Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just saw my neurologist who informed me I have a 7mm pineal cyst on the brain which I have had for some time. Also, my last two EKG s were negative. I have depression and anxiety and parkinsonism. I am currently on many meds and also suffer from chronic migraines which we are trying to get under control. Can you tell me or show me what the pineal cyst looks like? ### REPLY: I read your question carefully, and I understand your concern. I do not know if it is of much use to see a pineal cyst, you can't understand the significance of it without knowing brain anatomy, the surrounding structures and their function really. It is simply a fluid filled sac. If it doesn't compress any structures or obstruct fluid flow it doesn't cause any symptoms. If you really want to see how it looks like here is an MRI image where it is indicated by the arrows http://imgur.com/a/8lPFAI hope to have been of help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, I am from Ethiopia. I have been suffering from a mouth ulcer since 5 or 6 years and it come about two times in a month. I have checked it in different clinics and doctors has been telling me that it comes with stress. Recently I have been having the same problem but I m not busy nor not that stressed. Of Course I have to think about stuffs and can t help it. My life is actually busy n that s how I m living but not different from other people. I haf a gastric problem before and I thought that was a reason to get this mouth ulcer. However, my gastric problem is fine now while the mouth ulcer gets worse. The pain is extremely high and brings headache which can t be relieved by a painkiller nowadays. When I was in London, I used to use Bonjela which helped me to relieve the pain temporarily. Here in Ethiopia, I couldn t find that but I was using a Listerine mouth wash which is also difficult to get here. This the whole thing I want to mention and I want a help to get rid of this problem. ### REPLY: Thanks for using . Read your query. Mouth ulcers can be due to various etiology include the stress levels, gastric problems, vitamin deficiency and many others. These are conditions which are usually recurrent. I would advise you certain precautions which can be of help to you.* Reduce stress levels and avoid spicy food.* Multivitamin tablets after consultation with your doctor.* Mucosal / denote can be used on the ulcer two to three times till it reduces. If pain is not controlled, paracetamol can be taken.* Do Betadine mouth wash usage for a few days, as Listerine though a good mouth wash it causes a slight burning taste. Hope this was helpful. Thanks and regards. Any query is always welcome. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 23 years old and usually very healthy. I have recently been suffering extremely blurry vision and  strange heart beat; it beats very fast and then slow for quite a while, it has happened at night when I am in bed and during the day when exercising. It lasts about 10 minutes. My mother has cardio myopathy however the Drs are quite certain this was caused by the extreme levels of medication she has used all her life for her asthma. Thanks, ### REPLY: There are 50 chances of getting asthma in their child . Usually it starts with allergies and if allergies are not completely cured in starting it worsens to asthma and the medication usually land into cardiomyopathy but in your case there can be other causes like thyroid, sinuses and other diseases you have to get diagnosed for allergies so that the symptoms do not land into asthma in future get diagnosed and treat them and it won't cause you any problem if treated correctly ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my grandson has asthma and on New Years Eve needed his inhaler and we were at a party without an inhaler. Some one at the party had  dry calamine flower as he was asthmatic and we biled it and gave it to my grandson and it helped.  can you please let me know where I can get this and does it really work ### REPLY: HI, thanks for using  It would be best to rely on his normal asthma medications first. Though the calamine flower worked on that occasion, to rely on this to help him in an acute attack would put him at risk. There is medical evidence documenting the effect of the inhalers but there is scant information on the use of the flower. You may want to speak to his doctor for advice hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have lupus and have been fine since treatment. I have missed for period for the last 4 months i dont know if im pregnant all the test are negative. but the bottom of my tummy just don t feel right ill feel tired, i had a clear liduid coming out of my breast, my breast seems larger. Could i be pregnant? i had ktaken all the pregnancy test from the first absence of my period should i take another one? ### REPLY: Hi, I understand your concern.  If pregnancy test is -ve with multiple testings, mostly you don't have pregnancy. You should now get investigated to find other possible causes for your symptoms.  An USG abdomen would help to exclude pregnancy as well as will help in diagnosing conditions like POD/ ovarian problems which can cause your problems. In addition, you have to undergo thyroid function tests/hormonal assessment to diagnose thyroid problems as well as hormonal imbalance. After pinpointing the cause. You could get specific treatment under guidance of a gynecologist/ endocrinologist.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband has been diagnosed with an expansile mass enlarging and eroding the left neural foramen at C2-C3.It extends into the spinal canal and is not clearly distincly visualizd from the spinal cord on CT.  Surgery is recommended to remove.  How can we know the best available neurosurgeon in our market, El Paso, TX?  Or, should we have it done  in a larger market such as Dallas or Phoenix with more experienced neurosurgeon? ### REPLY: Hi, Thank you for posting your query. The mass or tumor in the cervical spine can be best visualized on MRI. So, please get a cervical spine MRI with contrast. Regarding the best neurosurgeon, you can visit the websites of local university hospitals, and then, find out the best neurosurgeon. It may be better to get it done in larger market such as Dallas or Phoenix. This is because they would have more experience in dealing with these surgeries. I hope it helps. Please get back if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 23 years old male who has started experiencing pain in the both testicle from last 3yr. I consulted many doctors and an ultrasound was done. They prescribed medicines and they  told me that everything was fine. I am not able to concentrate on anything and always think about whether there is pain or not. I always touch right testicle & push it upwards so that right and left are at the same level. I always feel alone and think of the pain. actully this pain is start due to gym. and because of this i m also sufer from back pain. Please help me...Read more at:  WWW.WWWW.WW ### REPLY: Hello, Since you have provided the specific history, this looks to be an inflamed part of the epididymis that is near the lower part of the testis.  Since the skin is just lying in vicinity the pain may be felt in the skin and applying the frankincense oil can take care of the skin sensation and as it can not go through the skin to be effective at the inflamed part. Another possible causes can be varicocele. This can be diagnosed by the following: Clinical evaluation by a General Surgeon or preferably a Urologist. Color Doppler with ultrasound can help further clarify. Tests of blood and urine can give further clue. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am experiencing very less appetite . Vomiting sensations throrugh out day especially morning before lunch. I was slightly under stress due to certain personal issues. Age :28 Male ### REPLY: Hello thanks for the queryStress has effect on all the systems of your body. If you are under stress for long it's going to end with many sever health disorders (ex-DIABETES, HYPER TENSION, SLEEPLESSNESS, LOSS OF APPETITE, etc).so try to stay cool in all the situations. don't take much tension, as every problem of life has a solution. The biggest thing is time heals every thing. So stay calm always doing meditation daily that will help you a lot.Try to avoid spicy foods for 1-2 days and eat your favorite food. Eat fresh fruits this freshens your mood. Hope I have tried to solve your problem ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been having this stomach ache for a few days now and it kind of goes away for a few hours but then it will randomly come back. Especially when i am laying or sitting down for a while and when i stand up i feel like i need to throw up. It also sometimes feels like i am really hungry or something and so i eat but that doesn t really help. ### REPLY: Hello. Welcome to . Your symptoms are too vague to specifically point towards a diagnosis. It can be due to stress or problem with your bowel where there might be an obstruction. I advice you to visit your physician who after examining you will try to point towards abdomen pathology or psychological like stress. Based on findings, he will order tests and treat you accordingly. 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 ve been on depo for about 9 months so I ve had 3 shots, I ve read alot of bad things about so I decided not to get my 4th shot which was on 2nd of July I ve been waiting on my period now but it seem to taking forever it s been 3 months now but last week I had brown discharge for 2 days no odour but now it s gone.. I ve had heavy breast for 2 months nothing serious but how I would normally feel before I start my period please help ### REPLY: Hi, I have gone through your question and understand your concerns. Demo proverb injection contains progesterone which has known side effects of irregular bleeding, spotting and prolonged amenorrhea. It also causes breast engorgement and tenderness. It has side effects up to 3 months after its discontinuation. I would suggest you to get a urine pregnancy test done and if negative, then you can safely wait for the period to come. Hope you found the answer helpful. 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: Ive had sleep apnea for approximately 8 years now. I also have polycythemia vera which started around the same time. I was constantly having to get plebotomies every six months when I wasnt wearing my cpap all of the time. But for the last few years now, Ive been real diligent about wearing it and I havent had to get any phlebotomies. Im now thinking that my polycythemia vera was because I was not getting enough oxygen? Am I on the right track? I would appreciate any help you could offer. Thanks. ### REPLY: Hello, Thank you for contacting ChatDoctorI understand your concern, I am , Infectious Disease Specialist answering your query. Yes you are on right track. This can happen to you for low oxygen tension. As apnea occurs during sleep time there is adaptation by mean of increase RBC which leads you towards the poly Bohemia. I advise you to use the CPAP during sleep otherwise the polycythemia will increase. I advise you to take the phlebotomies done and once the hemoglobin level is under control you can start using he CPAP. You can ask for further queries here on bit.ly/ . 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: hey my lmp was 7 june and i had sex on 15 june then i took ipill 1 hr later my periods r missing....i took.pregnancy teat bt its negative then i consulted doctor she told me tto take registrone 5mg i took it from 21-25 july still there are no signs of withdrawl bleeding...m very tensed plzz help ### REPLY: Hello misunderstand your concernCauses of delayed period in your case is hormonal imbalance that is caused by I pill as it contain high progesterone level. Doctor give you registrant after rule out the pregnancy, and it is correct . Generally period will be delayed by 7-10 days because I pill, and you should take registrant 10 days after delayed period. So I advise you to wait for period to come. It will come in 5-7 days after taking registrant. If bleeding will not induce then some time high dose of me ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI dr. My fiance has a problem with pain killers like combiflam & brufin.. Whenever she suffers through headaches or any body pain due to excessive physical exercise, she is supposed to bear the pain as she couldnt take such pain killers.. Any other remedy for killing pain?? ### REPLY: Hi, For body pain use hot pack it will reduce the pain, and ask your fiancé to do active exercises, aerobics, and light resistance exercises, relaxation exercises also. It will help in increasing strength and will also make bones strong and I believe it will help her in tackling body pains. Do take steam bath twice a week. And for headache use any topical pain balm and apply tight cloth around head and sleep. Along with these take 8-9 hours sleep. Avoid stress. Hope you will find the answer useful. 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: Morning, I have had what appears to be an allergy reaction to pollen since moving from One city to another. Runny eyes, runny nose, very bad chest cough, hot and cold flushes, slight temperature elevation. Saw my GP who said it was a reaction to pollen due to area I live in. Gave me Telfast 180mg. I have had this for more than 3months. Very tired, lack of sleep at night due to coughing fits etc. Also take a Multi Vitamin as well. I m 56 yrs and not getting any younger. Starting affect my daily routines, work, and external activities. Any suggestions please. Tony ### REPLY: Allergic rhinitis is not a rare disease and can effect a people of different ages. All the symptoms that you are having are more or less classical for this condition. There are three major ways to go about in treating Allergic Rhinitis1. Prevention - Taking medications to avoid having the symptoms2. Symptomatic - Taking medication to alleviate the symptoms you are experiencing.3. Immunotherapy - Make you immune to the allergens causing the symptoms in the first place. In your case as your symptoms have already started. We need to get your symptoms in control first. You are unfortunately having the full package of symptoms i.e., your eyes, your nose and your chest, all three things are involved. If your symptoms have failed to settle with an anti-allergic medication like Belfast and are experiencing fatigue and lack of sleep then its better you see your physician sooner than later. I would suggest that you should be on the following .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Really..... I was just surfin the Web. My Liver enzymes were high. Triglycerides up to the 3000 count. After a normal CT scan..... Ultrasound..... I was taking Gemfibrozil .... 600 mg. Twice a day. I am normal with all tests and now for my blood test two weeks later..... been and still taking Gemfibrol and walk on treadmill one to two miles. My Gastroenterologist never has encountered anything so quickly. He thought I was heavy drinker. I am a small person. BMI is 22.5. I am about 5 3 and weight is 126 ish.... give or take clothing weight. I am 50 years old and have been in menopause for approximately four years. I am divorced..... live alone..... have one son (28 yrs old/married) with no children. Any questions that may help? Maybe I can do something different..... maybe not. I have always had good numbers..... always healthy but not as athletic due to spinal issues. Thanks. ### REPLY: Hi thanks for asking question. Your main problem is regarding elevated liver enzymes and elevated triglyceride. Try to avoid stress as anxiety can aggravate your condition and chances of heart ischemic attack by excess stress. As far as liver enzymes concerned mostly you can have fatty liver because of high cholesterol. If you are taking alcohol then it could be the cause for fatty liver.USG helpful. Second also do your viral markers to rule out hepatitis.USG is also helpful. For stress relief do yoga and regular exercise. For liver problem take less fatty and fried diet. Avoid trans fat like cheese, meat, burger etc.Omega-3 fatty acid containing oil useful like olive oil and sunflower oil. More water. Green leafy veg taken more. Fruits taken more. After 6 month repeat liver enzymes profile. If needed liver biopsy can take. Are you taking any ? Because excess  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last night I suffered what I would classify as a major panic attack.  I have suffered with clinical depression for years but this was totally out of the blue and totally different  than anything Ive experienced.  