Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! I m pregnant. My last period was October 7th 2009. My doc says my due dates July 13th-15th. I had an ultra sound at 14wks an 18wks. They both gave me the same due date of July 13th-15th too.. My cycles are 31 days not average 28. (which is important when determining) I had sex with my husband everyday in October until we split. Then i slept with a friend on October 27th..One time. Based on this info whos most likely my babies father? ### REPLY: Hi, I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options. In a woman with regular cycles day 10 to 20 of the cycle is the most fertile period of cycle.  In your case it falls between 16 and 25 October.  Even if your November periods WE expected on 7 November, ovulation day, will be around 23 October.  I hope this information clears your doubt. Still you can get DNA paternity test, in case of any doubt after the birth of your baby. I hope this answer helps you. Thanks .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor would like to know something about conceiving....can help?I have had a stillbirth last year january. I was 37 weeks pregnant and i was told that my water broke 2 days back but i didnt knew and my baby died then. Well since last november we are trying to get pregnant and until this January i had normal 28 days cycle but after that i didnt get periods for 2 months and my gyneac gave me duphoston to get periods and also my prolactin came high so i was given prolactin medicine too. I have thyroid and i take half eltroxin. Well since last two months i am also taking  ltrozole for irregular ovulation problem which only started from feb.I am 32 years old now and my weight is 74. We are really getting frustrated with all this because now i am ovulating properly and my husbands reports are all good. Could you suggest something. ### REPLY: Howell come to ChatDoctorI really appreciate your concern and let me tell you that looking to your history given here, I would like to say that no need to be frustrated and never give off the hope, just keep trying for conception, pregnancy is natural phenomenon and this does not need any medicines only compatibility is matter like presence of ovum and sperm at the time of ovulation, it's all right, hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i am about a week & a half late on my period. my last period was about a week late as well. we thought it was stress related, right after i took a pregnancy test i started my period. 28 days later i was expecting my period again, nothing. so i took 2 more test, both negative. just starting a few days ago ive been getting light spotting. ive had constant to sever cramping, in my whole stomach not just my uterus. off and on feeling nausous. if my test say negative, where is my period at? or what may be the causes of this? ### REPLY: Hello dear, I understand your concern. In my opinion the irregular periods could be due to various reasons like stress, PCOD, overweight,obesity, hyperprolactinaemia where in there is increased serum prolactin. The normal cycle duration varies between 21-35 days in different women. Anything more than this regularly should be evaluated for the above causes by necessary investigations like ultrasound, thyroid profile, serum prolactin etc. As you have spotting along with cramps the pregnancy is to be ruled out. As the pregnancy test is negative I suggest you to repeat the test after a week. Because usually the pregnancy test gives accurate results a week after missed period. If the pregnancy test is negative the pregnancy is ruled out and the spotting might be due to hormonal imbalance and the above causes should be ruled out. Nothing to worry. All the above said causes are treatable. Adapt healthy lifestyle like exercise daily and healthy nutritional diet. Weight reduction in case of overweight or obese also helps in regularization of cycles. Hope this helps. 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: Hello sir...I have been bitten by my pet dog before a month.the Dog had been vaccinated regularly.but since it but near my chin,I have undergone rabies treatment...... Do I need to follow any meal instructions like not eating meat or anything like that? ....  Out else how long should I not consume meat? ### REPLY: Hello, Welcome to , Diet restrictions was advised during the era of nerve tissue vaccine (NTV) but after banning of NTV way back in 2006 there is no food restriction. The newer antirabies are very effective and they doesn't requires any food restrictions. During the treatment you can have the normal diet what you are having regularly and also there is no restriction of non veg food. Only thing is if you are an alcoholic and smoker you need to avoid them because it may interfere with the production of protective antibody titles to fight against the rabies virus. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I had a few fits over 10 years ago. And been on tegritol (carbapazimen) since. Over the last two years I have gradually weened myself off the tablets. I have been fit free. But am unsure what s best ( I m taking 100mg once or twice a week) is the weekly hit more likely to make me have fits again, rather then coming off them compleatly? ### REPLY: Hello, It is best to leave the decision of changing dose and schedule of medications to the doctor who is treating you. Carabamazepine in the dose that you are taking now is not an appropriate one. If you are seizure free for long, you can visit and convey it to your neurologist who will advise you're regarding the tapering. There does remain a small chance of getting fits again and so you need to be in regular follow up. 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: Good evening, for n few months Ive been feeling tierd and dizzy, my bp is normal, sugar level 4+, but for a week now Im feeling a pulsing inside my stomach, dont think its my heart, its above my bellybutton, and my husband also feel it, can it be linked? ### REPLY: Dear user Pulsations in abdomen near umbilicus is the normal pulsating aorta. In lean and thin persons it is more prominent in pulsation than obese persons in whom it is not felt due to fats. As you say you feel tired and dizzy, it may be due to low hemoglobin level in blood. So you are advised to undergo Full Blood Count test. And start healthy and balanced diet containing iron. And don't touch your belly for feeling the normal pulsating aorta as it will make you more anxious.  Thanx for asking. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 could it mean when small fingertip size moles on the outside 1/2 of 1 breast that appear suddenly? skin or brest cancer come to my mind, asking for a friend who is afraid to go to te doctor. there are more symptoms suddenly on her right breast? ### REPLY: Hi, Thanks for writing in. A fingertip sized mole over the skin needs to be investigated clinically even if it is most likely benign. Please consult your doctor without any fear. Without clinical examination it is not possible to guide you in the right direction. Since the moles are fingertip sized it is likely to be a little amount of increased pigmentation and can happen due to benign causes in most people. It is unlikely to be a breast cancer, and you can relax about it. Even the rare possibility of skin cancer persists only if there is sudden enlargement in the mole, rapid color change in the appearance, growth of hair on it or unexplained lumps anywhere else in the body. Please remember that delaying treatment might lead to complications in the rare possibility of it being a condition that requires immediate treatment. