Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a 26 year old temple experiencing a painless twitching/spasm feeling on my left temple that started this yesterday evening. The night before i had a really bad headache where i was nauseated and sensitive to light. I had also just went to the dr for numbness & tingling of hands and feet. The workup showed no elevated bs and some carpal tunnel mostly in my left wrist but feet and other hand are ok. I usually take Excedrin for headaches, which i get often, and drink sodas occassion. I had 2 prior to the start of the muscle twitching. I also have mixed connective tissue disease but has been well controlled with Plaquenil. I also was taking Flagyl but stopped after developing numbness and tingling. What could this nerve twitching be due to? Want to get an informed opinion before i get too nervous about it ### REPLY: Hello, Regarding your concern, I would explain that your symptoms seem to be related to migraine headaches.  Anyway, considering the fact that you suffer from connective tissue disorder, I would recommend consulting with a neurologist for a physical exam and a brain MRI study, coupled with a Doppler ultrasound of the temporal artery in order to exclude possible temporal arthritis.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have had a fall resulting in pain in my knee and lower left back. My MRI shows nothing but the pain is still unbearable and preventing sleep and giving pain if sat in a position or standing in a position for more than 20 mins. I also experience pain in my left side and have agonising headaches what could this be ### REPLY: Hi, Thanks for your query. After going through your query I came to know that you suffering from injury left back and knee. You can get your x Ray done to rule out fracture however it does not look like so. Its treatment is rest and analgesic such as ibuprofen for pain relief. You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, is spasmo cibalgin or pancreozyme similar to xenical or alli. age:53, wt 120, in pretty good health except for a lot of Gall BLadder stones.  has been xenical or alli for the past few years, only when i eat fatty/oily food.  I take around 4-6 a month except on vacation.  My moms doctor suggested Pancreozyme or Spasmocibalgin instead. thanks for advice ### REPLY: Hi welcome to ... If gall stones are asymptomatic than no active action required. .... Here if abdominal pain or any other complaint there than its removal is necessary by surgery.... You can take Adílio tablet for that .... Clinical follow-up necessary.... And if pain or complicated gall stone surgical removal can be from laparoscopy or open method..... Avoid fatty foods in excess. ... Heavy meal restricted .... Take care .... Advise : gastroenterologist consultation.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 (6 months) has dark green stools, some very mucosy.  he had a virus about 1 month ago and then diarreah about 2 weeks ago.  he has horrible nappy rash and the green poos smell quite sickly sweet. he is mixed feeding - some formula and some breast feeds. ### REPLY: Hi SO sorry for your kid to have that. This happens mostly in the weaning period as your baby is getting adapted to complementary feeds. YOUR baby had Dysentery from your description which needs to be treated with antimicrobial- definite. The Most important thing is to give her plenty of ORS fluids for each stool(25-50ml/stool) to prevent deny . Give her Zinc syrup 5ml for 14 days along with a probiotic like Enterogermina which are palatable. For nappy rash, please avoid diapers and apply a zinc oxide cream to keep it  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 DOC...I HAVE HAD QUADTRIPPLE BYPASS ABOUT THREE YEARS AGO, AND STAGE THREE COLON CANCER ABOUT A YEAR AND A HALF AGO....THEY REMOVED 32 CENAMETTERS OF MY COLON...I HAVE COPD AND I HAVE TYPY TWO DIABETIS....NOW MY ANKELS AND CALVS ARE SWELLING AND MY ANKLES ARE TURNING WHITE..AND TONIGHT MY RIGHT LEG STARTED OOZING A CLEAR LIQUID..THE BOTH BURN AND HURT ALL THE WAY TO MY BUTTOCKS AND I CANT WALK JUS A LITTLE WAYS AND I HAVE TO SET DOWN...COULD YOU TELL ME WHAT YOU THINK IT MIGHT BE ??THANKS.....DARREL..... ### REPLY: Hi, Sorry to hear the condition. The exact cause can not be interpreted by this information. Anyway in case of poor diabetic control many a time ulcer developed at foot. This is a common phenomenon. Consult your doctor, if any infection found then culture sensitivity will be done and antibiotics will be prescribed accordingly. Other measures like foot elevation will be helpful. Consult your doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Do I need to worry if my 3 yr old soon to b 4 in aug, 38lbs.....could have possibly taken 9 pills of synthroid 88. Called poison control and they said not to worry that he will b very hyperactive and moody for nxt 4 days. But my wife is still concerned even though we were told it will b ok after it works out of his system. What symptoms should we look for for the worst case scenario? Not sure if he took that many or not....that s the impression we are getting sence he threw away one of the packages and we can t find it now. That was earlier this morning not sure exactly what time.....but Definately over 9 hrs ago. ### REPLY: Hi, thank you for choosing . Regarding your son don't worry that much and just wait and watch as he must not have taken that many tablets as he is fine, you should expect hyperactivity, increased heart rate, not able to sleep, irritability and tremors of his hands etc., as he doesn't have these after 9 hrs, I don't think you should worry that much. Just monitor him for another few days, and he should be fine. Hope this has been helpful to you, kindly feel free to contact again for any queries. Kindly rate the answer if so. Take care.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello! I have a problem and I dont know what to do about it, my life is very screwed up. Ii dont know how to be happy, Ill hurt people and Ill wake up angry for no reason, my mood will change and I will feel attacked by everything, I cant be comfortable when people say my name and I dont know what its about, anything that happens hurts my head, it wont stop thinking and it gets painful, i get hateful with my self for it, I dont know what to do anymore... I have a therapist appointment but its getting worse. I checked my boyfriends phone because Ii was paranoid that I was being talked about, I dont understand what is wrong, I just want to be happy and not hurt people, I want to stop running away and getting angry for no reason, please answer me, I want answers. ### REPLY: Hi. I understand your concern. Sad mood /mood swings /irritability / lack of sleep are features of depression.paranoid features suggest psychosis or psychotic depression. It can be treated with medicine s/ psychotherapy / behavior therapy / ECT etc. Choice of therapy is depended upon symptoms and its severity. Medicines like SSRI can be useful. In SSRI sertraline / Escitalopram / paroxetine can help. It is useful for moderate to severe depression. Psychotherapy and psychological counselling can help in mild depression. ECT means electroconvulsive therapy is the choice in psychotic depression. Go for proper psychological evaluation and get well soon. Consult psychiatrist and get help. I hope I have answered your question. 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 went to the ER on Sunday. I was having chest pain, dizziness, shortness of breath and slight nausea. They performed a ECG and found sinus rhythm with frequent premature ventricular complexes and possible complexes with aberrant conduction. Prolonged QT were found. (QT/QTc 466/524) The second ECG found sinus rhythm with occasional premature ventricular complexes and prolonged QT. (476/510) Two sets of blood work was performed and the first found a .11 troponin level and the second was .13. I was admitted and my symptoms improved and was released. The doctor who released me said I did not have a heart attack, but could not explain why had happened. He also did not give a reason why a heart attack was ruled out, but did mention my age in my report. (I am only 29) Could someone explain this to me? ### REPLY: Hi, After going through your case, I want to know-1) Family history of heart disease.2) Habits like smoking, alcohol.3) Taking any medicines for any current illness or other long term medicines. Your ECG changes suggest abnormalities of electrical activity of heart with occasional abnormal conduction. There may be following reasons for it -1) Prolonged QT in ECG it is usually associated with use of certain medicines (some antibiotics, . 