The doctors have been changing my medications constantly, trying to find something that would work properly - the last change being adding amitriptyline (25 mg.) just a week ago and discontinuing Viibryd and Quitiapine.  Today, Ive still been showing symptoms of panic.  Any suggestions. ### REPLY: Degree understand your concerns went through your details. Please understand that depression and anxiety are treated with a combination of .  If you had a panic attack, it is due to an underlying anxiety disorder. You must be having a host of anxiety problems associated with your depression. You need to manage them with the help of psychotherapy and meditation. Please consult a clinical psychologist with the permission from your psychiatrist. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doc, my baby boy is now 8 days old. he got severe jaundice reaching at 31. Since 7th evening he is undergoing phototherapy and the number has now reached at 12. Now i am waiting for today s test reports. the only worry i got is that doc says it might affect his brain cells and it might have affected his hearing capacity. So, the doc advised that after 3-4 months they will do MRI and hearing test. Please advise. Thanks. ### REPLY: Thanks for posting on . When the level of bilirubin in blood rises beyond a certain amount, there are possibilities of its deposition in the brain, a condition called kernites. In such a case, brain function may be affected and hence the doctor has rightly pointed out that in your case a follow-up with an MRI and hearing test would be required. The fact that the bilirubin level has come down is good and unless it starts rising again, further interventions would not be required. You need not grow anxious at the moment. Relax. Hope that helps. Feel free to revert in case of further queries if any ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About 2 weeks ago, severe pain on my lumbar spine , directly on one of the vertebrae, flared up in the middle of the day, and it has yet to go away. The bone itself is very tender to the touch, and bending, yoga , lifting children, etc, are extremely painful. It doesn t feel like a muscular problem, (I ve had those before), and it hasn t gotten worse or better. I think it is swollen, but I can t be completely sure. ### REPLY: Hi, Thank you for posting your query. Clinical examination of your back and legs is required to arrive at a diagnosis. However, the most likely cause for your back pain could be a pinched nerve in the lower back. This can be confirmed by doing an MRI scan of the lumbar spine. As of now, you can take analgesics such as diclofenac or ibuprofen tablets for pain relief. If symptoms persist despite that, then, an MRI spine could be done. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 1.a patient suffering from CA cervix treated with radiotherapy landing into uraemia...... is there any relation between radiotherapy and uraemia in CA cervix patient? 2.what are the chances of aggravation of TB in pregnancy? which trimester is more susceptible? ### REPLY: Hello, Yes, definitely there is. The kidneys are the dose-limiting organs for radiotherapy to upper abdominal cancers and during total body irradiation.  The incidence of radiotherapy-associated kidney injury is likely under-reported owing to its long latency and because the toxicity is often attributed to more common causes of kidney injury.  The pathophysiology of radiation injury is poorly understood. Its presentation can be acute and irreversible or subtle, with a gradual progressive dysfunction over the years.  A variety of dose and volume parameters have been associated with renal toxicity and are reviewed to provide treatment guidelines. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a grape blueberry sized lump on my inner left thigh had it for a year or so and was pea sized when I found it. it doesn t hury and is pretty hard feeling and doesn t move to much . please help I ve made an apt for a few days from now just getting paranoid and worried ### REPLY: Hi. Thanks for your query. The causes of the hard lump on the inner aspect of the thigh can be :-The one you have explained as, pea sized when found a year ago and now grape blueberry sized, does no hurt, pretty hard and does not move much can be due to a sebaceous cyst. -The best way is to get a clinical examination from a Surgeon, which you are going for. -The best option is to get this removed for 2 reasons:1. You get rid of the disease, a part which is not normal for the body and 2. You get a correct diagnosis by histopathological examination after it is removed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 31 yrs old and had a salpingectomy/ laparoscopy almost three months ago and doctor removed my left Fallopian tube ( was only filled with water and no endometriosis).  After a month from the laparoscopy I started this sever pain on my lower left abdominal and it has not stopped since then. I have done abdominal CT scan, pelvic ultrasound and even colonoscopy and Cystoscopy to make sure nothing is wrong with my colon or bladder. The results were all normal and none of the doctors know why I am having this pain.  I am getting frustrated not knowing where this pain is coming from. I also saw another OBGYN and he did three trigger point injections once every week but did not help at all. I appreciate your help with any advise on what I should do in order to alleviate the pain. ### REPLY: Hi, Sorry to hear about your condition. Left sided abdominal pain may be due to many causes. More information regarding the nature of pain should be given. Duration of pain, intensity, any relieving or aggravating factors any radiation to any other site should also be mentioned. This may be a neuropathic pain also or other causes may be there. You should consult a pain specialist. Any neurological causes to be ruled out first. 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 been smoking weed fairly regularly over the past year and have also recently been diagnosed with ADD and currently take 36mg Concerta XL (methylphenidate hydrochloride) daily. I ve been told that smoking while on concerta can be very bad for me. As far as my research has taken me, many people say that from experience the two do not interact in any significant way, and as far as I know I can say the same. However, the doctor that prescribed the medicine said that the combination can make me depressed and demotivated, and give me more intense mood swings. Also, apparently concerta increases your heart rate, which I haven t really noticed until recently where I ve taken a break from smoking weed (only a week and a half so far). I skateboard every day and I ve always had an issue with sweating a lot very easily to the point where I ll look like I just came out the shower after 20 minutes of solid skating, but now my heart rate shoots up massively as well, which didn t seem to happen when I was smoking and taking the medication (even though I usually skate sober). So I m wondering if there s any information I m missing out on or if continuing to smoke weed while on concerta will be very detrimental to my health... I m aware this is a long question but I d very much like to know as much as I can because I enjoy weed immensely, but I also think the concerta benefits me a lot in many ways. Thanks for your time, a comprehensive answer would be hugely appreciated. :) ### REPLY: Hi, I suggest you avoid smoking weed while on Concert. Continue to take the medications given by your treating doctor strictly according to the prescription. Forcibly smoking weed will cause interactions with Concert causing ill effects to show later in life.  Profuse sweating and heart rate shooting up (palpitations) are indications that you have coronary artery disease developing. Get done lipid profile and ECG, echocardiography and stress test if needed along with MRI and CT to rule out coronary artery disease. In the meantime take boiled homemade food, stay away from stress, tension, anxiety and take adequate sleep.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 17 year old son in the past year has short term memory lost. He will look disoriented and them ask questions; such as, where is the bathroom or his bedroom? He usually realizes he just asked a strange question and just blows it of and does not seem concerned. Ask first we thought he was joking, but he continues to have these episodes. I had a brain tumor in 2010 so it makes me nervous even though I know my tumor was not a genetic medical problem. ### REPLY: Hi, He merits a neurological examination and very likely some form of diagnostic testing such as an electroencephalogram, MRI of the brain, and possibly blood tests.  