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor my wife age about 34 she is having high bp since from last 8month and she is under medication as per doctor advice with valiant80 vitamine cobadex but its still flacutred high frequintly by 150/120 plz advice me if there is any treatment and her diet thank you. ### REPLY: Hello dear, and thanks for posting your query here. The problem of high BP is mainly idiopathic, that means it is not curable but needs to be treated to keep it under control. But there are certain other causes of high BP which is present are sometimes curable. So your wife needs evaluation to rule out these secondary causes of high BP. I would suggest you to show your wife to a good physician to get her evaluated for secondary hypertension. This needs certain blood and urine investigations and ultrasonography and Doppler. And of course her medicines need to be optimized to get a better control of BP. The target BP is I hope this information would be of help to you. Thanks and 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: Hi, I noticed a small bb sized lump in my neck 4 years ago. I was told by doctor not to worry. This once bb sized lump has within the last 5days become the size of a quarter. It is warm to the touch, and red. It is located on my front lower neck, 2inches left from the center, & about an inch above collar bone. It does not have a head like a cyst may have. Can you advise? ### REPLY: Hi.based from your description, it could be a lymphadenopathy. Benign lesions such as lipoma, fibrous or a cystic formation must also be considered. Also, other tumor lesions (such as of thyroid gland in origin) must also be ruled-out. It is best if you consult with a doctor for physical examination and clinical evaluation. Neck ultrasound and a biopsy may be recommended. Management (medical and/or surgical if indications are found) will be directed accordingly, depending on the results of the evaluation. 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: I went to the dentist on Thursday and had a deep cleaning and they put Novocain and did my deep cleaning on one side first Friday I woke up I didnt feel good my throat hurts my head was hurting and I cant swallow so I went to urgent care today Sunday and they gave me amoxicillin to say Im sorry amoxicillin 875 and they said I think that you think I could infection but I just want to make sure something for me to worry I am taking amoxicillin thanks ### REPLY: Hello, Depending on the amount of inflammation present and your degree of periodontal disease, you may have varying amounts of discomfort after a deep cleaning. Inform your dentist of your symptoms and medication now being taken. It is possible to have a bacteremia after procedures that cause bleeding within the oral cavity. Follow all instructions provided by your dentist for cleaning the recently treated area. Your dentist may put you on a chlorhexidine rinse. Closely monitor your mouth and report any concerns to your dentist in the area recently cleaned. You may be experiencing a coincidental respiratory condition as well. Treat any associated symptoms accordingly. Please remember to take your antibiotic as prescribed and for the correct length of time recommended by your doctor. I hope you will start to feel better soon. You have taken the correct steps to treat your symptoms. Anti-inflammatory medications such as ibuprofen or acetaminophen may also help reduce your symptoms. Thank you for your inquiry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Lump in jawline. And swollen lymph nodes in neck. Sore when swallowing. Swelling in chest are. Chest sore to the touch. Fatigue. Sleep apnea. Poor vision. Blood in stool. Large lump inside anus, left side... Internal. Poor circulation and numbness and toes. Coughing mucas and blood. Showing signs of narcalypsy. Almost felt if I died in my sleep. Hands felt like they were balloons. Irregular heartbeat. ### REPLY: Hello, Welcome to . I understand you concern. You have not mentioned your age and sex. The symptoms you have mentioned are also too many and without any chronology. Still I will try to help you in the best possible way. Your most important problem seems to be lymph nodes in jaw line which are painful while swallowing. You have also mentioned soreness in chest, coughing of blood and mucus and blood in stools. These symptoms are suggestive of some serious illness like cancer of throat, chest or elsewhere in body, Tuberculosis or other infection in chest. Some disorder of immunity can also be there. I advise you to immediately contact ER. They may subject you to investigations like blood count, urine and stool test, CT of head, neck and chest, USG of abdomen to arrive at the diagnoses. I hope this will be helpful. 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 slipped going down stairs and fell on my back and slid down a few steps. I have pain on the right side just below rib cage and pain on my back right on my ribs. I m 38, 5 9 , 145 lbs and no other health issues. I have no trouble breathing, but it hurts when I cough, laugh or twist, bend to the side. There are no bruises, but the area is tender and hurts when I apply pressure. Other than fracturing a rib or two what other damage should I be worried about? ### REPLY: Hieven though you might have suffered # rib or not any injury to the chest is quite painful due to rich nervous innervation, this pain hardly reduces even if you are on pain killers application of local pain relieving gel can be of help. If the pain is not subsiding please go for a chest x-ray, & ultrasound abdomen to rule out for the chest or any soft tissue injury(ultrasound) of the abdomen. You can follow with deep breathing exercises, it really helps in lung expansion & relief of pain all the best take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had two 3- teeth bridges slide off recently; two back teeth that needed to be pulled; and a root canal . All of this happened within 2 months. Something is draining from what looks like under my teeth - usually it s slick and today it s foamy. It has a horrible putrid-sweet-sour taste and I haven t even eaten anything. Could it be some sort of bacteria under my teeth? ### REPLY: HI ROCKY, Thanks for posting your query. The foamy liquid is due to the abscess formed at the periapical area of involved tooth. The pus usually contains bacteria. I would suggest you get the tooth either root canal treated or extracted depending on the condition of tooth. Take complete course of antibiotics too. The sour taste will disappear once the pus . Maintain good oral hygiene. Please get the treatment soon as it can lead into sinus infection if left untreated. 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: Lately my body feels swollen like I am retaining water, more than what I normally do and both my hands fall asleep at night to the point where I cant feel them when I wake up.  What could be causing this?  I take a pill for over active bladder could this be the cause or perhaps it is damaging my kidneys, Ive been on this medication for two years now. ### REPLY: Hi, Nephropathy that is kidney disease has to be ruled out first. For that investigate with serum urea, creatinine, EFR estimation. I also suggest you to investigate with serum protein estimation, serum TSH estimation, SGPT and GOT estimation.  I suggest you to consult physician for examination. Kindly mention you are on which medication. 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 experiencing a mild chest soreness that is substernal and is felt mostly at maximum inspiration/expiration. i first felt this about 1 month ago and although the pain/feeling has subsided , it is still present. my ck/triponins,ekg/cxr were all wnl. i did however start lifting weights again about the time of the chest pain onset... your opinion is greatly appreciated. ### REPLY: Thanks for your question on . I can understand your situation and problem. Since your extensive cardiac work up is normal, no need to worry about cardiac cause. Substernal chest soreness is mostly due to HERD (gastroesophageal reflux disease). It is due to laxity of gastroesophageal sphincter. Because of this, the acid of the stomach tends to come up in the esophagus and cause the symptoms of burning pain or soreness in central chest. So try to follow these steps for better symptomatic relief. 1.  Avoid stress and tension. 2. Avoid hot and spicy food. 3. Avoid large meals, instead take frequent small meals. 4. Start proton pump inhibitors. 5. Go for walk after meals. 6. Keep 2-3 pillows under head in bed to prevent reflux. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mom is taking Glipizide and Metformin.  She is having really painful side effects which make her veins in her legs hurt so much she has trouble walking.  They were not controlling her blood sugar levels either; she got to 500.  I started giving her Humulin N, 15 ml day and night.  This morning she finally got to 147 on her blood sugar reading.  Her doctor has finally started her on Lantus 15 mg one time at night..  