2) Other metabolic causes like kidney dysfunction.3) Heart attack.4) Degenerative changes in heart (this is usually present in old age group)I will advise you to do following tests:1) 2DEcho of heart : it will give more information about pumping capacity, any findings of heart attack (regional wall motion abnormalities).2) Kidney function test (serum creatinine, urea, electrolytes, serum calcium, magnesium. Though your age is 29 and cardiac enzymes (Troponin) are normal coronary angiography may be needed if there is family history of heart disease, 2DEcho finding of heart attack. Avoid use of medicines causing prolonged QT interval. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother is 65 yes old.her creatinine in blood is1.42 mg/dl tested on 9th September-2015..blood sugar PP-107.0 mg/dl and fasting 82.0mg/dl ..what is the problem and how it is recovery..my mother is also an ostio arthritis patient..Which department doctor may I consult... ### REPLY: Thank you for contacting . Your mothers blood sugars are excellent. Fasting sugars should be less than 100 and post Pron dial less than 200, and she is having good sugar control accruing to the information you have provided to us. Does your mother have diabetes ? If these tests are done for screening and I do not think she has diabetes. Her sugars are excellent as mentioned above, they are falling within the limits. Your mothers' creatinine is elevated little. Is this the first time she had these tests done or do have a prior reading. sometimes we see a condition called chronic kidney disease (CKD) where persons creatinine tends up even with the age. High blood pressures and diabetes certainly worsens the creatinine and thus CKD more quickly. Please reply us back. Take care of her. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 doc,i just want to know how to deal a person with secondary to chronic liver disease? and what should i could help with that person with can kind of sicknes.thanks hope you can help me.age is coming 63 year old,weight somewhere around 69 kilos and height is 180cm. this is the doctor diagnosis ascitis probably secondary to chronic liver diseases ### REPLY: Hello, Thanks for using . I had gone through the data you have posted. Ascites forms in patients with liver disease due to low albumin and increased portal pressure. We need to restrict salt intake and start on diuretics like furosemide + spironolactone to optimize the fluid status. If serum sodium is low then we need to restrict salt and water intake. We need to start Beta blocker to reduce portal pressure. By doing this we can tackle ascites part of chronic liver disease... Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am curious to know why after 2 years of not having sex...I had sex a week ago and it was protected....but why am I still bloated from a week ago and I did have a bad yeast infection earlier this year but I don t think it ever cleared up too well....could this be a bad sign and I don t think I would be pregnant. Please help! ### REPLY: Hi, Since I have gone through your history, but still I would like to know that how did you come to know that you have got yeast infection? , do you have white discharge coming from vagina? If yes, you may need proper antibiotic course (metro or azithromycin) and pessary and get checked by Gynecologist. As you had protective sex, it seems less likely that you are pregnant, but if you miss the period get pregnancy test done and sex does not cause bloating. 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 had a mix of what has felt like sinusitis and an upper respiratory tract infection for about 3 days now. It started with a sore throat that I could feel in my ears (if that makes sense), almost like an itchy sensation, hard to describe. That was day one. On day two it progressed to congestion in my sinues (pressure in my forehead and nasal sinuses), then on to stuffy/runny nose, and sneezing. On day three I have a burning sensation in the upper broncial tree area of my chest and I have a slight productive cough, with light yellow sputum. Do I need an antibiotic or do I just need to ride this thing out until my immune system kicks in? Don t wanna waste a co-pay. Thanks in advance! ### REPLY: Hellowelcome to ChatDoctoryou should start .  Start net pot immediately.  Eat vegetable and light food. don't take heavy meals. Use warm clothes around your face for 4-5 times a day. Saline spray and steam inhalation 2-3 times a day will relieve your symptoms more speedy. Use paracetamol for relieving pain. I think antibiotics are not needed at this stage. It will be needed if cough with more than a week or high temperature. If you have allergy from something strictly avoid it. Thanks for contacting  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: At the end of October I had pain/stinging down my sides under my arm. 3 weeks ago I was told I had a very bad chest infection and was given an antibiotic to clear up. I had to go back to the doctor a week later and I was diagnosed with labyrithitis. Although the dizziness has gone I don t feel any better. The pain/stinging is still there and I am getting pain in my stomach and a sore back whicChatDoctores and goes. Thanks ### REPLY: Hello, Regarding your concern, I would explain that your symptoms could be related to gastritis. Pleural inflammation can not be excluded either. I would like to know if the pain is related to the food intake. This would be indicative of gastritis. Is the pain triggered by deep breathing or coughing? This would indicate a possible local inflammation.  You should discuss with your doctor on the above issues and on the possibility of performing further tests (a chest X-ray study, complete blood count, PCR, ESR for inflammation, etc.). Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I have spinal problems. Diagnosis: Spinal Disk Hernia. Have an awful, constant pain in my back and down my left leg. In 2013, I ve had a surgery according to this diagnosis, but in the next 3 months, the pain increased again. The pain itself is note gone, neither before surgery of course, but nor after it (totally gone). Could you please tell me if I can send you my MRI result? To know,it is a right diagnosis or not? Is there any hope to deal with it? I appreciate any kind of your answer. Thank you in advance. Bests - Lika. ### REPLY: Hi, thank you for providing the brief history of you. Since you mentioned you had disc herniation and have undergone surgery for the same. Post surgery the pain hasn't come down. So this shows it is a failed back syn .  Apparently now what you need to understand is the herniated disc is out of the body as the surgeon planned. Post this, the need is to undergo a graded planned exercise rehabilitation, which had to be performed under the specialist. Now since the pain hasn't come down, and it is increasing that means that the spinal muscles are not strong enough to hold the spinal column at required intervertebral disc space, and any little weakness is leading to nerve entrapment again. I will advise you to undergo a fresh MRI and compare with the pre-surgery MRI. Any comparative study at this point will be of great help. Along with painkiller if your Surgeon wish to prescribe you can go ahead with it. Also you need to now totally focus onto the physical therapy only. As reoperating the same level again as per my thinking will not give any benefit. The physical therapist will help you firs with therapeutic ultrasound therapy which will lose the scar tissue in the back. Later on the use of TENS will be symptomatic and as per the need. The physical therapist may apply the myofascial release of the spinal muscle spasm. Which will help to get some mobility of the spine. Now moving ahead you need to undergo a strong rehabilitation plan. As you core should become like 8 packs but over a period of time and with the limits of you physiological pain. You will even need to strengthen the spinal muscles to get the intervertebral disc space back to release the compression on the nerves. Post that strength conditioning has to be planned as the body functions as a unit. Strength conditioning will help the unit to function in equilibrium which will be of great input. I have seen the cases like this and all have responded well with pre-planned and graded rehabilitation process. Also to mention that it is slow and