He or someone should keep track of his forgetful spells on a diary or calendar which should also be taken to the doctor for review and analysis.  I would recommend a neurologist examine your son. 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: the pads on my hands palms) are swollen and hurt and some or hard lumps others soft lumps, I recently had chemo and radiation for breast cancer and c-diff infection 3X treated with antibiotics and aspirgillious spelling?) am 80 years of age. wondering if the chemo or??? is related ### REPLY: Hello, As you have breast cancer have you undergone any surgical excision of the same? During the breast cancer, there is the possibility of inflammation of the lymph nodes and this may lead to a reduced venous return. Also, you are 80, so we can expect the venous return to being abnormal due to any abnormal pathology. But with using upper limb stockings your swelling should reduce and do some simple exercises for the upper limb which is swollen. You should do well. 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: Hello, I am currently on 7.5 mg of methetraxate a week for psoriatic arthiritis, I have had a cyst on my neck that went infected, last week I went to the dr s and he put me on flucloxacillin, even though I am allergic to penicillin as I get thrush, although my neck is starting to get better I now have thrush, I have 2 days tablets left. What do I do next? ### REPLY: Hello, THX to contact us. I understand your concern. If I am your treating doctor I advise you that Methotrexate causes a state of immunocompromised in the patients in addition to it antibiotics makes the path for the yeast infection further. So to some up both the .  You can use fluconazole tablet for fungal infection. I will be happy to answer more of your concerns, kindly know me, Wish you a very good health at . . Infectious Disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My10 month old  son was diagnosed with coxsackie on Monday. He had a low grade fever Friday through Sunday and on Sunday came down with a rash all over his body, except for his hands and feet!  He had no fever Monday or Tuesday. Today (Wed) he is running a fever of 100.7 and is hardly drinking anything.  Is it normal for the fever to come back like this? ### REPLY: Coxsackie's viruses are RNA viruses that may cause hand, foot, and mouth disease (HFMD). HFMD usually occurs in child .  The majority of HFMD infections are self-limited, so no treatment is required. Clinically, blisters that are painful usually on the hands, feet, and mouth in a child with fever are considered diagnostic of Cossack virus infection. However, in rare instances, viral tests can be done to identify the virus, but the tests are expensive, usually need to be sent to a specialized viral diagnostic laboratory. He is refusing to  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had a vasectomy about a year ago and since then the coulour of the ejaculate has changed to almost clear with a little white (which i think is normal) but recently it has taken on a darker colour (cant tell if its dark green or light brown) as if whatever is coulouring it is in very small quantities. I have noticed this over the last couple of weeks. I have not had any injury directly to my testees but do run at least once a week. ### REPLY: Hi greetings Vasectomy is disconnecting the passage, called as was different of sperm from epididymis and testis. During ejaculation sperm from epididymis is pumped out and get mixed by the semen secreted by seminal vesicle and prostate gland. Majority of (around 90 to 95 %) semen is from seminal vesicle and prostate. So after Vasectomy it can become clearer and thin because it doesn't contain sperm, but it depends on how frequently you masturbate.? Now the color has changed to brown or dark means possibility of an infection has to be ruled out. Either it could be seminal vasculitis, prostatitis or any trauma causing minor bleeding inside your genital system. I would like to test your urine and semen. If abnormal I suggest you to consult a urologist for further evaluation. Hope you are convinced. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had two swollen lymph nodes on my neck, one in the back left side and the other on the right side between my collar bone and my ear. The thing that bothers me most though is the itchy rashes Im getting all over my body.  They come and go but seem to be on my back, stomach and now the legs.  Ive had these things for 3 months now and Im beginning to stop doing things because I itch so much.  I have seen a dermotologist and they just keep giving me steriod creams to mix wiht moisturizers but nothing seems to work.  I had a biopsy yesterday but havent heard back.  The itch is the most anonying and is stopping me from doing things....Please HELP! ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern looking to the history given here I could say that this could be hyper sensitivity reaction now you have already gone through the biopsy then just wait for the report I would like to suggest getting done the blood glucose test, you have not mentioned your age and gender otherwise it would be easy to think about some etiology related with age and gender, have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have noticed that I have these white blister looking bumps on the inside of my legs near my groin area. There is nothing on my scrotum or penis. The blisters do not itch nor is there any pain associated with them. Once they pop they turn red. What could this be? ### REPLY: Hi Dear !! Thanks for your query to . Read and reviewed your query and health concerns. You seem to suffer from-mostly Ringworm in early progress, or it could reboils, herpes,which needs to be ruled out by Consults with dermatologist. This could be sebaceous cysts also, molluscan contagious, and needs to be ruled out before treating these white blister like bumps in the groin. Hope this would help you to plan further care of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following  link-Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at  services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr, Iam on duphaston for 10 days .feeling slight abdomen pain.Is this normal? Does this tablet has any side effects? ### REPLY: Welcome to  Good Day Phaetons possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.  Headache Nausea Dizziness Bloating Skin reactions such as rash and itch Breast tenderness Menstrual spotting between periods Abdomen pain (20% of patients have this)Are you passing gas or having loose stools. Please visit your Gynecologist to know for sure what is causing the pain. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 never do this but I am at a loss as to what to do my son is now 9yrs old. and he has seen many different specialists. when he was a few months old he stopped breathing unexpectedly and I was able to revive him after a few seconds. when he was almost 2yrs old he started spiking fevers and was found to have a lymph node irregularity with unknown causes. he has had noturia since 5yrd old and at 7yrs old his wbc was elevated with no trace of infection and he was diagnosed with glomerular basement membrane disease and countless visits to the nephrologist and a biopsy. now 9yrs old. he is now suffering from full on incontinence, dysuria, and hematuria. today he complained of left sided pain from his shoulder down to his rib cage with dizziness and weakness and his skin was flushed. apical pulse was in range and bp was in range with no signs of distress aside from the pain. please help I am at a loss as to how I can best help my son. ### REPLY: Hello.  Welcome to Ask A Doctor.  I have read your query and here is my advice.  Dysuria and hematuria can be due to kidney disease, sexual abuse, urinary tract infection, or bladder stones.  When did your sons' incontinence begin?  Has your son ever been continent of urine?  Is he wet all the time?  Only during the day?  Only at night?  Is he ever ?  ----------------------------------------------------------------------------- Has he injured his left shoulder and chest?  Did he do vigorous exercise prior to onset of the pain?  