Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 little red bumps that itch and are painful to touch in my cleavage. What might that be? What should i do? When i first noticed i was in the shower and i just itched and it started to hurt. I waited two days and it turned into a bunch of little red bumps that hurt. ### REPLY: Hi, It may be shingles also called herpes zoster most probably. It is a viral skin disease caused by VZV virus. Consult the dermatologist for the perfect diagnosis and proper treatment. I would recommend antihistamines, antiviral and steroid tablets in proper doses. And also advise applying silver sulfadiazine cream on the lesions. The disease may take two weeks to two months for the recovery. Take rest for few weeks. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 43 years old ( male ) i am allergic to dust i am doing my best to avoid, i have taken all treatment but no use, once in a 3 months i am suffering from cough and converting into flum and suffering for 15 days,i have no Astma no suger over all no other problem, i have this problem from my birth, i am suffering a lot please give me a solution and lifetime releafe.  Dinesh 0000 ### REPLY: Hello Dinesh, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. I usually prescribe my such patients regular montelukast & levocetirizine for 30 days minimum.2. Furthermore, I would suggest you allergy testing, especially for air-borne allergens like house dust mites, common molds and pollen. This will help you identify the substances you may be allergic to and also to know the measures to avoid them.3. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which gradually improves allergy symptoms by working on immune system. This can be considered as long term solution of allergic rhinitis.4. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution.5. A healthy diet rich in vitamins and minerals will also help you in a long run by improving your immunity. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have consistent fluttering in my right foot. It s on the right side between ankle and baby toe. and it feels like blood rushing but it s not where a major vein is. But it has me concerned because it s been doing it every 5-10 seconds for the last week or more. ### REPLY: Hello, Your symptoms could be related to a pinched nerve or a twisted muscle. For this reason, I recommend consulting with your attending physician for a physical exam. Nerve conduction studies would help investigate for a possible pinched nerve. I would also recommend checking blood electrolytes and uric acid plasma levels. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I have Chronic Myeloid Leukemia and I believe my spleen is enlarged because I am having pain and discomfort on my left side by my ribcage. I also have diarrhea and was wondering if that could be a side effect of an enlarged spleen. Please give me an answer soon. Thanks ### REPLY: Hi, Thanks for writing in. Hope you are feeling better and continuing in your fight against your cancer. The spleen is an organ which is part of the immune system. It is located under the diaphragm on the left side. The pain you describe in the left upper abdomen might be due to an enlarged spleen. You should get an ultrasound scan done to see for the spleen size. The spleen grows from the left upper abdomen to the right lower abdomen and appears like a firm lump or mass. The pain might be due to spleen enlargement if present. However, the diarrhea is unlikely to be due to the spleen. Commonest cause of diarrhea in patients taking treatment for leukemia is common stomach infections. Please consult your doctor and take a short course of antibiotics and eat healthy home cooked food. 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 have polycythemia my hct is usually at 47.2 and higher. i get a copy of my weekly blood tests and my hct or my hgb has never been below norms always on thwe high end..three days ago my hgb was 13.2 and my hct was 32.7i had the symptoms of thick bloodbut as you see test showed otherwise. i also have a non itchy skin rash that shows up on occasion with no pattern but limited to my torso and back the rash resembles welts. i am also experiencing abdominal distress gas bloating nausea (not coming from my stomach it lower except the nausea)can it all be related to my polycythemia ### REPLY: Hello and welcome to , Polycythemia is characterized by high hemoglobin (He) and hematocrit. Itchy violations rashes are one of the manifestation of this disease. Besides itchy rashes, thrombosis and hemorrhage are also seen in polycythemia. Thrombosis can manifest as abdominal pain, chest pain, pain in head, etc. The abdominal symptoms that you have mentioned-nausea, bloating are features of indigestion and reflux. You can take proton pump inhibitors (PPI's) to relive these symptoms. For the management of polycythemia, phlebotomy is the mainstay of treatment. You need to discuss the symptom of itchy rashes with your treating doctor. Further management will be decided by the frequency and severity of the symptoms. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an MRI of my cervical spine done last Friday. Part of the report states that at C4/C5, irregular degenerative ventral disc/osetophyte complex notes asymmetric to the left superimposed uncovertebral disease. Partially effaces the ventral subarachnoid space. The only thing I understand is the part about the bone spurs and that uncovertebral refers to C3-C7 ### REPLY: Hi, In between the vertebra (bones in the back), there are discs.  Degeneration of the vertebra usually implies that there is arthritis of back. Osteophytes occur in arthritis. The spinal subarachnoid space is space in the spine which contains CSF. The imaging suggests that it is mildly affected. You should consider speaking to your neurologist or orthopedic surgeon. 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: Hello I am mukesh. I had a infection in my tooth. I have taken a complete dose of Ampoxin-500mg but it didnt work then I took Augmentin but still I think there is some infection in my tooth. please suggest me what shall I take now.?I am 30 yr old with height 5.8 ft. ### REPLY: Hello! Thank you for posting here. Infection in the tooth can not be completely eliminated with antibiotics. It just subsides to a level. Pain recurs after completing the course of antibiotics if you do not get treatment done. Source of infection is the tooth. So, removal of infection from the tooth must be carried out with a root canal treatment or extraction. A x-ray can help assess if a root canal or extraction can be done in your case. Take Augmenting for a 3 days course and a painkiller to combat pain. Do not take too much of antibiotics as it can lead to stomach upset. See your dentist for an x-ray and treatment immediately to prevent further spread of infection. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a injury on my knee some 12 years  when I fell and I had 12 stitches. The wound healed up fine, but since then I had sore knee over the years. Just few months ago I had this boil kinda lump show up which had pus in it, the wound healed up but then it keeps coming back the lump with the pus in it, it just would not heal. The infection dries up but comes back on the same spot on the old stitch mark ### REPLY: Hi, Dear,Thanks for the query to My  Clinic. I studied your query in details and understood your health concerns.-Treatment and Cause of your lump on knee-a-Mostly it is-a retained/buried- stitch thread-which is causing Chronic Abscess with soreness and pus discharge.b-Other Cause of ? Osteomyelitis of the knee bones below the infected but healed stitched scar wound, needs to be ruled out by Dry KNEE with nearby wound area.c-I would advise-to consult ER Surgeon-who would remove the -buried stitch thread. ER orthopedic surgeon would treat it if there is Dry knee lead to treat Osteomyelitis of knee bones. This advice would help you to plan treatment with your doctor. Hope this resolves your query. Wellcome for further query in this regard. Have a Good Day...!! With Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i am 35 years old married woman and i have 1 son...after i deliver my son i used different contraceptives.iucd for 2.5 years ..pillls for around 3 monthes and injection for 5 monthes(2 month first and next 3 month).but just after 6 months after the last injection my cycle start to come regularly till now for almost one year...my problem is i can not get pregnant till now...i went to a doctor and he gave me clomiphen ...do you think ..this will be the solution ..i want to have my second baby badly. ### REPLY: Hi, You definitely have a good chance to get pregnant, as you are in the correct age group & you already have a child. But don't waste time in small methods as you have reached 35yrs. Your ovulation is normal / regular cycles. But do confirm the patency of the tubes (bridge between uterus & ovary where egg & sperms meet & form baby). Unfortunately you cannot see it on scan. Get HSG (X-ray with dye) or SSG (scan with dye) or Laparoscopy. Hoping husband semen report is normal. Once all these are done you can try Ovulation induction with these tablets like Camphene, better with hormone injection. All the best .