steady, but gradually you may get to see the difference. I have myself treated cases with 99% of success rate. Now It's my luck or the effort of the patient that he recovered, but I have 99% scorecard. The one who kept patience all recovered even with an abnormal MRI my patient can climb 13 floor in 100 seconds without a pause. Well to cut down the story and come to help you, please organize physical therapy and get treated. With the grace of God I wish you a speedy 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: My mother has a pain in left ankle/leg ( diagnosed as gout ) , she`s got a pinched nerve in back she`s has medication but the pain subsides little but comes again especially in evening. She got Pradaxa from specialist, Mybulen pain stillers Vinovo 500/20mg, Colchicine 0.5mg. Can she use Puricos 300mg for pain as well ? ### REPLY: No. Colchicine, similar to chemotherapy, prevents cells from growing, turning over and releasing DNA that is broken down to uric acid. It stops the production of gout stuff. It stops gout flares. Allopurinol (prices) blocks the DNA breakdown BUT it is chemically similar to gout stuff and will trigger an acute gout flare. I cannot say in her particular case and nerve pain is not gout pain. Gout medicines do not interact with nerve 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: Hi, for the past couple of days i have been getting really bad stomach aches in the evening that last til late in the morning, pepto doesn t work, beano, tums, the only temp and i do mean temp is gingerale. and this sounds wierd but when i eat sour items the pain seems to subside. ### REPLY: Hi! Good evening. I am  answering your query. If I were your doctor, I would advise you not to eat from outside like fried, oily, or fast food, as intestinal infections could creep in through these and also in some the intestinal mucosa is sensitive to some components of this food resulting in such symptoms of yours. I would advise you to get your stool tested for ova and cyst, and get it treated if positive. Apart from this, you should go for more of roughage and enough liquids in your diet. Also, a regular exercise might help you to a great extent. Till then, you could go for a proton pump inhibitor .  I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im a 14 year old boy and Ive thought about having a sex change. For a while now the idea has been in my mind and Ive started to feel strongly about it. THe thing is I havent told anyone and I mean any one and Ive been looking for advice and help. Could you help me? ### REPLY: 1. going through a sex change means distressing condition in mind:any parental disharmony, low self-esteem, Psychological trauma, or you think you are born in the wrong sex??2. Sex change is kind of mutilation done to the body and moreover there are no concrete evidence of surgery success and nor any psychological benefits gained from surgery.3. The law call it gender reassignment or transsexuality.4. Even if you enroll yourself in Gender Identity Clinic (GIG) they will only accept you if referred by a Consultant Psychiatrist.5. Neither you nor your general practitioner can refer you, consult your doctor for further advice. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 expierencing chest pain/ discomfort and it feels like it hard to breathe and someone is squeezing my heart since yesterday morning around 11 and it has not gone away. Have been expierencing same type of pain for 4 years now randomly but it normally goes away after 10min. this time its not going away. I work at an ortho office and decided to have my coworker give me an ekg and each time it keeps saying abnormal ekg, abnormal t waves and to consider infierior and anterior ichemia, and sinus arrhythmia. it it just in my head? ### REPLY: Thanks for your question on . I can understand your concern. Since you are having abnormal ECG, we should first rule heart related chest pain in your case. So better to consult cardiologist and get done 1. Blood pressure monitoring 2. Fresh ecg3. 2d echo 4. Stress test (trade mill test). 5. Coronary angiography if required. You may need cardiac supportive .  Don't worry, you will be alright but consult cardiologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have suffered with asthma since I was a child I m now 23 and my asthma is still bad I ve been to the asthma clinics regularly and they have told me it isn t as well controlled as it should be. I have asthma attacks now and again and would find it really helpful to have a nebuliser at home. Can a gp prescribe this ? ### REPLY: Hello. Thank you for asking at . I went through your history and can understand your concern. I would like to make suggestions for you as follows:1. Personally I do not suggest any of my adult patients to have a nebulizer at home. There are many reasons. a. Fist of all, there are many good inhaler portable devices are available (Metered dose inhalers, rottweilers, etc.) which are very efficient, convenient and as good (sometimes even better) as nebulizer.b. Nebulizer has problems with maintenance, also requires electricity, also chance of cross-infections. In my opinion, nebulizers are good for young child . 2. Were I treating you, I would suggest you regular montelukast and controller type of inhalers like inhaled corticosteroids for at least 3 months.3. I would also suggest you allergy testing which will help you identify the substances that you may be allergic to and to know the measures to avoid them. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which slowly improves your immune system to improve allergy symptoms.4. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution.5. Personally I would suggest you daily breathing exercises, Yoga & Panama which gradually improves immunity and lung capacity.6. I would also suggest you a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc.) which are very important for overall health and immunity. (Allergies & asthma are basically immunity related disorders). Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I do not drink alcohol, had my gallbladder out 15 years ago and was treated from acute pancreatitis with surgery on the sprinter of Oddi two summers ago. I have once again started having intense pain after eating in the RUQ which is worse when I sit at my desk. This seem sort of like the same slow progression that lead to a five week hospitalization two tears. I was extremely sick! I ended up with two hospital acquired infection and lost over 60lbs in five weeks. I am concerned this thing is happening again, but last time it took several months of this sort of pain before I started vomiting and anything showed on labs. The pain is getting steadily worse and I am now having pain every time I eat. How do I get the doctors to pay attention and consider that this may be the beginning of a very ugly illness? Can this be the same darn thing and can pacreatitis be reoccurring in someone that is NOT a drinker? ### REPLY: Hello,1) Yes your present pain episode may be due to recurrent episode of pancreatitis2) Pancreatitis can occur again in person who is not a . 4) In your case, structural abnormality of sphincter of Odd might be the reason for repeated episodes of pancreatitis.5) Laboratory test of serum Amylase can confirm acute episode of pancreatitis. If value of this test is elevated then USG abdomen or contrast enhanced CT scan abdomen is recommended to evaluate extent of pancreatitis.6) Sometimes repeated episodes of acute pancreatitis can lead to structural changes into pancreatic tissue (fibrosis) and pancreatic duct (narrowing and stone formation) and this condition is known as chronic pancreatitis. Severe episodic abdominal pain is main symptom of chronic pancreatitis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 92-year-old male. A couple of years ago, my dentist installed a crown on the third molar ( wisdom tooth ) in my lower left jaw. Afterward, I started complaining of pain in the area and even some in the left rear side of my tongue . He examined my mouth but saw nothing to cause it. He referred me to a dental gum specialist who also saw nothing. The initial dentist removed the crown in early 2011 but the pain persisted. The tongue pain may have gotten worse. In the last month, he referred me to a dental specialist: an oral surgeon who saw nothing, even after a sort of CT scan . He suggested extraction of the wisdom tooth which was done a couple of weeks ago. The tongue pain (rear, far left) is much worse, especially when I