My mom wants to stop taking the other medications because of the terrible side effects, will she be able to do this and be able to take the Lantus alone?  She is 71, weighs 185 and is 5 ft tall.  Has high blood pressure and lipidemia. ### REPLY: Hello, Thanks for the query to . Forum. Weight 185 lbs, height 5, age 71 years, diabetic, epidemic, All are sufficient to develops pain in calf muscles(leg cramps). Since, how many days, she is having diabetes, mention it. Blood pressure is high ? Lower or upper (systolic or diastolic). In my opinion oral hypoglycemic with parental hypoglycemic will act together. Consult a Planetologist and get his opinion. Hope I have answered your question. If further any question I will help. Good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My son hit fell at nursery yesterday at 11am. His head hit the floor resulting in a large lump behind his ear with a cut. Today he has just had a nose bleed, not a lot of blood, (about a tablespoon). he is not feeling sick and his head doesnt hurt. what should i do? thanks carrie ### REPLY: Hi Carrie. Thanks for your query. The evidence of a nose bleed and the large lump behind the ear on head-injury must be investigated by MRI of the brain and the CT scan of the mastoids to rule out internal trauma or bleeding unless proved otherwise. Rush to ER, get investigations and clinical check-up done. The lump behind the ear is obviously a hematoma, you can request the doctor to aspirate it, apply a pressure bandage to have an early recovery. Keep the child under observation for any change in behavior, sensorial, ENT bleeding, vomiting, too much sleeping, not taking orally-this is very important as the child .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I broke my tibia 7 weeks ago. The fracture had minimum displacement. My OS placed a patellar cast 2 weeks ago. However, I had a minor scare at a restaurant where I slipped and lost balance and accidently stepped on my broken leg. The doc gave me permission to put 45-50% of my weight on it. But my concern is whether the bone can move after 7 weeks? ### REPLY: Hello, I have studied your case and can assure you that movement can not take place if your limb is in cast. This can only happen if cast is broken or damaged. But yes it can displace after 7 weeks also as some time there is only soft callous, and it can get broke. So I would recommend you to get a check x-ray to see if every thing is alright. I hope this answer will be helpful for you. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi there... i was cutting my self. and then last night at about 2 i sliced pretty deep into the right side of my right ankle... i put a gauze pad on it with some tape and then went to sleep, not thinking much of it. when i woke up this morning and took the bandage off it was still bleeding... i freaked out. i dont know if i need to get stitches or anything. its small probably less than an 1 long and like maybe 1/8 wide. it doesnt seem big but no matter how much i put fresh gauze on with pressure it wont stop... do i need stitches? ### REPLY: Hello and welcome to , continuos bleeding after minor injury can be due to platelet disorder or due to disorder of coagulation factors. Thus, you need to get investigations to assess the structure and function of platelets as well as levels and function of coagulation factor. I suggest you to get platelet counts, peripheral blood examination and coagulation tests-PT and apt. These investigations will determine whether there is platelet disorder or disorder of coagulation factors. You will need to consult a hematologist for further work up. 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: Good Morning Sir I am Gilbert Sumaylo. Can I ask a Question? Its all about my SGPT, I have 101 SGPT and 40 SGOT. I don t drink beverages and liquor or any alcohol, I don t also smoke. But I am really addicted in Soft Drinks like cola, and I also love to eat fatty foods. Can you help me to understand why i got 101-SGPT? Thank you. ### REPLY: HelloIncreased SGPT may indicate liver injury. It may be due to many reasons like hepatitis, alcohol intake, altered lipid profile, medicines,autoimmune causes etc. You may need few more investigations like routine hologram, random blood sugar, lipid profile, urine RE/ME, ultrasound of abdomen. I suggest tablet ursodeoxycholic acid 300 mg twice daily for three months to my patients. It helps in regeneration of liver cells. You should avoid saturated fat and go for brisk walk regularly. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello.. I am 27 years old and my husband is 37 years old, married for 2 years, we are trying to have a baby, which is not happening as both of us have problem.  I have been diagnosed as PCOD and my husband had motility problem, now recently tested his problem was solved to some extent and we were undergoing treatmetn for past 1 year.  Please suggest me for faster conception? ### REPLY: Howell come to ChatDoctorI really appreciate your concern, let me tell you something that pregnancy is natural phenomenon than the physiological one this depends upon certain compatibility like presence of sperm and ovum at the time of coitus, with the perfect hormone balance without this conception may not be possible, no medicine would be helpful may exert the placebo effect, take care and best 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: Could i be pregnant if for 2 days ive been seeing pink discharge and then the next day brown pinkish discharge for 2 day then bleeding alil red pinkish blood ive took 2 pregnancy home test and they say negative but before the discharge changing colors my eating has changed my sleeping has changed and ive been peeing more than normal and also i use to have a weird spasm in my lower tummy? ### REPLY: Hi, How are you doing ? If you have negative urine test (clearly), then there are no chances of pregnancy. But if you are till doubtful, have a Serum Beta  to confirm absence of pregnancy. This can diagnose even the smallest of pregnancy. If negative, this could be just the imbalance of hormones. This may be the premonitory signs of next periods.  Pain is due to the uterus trying to expel the inner lining of uterus. It will go only after the periods. If periods are delayed by more than 14 days, have urine test again for pregnancy & meet a gynecologist, who can put you on hormone pills to cause with .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is 80 years old. He is on several medications for his heart, high blood pressure, etc... Yesterday, he checked with his internist concerning a cough and congestion; sudafed and neti-pot therapy was the RX. Tonight, he seems a bit disoriented....he is shivering and has some blood when he blows his nose. Please advise. ThAnk you. YYYY@YYYY ### REPLY: Hello! Thank you for asking on ! I understand your concern, and would like to explain that to differentiate his nose bleeding and all the other associated complains, it is necessary to closely monitor his blood pressure frequently (several times daily). Cough and nasal congestion are less probably caused by hypertension. A local inflammation, like sinusitis should be excluded first by a careful physical exam and additional tests. An ENT specialist consult is necessary for this purpose. Somme routine lab tests, like complete blood count, PCR, nasal sinuses X-ray study, etc. should be performed for the differential. If the average BP value is abnormally high, then an antihypertensive therapy modulation should be sought. You need to discuss with your doctor (internist or cardiologist). Hope to have been helpful! Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 46 yr old female. History of kidney stones - last one ten yrs ago. Blood in urine and stool. small black particles in urine (2 millimeters?). pain on left side. difficulty urinating. lots of pressure in groin. bloated. dr said white cell count elevated. prescribed antiobiotic and colonoscopy later after feeling better.  What do you think?  should I be concerned about a kidney issue? would cyst on ovary cause any of this.  