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went camping last weekend got bit over 50 times by mosquitos went swimming in the lake did get water in my mouth by sunday I had stomach ache and diareha fatuige and now I have headaches too and yesterday a mouthful of cold sores. and still feel this way today what can it be ### REPLY: HIT hanks for posting your query to  .  There is a high possibility that you have contracted infection (both Throat and stomach) That to a combined throat and stomach infection raises the possibility of Bacterial infection. You require an antibiotic course for treatment. But before starting you need to get Throat Swab culture sensitivity test and stool culture sensitivity test done. Consult your doctor for an antibiotic prescription and revert after the reports.  Any clarifications or Queries feel free to ask.  Happy to help you.  Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? Please type your query here...i have bein suffering pain in my central back region for over a week i was prescribed antibotics as blood showed up in urine sample.pain hasnt eased much and is in my front left side region of my abdominal and around my bowel area. Iwas very constipated and had to take ducolax until the moved. That was last thurs and they havnt moved since but i still have sharp pain radiating up and down my left side down into abdominal area and left back area. What could this be.i am very anxious as i fear bowel problems. I am 42 yr old single mum of three kids my mum died from a preforated bowel and i am anxious if its heriditary i would be very grateful for you advice ### REPLY: Dear madam, your pain in central back has nothing to do with your other problems.in fact, amongst many causes, blood in urine can be because of urinary tract infection which, I know from my daily practice, can cause abdominal pain. Apart from that, constipation can cause your pain in the bowel region of abdomen. As far as bowel perforation concerned this is not at all hereditary. So there is nothing much to worry. Wish you a healthy and happy life. 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: what is the best treatment for chronic kidney stones? Calcium Oxilate stones. (Forgive the spelling) I have had them for over 20 years and nothing but lithotripsy has effectively worked. I am careful with my diet, drink plenty of water, but continue to develop and pass stones on a regular basis. ### REPLY: HelloThanks for query. You are known to get recurrent urinary (Calcium Oxalate) stones since last 20 years. The primary cause of getting recurrent stone is abnormal calcium metabolism and needs to be investigated Please consult qualified Urologist for clinical examination and get following basic tests done to find out the cause of getting stones 1) Urine routine and culture.2) Stone analysis of a stone passed spontaneously 3) Blood test for Serum Calcium and phosphorus 4) Kidney function test. You have to follow regime to prevent recurrence of stone 1) Ensure to . This should help to prevent stone recurrence to some extent. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 an assortment of rashes that come and go for no apparent reason.  One severe rash on my left shin improved after steroid pills and lotions.  The other (different) rashes cleared some with the oral steroid until dose was lowered - so dose was increased-with improvement; then decreased with increase of rash again.  Right now, as this afternoon has begun, the rash on my face is starting again.  Is there no solution to this sort of condition?  My hands are really bad and that has been ongoing for over a year.  I wear latex gloves over slathers of vasoline to keep the palms of my hands from developing deep, painful gashes. ### REPLY: Hi, Welcome and thanks for posting your query to . After reading your query it appears to be due to the closest possibility of "Urticaria". This is a condition caused by bursting of allergy producing cells known as "mast cells". As the chemical inside them is released causes the kind of rash which you mentioned. Kindly follow the suggestions below:-Apply over the counter calamine lotion 3-4 times a day.-You can do cold water compresses to reduce the intensity of itching.-Do not scratch or rub the skin as it can lead to further aggravation.-Kindly stop taking oral steroids as self-medication as it can lead to side effects. So you can take oral anti histamine like loratadine or levocetrizine under medial advise. Despite above measures if the problem is not getting better than it is better to consult a dermatologist for best guidance. Hope these information will help." With good health wishes" .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My father is 59...He recently had body pain, throat infection and complained mild chest pain...we showed to doc and he recommended ECG and then TMT test. TMT test mentioned that Inducible ischemia is positive. what it means? What should be next step? ### REPLY: Hi, Thanks for your question. Inducible ischemia on TMT means - There is insufficient blood supply to heart when there is increased work load on heart. This may be due to narrowing of blood vessels that supply blood to heart (coronary arteries). In such situations during resting state blood flowing through coronary arteries is sufficient to meet metabolic need of heart. But when there is increased work load on heart as during any type of physical or mental exertion, (there is increase in demand of oxygen and blood supply of exercising body to meet this demand heart has to work more) the blood flowing through coronary arteries is not sufficient to maintain metabolic need of heart. In that case there may be development of changes of heart attack in heart. In such situation it is advisable to do CAG (Coronary Angiography) to know- Whether there is blockage in coronary arteries or not. - Degree of blockage if present. - Number of blockage. Depending upon it appropriate treatment can be advised. Hope this helps you, if so do vote as helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My grandson is 4 month old & breast feeding. He had regular bowel movements (like almost everytime he nursed) for the first 3 months. all of a sudden he quits having reg movements and goes as long as 5 days now - same diet - no food - just breast milk. Mother is very careful about what she eats and drinks. he is very fussy and passes gas that is very fowl smelling. He had a bm last night that was very runny and leaked thru his diaper and in the floor and all over mom. Thought he would feel better today but he didn t. Have had him to the Dr. and she says the fowl order is from bacteria. Is this normal? Don t know if we should take him elsewhere or what. We give him gas drops and gripe water and he is on a medication for reflux that he has been taking since he was about a month old. Can t tell you the medicine as I don t have the prescription bottle with me tonight. ### REPLY: Hi, I had gone through your question and understand your concerns It is normal in infancy to pass motions in 5 days, provided it is not hard, baby active accepting feed, passing urine. Foul smell with gas is due to fermentation by bacteria, and as freq is of 5 days, it is more foul smelled. I do not think any reason to concern, Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.  