In addition to a fractured bone other possibilities are a pulled elbow or inflammation of the thin tissue that covers the lungs.  Does he have any nausea or vomiting, abnormal eye movements, or ringing in his ears(which are related to dizziness)?  Is he able to ride his bicycle without difficulty(which is related to weakness)?------------------------------------------------------------------------------ Since his shoulder pain, dizziness, and weakness are so recent in onset, perhaps we can put them aside for the present, see how he does over the next several days, and concentrate on his kidneys.  May I ask, what were symptoms that lead to the diagnosis of kidney disease?  Does a pediatric nephrologist monitor your son?  How often is your child see by the kidney specialist?  Does your son take any medication?  How are his lab studies doing? Complete Blood Count, BUN, and Serum Creatinine.  Should you want a second opinion I recommend that your son be seen by a pediatric nephrologist who sees 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: sir, my friend had been scratched by an unknown cat 7 days before.she did not take injection till now..she has no symptoms of rabies now.but we eat the remains of the food she had eaten and also drank the water which she p drank.is these situations may cause rabies to us????? ### REPLY: Hello, welcome to , Rabies is a disease which is transmitted by the licks, bite and scratch by the rabid animal.  Rabies is a 100% fatal disease nut it is 100% preventable by proper and adequate treatment. It is not transmitted by sharing of the food and water. It is transmissible only if your friend is having rabies.  Otherwise, nothing to worry.Don't neglect to take treatment.  Your friend should take minimum of three doses of antirabies vaccine to the shoulder. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I really do not know what I have. I m 11 years old and I looked all over the web of symptoms of many illnesses. I m not sure what I do have still! Here are my symptoms right now: stomach ache, sore throat, weakness, yellow-light green mucus when I cough (I also have Asthma) runny-stuffy nose. It was terrible for me all night. The symptoms come and go. One week I d be fine and the other I m horrible. So Please doc, tell me what I have without having to but a price on my worried body. ### REPLY: Hii child, dont worry is there any resp distress during playing or at rest. If so u need to go to hospital it may be pneumonia. If no resp distress it may be just upper respiratory tract infection adv:take paracetamol and antibiotics(do not know organism as culture and sensitivity not done, emperical treatment cant be started as i don't know you are medical allergies} for sore throat take lozenges and for cold n cough take anti histamine{tab.cetirizine}.it may be psudomonas infection because as u r asthmatic. So pl consult u r pediatrician ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 used xylocaine pump spray 10 yesterday at around 9:00 am since I had pain in my tooth, I used the pump for more then 7 pumps unfortuantely my cheeks got bulged and the tooth got infected and pain increased.the cheeks are becoming more bulged, its asif I have the half of my face being introduced to some botox injections.. What am I supposed to do to let the bulged cheeks get to its normailty.. ### REPLY: Dear friend. Thanks for sharing your concern. Excessive usage of Xylocaine is not recommended, please remember your tooth is already infected, so the swelling is due to that, and excessive usage of anesthetic spray has added on to this phenomenon. It can effect locally, but your toothache is due to deep pupal infection, which requires treatment. You can confirm it through x-ray. You are advised to visit your dentist soon and start with antibiotics and analgesics for reducing pain and infection.Meanwhile, please stop using Xylocaine, If required, you can take analgesics till you visit your dentist. Swelling will reduce only after appropriate treatment, probably root canal. Warm saline rinses will help relieve oral infection. Hope it helps. Thanks. 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 fell ans landed on my knee with all my weight last week. I have numbness and tingly feeling right under my knee cap. it I bump it at all it is very painful. I have no insurance so no doc. I have full mobility and it does not hurt to stand or walk. will this heal on its own? ### REPLY: Hello, An x-ray or the knee is advised.  As you had a fall and a direct impact on the patella bone it is advised to take an x-ray. Post which it fractures is found than immobilization is advised. But if not fracture then exercise will be advised. Doing hot water fermentation, using knee cap, static hamstring, static Qua .  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: Hello, I suffer from Sickle Cell Disease, SS. I extremely familiar with this disease, including the fact that infection may keep u n pain. I ve. Had four anti-biotics for an uti , non of them worked. So, I tried Diflucan ...nothing I try or the Docs try wrk, and as a result, I stay in pain. Not sure what to do beyond what I have. ### REPLY: Hello and welcome to , You have mentioned that you are suffering from urinary tract infection not responding to any of the antibiotics. In this case, you need to get a urine culture done. Urine culture will isolate the causative organism for UTI. After identifying the organism, most appropriate antibiotic can be identified by culture sensitivity. Sickle cell anemia is known to cause a lesion in the kidneys called papillary necrosis. Papillary necrosis is characterized by necrosis or destruction of the tips of the papillae of the kidney. Papillary necrosis cause blood in urine and pain. Consult your hematologist for evaluation of your symptoms, relevant renal investigations and hence management. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have just been diagnosed with odontogenic keratocyst after a byopsy, however, for the byopsy they removed my wisdom tooth to be able to take sample for the byopsy which really upset me and up to now am still in pain more than 4 weeks after the extraction, now with the diagnosis, i have been told they might have to remove 2 of my tooth to be able to remove the cyst even though the cyst has not affected my tooth. i was wondering if there isnt another way of treating it without removing my tooth. Thanks ### REPLY: Hi!welcome to ! Odontogenic nematocyst is benign but locally aggressive developmental cystic neoplasm. It most often affects the posterior mandible. Although photogenic nematocysts (OCS) are benign, they are often locally destructive and tend to recur after conservative surgical treatment.it is very essential to completely remove the cyst hence they might have to remove your tooth to approach and completely remove the cyst. Hope this will help you!take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,I got some swelling on my left foot..and it is almost a month now. iam diabetic on insulin.also take blood pressure tablets.the swelling goes for a while but a little and again it starts to swell.the pain is on top of the foot at times when I keep the foot down iget a pain on top but not always near the calf muscle kind of a cramping pain at times .I have neuropathy as well and some times the nerve pain comes near the ankle on the same foot sometimes looks like its pain in the bone.i am thonkimh every day it will go away.my questions are, my GP said my pulse are good,but I did not tell him about the pain ,he said if it becomes red you must see us.however it does not interfere with my sleep is it kind of a stres fracture,is it a clot or just the ligaments is it diabetic related ### REPLY: Hello, The swelling on left foot, do you recollect how it started? Is there any pain and difficulty in walking? Is there any change of shape in the foot? Have been a regular walker or doing any exercise causing constant impact? Is there any color change noticed on the skin? How is the sensation in the foot and sole? I need to know answers to all these questions. So my suggestion is: 1) Keep your blood glucose in strict control (FBG Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I had a question last year about liver serosis patient if he can fast and I did not fast last year and this year , before last year I had bleeding from varises , my health is stable no bleeding for 3 years but I had low platlets, and I want to improve the blood count naturally, what do you recommend . ### 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. There is no natural remedy to improve your thrombocyte pounds. You can have vitamins and healthy diet of course which will improve your immune system and general health, and it may slow down liver failure progression and on this way it will improve your blood count. 