chew, even though I keep the food as far away on the right as possible. My speech is impaired. Suggestions? ### REPLY: Hello and welcome to  forum, i am glad you wrote in, according to the dental history provided by you, it seems that you have been suffering with this problem for quite a while now, I would like to inform you that in my opinion, the pain is due to a neurological problem, the nerve that supplies your tongue might have been affected years ago. But, the reason is unknown as your dentist could not diagnose it.I advise you to visit a neurologist once as he/she might be able to provide you with a treatment plan. Also, I assume that your tongue does not have any ulcers, kindly be calm and see a neurologist soon, i wish you good health, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 11 years old daughter complains she feels weak and agitated and begins to cry almost every other day. Time to time complains about breathing problem. We have had her checked for asthma and other but no result. She is not worried about anything. She is a Beta-Thalassemia carrier and her mother diabetic. Confused! ### REPLY: Hi, please get a complete blood count, urine routine test and a random blood sugar test done for the child if these tests have not been done before. Tiredness may be due to anemia or blood sugar related issues, so these have to be ruled out. A spirometry test may also be done to test for lung function. You may also get a test called TSH done which is a screening test for thyroid function. Is the children height and weight OK. Based on the above I could give you a more comprehensive opinion. How is the school environment and academic performance of the child. Are there any issues at school that are distressing?. Child .  You may have a friendly discussion to explore if there are academic or interpersonal issues at school or home. Please post the test results here so that I may assist you with more information. Warmest 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: Five year old girl running mid grade fever for three days along with stomach pains and severe headaches. Typically I would not worry about these symptoms however they return once we every month to two months. Every time I take her to the doctors they tell me it s viral and send us home. They say she has a low immune system and that it will get better but it doesn t. It s getting worse. I m so worried and not sure what to do next. Please help me. ### REPLY: Hi...this looks like viral illness only. Please do not worry. Her immune system is perfect. We need to consider immunodeficiency only if she has got more than 3 pneumonia requiring hospitalization/ bone and joint infections/ unusual skin and soft tissue infections/ brain or CNS infections till now. If nothing like this happened, this is not immunodeficiency....do not worry. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had 4 days niece but i don t know how he died . I will tell you what happened ,actually his weight was 1.5 kg at the time of birth but doctors said that he is perfectly fine ... and his mother was not having her milk so his family members feed him with cow s milk and polio drop also and after half an hour he sneezed and white colored foam start coming out of his mouth as well as nose ### REPLY: There are several possibilities, first is that the baby developed an allergic reaction to cows milk. Newborns are not supposed to be fed with cows milk. He should be fed with formula milk if breast milk is not available. If both formula milk and breast milk are not available, cows milk can be used with extreme caution and after adding sterilized water (one liter of water is added to each one liter of cows milks)the second possibility is that the baby aspirated amniotic fluid during the delivery leading to aspiration pneumonia and pulmonary edema ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes I just recently had an mri don due to job injury about a year ago,it came out normal but im still in pain everyday.My physician says he don t know what it could be,he ordred physical therapy again.im wondering if it has to do with some nerve damage? ### REPLY: Hi, as mentioned by you the history of your illness, what I can understand is you have a general body pain. Now to understand your pain the MRI was suggested. Apparently, with the grace of God it came normal, and it is good news. Now what needs focus is to understand that due to workstation, there is something called as - Repetitive stress injury. This injury are divided into wide based classification. On a general note when you perform the office work while sitting or standing in a same position for longer hours there is a static contraction in the muscular system and leads to the metabolism of the muscles and early fatigue. Which leads to the pain. To help this issue. You need to perform regular gents body exercises, breathing exercises and meditation. The exercises help improve the cellular metabolism with the help of oxygen assisted by the respiratory exercises. Performing regular exercises will help you further and avoid pain and aches in the future. I have personal experience of dealing with patients with similar complaints and with this protocol of exercises they are helped. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my name is jawaria and since september i started to get these rashes that looked like bruises, very itchy, i scratched them a hell lot and now they are at my back, arms, neck , chest and also now on my torso, i m very scared as i dont know what it is, they are dry but don t go away, they are faded purple and the ones on my chest are faded red, i do not have any food allergies , once in a while i get difficulty breathing and my feet swell up, for that i take zyrtec and it goes away, please do help me as i do not know what this is or whether this is life threatening or not, i don t even have insurance and i m scared how will i treat this ### REPLY: Hello Jaw aria, I am sorry to note your present state. The condition that you describe is consistent with urticaria, and very itchy red hives that fade away but reappear within a few hours. Some attacks on the skin are raised and known as angioedema due to the chemical called histamine released from mast cells. These cells are present in the lips, tongue, skin, chest, gut etc. and therefore wherever histamine gets released, you get the specific organ related symptoms. Another condition called urticaria vasculitis definitely needs to be excluded and Moreno when there is no response to antihistamines.80% of people with urticaria do not have any allergies which is the case with you. Long-acting non-sedating antihistamines like fexofenadine 180 mg once daily plus/minus cetirizine 10 mg at lunchtime/evening is required for 3 months. Occasionally the treatment may need to be longer if there is a recurrence. Tests such as CBC, Lots, renal profile, TSH TPO abs are standard investigations to exclude a secondary cause. Most people go into remission so do not worry. 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: Hey there, I am a 30 year old male and had anal itch . I went to the doctor and he proceeded to do a DRE to look for hemroids. He discovered my prostate is large. He stated that my prostate is large for my age and asked if I had any symptoms. I told him no because I didn t. The exam was uncomfortable the whole time. I don t know if it was because I was uptight or what. Odis have prostitis when I was about 19 years old. Anyways, now I am extremely anxious tht I have prostate cancer to the point that I can t even sit down to watch a movie with my wife. I am also experiencing some pain in my prostae since the exam. So I guess my question is, how likely is it that I have prostate cancer and how can I deal with this incredible amount of anxiety ### REPLY: Hello. It is unlikely that a male of 30 years has prostate cancer. Probably your prostate is enlarged by chronic prostatitis, due to acute prostatitis that you had at 19 years old.However, your urologist must request additional tests to rule out prostate cancer. For anxiety, I treat my patients with lorazepam or alprazolam. Please consult your local doctor for a prescription. I wish you good health.