Wishing your baby 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: dear sir/ madam i am suffering with chest pain and cough from last 4hours it happen suddenly one person come too close to me who had the gutka in his mouth and that smell  is gone badly into my lungs through my nose... is this astama or  what .even  i had cigarette smell allergy from my childhood ,now my age is 27. i dont have any smoking habits. please help me out. ### REPLY: Thanks for your question on . I can understand your concern. No, this is not asthma. Your cough is mostly due to irritation in the lungs Fromm that gut smell. Some stringent smell can cause irritation in the airways and this produce cough. Cough will cause chest pain due to sudden spasm of intercostal muscles. So no need to worry about asthma or any serious illness. Inhale fresh air, take antihistamine and painkiller .  Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I get eczema a lot on my face, especially around my lips. When I get it, it s bumpy, inflamed, and weeping but the last time I went to the doctor for this (two years ago) I was prescribed Triamcinolone Acetonide cream (0.1%). I mention this because the cream helps me with my current problem. Now I m having issues with my right ring finger. The skin is red, dry and cracked and will bleed if I don t put the Tri cream on it with a band-aid sealing it off. The cream, when used on my face, usually makes the eczema disappear in two days if I catch it right away and apply it twice a day (in the morning and before I go to bed). I ve used the cream on my finger because I thought it was another type of eczema, but the cream doesn t heal it completely. It heals the damage and makes it so the worst of it is gone and there s no more completely cracked and bleeding skin, but if I stop applying it it becomes dry and cracked again. I used the cream in tandem with Cetaphil (also recommended by my doctor for the eczema) for nearly two weeks, twice a day, and it looked as though it had healed completely, but after a day or two the problem came back with the same intensity as before. Is this eczema? Should I keep trying the Tri cream and Cetaphil? Do I need a higher dosage of the cream (0.5% instead of 0.1%)? ### REPLY: Hi...most likely you have got Hand eczema. You should apply dexamethasone 0.05% ointment on your affected area...twice a day.for around 15 to 20 days.then gradually taper by applying once at night for 10 days...gradually decreasing frequency...until u just apply on weekends or when it flares up....also most important that u keep your skin HY . .you should be careful about using detergents, paints,antiseptic soaps, gardening....as these are important factors in flaring eczema... Take care. 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: occasionally I find pimples on or around my penis , but when I pop them the pus is not like regular pimple pus, but rather pops out as an intact rubbery kind of pus about the size of a sharp pencil point. I cannot find any info on the internet. could you give me an idea what this could be? ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have multiple sebaceous cysts over penile shaft. The penile skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac). .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor please interpret... Thank you so much. ---- Both Kidneys are normal in size, the right measuring about 10.1x4.8x3.8 cm (LxWxAP), and the left measures approximately 10.8x5.1x5.0 (LxWxAP). At least 2 tiny echogenic foci are seen in the right mid and lower pole calyx, each measuring about 0.3cm. The parenchymal echopattern is homogenous. Both pelvocalyceal systems are not dilated. The urinary bladder is distended showing smooth contour. No evident lithiasis seen. The wall is not thickened. The prostate gland measures about 3.6x4.1x3.4cm (LxWxAP) with approximate volume of 26.2 grams. There are calcifications within the parenchyma. ### REPLY: HelloThanks for query1. Your both kidneys are normal.2. 0.3 mm echogenic loci in right mid and lower pole calyx may be sinus fat or small concretions. Don't worry about small concretions if it is not causing pain.3. Both pelvicalyceal systems are not dilated, indicates you don't have HY . 4. Smooth contour of urinary bladder is also healthy condition.5. You didn't mentioned your age. Volume of prostate increases with age.  26.2 grams of prostate can be considered normal assuming you are middle-aged person.6. Calcifications within parenchymal may be due to many reasons. So, you have normal findings. Take Care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doc my peridos arent regular & i want to concieve ,so consulted gyna she prescribed me siphene 100 for three months but no luck.when i stopped siphene my perioda got delayed by 68 days 45 days & 34  days respectively.But for the last three periods its 34 days & this time i didnt got my periods still.My last period was on 11th dec.I dont have any pregnancy symptoms & my pregnancy test also came negative.So what i should do now? ### REPLY: Dear member, Thanks for writing. You clearly have an ovulation where you don't ovulate. In absence of ovulation pregnancy cannot occur. Only sphere cannot correct the problem. You need detailed hormone analysis along with. FSH, LH, PROLACTIN, THYROID. Profile. After a detailed analysis of these reports then the problem can be analyzed. Some women with an ovulation have PCs which will be associated with obesity. Such patients need weight loss. Kindly do write with reports of the above to . Will be glad to help. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my 3 year old persistently says that when he sits for too long his legs hurt. This happens even after sitting on the toilet, or in the car seat for a ride in the car. He says his feet hurt, his legs, and its always tingly inside. I m just wondering if I should be concerned. ### REPLY: Pain threshold varies considerably between different individuals, and you need to first consider if your son has a low threshold for perception of pain and complains earlier than other child .  If you think that his threshold is NOT LOW, but he still has pain on consistent basis, you should try painkillers like paracetamol or ibuprofen. If these are also not useful, you should take him to a pediatrician or/and an orthopedic surgeon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi...I was just wondering what numbers is concern (if any) with blood pressure. I just checked mine ant it s 93 over 70....altough I do have migraine....I m wondering how much closer they can get to each other before I notice something is worng? Thx. ### REPLY: Hi, After going through your medical query I understand your concern and I would like to tell you that migraine has many triggering factors and high/low BP can be one out of all reasons.  Generally BP under 140/90 is normal and 90/60 is low. Your BP stays in lower side for which you should take extra liquids. Take Seldom during migraine. 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, may I answer your health queries right now ?  Please type your query here...I have been having gloating in my upper stomach in the evening with hardness. I can feel my stomach bloating. Is there any reason for concern. I am 51 yrs of age. I also have had more bowel movements. Is it just gas? ### REPLY: Hi. Thanks for your query. Just a gas ! This can not be a lone problem, we have to find and treat the reasons:::The commonest causes of bloating at the age of 51 are as follows:Aerophobia- the commonest reason is anxiety and stress > you have a classical history of bloating developing in the evening with hardness. The pressure in the intestines and a wish to pass it out may be due to the presence of gas itself. Other reasons can be some specific foods and beverages that are gas producing and now-not-so suitable for you. Please find a correlation and stop such foods. Another is - Intestinal infection with gas producing bacteria. I would advise you to have the following:Take a course of an antibiotic, metronidazole, probiotic, activated charcoal tablets and multivitamins;Reduce anxiety or take medicines for it if needed;stop foods causing such problems there is full response, nothing to worry. If no relief:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen, *Colonoscopy All these investigations should be within normal limits for one to say you have IBS. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 5 month old 31.3 week old premee triplets. that was just put on neocate formula due to allergy/intolerance to milk,soy, & grains causing severe reflux, with it being a silent reflux in one of them. I am looking to thicken the formula due to this issue. what can you recommend to use as a thickener. I have been told that either carobel or gaurcol could be used, is this true. I have not been aable to find an ingredient list for either and do not want to give them something that has ingedients that they have an intolerance or allergy to. ### REPLY: Hair I'm . But it will settle once the baby grows and the coordination of swallowing and breathing are maintained properly. As they are 5 completed months and being triplets your breast milk will not be sufficient and it's time to start on reign and rice feeds. You can add this as a thickening agent. Add 1ml of MCT oil to each feed. Way ever you feed them give in easily swallowable form and do feed them in sitting position only. 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 was recently treated for a genital herpes outbreak. It was over a week ago that I finished the medication. Now I am having a yellow discharge and my clitoris is extremely sensitive when I wipe. Is this normal after just having that or can it be another problem? ### REPLY: It could be a secondary problem related to the first problem or that the infection is not completely cleared up yet. I would not call it normal. The herpes sores could have become secondarily infected with bacteria. You could have another sexually transmitted disease-often when you get one you are at high risk for getting another, or they could have been transmitted at the same time. In any case, it would be best to have this evaluated as a different treatment may be needed. 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 been experiencing a stiff neck blocked sinus with lots of nasal drip constant throat clearing and now feels like lump in my throat for about 6months.  Its always on the left hand side..my shoulder feels tight and am feeling very anxious about it..I had antibiotics when it first started and it seemed to clear up but keeps returning sometimes worse than others... ### REPLY: HelloWelcome to , The history and symptoms are suggestive of some viral infection affecting your respiratory system. The constitutional symptoms are maybe a flu like symptoms which will subside by itself. If the symptoms are not improving you may need lab investigations. For the present symptoms I would suggest you to follow1. Steam inhalation with vocals.2. Oral antihistamines.3. Oral antibiotics like Tab Autoclave.4. Oral NSAIDs. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My lower back hurts slightly when i stand and some times when i sit.  When i sit down and stand up i sometimes, but not always feel a bone move in my lower back. It feels/sounds  like a pop. It is not a crack. It does not hurt when it pops in and out when i kick my right leg out, but when i stand and it some time pops it does hurt. It does not happen when i kick my left leg. I have this problem for a few weeks now. I have no problems at all when i lay down to go to sleep. No other part of my body hurts just my lower back. Whats wrong with me? ### REPLY: -dear friend, no need to worry. Your low back pain seems muscular pain. You can take muscle relaxant medicine like combination of diclofenac+paracetamol+chlorzoxazon if only severe pain is there. If low back pain is of long duration physiotherapy and exercise will help you a lot.-exercise for low back pain-raise your leg straight from hip joint without bending from knee after sleeping on back and then put down slowly. Same exercise for another leg and then raise both leg simultaneously. Sleep on abdomen and raise your head and chest backward. Do all these exercise 40-50 times per day by increasing slowly every day.-supplement medicine which help to make strong your muscles and nerves like combination with methylcobalamine should be taken. Hope this answer will be helpful to you. For more queries please don't hesitate to ask. Get well soon dear friend .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I woke up in the middle of the night with this sharp pain in my chest. It is not constant but it comes every 3 or 4 minutes. I tried aleve, tylenol, and even alka selzer and nothing is working. It might be a bubble in my chest but even burping hasnt healed it ### REPLY: Thanks for asking your question completely understand your question chest discomfort, sharp chest pain can be due to cardiac or lung ailment sin my patients I would like to rule out these diseases by a chest X-ray and an ECG and 2 d echo if needed if all these diseases are ruled out I may start my patients on proton pump inhibitors like pantoprazole because these symptoms can also be due to gastritisthanksfeel free to ask more questions may god bless you with 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 2years &11 month old son got and upset stomach slowly thru out the day and has had eggy stinky burps about 5x today and late this afternoon he started to get watery diarrhea and bubbly gassy tummy which causes t to get hard from the gas he ate today normal and he was playing all day just a little irritable and cranky with some episodes of toddler tantrums. but tonight i am worried cause now he has had diarrhea and rotten egg smelling burps he has watery bowl movements and gassy bubble guts and cramping. his last bowl movements are bright green watery with chunks sorry so graphic need to know what to can be causing these symptoms and if i need to seek medical attention,he ate normal all day and drank normal as well, he has drank a lot of milk juice and powerades as well and grape soda he has ate fruit snacks and fruit roll ups too some candy like those something like that he ate fish which is knew to him and tarter sauce and sausage.please answer me anything will help 1st kid and single mom with no parents or family just need to get a lil advice thank you i greatly appreciate it ### 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 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: hello  i have a 2yrs old son and today everytime he ate he would throw it up within 10min of eating and the he goes back to his normal self running laughing and playing now when i put him to bed he is burning up but when i use a rectal temp he is only at 99.5 ### REPLY: Probably your child is suffering from gastreosophial reflux, gastritis, food allergy etc. Give risperidone, sanitizing and ORS solution, and he will improve within 2-3 days.However, if your child develops fever, stiff neck, headache, burning micturition, abdominal distension other warning signs, then you will have to consult doctor. For further queries regarding this disease or its medications you may take my appointment at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had sex with a girl and noticed that she had a reas line between her butt checks, what is that? Is there something weong with her or something? I didn t ask her couse I tought that it probably was something bss or that she probably would be embarrassed. ### REPLY: Hello, Thank you for writing to  about your query, Brief Answer -those red lines most possibly could be stretch marks. Explained answer -No need to worry here, It could be stretch marks only nothing else. It would be allergy reaction caused by sweat from the activities. So, Don't be so worried about it. Still if you want then you may concern skin specialist for more clear instructions. Hope it will enough to getting idea on your question. 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. Around 4 months ago my blood platelet count was only 1000. The doctors never found a solution for this and my platelet count did rise eventually. They didnt find any petechia, but when I was 9 years old I did have some and the doctors thought that maybe I had the same low platelet count then. I did have a slight fever 4 months ago and my tonsils had cuts which bled nonstop and thats why we went to the blood tests to see if I had tonsillitis, but it was negative. Through the blood tests they found out about the low blood platelets. I am still curious about what it might be.I am a 14 going 15 year old girl. ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Tonsillitis does not usually cause low platelet count2. Viral infection causing secondarily ITP is usually the common cause of low platelet count.3. Bone marrow biopsy evaluation will help in confirmation, if ITP is the cause.4. Platelet of 1000 is too severe and will need platelet transfusion to avoid internal bleeding risk. It was possibly ITP or immune thrombocytopenic purpura. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr Samuel - for the last number of years I ve had a number of short (once or twice a year) intense shooting pain in my left arm and left side of my head which lasts about a second. Over the last few months this has increased to a nearly daily occurrence. any ideas? ### REPLY: Hi, thank-you for providing the brief history of you. A thorough clinical examination is advised. As the shooting and shock appearance of the pain is more of a neuropathic and needs an attention. Since the history suggest about the one side limb pain and also the head pain, I will advise you to get a thorough neurological examination done and also an MRI later of either the brain or the cervical region. As post thorough neuromuscular examination and by understanding the MRI reports we can come to a conclusion. Also, we need to know if there is any motor functions compromise or not. As this will be a major area of concern. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I adopted two kittens Friday. The Ragdoll is terrified and has been hiding behind and underneath bookcase. I pulled him out and he has bitten me deeply in several places on my hands. My fault! I rushed the extraction and was quite aware of how sadly frightened he is. I thoroughly washed areas with hot water and antibacterial soap. Cleansed with alcohol, betadine, and applied polysporin. How else do I treat? ### REPLY: HI, thanks for using  It would be best to see a doctor. Bites from cats/kittens can easily become infected requiring antibiotics in some cases. Early treatment would prevent this. Antibiotics are required in some persons even if no infection is seen at the time. These persons are: (a) those who are immunocompromised- diabetes, on steroids treatment or other medication, HIV(b)no spleen present(c)advanced liver disease(d)previous swelling in the area(e)moderate to severe injury especially on hands and face any of these apply to you then antibiotics are needed as soon as possible. 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 am suffering from Bone Tubersulosis. The same was diagonesed 15 days ago I am taking atR-4 but i am having severe back pain and i am having probelm in sitting and sleeping . is this a comman symptom of Bone TB and how many days will it take to get rid of the pain ### REPLY: Hi Welcome to  After going through your query I concluded that you have bone TB. You have started its treatment 15 days back. You are having severe pain and discomfort. It is usual in TB. Generally pain relief is expected in two months after starting treatment. You should avoid sitting. For pain relief you can take analgesic such ibuprofen for pain relief. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then please don't hesitate to write to us. I will be happy to help me. Wishing you 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 noticed a small red spot  on my upper gum directly above the gum line of my tooth. I noticed it about a week ago while flossing . There is no sign of infection,bleeding or any discomfort etc. What might cause this and should I have my dentist check it out ? ### REPLY: Thanks for your query, I have gone through your query. The small red spot on the upper gum can be because of the trauma secondary ti the use of floss or any tooth brush injury, or it can be because of gum infection. Consult an oral physician and get it evaluated. If it is gum infection get your teeth cleaned. If it is secondary to trauma, then you can apply chlorhexidine gel over the red area. If you have pain, then you can use topical anesthetic like lidocaine gel 2%. 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: Should we go to the urgent care now, or see his doctor in the morning?... 16 year old male, fever of 100 on Friday night, fever of 100.7 (managed to play a soccer game that morning in the rain), 101 Saturday night, 101 Sunday all day. I have given him ibuprofen around the clock, the fever is back before the next dose is due. Sunday morning started with a mild cough. Sunday mid morning pain in right chest only when he coughs. Cough is mild and not frequent. Should I wait to see his physician or go to urgent care? ### REPLY: Hello and Welcome to Ask A Doctor service. I have reviewed your query and here is my advice.  Fever and cough can be due to viral infection, while it can also be due to bronchitis. For now, you can take cough suppressant containing Dextromethorphan and along with it, you can take a combination of Levocetrizine and Montelukast.  Take Acetaminophen to reduce fever.  Also, .  If there is no improvement consult an Emergency room and get evaluated.  Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had chronic back pain for almost 2 years and tried dozens of medication, physical therapy and injections? I have been to 2 neurosurgeons and going to another soon and they have said Im too young for surgery. I have 3 bulging discs, and 2 herniated disc plus one that looks like a slipped dics. I have a little par time job that I can not do anything at like lifting or bending. I wondering what this neurosurgeon will say. My primary care dr says I have 2 choices in the matter, live with it or have the surgery. I have tried everything else possible. What should I tell the neurosurgeon or what should I do? Any recommendation or medicines u have used that would help the pain?. ### REPLY: Hi, thanks for writing to . I personally think that young age is not a specific contraindication for surgery. If your symptoms of back pain along with articular pain (shooting pain down the whole leg) are very severe and are not improving with conservative method of management, then surgery is indicated. As all modes of conservative methods have failed to provide pain relief for you, surgical decompression of the disc is indicated. An Endoscopic discectomy or a Microlumbar discectomy will provide promising pain relief with very minimal morbidity. Hope this information is helpful. Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had routine lab work done in nov and my troponin level was 6.1.  A week ago I had lab work again and the level was 9.5.  I have a Thallium stress test scheduled for the end of the week.  Needless to say I am quiet anxious about the test.  I have not had chest pains. ### REPLY: Hello, Brief answer: Troponin level may vary according to acute heart insult also from lab to lab. Sometimes false positive troponin present. Explanation: My opinion is that troponin level is used to diagnose acute coronary syn .  Chest pain and dynamic or ischemic changes in EGC are an indication to measure troponin. So, it is not any time investigation such as CBC. Positive troponin points to myocardial injury, so anti-ischemic measurements should be initiated. Sometimes false positive troponin presents with renal failure for example. Also, variation in lab results may be an error in lab procedures. In your case, having no past history of chest pain makes diagnosis of ischemic heart is far-fetched. I suggest my patients the following if positive troponin. Do an EGC, echocardiogram and if those suggest myocardial ischemia, anti-ischemic measures are initiated on spot. The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about other risk factors to develop ischemic heart disease, smoking, obesity, family history, etc. Also ask about diabetes as in diabetics silent ischemia happens (that means without chest pain). Conclusion: I suggest you do your thallium study as soon as possible to see if any ischemia develops in your heart and so treat accordingly. 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: male, 30 yr old., wt 55kg,ht 160cm...i was diagnosed itp early January...now on steroid treatment..last week my platlet drop to 37000....my problem is,yesterday i got job at pharmaceutical factory.and they need me to do test for penicillin...is penicillin effect for my itp? can i work in factory produce peniccil drug? hope u can help me..tq ### REPLY: Hello and welcome to , ITP is an autoimmune disorder caused by viral infection most commonly.Many cases do not have any definite cause.ITP responds to steroids. Penicillin will not have any effect on the course of ITP, however, it can cause depression of bone marrow and thus reduction in bone marrow. Penicillin is not know to have such an effect, however, idiosyncratic effect or unexpected effects can occur. Get your platelet levels checked regularly. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My implant crown fell out. I have a terrible time brushing my teeth because I am a survivor of sex abuse.  When I put a brush in my mouth I feel intense anxiety.  Psychologists say that most of the time they cant fix this.  Do you have any ideas.? ### REPLY: Thanks for your query, I have gone through your query. There is no need to get anxious or panic about a fallen off crown. Consult a good planetologist and take a radiograph to see the status of the implant. If it is stable and firm, you can get the crown replaced. If the implant is failing, then you have to get the implant replaced. Till then, you can use a temporary crown or denture. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is chantele im 17 and im freaking out, i have trouble breathing sometimes, im not sure what this one is but its either my chest or my heart hurting, i have trouble sleeping because i keep thinking im going to die, i also get really sweaty and shaky when i get scared , is this anything to worry about? will i die? i need answers, im really scared! thank you for your time. ### REPLY: Respected user, HiT hanks for using .come have evaluated your query thoroughly.* This is most probably from psychosomatic manifestation of underlying anxiety disorder.* Suggestions for better outcome - One time consultation with expert Psychiatrist.- Avoid stress, anxiety.- Try to have sound, regular sleep of 8 hrs.- No smoking or alcohol.- Regular walking in fresh air, exercises, deep breathing, YOGA Hope this clears your query. Welcome for further guidance. 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 was looking for some help and advise.. have been going through the unexplained infertility treatment from long. last month was on progynova to increase the thickness of lining. have missed my periods this month of ver 10 days . did check the urine but was negative last week. please advise. regards Sonia YYYY@YYYY ### REPLY: Hi, Treatment of unexplained infertility is super ovulation with GUI. There is no need to take progynova to increase the thickness of lining as this will prevent pregnancy. Also, as long as you are taking progynova, you won't have menses. So it's not surprising that you had delayed menses after taking the medicine. It's better to consult infertility specialist & get proper treatment. Treatment given for super ovulation will increase your estrogen levels & hence endometrial thickness & you won't require progynova for that. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i HAVE HAITUS HERNIA 3CM. I WAS ON LANZAPROZOLE BUT KEPT FEELING SICK AND ILL IN THE STOMACH. G.P HAS CHANGED TO RANTITIDINE 300MG AT NIGHT. I HAVE NO SPLEEN AND COMPROMISED IMMUNE SYSTEM ALSO AS A RESULT OF HAVING HAD MAJOR SURGERY FOR PSEUDO MYXOMA PERITONEI 8 YEARS AGO. I ALSO HAVE OSTEOPOROSIS NOW - I AM FEMALE 64 YEARS WIGHT 7 STONE, 5 1. I AM DOING MY BEST TO EAT ALKALINE DIET AND EAT ONLY NATURAL FOOD ON THE WHOLE EG FISH, VEGETABLES FRUIT, NUTS, BUT CAN EAT VERY VERY LITTLE NOW DUE TO FEELING FULL AND UNCOMFORTABLE EASILY. IAM DULY WORRIED ABOUT THE SIDE EFFECTS LONGTERM TAKING PPI S -I FEEL TRAPPED - WITHOUT THEM - THE BURNING IN MY STOMACH IS RAW - WITH THEM - THERE ARE ALWAYS SIDE EFFECTS TO ALL MEDS. HELP!!! ### REPLY: Hello, Welcome to the . Brief.you may use tab.omeprazole and allover juice in the morning. Detail... Since you have been suffering different problems and might be having different medicines for treatment apart from that you have hiatal hernia. Your cause of indigestion is obvious. As if you can not tolerate lansoprazole then you may change tab.omeprazole 20 mg before breakfast and before dinner. Some home remedies may also be very helpful.1. 60ml if allover juice in the empty stomach is very helpful to maintain the PH. Also, you avoid spicy and fried things and have plenty of water. Hopefully my answer will be helpful. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 2 month old boy(Jacob). I am completely breastfeeding him. After feedings he vomits projectile mostly),sometimes its this thick slimy mucous like vomit. He goes a week or more without a BM(i give him apple juice after a wk). this is every feeding ### REPLY: Thank you for following up.It's common for babies to burp often in the early months as they adjust to feeding and introducing of new food and as their bodies develop. You can tell me when your baby is vomiting after birth or after introducing of apple juice. The sudden onset of vomiting is more likely to be caused by intestinal infection, such as gastroenteritis. This infection is often accompanied by diarrhea.  Constant regurgitation may be due to pyloric stenosis, pylorospasmus, which is a rare condition. Pyloric stenosis is most likely to begin when your baby is a few weeks old, but could show up at any time before he reaches four months.  Best regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having pains in my stomach for the past few weeks..I went for my yearly checkup last week..my Dr.. did a pelvic exam as I have had a total hysterectomy, he said everything looked good...However, the last few days I have had a yellow discharge on the tissue after wiping.. today my stomach has been hurting as well as the lower right side of my back.. I have also had several bowel movements today as well ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You had stomach pain, yellow discharge, since few weeks. Today you had pain on lower right side of stomach, and several motions.  Your previous pain could be different, and depends upon the place of the pain. If in the upper abdomen may be gastric irritation due to peptic ulcer, or irritant foods, gallbladder or pancreas pain.  If in the middle kidney pain or upper ureter pain, due to infection or stone in that part, or due to worms in the intestine.  If in the lower part, may be due to lower ureter, or bladder pain due to infection or stone in that part. Trichomoniasis or bacterial pelvic infection.  Present pain is different and is due to gastroenteritis infection, and needs to be treated immediately, otherwise you may go into deny .  So I advise you to consult a doctor for diagnosis and treatment, and infusions.  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 got pricked by a needle which was on the patients bag, which she was using to close the bag because the actual clip is broken, this patient is hiv positive since 2010, in the event that she has been pricked by the same needle what are my chances of contracting and what should i do? ### REPLY: Hi, I am really sorry to hear about the incident. If she wasn't pricked with that needle, you need not worry and just washing your hand with water and spirit will do. However, If you are sure she is HIV positive and that the had a prick with the same needle, you require URGENT attention immediately. 1.First, keep your hand (puncture site) under running water immediately for full 10 minutes. 2. Apply Spirit locally.3. Visit a doctor immediately as you require a course of anti-retroviral therapy. This should be initiated within an hour. Remember, there's only 0.32 % chance of you getting the HIV if you were pricked with the same needle which pricked her. However, you need to take all the above-mentioned measures without fail. Hope this information helps. Feel free to ask if you have any doubt. Ensure precautions next time when dealing with HIV positive patient. Wishing you the best. With warm 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: Can my dull ache on both sides under my waistline, on the hips above the buttocks be helped? As soon as I sit down, the ache completely disappears until I start to walk a distance or stand, just in and around the house. I get exhausted from the dull ache. ### REPLY: Your pain might be related to the hip arthritis, or back (lumbar spine, disc) problem. Here you have to take x-ray of hip as well if that is normal then also do a MRI of lumbar spine.  One most important thing to watch is do you have numbness or radiating pain from your back to legs if yes then surely its problem with your lumbar spine.  