Had one at checkup in January - decided to monitor but didnt say how?  thank you! ### REPLY: Hithanks for posting in ChatDoctorI have understood your concern reasons for blood in urine and stools are different.1.blood in urine may be because of a. stones induced b.urinary tract infection c.glomerulonephritis2.blood in stool may be because of a.hemorrhoids b.ulcers in the colon c.polyps or any other bleeding mass in the colony can suggest you to get done1.urine routine and culture2. Serum creatinine and electrolytes3.CT KUB4.colonoscopy to check for cause of blood in stools. Hope this helps you any further questions please let me know thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor,i want to ask u that before when i had a wet dream or masterbate,the liquid that used to come ou was sticky ,somewhat like semiliquid,but now it is has very less density,it is almost like water with very little stickyness,please give me suggestion if it is normal or do i have any problem..i wil be very much thankful to you ### REPLY: HelloThanks for query. The watery thin secretion that you pass on masturbation or during night emission is a thin mucus secreted by Bulb urethral glands located in Bulgar part of urethra which gets stimulated triggered by audiovisual and tactile stimulation and secrete excessive secretion of mucus making it thin and watery. This is absolutely normal and does not require any treatment. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: In June 2008, my mom was diagnosed with bile duct cancer, and the whipple surgery was performed.  Things were fine for a few years and in June 2011, they detected a tumor in her lung and since they could not determine if it was a metastasis with 100% certainty, they removed her lung.  We received confirmation afterwards that it was in fact a metastasis.  Then this past november, they detected a spot in her pancreas.  They sent her for a pet scan and it was detected that she also had a spot in her jaw and shoulder (all less than 2cm).  Right now, she is receiving chemotherapy once per week.  In reading, I can see that this would likely be considered Stage 4 (which I know is bad), but I would really like to know what this means in terms of time (i know there is not sure thing, but even an approximate amount of time could help us deal with the situation better). ### REPLY: Welcome to  .  Cancer of bile duct with metastases like what your mother usually has a life span of about 1 to 2 years. But it also depends on the particular type of cancer.  She seems to have a relatively good type because she had lung metastases 3 years back and is still fit enough to have chemo... Let's pray for the best... If you would like to know further please send me pathology reports of previous surgery so that I can help you out... Hope this answered your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 62 yrs old,having sunlight allergy.If I am exposed to sunlight for a few minutes,next in a day or two red patches/hives on my face develop and it remains for couple of days.Slowly comes to normal but during the process peeling of skin takes place.Not much itching is noticed.However skin gets allergic to bright light of sun even on being in shade or inhouse.So far have tried cold compression,moisturiser,sunscreen lotion having 30spf,and on ocasion of high inflamation of face used Lariago Tablet for 7days @Tablet/day.Avoiding direct sunlight between 9am to5pm.Any other medication/measures you advice please? ### REPLY: Avoid oily greedy food take warm water use nontoxic soaps shampoo and ointment and oils no use of mustard coconut walnut groundnut almonds oils use olive for cooking and application advise tab methotrexate 2.5 MGM once a wk which is very effective I have treated large number of patients with this take it for 6 months 4 tablets per month apply histocalamine lotion BD take Allegra 120 mg SOS when itch ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 think I am 7w1day pregnant but just had a scan which gave a CRL measurement of 1.4mm and a yolk sac measurement of 3.7mm (mean). there was a heartbeat which was described as nice and fast. I had a miscarriage last October and it looks like it is happening again... ### REPLY: Hallow Dear, The reports of the scan at this stage do not indicate any risk or impending danger to your baby or pregnancy. The growth of the baby and the heart sounds are well within normal limits. Had you mentioned the events of your previous miscarriage, I would have been better informed about the probable cause of miscarriage. You can continue this discussion further by asking me a Direct question. I do not know why you feel that miscarriage is happening again. Are you having any other symptoms? Please get back to me with more detailed information so that I can guide you further. Till that I hope this information is sufficient to encourage 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: Ive been doing a diet plan called trim healthy mama since July..have u heard of it? Basically it teaches u to eat natural sugar and eat low carb..Ive been strict for the most part but then I have a cheat day and eat something with refined sugar and Im noticing my face with itch, burn and break out badly the next day or sometimes a couple hours after...can u explain this? ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. Generally speaking, allergy to refined sugar is rare. A sugar is a pure carboy . 2. In your case, I would think of an allergic reaction to some additive (preservative/other chemicals) used in the refined sugar that you are using. I would suggest you to change the company/source of refined sugar that you are using and try a small amounts and watch for symptoms. If you don't have symptoms, I would think your reactions were due to additives.3. I would also suggest you to observe your symptoms pattern carefully so that any other food causing such reaction can be thought of and avoided.4. For your symptoms, I would suggest you to take an antihistamine like cetirizine or fexofenadine or HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir I just got a scratch from my dogs nail n it did bleed a little. The problem is his injections were due this march but v couldn t get him as the vet was unavailable here n he is not used to car rides. Do I need to get injections, or pls give me an alternate as I m really scared of injections :( ### REPLY: Hello, Thank you for writing your query to , I would like to inform you that as you described It's nothing serious that shows you have to take injections. As, You described you are having just scratch on your body, So I would like to suggest it's will be fine if you will not take injections.Also, suggestion that please go to doctor once he/she will prescribe medicine for not getting infected. Hope you will find it out helpful. 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: Morning Doctor, i went to undergo pulse treatment earlier today, there are broken tooth in my lower tooth inside my last jaw, after pulling the toothearlier today iwont be able to sleep as the pain hurting on my cheek bone..is there a way that u can help me to solve the pain n make me get back to my sleep. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint pain after tooth extraction is not an abnormal finding and the pain is the reason for disturbed sleep and I suppose your dentist must have definitely prescribed you with antibiotics and painkillers and in case if they are not prescribed or it those medications are not providing you relief you can take strong painkillers like ULTRA [TRAMADOL] or KETOROL-DT for relief. In case if the pain still does not subside you should consult an Emergency room and get an injection of painkiller like Veteran injection for pain relief and by morning consult your dentist and get evaluated for exact cause of the problem that is causing so much of pain. Hope this information helps. If you find the answer helpful please give me a Five-Star Review and click on found the answer helpful as a token of appreciation. Thanks and regards. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell down the stairs about a week and a half ago, I fell on my butt with my butt hitting three to four stairs on the way down quite hard.  I had a big black bruise, but now it is almost gone leaving a hard bump where it was.  What is this and do I need to be seen? ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in full details updated from you. I understood your health concernsBased on your query data, In my opinion, Dear You seem to suffer from Fibrosis Hematoma of the butt, due to the butt trauma from fall from staircase. The big bruise you had was due to the post-traumatic hematoma from fall. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come.hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. . N.M.S. Genl-CVTS -Senior Surgical Consultant ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 7 weeks pregnant. I had heavy bleeding on my 6th week. I went to ER, they check my ChatDoctor level it was 28000 and they cheecked the heartbeat of baby it was also good 136. now I am having lot of viginal discharge after that bleeding, first 4 days it was black and now they are brown spots large in quantity. I am very worried am I miscarring my baby. I don t want to lose it. plz tell me what precautions should i take and what else can i do? ### REPLY: Hello dear, I understand your concern. In my opinion there are many causes for bleeding during pregnancy like :-1)Abnormal pregnancy like miscarriage 2)Hormonal abnormalities like thyroid abnormalities, progesterone insufficiency etc.3)Bleeding from cervix.etc. So all the above causes should be ruled out by ultrasound, thyroid profile and physical examination. But as the Ultrasound is normal you need not worry as any abnormal pregnancy is ruled out. Thyroid abnormalities should be ruled out by thyroid profile. Bleeding from cervix can be diagnosed by physical examination. So I would like you to consult doctor to check for the cause of bleeding. Avoid physical stress and intercourse. Take prenatal and progesterone supplements.Don't worry. Hope this helps. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi!i have ma uterus removed 18 years back!i am 58 years old n hypertension patient. i experience high systolic pressure!!i am really worried about it i am taking regular mediciens with it and anti depressants too. i want to ask is this because of thyroid problem? ### REPLY: Thanks for your question on . I can understand your concern. Yes, thyroid related diseases especially hyperthyroidism can cause uncontrolled hypertension. So get done thyroid function test (T3,T4,and TSH). Other causes for uncontrolled hypertension are hormonal imbalance after menopause. So get done female hormone levels (FSH, LH, Estrogen, Progesterone) etc. Sometimes age related atherosclerosis can also cause high BP. So in that situation, you need to take centrally acting antihypertensive .  Discuss all these with your doctor and plan accordingly. 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: hello. i had my x-ray and this is the result.A small calcified nodule is noted at the left lower lung zone with normal sorrounding lung parenchyma.  Clear rest of both lung and both costophrenic angles.  Mild bilateral congestion associated with increased bronchovascular marking.  The cardiac shadow appears normal.  Both copula of the diagphrag are regular and well defined.i am 30 years old, 4.11 ft tall, 45 kilograms.  i dont remember any serious illness in the lungs except for coughs  in the past.  i am now in middle east country.  when i arrived here, its very hot and inside the house and office very cold because of aircon.  so, as a result i sometimes i spit clear phlegm.  in middle east country very strict with medical exam with regards to TB.  i am very confused. am i going to fail the x-ray.. please answer asap.. thanks very much...  please advise me on what to do.. ### REPLY: Thanks for your question on . I can understand your concern. Calcification in lungs on chest x-ray is always suggestive of old, healed scarred lesions. You might be having previous tuberculosis or pneumonia or any lung injury which heals by calcification. This might interfere with your medical clearance. So better to consult pulmonologist and get done CT thorax and bronchoscopy with BAD (bronchoalveolar lavage) analysis. If both of them are negative then no need to worry about active infectious disease, and you will clear your medical fitness. 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: Hello yesterday morning when I got up I had a little pain in my stomach kinda like I was hungry I ate a german waffle and I still kinda felt bad, so i ate another one and then took a shower the whole day it wasn t a bad pain til about night time when I had ate a Bean Burrito and some chips my stomach was hurting very bad. I figured I had a stomach ache and it just hurts badly because I havent been sick in a looong time the whole night I was using the restroom and felt like i was going to throw up, I finally got some sleep that night after a couple hours of pain When i got up I felt normal for some time I ate a Peice of Vegetarian pizza 2 of them and well my stomach started hurting up until know Im treating my stomach as if i have a stomach ache eating non acidic foods and elevating my feet i feel a little bit better but im not sure if i have a serious problem or not I just want the pains to go away and i keep trying to get my mom to take me to a doctor because Im unsure of my issue. Right know the bottom of my belly hurts like by my belly button. and all today i had pains on my left side of my stomach. I don t believe i have any bugs as i lived at a vegan for some time but i decided to go vegetarian for the nutrients because im still growing and i think that might be my problem. Please help i don t know what my problem is it would really ease my mind if its minor and will be gone in a week or less. ### REPLY: Hi welcome to  forum.  Thanks for choosing . F.  Your stomach pain started as a hungry first, then it descended to the belly button, then to the left side of your stomach, as i understood it is the upper left side of abdomen.  All this suggests the gastric irritation due to spicy food, or peptic ulcer, or may be the worms in the intestines.  I advise you to consult a surgeon for diagnosis and treatment. You may need to have gastrostomy besides other routine tests for confirmation. in the meanwhile you can use bland diet with bread, milk, curd, etc. to avoid gastric irritation.  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: hi,am on internship,and after two years,my wife could not take in;i have finally gone ahead to the lab where she went through ovarian cyst test;she was free from complications.Lastly i have tested her for tube blockage[hsg]hence the pronouncement of impression of an uterine synaechia,and,or,bilateral perifimbrial blockage.Please advice. ### REPLY: Hi, I think you should go for a hysterolaparoscopy for your wife. It will confirm if the blockage is there or not. Also, if possible, cannulation can be done If block is proximal. Regarding uterine synechiae, it can be treated surgically by hysteroscopy and then by medicines. Discuss with your doctor regarding this. After that you can go for GUI if tubes become patent. If not, the only option is IVF.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor, im 26 years old and planning to have a baby. I had a PCOS and i dont have menstruation for 3 mos. (last menstruation is on January 19, 2013) so my doctor advice me to take duphaston for 10 days and on the 10th day my menstruation came on May 19, 2013. Then, he advised to take ovamit on 2nd day of my menstrual flow. My question is, when will be my fertility period or any possible fertility period? i had also an inverted uterus, is this a problem also in conceiving? I really wanna know, since my husband is a seaman and will be leaving aboard on July 2013. We are making the best that we can on the remaining time.  Thank you very much. God bless ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You are 26 years old and planing to have a baby. You had SOS, and you didn't have period for 3 months. Your doctor advised you to take unfasten for 10 days, and you had period, on 10 day on 19th may. Then I was advised to take omit, on the 2nd day of the flow, when it will be your fertility period, you ALO have an inverted uterus. Your husband is a seaman, and so concise planing is required.  Usually the ovulation day is from the 11th day of the period to the 20th day. So you are expected to have sex in between.  Try to have sex with male above position, and stay for at least 15 minutes after sex.  You can have your ovulation detected by a vaginal thermometer, it is 1 degree more than the temperature of other days.  I hope you understood my reply.  Wishing for the best result. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 prescribed with Ovaral L - 21 days from the 5 day of my periods,Decden 0.5mg -half tablet,Glygomet 500 mg -3 times a day it is possible to get pregnant by taking these tablets ,I know i am taking these tablets to control my harmone level.Doctor said there are some harmone difference so they gave these tablets.Please guide am i going in right way for infertility treatment ### REPLY: Hello, The tablet oral l is given for regularization of periods, as you said for some hormonal imbalance correction. While on this tablet, you can not conceive. This tablet is given to regularize your periods, as you must be having irregular periods associated with hormonal problem that is polycystic ovaries. You need to take the oral l and glycogen for about 3 - 6 months. But, if you are keen on conceiving, you should consult a fertility specialist and get yourself and husband evaluated. You will need medication for ovulation induction and follicular study to monitor growth of follicles. Also, if you are overweight, try to reduce weight by diet and exercise. Hope this information is helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am Shobana Mohan married for 4 years and trying to conceive now.I had a Chocolate cysts and has been removed through laproscopy surgery and found there is a tubal blockage on right hand side.Doctor told blockage cant be removed since is is affected by PID.Still is there any chances of getting pregnant naturally? ### REPLY: Hi, As you told that block is only on right side, I think it is possible for you to get pregnant because there are two tubes. But you will need some medical support for that. First you will need some tests like AMH and an ultrasound to see for your follicles. Then you can go for ovulation induction in which medicines will be given for growth of your eggs. 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: Ive been diagnosed with nerve damage and also ive blacked out a couple of time which doctors suggested seizers , and out me on medication ive been on the medication for about 6 weeks now, but ive been feeling very tired sick nit eating not sleeping but ive got this horrible intense itching deep in my body like its coming from my bones it is really a horrible and strange feeling could anyone help ? Thanks ### REPLY: Hello, You may be suffering from allergic reactions to the medications.  If there is a body rash that has erupted in the neck, trunk, or torso-even if resolved or resolving the internal itching sensation is still a sign of your potential allergy situation.  I recommend you speak with the doctor who placed you on the medication and see if there is an alternative to take. There are many nowadays that could be substituted to still give you protection from seizures and not cause the side effects.  The other effects of loss of appetite and trouble sleeping are also likely due to medication effects. 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: Dear Sir/Madam,I have been detected fatty liver problem since two years. Please find latest report for LFT AST (SGOT) 63ALT(SGPT) 136GGTP  99I am a banker and do not involve exercise in daily routine, I drink alchohol twice a week and Doctor suggested me to have ursocol 300 and Evion 400.Kindly advise to get rid of the problem as i observe mild pain on right side of stomach frequently ### REPLY: Hi and welcome to . The most common liver disorder is fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar. So you should treat these things first. You should treat it by changing dietary and lifestyle habits. Do exercise if overweight, avoid alcohol, smoking, fats, fast food and carbonated .  Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be prescribed, but I suggest going step by step. 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: Hi doctor I am a male around 26 years old from india. I didnot find any girl in my life and consequently indulge my self in masturbation. I have started masturbating for around last 10 years and that 3 to five times in a day and almost daily. Now I even discharge my semen in 20 second to 1 minutes. I want to quit the masturbation but do not know how, because it has become an addiction for me which is effecting my career and my life. Please suggest me how to quit. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  Masturbation is not a sin, unnatural or unhealthy. But anxiety about masturbation is unhealthy. If you masturbate 4 or 5 times a day, what is your career or occupation? Where do you get time and energy to masturbate this many times? That is the answer. Forget about masturbation and engage yourself in your career. Once you gain passion in your work, automatically your masturbation will stop. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am looking for the forum to get help for my husband, rather, for me. My husband is taking his monthly medicine within a 2 wk period. He is in pain, I realize. However, I do have similar issues and only take when needed as says on my script. We see the same doctor. Should I alert the doctor? My husband is angry, and frequently down right mean, to but it bluntly. I am to blame for whatever it is. At present, he is determined to not make payments and wants me out of his life because he stays mad at the world. So much. Just dont know where to start. I just know he needs HELP! ### REPLY: Hello, I can understand that you are quite distressed regarding your husbands problems. Firstly, it may be dangerous for him to take an overdose of hos medication. So, it would be advisable to alert his doctor. Secondly, regarding the relationship problems that you both are having, I would advise you both to see a counselor or a psychiatrist for professional help. This will also give a chance for your husband to have a detailed evaluation and further help for his anger issues. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband is in the hospital with a collapsed lung secondary to stage IV non small cell squamous carcinoma.  The doctors told us he also had a "mild" heart attack during the lung episode.  It showed up in blood work.  What would that be and what is the number I should be concerned about.  Thank you! ### REPLY: Hi, Thanks for writing in. A patient having a cancer can also have a heart problem and the two being unrelated if that was there from before or can be a recent development after the cancer. The heart is a biological pump and helps in pumping blood to other parts of the body. It might happen that he previously had a coronary heart disease which led to decreased blood supply to the heart and when he had a collapsed lung, this problem aggravated, and he suffered a mild heart attack. The heart gets weaker with age and since your husband is having cancer and has been getting chemotherapy, some medications can also cause side effects on the heart. You should discuss his echocardiography findings and cardiac enzyme test report with the treating doctor. 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 been noticing alot in my life lately i have alot going on right now but i always did have anxiety issues especially when i know i have something important coming up. also i find myself in a different mood everyday ive been irritable and just recently lost friends cause i say things that are mean for whatever reason and i have been very forgetful lately and tired alot but have trouble getting to sleep at night and i have a hard time letting go of relationships that are over and moving on im almost always talking about the same things over and over again and i have no money to go to a doctor i was on medicine for a while when i was little for depression and anxiety and things but everyone keeps telling me its nothing just me being stressed out but im not sure anymore. ### REPLY: Hello..... Thanks for your query. I can understand the concern with your symptoms. Most of the symptoms you report of point towards an underlying depressive disorder with an overlay of anxiety symptoms. I would suggest you undergo a thorough psychiatric evaluation for an underlying anxiety or depressive disorder. Effective antidepressant/antianxiety medication are available in addition to psychotherapy (e.g. cognitive behavioral therapy) for management of your condition. Adjunctive sedatives can also be prescribed for your sleep difficulty. Hope you found the information useful. 