(If the answer has helped you, please indicate this) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir...I m planning to conceive...but this month I m taking norethisterone (month of april) to stop my period bcz of a wedding function..after stopping pills I ll get my period...so my question is that can I try to conceive from my coming ovulation date( month of May)???what would be my chances of getting pregnent??? ### REPLY: Hello dairy understand your concernNorethisterone contain progesterone and some time it causes hormonal imbalance. So it may cause disturbance in your next menstrual cycle. But it will not affect your conceiving process. You can do unprotected sex in fertile phase of the period according to length of cycle. If you have cycle length of 28-30 days then do sex during 10th to 20th day of cycle. So you have high chance to become pregnant. Avoid stress, take healthy diet, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 used efferdent to clean my dentures, I guess I am allergic to the phosphate or whatever is in it and now my mouth tastes terrible and my toungue keeps getting red.  How do I get this out of my dentures.  They are not redlined.  I have soaked them, brushed them etc.  HELP ### REPLY: Hello there, Welcome to , Efferdent is an antibacterial denture cleaner. It in fact Kills the germs that cause denture odor. It contains PERSUADES, I suspect you are allergic to the product due to which you have tongue irritation. Discontinue the use, if your dentures seem to have its smell you can get the dentures polished from a dental lab.Polishing of the denture with pumice removes the effects of the product and will help you use it. I hope this helps, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 7 year old daughter has an allergic cough, and it happens in some periods and increase at night and it becomes very annoying that she couldn t sleep well at night. The doctor told me to use Clenil inhaler and ventolin inhaler. I used them but in vain. I also tried vaporisation and different cough syrups. I also used Vicks Vaborub but I failed. When she has cough, she also suffers from phlegm. Please, tell me what to do...?? Especially, I am afraid that a decrease in sleep could affect her growth. Thank you for your help and efforts. A SAD MOTHER ### REPLY: Hi, Thanks and welcome to . Severe cough throughout the night may be whooping cough, allergic cough and even asthma. Ebastine syrup controls allergy. Moteleucast will prevent asthma attacks. Deflazacort syrup 2-3times daily gives relief from spasmodic cough. Better consult pediatrician to arrive at a conclusion and for proper treatment. Hope this answer serves your purpose. Please feel free to ask further queries if any. . V. Subrahmanyam. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: doctor i have fungal infection on my parineum and i already using terbinafine 1% cream from one month but no effect.i have history of the infection from 3year .i take fluconazole 150 mg dose weekly twice .but no effect.so do you have any suggestion for me? ### REPLY: Hello, Welcome to , The fungal infections are common in the perineal region as the fungus are the normal comedians of this region, which will be kept under control by the helpful organisms. Whenever there is any change in the environment it will activate and produces these symptoms. In spite of antifungal treatment your symptoms has not come down. I would suggest you to undergo lab investigations like KOH mount to confirm the presence of fungal infection. You may need physical examination to confirm whether it is a fungal infection and based on that we can decide further mode of treatment. 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: L5 SACRALIZATION. Very painful. Tweaked the other day. What are my options as far as bending and lifting. My boss wants me to do warehouse work, but I m afraid that those days may be over. Problem is, one wrong step and I can hit the floor from seizing up and pain. The sacralization is on both sides. ### REPLY: Hi... Please don't worry about sacralization...as it is there from the time you were born...so relax... Coming to your pain... I would recommend you to Keep icing your back frequently...to reduce spasm... To do a lot of core muscle strengthening workout... To do glute stability to improve spine stability... To stretch your hip flexors and gluteus to reduce forces pulling on spine... Avoid lifting weights for a while.if happen to lift keep your back straight and bend your knees to lift weights . Do spinal extensions frequently to avoid imbalance to set in.... Hope this is helpful for you. Kindly revert in case you need any further help in this regard. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sore left jaw, upper and lower, and it radiates toward my ear, and I get a headache. I went to the Chiropractor and he told me my neck was all messed up, but if it didn t go away to see an MD for possible heart attack. I am 47 with no known heart problems. When it happened, I was chewing gum and thought I broke out a filling. It started hurting in my upper and lower jaw and I couldnt tell which tooth it was... ### REPLY: Hello, You may be grinding your teeth causing stress on the TMJ. I mention this because of the chiropractor telling you your neck has some problem. A night guard can be helpful if you grind your teeth at night and offer some relief. Your dentist can evaluate your bite and make a recommendation. You may have an infection in a tooth that needs treatment. See your dentist for an evaluation and necessary x-ray. If you broke a filling, you also need to take care of that to avoid a larger problem. Broken teeth or filling can also be a result of grinding your teeth. Maintain good daily dental care which includes brushing, flossing, and rinsing. Look for sensitivity to temperatures and pressure. Take Motrin or Tylenol if you are experiencing discomfort before you can visit your dentist. Plan to make an appointment soon. Plan to have a physical to rule out heart problems as recommended as well. Thank you for your inquiry. I hope you feel better soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I injured my knee at work about 10 weeks ago. I finally received my MRI results today. My patellar tendon is bruised and there is some fluid in the kneecap. How long should the pain when I stepped down every time last in the front and back of my knee? And should I stop using the cane if I m still having pain? Thanks ### REPLY: Hi, I have gone through the MRI report you have mentioned. This report is not worrisome, but you need immobilization of knee for proper healing. You should rest for at least 2-3 weeks so that your bruised patella and fluid can be healed. You will definitely improve after proper immobilization. If you don't rest, this might further worsen.  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: age 47,height 178cms.fit so far, except high cholesterol 230 detected ,smoker.also chewing gutkha due to which my left side teeth are very sensitive,i am having pain also emanating from atleast one tooth, teeth abrasion is also there.i have stopped using tobacco in any form now for last 10days.but i am scared, do i have cancer? ### REPLY: Hello! Thank you for posting here. Pain and abrasion cannot be diagnosed as cancer. You did not mention if you have any soft tissue symptoms like burning sensation, pain,ulceration etc. Okay, now you decided on quitting tobacco. This is a good decision. Avoid completely. Get complete scaling done with a dentist to remove the stains on your teeth. Maintain good oral hygiene. Get treatment done on the teeth you suffer pain. A x-ray must be taken in deciding the treatment. Get a biopsy of the mucosa if you suffer symptoms. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have a 10 month old son the doctor gave me predcort ds,histal and zinnat to give him i feel this is a lot to give him one after the other they all finish at different times one is only 3 days other is 5 days and histal is for 6 days am i panicking or should i not be giving him all at once? ### REPLY: Welcome to the ChatDoctorI completely understand your concerns. I will be able to guide you in a better way if you tell me about the symptoms of your child. The .  I would not recommend you a steroid and antibiotic unless and until its absolutely necessary for your children condition. So, kindly post your children details, symptoms as a direct question to me, so that I may help you in the best possible way.Don't worry he will be fine. 