems. You may consult a psychologist for professional opinion. But no obsessive thinking please. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, This is Saravanakumar from Bangalore. My uncle aged 63 years is suffering from multiple problems like, legs are swealling for the past three months, having thyroid problem as diagnosed early. Last two days he developed breathing problem and his stomach is bulgy and have chest pain around the lungs. Could you please suggest your advice? we are coming to visit the St.Johns hospital tomorrow. Can we get the appointment with the specialist doctor tomorrow? Thank you ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of congestive heart failure (CHF) is more likely in your uncle s case. Swelling in feet, enlargement of abdomen (ascites) and breathing difficulty are characteristic symptoms of CHF. And CHF is common in patients with thyroid disease. So better to consult cardiologist and get done blood pressure monitoring, ECG, 2d echo and coronary angiography. He may need diuretics and other cardiac supportive .  Hope I have solved your query. I will be happy to help you further. Wishing good health to your uncle. 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: Sir, I have checked my semen analysis. It has issue of low motility. Total motitiy is 40%. 8% is rapid linear progrossive and 52% is slow/non linear progreesive and 40% is non progressive. Is it medically possible to concieve with this quality of sperm? and can sperm motility be improved? ### REPLY: Hi, Welcome to . Your sperm motility is slightly below normal according to latest WHO2010 criteria. (Normal motility >40%, Progressive motility should be >32%). In your case progressive motility is 8+52=60% of total motility (or around 24%). If sperm count is above 20-25million/mL, it should compensate for motility & there should good chance for conception provided other factors (wives tubes & ovulation) are normal. Wish you good health. Regards. ### END