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: I have an 82 year old Aunt that is on a vent for 6 days now. She had a sigmoid colon surgery done the 3rd day in the hospital. She is not awake and Drs. are talking about doing a tracheotomy next week. Is this really need ? She has diabetic, her heart works @ 50%. She is very weak, BP goes up & down regulated by meds   oxygen level 90 ### REPLY: Hi and thanks for the query, I do think her health condition is a very delicate one form your description above. It might necessary to accept the tracheostomy especially to improve her oxygen saturation in blood. Oxygen is the main gas required for metabolism by the brain, in case it remains under certain thresholds, brain functions remains compromised. Detailed evaluation, especially to consider her clotting profile must be considered before engaging in surgery. I think with this scenario, tracheostomy could help. Thanks and best regards. Bain LE, MD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I brushed my daughters teeth last night and noticed that her gums started to bleed. She has some tooth decay, she woke up with a fever. I gave her some ibuprofen and the fever reduced, but her gums are swollen. She is almost 3 yrs old. Any suggestions? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concern. As per your complaint bleeding from gums along with swollen gums and fever can be due to viral infection leading to Gingivostomatitis and fever. However, there can also be infection in gums leading to Gingivitis, and it can also be a cause for bleeding gums and swelling. I would suggest you to consult a Pediatrician and get her evaluated. In case of viral infection, it will get resolved once the virus completes its cycle in human body. As of now you can give her supportive treatment like giving a combination of Ibuprofen and paracetamol. Do cool compresses over the gums. Make her gargle with numbing mouthwash to relieve pain. Give her soft and bland diet and plenty of fluids. Maintain a good oral hygiene and use an ultra soft toothbrush to clean the teeth. Hope this information helps. 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: Hi, im a 38 female I went to the er with chest pains and they did an ekg blood work and chest xray but everything came back normal im dad died last sat and everyone one on his sideof the family have heart problems er dr wants me to have a stress test. My question is can I still have a bad heart I was want to know why I have bad chest pains ### REPLY: Thanks for your question on . I can understand your concern. Possibility of cardiac chest pain is very less because you are having normal ECG. Sometimes patient can have cardiac disease despite normal ECG. You are also having strong family history of heart disease. So better to get done stress test. If stress test is normal then no need to worry about heart diseases. Anxiety and tension can also cause similar kind of chest pain. So avoid tension, be relaxed and calm.Don't worry, you will be alright but get done stress test first. 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 have and I wanted to ask about the marriage system here. In my religion cousins marriages are allowed. So can someone like me marry a first cousin who does NOT have thalassemia minor ? and what chances are there for the baby to be abnormal or thalassemic as well ? ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion sibling marriage should be avoided as much you can avoid. It is observed that when you marry to siblings variety of inborn error occurs in the coming babies. Though your cousin do not have thalassemia it is likely that her gene contains the silent gene for thalassemia on her genomes. When you marry your cousin this silent gene may get activated and cause thalassemia in your child . Avoiding such situation may prevent you for this type of results. I will be happy to answer your further concern, you can ask me on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 2 yr old grand daughter had a pilonidal cyst had it lanced that one is healed now she has what seems to be another one coming right now its just a hard spot its not swollen her dad had plans for them to go to the lake swimming and ect .should we be concerned about her swimming ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. You should avoid swimming for the girl. Sinus has opening when the water enters into the opening there is chance of infections. You can use some waterproof material that can give cover to the sinus preventing infection. So avoiding a swimming is a better option. Because once the infection starts it will be very difficult to cure it in colonial sinus. I will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: if u have been diagnosed with bone cancer and have been taking the chemo pills because of age been elderly; and the elderly person has no appetite and now has a infection and is on antibiotics and now the white blood cells are to low and the doctor said it was nothing medical that can be done. what would you suggest? But the doctor want the patient to come back to the doctor because the patient is still taking the chemo pills, they want to see if the pills are still working. the doctor said the patient was malnourished because of loss of appetite and that the white blood cells was to low and there was nothing else he could do although the cancer has not spreaded in the bones. Its only in 3 areas, hip bone lower back and upper back. ### REPLY: Hi, Thanks for writing in. Loss of appetite can be due to many causes. In a patient diagnosed with bone cancer who is taking chemotherapy, the loss of weight is usually due to a side effect of chemotherapy itself or can be a psychological response to the disease condition. Please get a diet plan based on what the patient likes and dislikes. This diet plan should include 1800 to 2000 kcal per day in divided meals. The patient might not like to have large meals and this can be solved by giving small servings of meal every 3 to 4 hours in the daytime. Adding fresh juices and fluids will also help. You can also add cereals and energy foods and fruits. Avoid giving artificially flavored and processed foods. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son has been having a cough for almost 2 weeks.I took him to the doctor and since his regular doctor wasnt there the doctor on call said it would go away by itself but this was last Tuesday and he still has the cough.is there anything I can give him to help him? ### REPLY: Hello, Welcome to , As your son is having cough for last two months the cause for the cough should be found out, and it is important to know whether it is associated with sputum or not. As he is having cough for more than 2 weeks it is important to evaluate your son to find out the cause. I would suggest to undergo1. Sputum smear examinations2. Routine blood investigation. 3. Chest X-ray. For the present symptoms I would suggest your son to take antibiotic like Autoclave and antitussives like Spy Pricier. 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 Over the past 2 days I have had a sore jaw on the right side only. Doesn t feel sore on the outside of my face, but extremely tender on the tendon that attaches jaw together. Inside of cheek also appears swollen. Right side of tongue feels strange, and slightly sore to swallow also. I m 40 but my wisdom teeth never came in, could this be a cause? ### REPLY: Hello, I can understand your concern. Usually, wisdom teetChatDoctore in mouth at the age of 18 to 25 years. However, as you have never had them in mouth, it is possible that they might be impacted or locked in the jaw. As right side of jaw is causing you pain, let us focus on that only. Due to absence of physical space to come out in mouth or due to its improper position, it might be possible that the wisdom tooth of that side was locked in the jaw all this time and now might be impinging on the muscle of the mastication or nerve that supplies tongue causing you the pain and discomfort you are experiencing. It is also a possibility that a tooth might be decayed on the side of the jaw that is causing you problems, has developed an abscess that is causing these symptoms. In both cases, you need to visit a dentist to get an oral examination to find out if any tooth is decayed and taking x-ray of the wisdom tooth area to diagnose wisdom tooth related problem. By the time you ET an appointment of the dentist, Ibuprofen 400 mg thrice a day will help you in getting relief from pain. Please refrain from hot water gargles or heat compression as if the pain would be abscess related, it would worsen. I hope this information helps you. Thank you for choosing . I wish you feel better soon. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my fataher aged 62 has 15 yrs dieabetis, and renal problem. now his s.cretinine is 2.3, and last month doctor suggest to count leukocyte. in tthat his monocyte result comes 04.00 and eosinophil is 15.00 on the other hand his ESR (westergren) is 38. Is this harmful for his health ### REPLY: Hello and welcome to . As a Urologist, I can fully understand your anxiety. Your father has, diabetic nephropathy, associated with an allergic pathology. Nephropathy, is when kidney function is affected by diabetes. Allergic cause is reflected in his high eosinophil counts. Blood counts of ESR are usually high and monorail may be high in some people. The urea, creatinine, uric acid,HbA1C,electrolytes and all blood counts, need to repeated at weekly intervals, while on treatment. This isn't harmful for health. Some patients may need a kidney(renal) biopsy for diagnosis. If you want my expert opinion, on any doubt, send it as a direct question. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 64 yo healthy female with no heart disease, nonsmoker, no history of clots. ?htn. Hx of chronic pain. Recently on mobic 15mg daily for several weeks. To er with eoigastric pain, belching, nasusea, vomiting. Neg EKG. Neg cxr. Relief of nausea with zofran. 80 percent relief with GI cocktail. Positive d dimer (3.05). No sob. No dyspnea. No tachycardia. Is spiral ct necessary? ### REPLY: Hi ! Good morning. I am  answering your query. Even though D Dimer test could also be elevated in some other situation (like an arthritis with chronic pain as in your case) as well, I would advise you to go with your doctors' advice for a spiral CT to rule out any other likely source to prevent any serious problem. Till then, you could go for a proton pump inhibitor .  At the same time, I would also advise you to get your routine blood check up done like a CBC, ESR, RA factor, serum uric acid, serum lipid profile, blood urea, and serum creatinine. Further management would depend on the reports of investigations. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my self brajbhushan mishra,age 56 years. i am suffering from thyroid problem and taking thyroxine medicines from last eight years, bur from 3 monyts i have pan in some time hand,leg, neck. doctor saying it is due to calcium decay from body. what i should do to overcome from this problem. ### REPLY: HAI, all hypothyroidism patients are more prone for calcium deficiency and electrolyte imbalances, sugar problems, generalized body pains, weakness, obesity, thyroid hormone is an excellent energy booster for the body, so such patients are asked for regular thyroxine tablet s.u can go for calcium and vitamin d3 and cholecalciferol tablets. For pain simple paracetamol 650 tabs will do wonders in your case, causing no side effects ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has severe back pain on his right side it is so bad when he sits down he can hardly get up it is all the time at nite he is up and down the pain is so bad he has x-ray the dr. says its artritis but should he be in pain all the time,he takes tylonel like candy no relief,6 years ago he had triple by pass heart surgery,please help me for his sake. ### REPLY: Dear Madam, Greetings!! Thank you for posting your query at .Tommy advice would be-1.  Hot water fermentation multiple time in a day.2. Avoid one posture for long time3. Sleep on firm mattress4. Keep your back straight, maintain all 3 natural curves in your spine5. Distribute your weight evenly on both hips6. Keep your head and neck aligned over your shoulders7. Sit back in your chair; your back should be supported by the seat back8. Adjust your chair height so that your hips are slightly higher than your knees9. Be sure your feet are supported by the floor or a footrestStrengthening exercises:Abdominal curl-with hip knee flex, lift the neckBridging exercise-hip knee flex and lift the pelvis isometric of back-hip knee flex, put a roll of towel under the low back and press against it. All the exercises to be done twice a day for 15 mins for hold count each positing for 10 counts. Muscle relaxant will help. If the pain is still not coming down I would suggest you get an MRI done to know extent of involvement in spine around region and consult an orthopedic doctor for further course of treatment. I wish a speedy recovery for your husband. If you require any further information please revert to me. I will be happy to assist you. With best wishes, Tehzib Sailed(PT) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What is the difference between high functioning autism and making the conscious choice to truly discover self in solitude? is this something being faded out for the better of society this nearly terminal uniqueness of a philosopher in solitude or is it related to the self obsession of autism and the mental self stimulatory? many would call such solitude or isolation sinister if in beliefs. in other words do I have autism and do I really have to accept the diagnosis? ### REPLY: HiT hanks for using  In autism, a patient like a stay or play alone, due to his poor communication skill or social skill. Such kind of patient even does not bother about family member and also has some stereotypical behavioral. Self solitude is normally seen in depressive patients. Such kind of patient are not much happier in solitude, but they prefer to stay alone to avoid other people. I do not think, you have autism. An autistic never bother about being alone, that means, you have some depressive symptoms. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with the flu (type a) on Sunday. I have a deep cough and this morning it hurts really bad to swallow. There feels like a large lump in my throat and when I tried to cough it up, it was dark green with a lot of fresh blood. The lump is smaller but still there. ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of lower respiratory tract infection(LETI) is more. LETI is common after flu infection. You are also having cough, phlegm and blood in sputum. So possibility of LETI (pneumonia) is high. So first get done chest x-ray to rule out LETI. If chest x-ray is normal than no need to worry about LETI. Sometimes cough cause friction bleeding. So you need antibiotic, antihistamine and anti-inflammatory .  Do warm water gargles 5-6 times a day.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my baby is passing stool frequently with mucas..almost 8 /9 times Otherwise baby is active, no blood in stools, no vomiting . I need your advice whether Zerolac should given or not..Dear Doctor, My baby is 6+ months old . The Pediatrician we consulted had suggested to start giving this.& baby is fed nan pro 1 upto 6mnth.no such problm occure then..is there any possibilities to lactose intolarnce now how we know...& what should feed next aftr solving this problm please let me know... ### REPLY: Zerolac can be given as there is no harm in it . it's a baby food without lactose. As lactose is implicated in diarrhea in babies with lactase deficiency Watt hey call lactose intolerance. Its more common in babies with prematurity and milk powder fed infants. Lactase enzyme .  Lactose intolerance can b diagnosed by lab examination of stool for lactose reduction test. If yes v should avoid lactose containing substances. And lactase enzyme artificially to solve the problem. Hope u liked, if any questions feel free to ask. Thank u. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 travelling a lot from Wed thru Sat with less hours of sleep and it included a 5km trek uphill and down to a pilgrimage. I was not feeling well on sunday and consulted a local physician who checked my BP. BP was on the higher side - 153/103 at 8:00pm on Sunday. I again checked my BP on monday at 11:30am and the BP was 130/110. I am 33 years old and my work included both sedentary on some days and walking a lot on some days. I love walking and used to go for long walks when the mood is right. But off late I feel heaviness on my legs. I used to smoke. But quit it a year ago. I do eat non-veg especially fish. I weigh 82 kgs and my height is 169 cms. How can i bring my BP back to normal? What should i do to maintain my BP within limits? Kindly advise Regards, Hari ### REPLY: Hi hard, you are young to have hypertension, however with our changed lifestyle and the stress of professional life I am increasing seeing patients in your age to have hypertension.  Considering this as newly detected BP, from today itself you should start on lifestyle modifications like cutting salt in your diet to less than 3 gas, bringing regularity in life and exercise, at least 45 mins 5 times a week.  Keep on tracking the pressures at different time on different days.  See what is the trend.  At the same time get yourself evaluated for secondary causes of increased BP and if founded treat the cause.  If this doesn't help a single antihypertensive in small dose should do the trick which at later stage we can gradually decrease and wean off if possible.  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 Doc, I am having this problem of shortness of breath for last 3 years now. The problem is usually elevated when whether is more humid and its raining. I have been smoking for 8 years until last 5 months. I drink 2-3 times socially in a week as well. I consulted a specialist last year, and was told it is an allergy and would be trated over the period of time. For the last few days, the shortness of breath is severe and can not sleep also because of this. I am also having pain in right lower chest when deep breathing. I stay in a very humid place in the world (singapore) and one thing i have noticed that on a very humid day, this problem turns back with nausea as well. I consulted a doc few days back (General Physician) and he gave me some tablets (allergy and to clear the air ways). It worked for 2 days. The problem turned back again after a day. (Its raining again !!) what are the possible causes of this problem? Is there anything to be worried.what tests do you suggest me? Appreciate your help ! Thanks Doc, JayD ### REPLY: Hello Mr Jay. Thank you for asking at . I guess you have quit smoking for last 5 months, and if I am correct, congratulations on that. It is a very important step for your respiratory complaints. From your history, I would conclude that you are having recurrent breathlessness, worsening on humid days. You may be having allergy to house dust mite or molds, which increase in concentration during humid days or pollen which are released during rainy season. I would suggest you to consult an Allergist-Immunologist who will take your detailed history and suggest allergy testing. He may suggest you allergen immunotherapy after allergy testing. If you have frequent shortness of breath, you may need daily controller medications (inhaled corticosteroids, montelukast, etc.)I would also suggest spirometry with reversibility testing. This test is helpful to differentiate between asthma and COPD (chronic obstructive pulmonary disease).  Apart from these, ensuring proper sunlight & ventilation in your rooms, avoidance of smoke-dust-air pollutants and regular breathing exercises will help you on a long run. Hope this will be helpful to you. Wish you the best of the health. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been on a doctor monitored low carb high protein diet for about 7 weeks with great success . About 3 weeks ago I noticed my tail bone started hurting no matter where I sat or layed. Yesterday I woke up and had bad pain in my right ankle (front of ankle & top of foot) with no swelling.This morning I woke up and it was so bad I have to use a cane. I read on line that it may be gout do to my high protein diet. ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. Gout is usually presented with swelling and reddish appearance. Mostly it will be on metatarsophalangeal joints of toe. Even ankle, knee or hip or hand joints can be involved. If you have such symptoms you can run a blood level of uric acid test. But if that is normal it can be most likely sciatica. An orthopedic examination followed by an x-ray and MRI if needed will rule out that. In such case NSAIDs like fetoprotein, muscle relaxants like thiocolchicoside and neurotrophic .  If it is present for long term then I advise muscle strengthening exercises and physiotherapy. Hope this may help you. Let me know if you have any further query. 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: Im having a bone marrow biopsy done in a couple weeks. My WBC has been high for months now, hovering at around 13,000. Ive had a CT of my lungs which showed nothing and I quit smoking with no decrease in count. What could the doctor be looking for in my bone marrow? Is that WBC typical with any types of leukemia? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have only slightly high total count.  It doesn't require bone marrow examination.  However, if your differential count show say atypical cells, or you have hepatic or spleen enlargement then bone marrow examination is needed to rule leukleukemia. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am 22 wks pregnant and had my 20wk scan 2 wks ago. Everything fine with the baby but they found out my placenta is low.......i have been worried since! do i have reason to worry? This is my fourth child and i had no problems with the other 3 pregnancies. I also had bleeding when i was 12 wks and they said this could be the cause. ### REPLY: Hi, Placenta can be found to be low-lying in 1/5 pregnancies at 20 week scans. This usually migrates by itself in most of them, by term. I would like to know if all your previous deliveries were normal or cesareans. Because if they were cesareans and the placenta was anterior, you may require further tests. A repeat scan at 32 weeks will help further to decide the mode of delivery, and usually if all previous pregnancies are normal most of the placenta are found in upper part of the womb, as they migrate, and normal delivery can be considered. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister did chest xray and with the result of Right apical infiltration.may i know the causes of right apical infiltration ?what will be the treatment for the case?She has a long history of bronchial asthma which was come and go while on medication. ### REPLY: Thanks for your question on . I can understand your concern. Asthma patients are prone for lung infection because of poor lung defense. And right upper lobe infiltration is commonly seen with lung infection like tuberculosis and pneumonia. For diagnosis, get done sputum culture and sensitivity report for pneumonia. Get done sputum examination for AFB (acid fast bacilli-bacteria causing tuberculosis) for tuberculosis. If sputum is not available then get done Bronchoscopy and BAD (bronchoalveolar lavage) analysis. She will need antibiotics or anti-tubercular .  Don't worry, with proper treatment, she will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your sister. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with oesophigitis, hiatus hernia , ulcers and now gallstones. I am a 44 yr old female. I am waiting for anappointment with a specialist which seems to be taking forever, i have started having gallbladder attacks the pain is herendous. Also suddenly suffering extreme tiredness and have developed tiny red dots on my stomach, is this something to be concerned about and is all these conditions related. ### REPLY: Your symptoms seem to fit into a condition named as Saints triad. This comprises hiatus hernia, gallstones and diverticulosis cold. I would suggest you to undergo a colonoscopy immediately for diverticulosis cold. The weakness feeling you are experiencing may be due occult bleeding due diverticular disease. As soon as that is done you need to undergo surgery for gall stones as they have become symptomatic. The severity of the hiatus hernia need to be determined in order to decide on surgical intervention. If that is required and if you have access to skilled surgeon you can get both these surgeries done in one sitting. ### END