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: what is abnormal repolarization possible nonspecific. I have just had an ECG (EKG) and been told I need to speak to my doctor. I have had hole in the heart surgery when I was 10 yrs old and repair on atrial fibrillation 10 yrs ago ( I am 37). Lately I have been experiencing palpitations, light headed and breathlessness. Not sure if it s physical or I am having anxiety attacks. Bloods all done and normal. Just worried about this ECG result. Can t find anything on net about it. Thank you in advance ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should first rule out heart diseases for your symptoms before considering anxiety attack. You are having significant past history of atrial fibrillation and heart surgery, so we should first rule out arrhythmia as a cause for your palpitations. So get done ECG, 2d echo and Holder monitoring (24 hour continuous monitoring of ECG). If all these are normal then we can say that your symptoms are due to anxiety attack. In that case, you need to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Don't worry, you will be alright. First rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i went to my gp and he did a test and it came back at 49 so he did one more and it came back at 39 and he said thats ok but i feel that it is not he is going to test me again in 8 weeks is there ant thing i can say or do thanks a m robinson sorry thats my ESR x ### REPLY: Thank you for your contact to . I understand your health concern, if I am your doctor I suggest you that right now the ESR is OK, but you should test it for second time after a 15 or 20 days. If it again comes as positive as you should be enquired the likely cause of high ESR. One single high ESR won't consider to be diseased. I will be happy to answer all your future concern. Thank you, ChatDoctorInfectious disease specialist. Wish you the best health 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: Hello,  I had my chest problems 8 months ago and My doctor advised e to take Fixcom 4 for 2 months and Fixcom 3 for 4 months, ive done that already but after 2 months I feel the same way, do I have to undergo another Xray or take more medicines of Fixcom 3? ### REPLY: Thanks for your question on . I can understand your situation and problem. You are taking treatment for tuberculosis. Fix com 4 and Fix com 3 are combination of anti-tubercular .  You have taken correct dose for correct interval. Recurrence of TB is common. And in your case possibility of recurrence is more because you are feeling similar symptoms after completion of treatment. So better to consult pulmonologist and get done clinical examination of respiratory system and chest x-ray. You may need sputum AFB culture and sensitivity to rule out M ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Ivelin. I had x-ray to both knees and patellae lumbar spine , the results are for my knees: minimal medial compartment degenerative change and for my lumbar spine is: minimal spondylosis . My question is what s that mean and is it ok to continue to lift heavy louds, because my job is to lift boxes and build a pallet with them, I feel pain when I m doing that. Thank you for your attention! ### REPLY: Hi welcome to ChatDoctorThanks for posting your queryBoth report shows degenerative changes or ageingThere are four independent joints in the knee. Each of these joints can undergo degenerative changes that progress to osteoarthritisSpondylosis refers to degenerative changes in the spineSpondylosis means stiffening or fixation of the bony blocks of the spine (vertebrae) as the result of a disease process. 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 48 years woman having low blood pressure 65/110, I am suffering with no sleep in the night but sleep comes at the early morning at 4 to 5 am and sleep upto 10 am for 4 to 5 hours daily. Please suggest me some medicine for good sleep. My weight is 45 kgs, no diabetic ,no sugar etc . ### REPLY: Mam your BP, is in the low normal range and so you need not worry about the same.  It's normal for many patients and rather studies have proved it to be beneficial.  As what you describe you have problem with induction of sleep, i.e. Getting to sleep, while you are able to maintain it.  If you ask me for a medication, I will suggest collided 10 mg as it is the one which no to minimum addiction as compared to the more widely used benzodiazepine plus it has faster action, so you can try getting sleep with the meds and if you still can't take the med.  It will be active with 30 mins, with a shorter action so you don't feel .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother has cardiac problems. Her Angiogram report says " LAD -Type III, good size vessel having 40-50% stenosis at its proximal & 70-80% stenosis at its mid segment. D1 has got 95% stenosis at its proximal segment. D2 has got 30% stenosis at its proximal segment.LCX: Dominant, good size vessel having 95-98% stenosis at its mid segment.RCA: Non dominant vessel having 60-70% stenosis at its proximal segment. What does it mean? ### REPLY: Hello. Thank you for your question and welcome to . I understand your concern. This angiogram report indicates that this is a three-vessel + secondary vessels, coronary artery disease. As it happens only in 8% of people worldwide, the left circumflex (LCD) artery is the dominant artery. This is only statistics, and it is a normal variable. Now, usually, the treatment recommendations vary from one clinic to another and from one country to another. If she was my patient, and if there was acute ischemia, I would treat only the culprit artery of the heart attack in the first time, with an angioplasty and stent placement. In a second moment, i.e. two weeks later, I would treat the two remaining blockages, the one in the mid-LAD and the one in D1 with stents, if suitable and if in a favorable position. If there was no acute myocardial infarction, and the three arteries would be suitable targets for stents, I would treat them with stents all at once. Even with all these said, there is no invasive cardiologist in the world that would be sure without seeing the angiogram film. There are detailed things that should be best discussed with the operator that carried out the procedure. There is one sure thing: the recommendation is that something should be done about this three-vessel coronary artery disease, whether it is angioplasty+stenting, or coronary artery bypass grafting. I hope I was helpful. Take care.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a diagnosed inched nerve in my neck that affects my left thumb and wrist. Neurosurgeon has been suggested because there are buldging and protruding disks between c-4 and c-7 that are compressing my spinal cord. I really do not want radical surgery I just want the nerve released. What do you recommend? ### REPLY: Hi, I had gone through your question and understand your concerns.First, don't worry much, of course there is an alternative for it.  Your condition is called as cervical radiculopathy. I would recommend you to go for skilled physical therapy.  An individual treatment plan based on the findings of your initial evaluation will be made which should include pain management, manual therapy(traction, nerve mobilization), posture education, ROM exercises, strengthening ex., functional training and also home exercises and precautions should be taught. Be regular with the treatment and home exercises. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have rhumotoid arthritis and goit and I am taking 300mg allopurinol,30mg lansoprazrazole,5mg lisinopril,250mg naproxen,40mg simvastatin,200mg hydroxychloroquine and 500mg paracetamol.My hands,elbow joints,neck and shoulders are still very painful,am I taking too many tablets or are they the wrong combination.I am male and 69 ,thank you. Peter ### REPLY: Hello, To comment first on the history with respect to medication, it is totally a physician decision based on the symptoms provided at the time of writing the prescription. So he will be the right person to give justification on why so many medications were prescribed.  Now coming to your pain part. The pain is due to inflammation of the joints. Which you might be aware of. RA is a moving pain and can lead to pain at small joints and big joints also at times. You have a take a bigger precaution and that is to keep yourself warm. Like staying in cold weather will aggravate the symptoms. So keeping yourself warm will be first line of action.  