Now after taking report do visit orthopedic as well Physiotherapist for further treatment which can help you to get cure from your problem with few of medication and physiotherapy treatment as well as with few exercises. You can also use hot and cold pack at the area which is symptomatic frequently at home to get some more relief. 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: A little over a year ago i had my gallbladder taken out it was sudden and very painful but since then i have had pain in my right lower quadrant pain, I am an alcoholic and I quit drinking for four months to see if that took care of the pain but it didnt the pain is sensitive to the touch and a dull ache and when i bend a certain way it feels like it is pinching or tearing something. I use Ibuprofen for the pain and tylenol but nothing seems to help. Can you tell me anything about what might be going on? ### REPLY: Hi.noted history of cholecystectomy and occurrence of right lower qua .  It may be a radiating post-operative pain, but other causes such as muscular strain, infection (diverticulitis), obstruction (possibly new lesions), appendicitis, ileitis must also be ruled-out. It is best if you consult with a doctor, preferably a gastroenterologist or a general surgeon, for physical examination and clinical evaluation. Diagnostics (such as ultrasound, ct-scan, blood counts, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly. Hope this helps. Good day!!~ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My boyfriends 18 yr old son seems to have many issues that his father doesnt know how to handle. He is totally disrespectful of his dads wishes and feels that he should be able to live his life his own way with no rules. He smokes pot in his room constantly even though his dad had asked him many times not to. He has his girlfriend sleep over pretty much every day of the week when his dad told him it was only allowed on weekends. There are times when he just totally loses it and screams and swears at his father and blames him for not disciplining him. Then will break down after awhile and start crying and saying that he is just a screw up and nobody loves him. He has at times mentioned suicide and has tried choking himself. I have seen and heard a lot of things in this household in the past 6 months and it infuriates me to witness it. My boyfriend has tried so many times to get through to his son but it just goes in one ear and out the other. He has no respect or regard for anyone but himself and his world seems to revolve around his girlfriend. They spend 80% of their time in his room playing video games and eating everything they can get their hands on. They cook in the middle of the night and then forget to shut off the stove. It has been told to him that this could cause a fire and he just doesnt seem to understand the importance of anything. They constantly hoard dirty dishes and garbage in the bedroom and then when they do decide to bring it out they just leave the mess for us to clean up. My boyfriend has tried taking him to a doctor but the end result was nothing. I know this seems like a lot but Im hoping you might have some answers that might help. Thank you. ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. The possible illness that your boyfriends' son is having is an antisocial personality disorder and this illness requires intensive psychotherapy. Mood stabilizer and antipsychotics may also help in reducing the problem. Behavioral therapy should also be tried intensively. He should be given privileges only when he behaves appropriately with restriction when he doesn't behave appropriately. Be care and seek help soon otherwise he may land up with other forms of strong .  Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, or want to know any further details about your query, you can use the below-mentioned link:bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My four year old son a hour ago started making alot of saliva , this is not normal for him he has not drooled since he was a toddler , I have him laying up now on couch to sleep so I can watch him , could it be a cold? or something worse, he is responsive as he always is, just keeps getting mouth full of spit and its watery not thick at all ### REPLY: Hi...probably he is having difficulty in swallowing and this could be the first sign of a viral or bacterial pharyngitis. Because of pain while swallowing he might not be swallowing the Silva and this shy he might be . I suggest you to wait and watch as he is otherwise active. But if he develops fever or sore throat - then I suggest you get a rapid streptococcal antigen testing done at the pediatricians office and proceed further. 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, We are trying for concieving from the past 7 months but no result. My waife has undergone TSH,VDLR, Blood test, Ultrasound also but results are positive. I also went SEMEN Analysis test and mysperm count is 55million/cc. Plesae advice do we need to go for furthe tests or what medicines we need to take to get my wife concieved. She has a regular periods also.. ### REPLY: Dear member, Thanks for writing. It is good that most of the tests are normal. You have not written complete semen analysis report. There are other factors like morphology and motility of sperms. Please upload your reports and wives reports. I will be able to guide better. If every thing is fine then ovulation induction to induce eggs can be given to your wife. Usually 60-70% couples with all normal tests conceive by 5-6 months of treatment. Please write back with reports. 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: Hello, my boyfriend keeps experinencing stomach pain....he says it feels like hes been kicked in the balls....it can hurt alot for hrs then as quick as it came it goes off again? It seems like he can b moving or sitting and it just comes on. He is 52.....and he was diagnosed 3 months ago with diabeties type 2. He also has high blood pressure . it takes him forever to pee,and he has to sit to urinate,as he says it feels like he may poo when he does. Medications he takes daily are: Morning} Verapamill,, Lisinopril , Asprin, Ranetadin,, Frusomide, Spironolactone , Cardozin xl Evening} verapermil, Simvastatin, Ranetadine, Thank u for ur time and advice. ### REPLY: Hi, Thanks for posting your query. With the available described symptoms, there could be possibility of acute gastroenteritis or chronic pancreatitis. Presence of recently diagnosed diabetes with abdominal pain suggest the diagnosis. As he has increased frequency of defecation, possibility of gastroenteritis should also be kept in mind. You should consult with internal medicine specialist and should go for thorough check up. He should also go for complete blood count, serum amylase and lipase, CT/ MRI scan abdomen and renal function test. He should also go for endoscopy for better clarification. He should take complete antibiotic therapy, antispasmodics and proton pump inhibitors. He should take Tramadol when ever needed. Take care, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my wife has suffered from allergic reactions for the past several years . she  does not consume milk and products since birth . every now and then she suffers symptoms of itching and sometimes swellings allover her body and face,arms and legs , whether there are any allergic tests and whether they are available in pune india. ### REPLY: Hello. Thank you for asking at . I went through your wives history. I would like to know more about her symptoms like - What are her symptoms while she consumes milk? Since what age she started having allergy reactions? What is the frequency of these reactions? Does she have any other medical problem? Does she take any regular/frequent ?  