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 have a history of very high GGT in blood tests - it varies between 192, (in 2002) which I know is high & the last reading in Jan. 2014 of 443 - How can I get this reading down to the accepted standard 0 - 45 ? I am mid 60 s - non smoker & social drinker. ### REPLY: HelloSign GGT may indicate liver injury. It may be due to many reasons like hepatitis, alcohol intake, altered lipid profile etc. It is important to know other parameters like SGPT, bilirubin,alkaline phosphatase level. You may need few investigations like routine hologram, random blood sugar, lipid profile, complete liver function test, ultrasound of abdomen. You should avoid alcohol completely. I suggest tablet ursodeoxycholic acid 300 mg twice daily for three months to my patients. It helps in regeneration of liver cells. You may need to take few more medicines after full investigations. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello Sir, I am 28 yrs old and from April of this year I am feeling mild pain in my left abdomin.I visited my many doctors and gone through many treatments but didnt get any result.The doctors suspected infection in my overy as they didnt find any thing in the sonography report but when the antibiotic which they had prescribed didnt work they come to a conclusion that I have endrometris.All the Doctors told me that I need to do an operation for this.I feel this pain when urin accumulate in my bladder .Some during intercouse I feel the pain.We have always used condoms as a precaution so I dont know whether I am infertile or not.I want your guidance.Please help. ### REPLY: Hi, Thanks for your query. I read your query and understand your concerns. Following is my reply: Its worth going for laparoscopy in your case for 2 reasons: 1) Endometriosis can be surely seen and treated. 2) Tubal patency can be tested to know whether it is cause for infertility. Go ahead with laparoscopy. I hope I answered your query. I will be available for any follow-up queries you have.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 concern about my sister who is 34yrs. My mom went to her room and find out she had too many medications... Not just over the counter but most of them are I believe narcotics,.. Too many of different kinds of medications,like pain, allergy, insomnia,,,, she has a pharmacy in her room that my mom called it. Pls help what we do to minimize her meds, because she s starting to have a mood swing that we can t understand her, she like to argue a lot... ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. Mood swings are a common side effect of most of the medicines and especially narcotics. Before commenting on reducing the medications, it is necessary to understand why she is on medicines. It's possible that she could be genuinely be requiring these medicines. We request you to provide further details regarding the indications for which she is on .  Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am a 19 year girl with regular menstural cycle but lots of facial hair and weight gain . i suspect i have polycystic ovary . kindly suggest me ayurvedic medicine to solve my problem of hirsutism ### REPLY: 1. treatment imparted will not be given to hirsutism as advised/suggested but to the underlying disorder i.e. PCs.2. Was PCs diagnosed by your Physician or is itself labelled?3. Have you checked your Thyroid Profile and Blood sugar level?4. Probable pathology is in the pelvis (Japan Vāyu Area), leading to accumulation of toxins.5. Thus treatment offered by any Ayurveda Physician will be directed towards clearing the obstruction, normalizing the metabolism and regulating the menstrual system. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Just recently I have noticed that my tongue was bleeding...for no obvious reason...the only thing I have done differently in the past couple of weeks has been using 3% peroxide to rinse my month after brushing...too whiten my teeth and improve gum ??? ### REPLY: Hi. Welcome to  . As per your query bleeding from tongue can be most commonly due to traumatic injury to the tongue while can also be bleeding from gums if they are infection. If you have sores on tongue, then it can be due to bleed from sores. I would suggest you to consult an Oral Physician and get evaluated, and a thorough clinical evaluation will help in diagnosis. As far as peroxide rinse is concerned you should avoid using it without proper advise as it can cause teeth sensitivity. As of now take soft diet and do warm saline gargles. 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: Hi I am a 23 year old female. I work part time in retailing. I am severely unhappy in my job hence have chosen to quit. But I know that even this will not 100 percent help I how I feel. Most days I feel unhappy and sad. Some days I start crying for no reason. I tend to suffer from mood swings on a regular basis. These usually occur many times during the week. I also seem to feel tired quite a lot. I have lost interest in many aspects of life that before I would have found enjoyable such as socialising with friends or even sex.  I feel that I would love to get away from everything and everyone around me sometimes. These feelings have been going on for about 2 years or so but have become worse in the last 6 to 8 months. A good thing though is that I have never thought about taking my own life as I know life is precious as a close relative of mine passed away a few years ago and I have been in a relationship with someone and this relationship has caused me a lot of stress. There are relatives of mine who suffer from depression and I am curious to find out if this is my problem also. I would appreciate any help so that I would be able to get hep. Many thanks in advance ### REPLY: Hello & thanks for the query. Short answer is yes you are suffering from depression. Long answer is you are suffering from a chronic low grade depression known as dysthymia where one tends to feel low, tired, non-energetic most of the time but not to the extent that it would severely hamper a persons work performance. In addition, stress from a non-helpful relationship, job etc. usually adds up the woes of a dysthymia person causing an episode of major depressive disorder superimposed on dysthymia known as double depression. Good news is this condition can be treated fairly easily by a multimodal treatment approach. There are .  Next up, a Psychiatrist or Psychologist will take up with you lifestyle modification; how to manage job & relationship stress, doing daily physical exercise to keep mental as well as physical health at a premium & ;lastly factors unique to your personality, environment & possible stressors to avoid preventing a relapse will also be dealt with. Do consult a Psychiatrist & if required; revert to me for further help. Good Luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have a problem related to penis,on the foreskin of my penis there is a black mark which is there for some time and not going, i applied some anti-bacterial ointments as well but it still there,and it appears like ringworm infection. kindly sugggest what to do to get rid of this? ### REPLY: Degree understand your concerns went through your details. Please do not self diagnose of self treat. Ringworm is a fungal skin infection caused by a fungus. Ringworm occurs when a particular type of fungus grows and develops on the top layer of your skin. The fungus infection thrives in warm, moist areas such as, under the foreskin of your penis. The infection is a common fungal skin disorder, affects people of all ages. Although its name suggests otherwise, it is caused by a fungus, not a worm. Ringworm is contagious. Ringworm can be treated with antifungal creams and ointment. But before that, you should consult a skin specialist to confirm that the problem is related to ring worm. Consult a dermatologist. 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 detail possible. Hope this answers your query.  Further clarifications are welcome. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, really hope you can help me. My boyfriend and I were heavy petting on 7 June and although there was no proper penetration there was a little pre-ejaculation. We had both been drinking and my boyfriend said that there can t have been any sperm in it as he experienced slight pain. As a precaution I took the morning after pill around 11 hours after the incident. My last period started on 28 May. Is there any possibility I could be pregnant? Thanks very much for your help. ### REPLY: Hello, and I hope I can help you today.First, unless penetration occurred, there is no reason to suspect that you could be pregnant.  There is a small amount of sperm in pre-ejaculate, but unless you and your boyfriend had direct genital contact there is no way the sperm could have traveled up your reproductive tract because sperm die when they are exposed to air.  