Next will be since how long you been facing this pain, and when was this RA diagnosed to you? This plays a key role in the overall guidance of the treatment plan. Regarding the medicine part please visit a rheumatologist as he will be the right person to take care of it.  Now treatment part. First thing is to keep the muscle and joint mobility to the maximum. So a physiotherapist will play a key role here. They might perform some passive or active exercise based on a physical assessment. Also, physical therapy pain reduction modalities like Ultrasound therapy and TENS therapy will be of benefit to reduce the pain.  Besides, please understand that this is only symptomatic for the pain. But to improve the metabolism and keep the body warm internally is only in your hand. The more the active you are the more, the better the outcome score. Usually, I see chronic RA cases in my clinical practice. They all respond well to exercise. Any kind of deformity present needs correction via physical therapy or with the help of splints. But most patients respond well to exercise in long term rehabilitation. Hope I have answered your query. Let me know if I can assist you further.  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 have bloating and too much gas problem even when I release it it takes like 4 to 7 seconds and now I have urination problem too. I don t feel any urge for it but it is right there and just a little comes when I sit for a leak and dripping occurs when I stand up and finish it ... plz help ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have abdominal pain with acid reflux. Well there can be many reasons for symptoms you mention in query, but in your case it seems to me that the symptoms are probably occurring due to acid reflux as well due to condition like UTI. I would suggest you to eat light and non-spicy, take small and frequent meals, take light walk after every meal and take antacid after every meal. Consult gastroenterologist for proper checkup. Doctor may prescribe H 2 blocker or proton pumps inhibitor along with sucralfate. Also consult urologist, who may prescribe antibiotics for a week. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My last relationship was with a man who was a swinger.  He is claiming that he didnt contract Chlamydia, but I had the infection.  How is it that he didnt have the infection like he claims when the sex between him and I was always unprotected?  Also, he was pressuring me to smoke meth, I dont think meth smoking alone can cause the infection? ### REPLY: Hello, Welcome to , Occurrence of sexually transmitted disease like chlamydia in individuals is all about chance nothing can be told for sure that it will definitely happen or not happen. It will all depend on various other factors. In your case, as you happened to have an unprotected sex, there are chances of you getting the infection. Chlamydia is treated by either doxycycline 100 mg two times a day or azithromycin 1gm single dose. During the week of treatment please avoid sexual intercourse to get away of the cross infection to the partner. Partner also given the same treatment for same period. Once both of you are cured, you can resume with sexual activity. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 21 weeks pregnant and I am suffering from loss of appetite and nausea. I struggle to eat and when I do, it make me feel nauseous and I usually vomit. Same problem when I drink, even water turns my stomach. It s concerning as I worry the baby isn t getting enough nutrients and I seem to be losing weight rather than putting it on! Please help? ### REPLY: Hello, I have gone through the query and understood your concern. If this is your first pregnancy, it is likely that the morning sickness could be continuing well into the second trimester also. Yet, you should also get regular assessment of your blood pressure, blood glucose levels and renal function. To manage the nausea, you may continue with the Dopamine prescription usually given early in the pregnancy. Make your meals easily digestible, small and frequent. Avoid spices, deep-fries and fast foods.  .  If you cannot  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 just experienced an outbreak of mouth ulcers , and I have a heavy blocked nauseous feeling in my stomach. The ulcers are very painful. It doesn t seem like a virus as I am not otherwise sick. I wonder if it could be related to a course of antibiotics I just finished for cutting my finger and receiving stitches last week? I also had a tetanus shot. ### REPLY: Hello and welcome, the antibiotics can cause nausea if you do not take.anti-acidity tablet. Mouth ulcers appear either due to vitamin-b deficiency, intake of more salt and spicy food like mixture etc. Always clean and rinse your mouth after every meal. These ulcers are of authors type.I would advise you to take tab.flanzen-10 mg,thrice daily for 3 days and tab.wysalone-5 mg,thrice daily for 3 days. Brush your teeth mildly using soft interdental brush and dental floss.to relieve nauseous feeling, take tab.rantac-150 mg,twice daily half an hour before food. Take warm saline gargle and chlorhexidine mouth rinse frequently. Maintain good oral hygiene. 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 m swapna khaira from indore . i have very good features but my colour is dull and my whole face complextion is not same. in forhead and in near of my mouth is going to black remaining face colour is same but forehead and mouth its not look good so plz tell me how can i remove it? ### REPLY: Hello, Thank you for posting on . Complexion of any person is having two components; constitutive, one which is predetermined by genetics and racial factors and usually cannot be changed with any treatment. The other component is due to external agents like environmental exposure, sunlight, use of any cosmetics etc. and is amenable to treatment. You can get a series of chemical peels, which actually remove the upper dead layers of skin and stimulate regeneration of collagen and thus newer layers of skin. Many options are available in chemical peels depending on the requirement and skin type. (Glycol peel, retinol peel, cocktail peel etc.)Also, chemical peeling can be preceded by a simple procedure called microdermabrasion or commonly known as skin polishing to augment the results. Also, at home you can try using cream containing comic acid, betray . Always use broad spectrum sunscreen before going out in sun. Use a plain moisturizer like detail DAM on daily basis for healthy and HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My brother is under treatment in hospital for Dengu.His blood platlattes came to normal from 36000 to 148000 during this treatment.But his SGPT & SGOT levels are higher than 1000.Please advise me about,1.specialist doctor in this area to consult in Pune or in ahmednagar.2.what is probabalie desease ..?Hepatatis ?3.Precaution to take regarding diet and other if any 4.If possible let me know name of medicins that can cure this. ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can.AST (GOT) and ALT (SGPT) are reasonably sensitive indicators of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests. So the next step is to look for certain liver damage and most common case is fatty liver disease. It should be confirmed by ultrasound. Other causes are viral hepatitis’s cirrhosis, medications, alcohol intake or autoimmune diseases. To verify exact cause, US, bilirubin levels and tumor markers should be additional done Then appropriate treatment can be started. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Unfortunately I had to take the Morning after Pill twice in the last week. I am now feeling severly drepressed and presume this to due to the high dose of hormones in my system. I have a history of depression linked to the oral contraceptive pill . Can you tell me please when I can expect the depression to lift? Thank you ### REPLY: Hello mam, thanks for trusting . It is a contraindication to use pills in patients predisposed to depression with them, as you must be knowing already. This depression takes around 5-7 days to wean off. You can take alprazolam at night so that depression is relieved, and you get a good sleep at night. In case you have further questions you can consult me on  forum and I will be happy to help My URL is http://bit.ly/ .  ### END