Were I treating her, I would suggest her Specific IGE by Immunogen for milk protein or skin prick testing or preferably both for milk allergy. If it is positive, I would suggest her to restrict milk & milk products for at least 6 months. If it is negative, there are high chances she has milk intolerance rather than milk allergy, which is an entirely different condition.2. Not all hives/swelling of body parts are always due to allergies, especially if they are present for more than several months and no clue can be thought of about precipitating factor. In such cases, I usually advise tests like complete blood counts, ESR, CRP, ANA, tests for liver, kidney & thyroid function, allergy testing, urine & stool examination, etc. Selection from these tests can only be done after reviewing complete history of the patient. I would also suggest her testing for physical urticaria which is performed by allergists/dermatologists. With these tests, usually diagnosis can be made in 60-70% of the cases, but not in all the cases. Hope above answer will be helpful to you. Should you have any other concern, please feel free to ask at . Wish your wife the best of the health. 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: Dear Dr... My SGPT level 109 & SGOT level 70 Since 2 weeks I am taking anti-biotic for UTI, & the test has been made after 1 week of taking such anti-biotic medicine.. As per USG report - thicker inner wall of urinary bladder Still my urine color is yellow, specially on morning... Still I have some UTI symptoms.. Dr. also advised for Hepatitis B test Please Advice xxxxx ### REPLY: Hello! Thanks for putting your query in . I am a Gastroenterologist (DM). I have requested many times to you all that please mention age because much diagnosis depends on the age for e.g. USG report show thickening of urinary bladder wall. If you are young nothing to worry it may be due to UTI bur if you are of elderly age it can be malignancy also. So please always mention your age. Increase in transaminase levels (GOT and SGPT) may be due to antibiotics you are taking for UTI, see again you haven't mentioned which antibiotics you are taking. Consult your doctor for if any such antibiotic that is causing liver damage ask him to change that, and they will normalize in a couple of weeksHowever you still need to investigate for other causes for elevation of transaminase levels like:1. Alcohol if you are taking then please avoid it2. If you are obese or overweight you need to reduce your weight3. Other common and treatable causes like Hepatitis B and C virus, Serum ceruloplasmin for Wilson disease especially if you are young, ANA and SMA for autoimmune disease4. Lipid profile and Ultrasound abdomen to see for liver echotextureFor UTI get your urine culture and take antibiotics which is least hematologic according to the report and take plenty of floods hope I have answered your query and this will help you. Remain in touch and get-well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my baby is 10 months old and is 8.4kgs.she is having temperatures between 38 and 39 degrees.plus diarrhea.six times a day,watery consistency.Can I give her meftal.if yes how much.Thanks ### REPLY: Hi, Metal contains Metonymic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Metal. 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 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: Hello online doctors. I recently diagnosed with Pulmonary Tuberculosis. I had my Chest Xray done with infiltrates right upper lobe. Impression: Pneumonia vs PTB. The doctor advised me to take 10 days Levofloxacin then repeat CXR. Still no changes. I had my GENE Xpert done whicChatDoctore out negative. I don t have any of Tuberculosis symptoms. So what I did is consult a Pulmonologist. After seeing my CXR she immediately diagnosed me with PTB. I told her I don t have any symptoms and I feel healthy. My Gene Xpert is negative. She replied to me saying that Gene Xpert are only 50% accurate. So she took her prescription pad and wrote down TB meds that I should take for 6 months. I am still in a state of denial. Eventhough I am not really convinced, I still started the TB meds for a week now. Is this how doctors diagnosed patient with Tuberculosis? Do I really have TB? Am I misdiagnosed? ### REPLY: Hi, As per the recent WHO guidelines, the diagnostic criteria are multiple levels and beyond complete scope of this online platform, but still, I am narrating salient features herewith to help your case.@ Tuberculosis diagnosis firstly must be confirmed via microscopy such as sputum, gene expert, lymph node biopsy or else when X-ray chest is normal or inconclusive.@ Supportive data of symptoms as weight loss, persistent fever, anorexia, cough are vital co relations to be considered.@ The response to primary treatment of underlying pathology and its regular evaluation on periodic basis is the foundation of giving trial anti-tuberculous treatment. As per my clinical experience, I would say you to take second expert opinion with a pulmonologist. 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: Yes I have a daughter that is 18 years old and has been in the hopital ER twice this week with shortness of breath and  chest pain she has even been admitted to the hospital on the second ER vist. they ran blood work, X- Rays, ecocardio gram, altrasound on veins and pelvic also a MRI and she has been see by a Gastorologist, and a Cardiologist.  Both doctors say they feel that her problems dont have anything to do with them. ### REPLY: Thanks for your question on . I can understand your concern. Since all her reports are normal, no need to worry about major heart or lung related diseases for your daughter. In teenagers, stress and anxiety can also cause similar symptoms. So better to take her to psychiatrist and get done counselling sessions. Try to identify stressor in her life and start working on its solution. She may need anxiolytic .  Don't worry, she will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. 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 have got operated for Varicocele-Lt a 10days back. After surgery i found to have a swelling in my left scrotum. I asked doctor about the same but he said its just a swelling due to previous surgical. Now even after 10 days of surgery the swelling has not reduced. I fear of hydrocele as I went through some websited. Its painless.Kindly help. ### REPLY: HIIT is very common to get swelling of the scrotum after varicocele surgery especially so if done by open surgery. It is likely to improve further given few more weeks. You are right in saying that HY .  So please put your mind to rest. You could wear supporting underwear to prevent the scrotum hanging loosely. Also, please elevate the scrotum at night or while lying down by placing a rolled towel in between the thighs to reduce the swelling. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 tested My semen in Dec 2009 and found 5 Million Counts only (Too Low) and due to various reasons i couldnt under go treatment. But now i consulted the Sidha Doctor for this, Again he asked to take Fertility Profile and Semen Analysis.  And Lab Results were showing Azoospermia. My friend also had this type of problem when he tested his semen in laboratory, Subsequently the Lab in charges asked him to give another sample (interval of 4 days) and tested and found 15 Million Counts. He advised me to have a one more test in this regard.His statement is correct or not, Please Clarify.Also requesting you is there treatment for Azoospermia. If so please let me know.Thanks/Regards ### REPLY: Hi, The sperm count can be falsely low if semen analysis is done within 3-5 days of ejaculation. So repeat after three to five days of sexual abstinence if applicable to you. If again your sperm count lower than serum prolactin, testosterone estimation and Ultrasound testis done for primary workup. The treatment for azzospermia available and done according to the underlying cause. Meanwhile, hey forte like medicine can be prescribed for you.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was wondering if there have been any breakthroughs on treating spasmodic torticollis. The botox injections are only a temporary mask to a disabling condition. I just spent more than 5 minutes typing out a description which has not shown up here. I need a neurologist/specialist in brain/movement disorders. ### REPLY: Kindly meet a physical therapist. Sit down and learn the mechanism involved in tortillas. Your physical therapist will be able to help you get rid of the situation. As you have Googled all things by now, tortillas occurs due to weakness of the other side of the muscle present. Kindly slowly strengthen the other side muscles and relax the spasmodic muscles. Your physical therapist will be of help to you. Be slow be steady as certain times slow-going helps for longer time ### END