Furthermore, even if you did have intercourse, the morning after pill prevents pregnancy 90 percent of the time if taken within 72 hours. So I really do thing that you can be reassured that you are not at risk for pregnancy. I hope I was able to adequately answer your question today and that my advice was helpful. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been graded as GRADE1 Fatty Liver (SGPT=138,SGOT=71,Total Cholestrol=238,Triglyceride-332) after Ultrasound scan & that was around 8 months back. And doctor suggested me to have Atorvastatin 150mg daily & Ursodeoxycholic acid tables 300mg daily(150 each in the morning & night) and below is my present conditions: Total Cholestrol = 151 SGPT=108 & SGOT =32. I have started exercise & controlled my diet as well.Please suggest me,whether I am going to be in a normal condition & Should I continue the same medication? ### REPLY: Dear friend, You have no eminent signs of worry. This would have been great if you mentioned age with other information. However, regulating diet and doing exercises is the best mode of keeping your self away from any risks generated out of fatty liver and cholesterol. As you show controlled cholesterol levels, you should continue with the medicine for another 3-4 weeks and continue with diet control and exercise after that. You should also stay away from alcohol or smoking if it is there with you as they work as risk factors for further liver damage and put you heart at risk too. You may ask for more details in this thread or can ask directly to me through ask a question now tab. 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 have chronic atopic ezcema and my recent blood test taken a few months ago revealed an eosonophil count of 7200. How do I reduce this? At the moment I regularly suffer from itchy and runny/ watery eyes. I am not on any medication, except for use of elocon ointment mixed with vaseline, for my everyday rashes. Thanks, Atul ### REPLY: Hello ATL. Thank you for asking at . I went through your history and I would like to make following suggestions to you:1. High eosinophil counts only suggest that you are having long-standing allergic disorder, atomic eczema or any other allergic disease. Unfortunately there is no specific treatment to reducing eosinophil counts.2. Personally I would suggest you allergy testing which will identify the substances you are allergic to and also measures to avoid them. Reduction of your exposure to allergy causing substances will reduce your eosinophil counts.3. High eosinophil counts also may be due to intestinal worm infestations. If you have any abdominal/digestive complaints, personally I would prescribe you a small course of antiparasitic . Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My boyfriend o six months complains that sometimes after sex he gets pimple like sores on his penis. Sometimes they last a few days, sometimes longer.  I have spoken to my gyno and he assures me that I am well and am not nfected with anything.  We only have sex with each other.  Any ideas what might cause this. ### REPLY: Dear, We understand your concerns went through your details. The pimples could just be rashes and there could not be anything to worry. Request your boyfriend to consult a skin specialist. 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 detail possible. Hope this answers your query.  Further clarifications are welcome. Good luck. Happy New Year. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear doctor , iam 34y old, married male, Sir, i am suffering very much pain about my penis, where it is fully have cuts on outer foreskin. even i cant open it to clean inner foreskin, pls help me y it is so , this is the problem since 7-9 months as on today  my email id is   YYYY@YYYY ### REPLY: Hello, Irritation can resemble a cut. And if you scratch itchy spots on your penis too often or too hard, you can tear open the skin. Untreated Atlantis can also cause your foreskin to become impossible to pull back, which is known as fibrosis. Please consult a doctor for physical inspection.  Hope I have answered your query. Let me know if I can assist you further. Take care .  V. Anand, Psychologist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 blood glucose has been very low, infact I was diagnosed with insulin resistance and polycystic ovarian syndrom and prescribed metformin 1000mg twice a day. My blood sugar continues to be low, frequently in the 30s -50s. Now my liver enzymes are elevateded and also Inflammed bowel tests were elevated? any thoughts? ### REPLY: Hi and welcome to . Thanks for the query. There are many possible causes and additional tests are required to define the illness. It may be caused by viral hepatitis, cirrhosis or biliary stone and first step should be ultrasound and viral markers check. Also, fatty liver may go with diabetes and this is treated with dietary changes and lipid and sugar regulation. So lipid profile should be checked as well. I hope I have answered your question. Wish you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have had 2 major ulnar nerve surgeries and the 2nd one the ulnar nerve was put inside a cortex tube for protection the last surgery was 6 years ago and I am still in major pain at the site where the tube is. Will the specialist remove the tube? ### REPLY: Hi, As the removal of the tube needs to be decided based on the clinical examination. If the requirement is there to be removed than the surgeon will remove it. But we need a detailed description of the history that for what it was inserted and what procedure was performed. Also, the pain is totally related to the nerve inflammation and this is the functions of the nerve to have disturbance in the normal physiological process. So get it examined once before taking up any thoughts. 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: Hi I have had 3 bowel movements today.  All have been fairly normal that is soft.  The first one was right after breakfast.  The second was during lunch.  The last one was as soon as I got home at 1:00 pm and it was normal, but I have had stomach pains on my left abdominal side.  I had some herbal tea.  I seem to have pass gas and it smells very bad too.  my pain on my admonen is soo bad that I have  heatig pad on my stomach. ### REPLY: Hello! Thank you for the query. Your pain in that area can be caused by several issues including stomach issues (peptic ulcer, stomach inflammation), urinary tract stones/inflammation, bacterial infection of gastrointestinal tract or even bowels' obstruction. Stomach issues usually give upper abdominal pain which is associated with foods intake. The pain is dull and does not go away with painkillers. Urinary tract issues give also frequent urinating, burning while urinating, lower abdominal pain, fever. Infection usually gives also loose stools, bad smelling stools, fever, nausea. Bowels obstruction (partial) can give cramps and bloating. I suggest you to consult your doctor. Abdominal ultrasound, blood work, urinalysis should be done at first. If nothing will be found, gastrostomy should be next. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hiii my father is suffering from high BP ... we hv consulted many doctors and dey hv recommended to do exrcyz n ol n to eat healthy... bt d thing is dat my fathera exrcys daily fr 2 hrs n alwez eat healthy .. n he is taking amtas frm last few months .. bt still he ia unable to cure dis problem .. kindly advice wat shud we do ... ### REPLY: Hello, Please note that light exercise as walking decrease blood pressure in people who were sedentary already.  As your father is already exercising and amlodipine is not working, then I will recommend adding April to amlodipine. I will also suggest decreasing salt, alcohol, coffee, tea, energy .  Plenty of sleep advised. Most important is kidney function tests as blood urea, serum creatinine, serum uric acid, etc. Keep his blood pressure below 140 /90 mm Hg. 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: my mri report says that I have an acute annular tear at l5-s1 disc posteriorly towards right. posterocentral disc protrusion at l5-s1 level indenting thecal sac and contracting bilateral traversing s1 root. How serious is that since the pain is still there after 10 sessions of traction in physiotherapy and what is the cure ### REPLY: Hello, I have noted the MRI data If the pain is still persisting despite physiotherapy, you can visit your neurologist and get evaluated. This is especially to look for the signs of nerve root compression that is being described in MRI. If there are no clinical signs of nerve root compression, I feel that you can still continue conservative treatment with medicines like Gabapentin, pregabalin. Surgery should not be done for pain alone. But if all conservative treatment fails you may opt for surgical management. This is nothing serious. There are options available to deal the problem. Just don't worry and get reevaluated as I discussed Best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im a 44 year old African American man who recently stopped working because of chest and back pain, and well, quite frankly I just didnt have the energy anymore. My body feels really wears most of the time, sharp pains everywhere and flashes of light in my periferral vision....Whats wrong with me? ### REPLY: Hello Thank you for trusting  When the vitreous gel inside your eye rubs or pulls on the retina, you may see what looks like flashing lights or lightening streaks. You may have experienced this sensation if you have ever been hit in the eye and see "stars." These flashes of light can appear off and on for several weeks or months. As we grow older, it is more common to experience flashes. If you notice the sudden appearance of flashes, you should visit your ophthalmologist immediately because it could mean that the retina has been torn. Along with that your having minor depression or viral myalgic. So consult your doctor as early as possible. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 150 lb. 50 yr. old woman with no previous gastro concerns, no daily meds, a daily antioxidant supplement with a multivite w/iron, daily diet with variety of fruits & veggies, milk, yogurt, chicken, fish, beef, whole grains, & beans with very little processed food, no food allergies.  Lifelong exerciser, presently in pool 2x - 3x a week, but sedentary lifestyle past decade due to spinal injuries.  Developed bouts of severe abdominal pain and GI distress with heartburn & reflux this year.  Suspected two pain meds used occasionally for chronic back and neck pain (Percocet & Fiorinal) but discovered each time I eat pistachios, even just 10 or 12, I get the same horrible GI distress.  No itching or hives or other allergic-type symptoms.  Is this considered an allergy?  Is there a name for it, the way that gluten intolerance is called Celiac Sprue Disease or "wheat allergy"??? ### REPLY: Hi. Thanks for your query and an elucidated history. Pistachios are known to cause an intolerant GI symptom and is called Pistachios Intolerance. This is definitely an allergy to its contents but only with Gastrointestinal manifestations. So the treatment is basically never to have them or any food parts which have similar properties. In addition, you have been taking Percent and Final. Both these can enhance the already existing problems. Sedentary life will have its negative effects on the body. Try to be as much ambulatory as possible, and you can certainly go for passive exercises under the guidance of a Physiotherapist, ... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a throbbing sensation in my left calf, it s been there sometimes now. It doesn t hurt, it s more annoying than anything but I can actually see the vein throb when it happens, and guess I m just concerned it s got something to do with DVT, Any help would be greatly appreciated. Thanks. ### REPLY: Hello, As mentioned in history about throbbing pain in veins, I will ask you to check out a few things - your blood pressure, blood glucose levels and also Doppler scan. In DVT, the throbbing pain is common, but one should check for skin discoloration and also have the use of Doppler scan to rule out the symptoms. Once done you will get a clear picture of the same. Even patients with high blood glucose levels may also complain about similar symptoms, but it may not be related to DVT but neuropathy. Having a proper clinical examination and assessment should help us know what is the diagnosis and what measures can be taken. 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: Hi, I have been experiencing frequent dizzy spells. This has been happening for the last 6 to 8 months. I had a couple very big changes in my life happen about a year and half ago that caused me to have a panic attack, then shortly after I now have anxiety. I have been reading about dizziness and anxiety is a common. Is there anything I can do to shorten these episodes or completely get rid of them? ### REPLY: His had gone through your query. Panic attack is one of the type of anxiety and dizziness is one of the symptoms of it. It can be treated with medicines plus behavior therapy. In medicines SSRI and anxiolytic will help. SSRI like Escitalopram/paroxetine/sertraline will help to reduce further attack and shorten episodes. Anxiolytic like Mizoram or clonazepam will help to control acute attack of it. Besides this Behavior therapy or cognitive behavior therapy will help. Exercise/ meditation/ deep breathing exercise/ hyperventilation can help. Still if you have query then feel free to ask. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my dog bit me monday night and i rushed to the hospital and got 3 stitches on my forearm, i went yesterday back to the hospital for a wound check and the doctor told me i was doing great that i heal well, he then but a red/yellow liquid and but a big bandage and told me to go back on monday to get the stitches removed. I noticed last night and this morning it has some puss in the wound and itches lightly, is this good or bad? ### REPLY: Hello, Welcome to , As you were bitten by a dog over the forearm for which your doctor as stitched the wound as it was a lacerated wound. Rabies is a disease which is transmitted by dog bite having the rabies virus. Preferably the dog bit wound should not be sutured and if it is to be sutured it has been done only after administration of antirabies serum around the wound otherwise the suturing may fasten the movement of the virus towards the CNS. As there is some discharge from the wound which is yellow color may be due to some secondary infection in the wound which should be treated appropriately after consulting your doctor. 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: Hello SIr, I am a 28 years male. I have swelling under my lower part of rib cage on left side. It is from 4 years now. I never felt any pain before. But I feel discomfort when i bend on left side. I have never felt any pain but some times it pains in left abdomen or under left rib cage for a fraction of seconds. I dont know what it is. One can easily see that left rib cage is swollen nd not in shape as of Right rib cage. Please help me i am bit worried. Is it something serious. ### REPLY: Hi welcome to  forum.  Thanks for choosing . F.  It appears to be the lipoma, and nothing else. What ever pathology of left upper abdomen like gastritis, pancreatitis, etc. will never elicit to the outside. More over it is painless at the same time causing discomfort.  I advise you to consult a surgeon for diagnosis and treatment. You may have to take C.T.scan, besides other routine tests and manual examination for confirmation.  Wishing for a quick confirmation of the disease and cure. If you have any doubts you can approach me for follow up.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good morning , I ve been having this annoying cough for nearly a year , been to my family doctor a few times he then gives me an anitbiotic and prednisone . This only stays away for at least a week to 2 weeks then its back. i keep getting told that its an allergy . i need a more permanent solution , i cant handle the cough as it feels as if i m coughing my lungs out and its very irritating to the next person. Also it starts off as a normal dry cough then I become wheezy chesed within an half an hour. ### REPLY: Hi, You seem to be suffering from bronchial asthma (Typically cough variant asthma) or may be Upper airway cough syn .  You need to get yourself evaluated by a Pulmonologist/ Chest Physician. Investigations that may be required are chest X-ray, serum IGE levels and pulmonary function test in consultation with the Pulmonologist. Depending on the evaluation results you may be prescribed certain inhalers and oral medications along with a nasal spray. Also, you are a candidate for yearly flu vaccination and 5 yearly pneumococcal vaccination.  Regards ### END