Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir I have seizures from my school days which is not stopped even now .The seizure occurs in the right leg which is has uncontrollable movements for some time (say a minute or 2 minutes ) . please give a suggestion so that i can run my life in tablets without seizures.Already seen many doctors.Medicines taken are dilantin , epilan , ,encorate , dicorate , levera , zapiz , pacitine , tegretol , topomax. etc pls help me.Eplilex chrono now my age is 43 yrs old.My name is R.Ravindran form , Chennai, Tamilnadu,INDIA ### REPLY: HelloWelcome to ChatDoctorYou have mentioned that you have seizures in right legs characterized by uncontrollable movements and probably without the loss of consciousness. Most likely these are partial seizures. You have taken multiple medicines like Phenytoin, Sodium Valproate, Levatiracetam, Carbamazepine, Topiramate etc. and with no or poor relief. See a lot of people with epilepsy don't respond to single .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 rash on my neck , wrists and my anticubital area. It has been diagnosed as azsema once before and I have been given protopic tacrolimus ointment but that had no effect. I have yet to go get an allergy test which I hope is the cause but I have been experimenting taking things out of my diet and then putting them back in to see if there is any change and I have yet to find anything food related. One thing to note is that I am a non-strict vegetarian. I have never switched to a heavy meat diet for experimentation due to price and the amount of fats in meat itself. Any suggestions? ### REPLY: Hello, A restricted food diet is never a good idea as you keep taking things out of the diet and will find it difficult to re-introduce. Food allergies worsening eczema are not very common while some observational studies report eggs, milk, shrimp to worsen eczema in child .  Other studies have suggested an association with wheat.Therefore, it is always best to get a skin test (when you are NOT on antihistamines) as specific IGE blood test for eczema may sometimes give false positive results if the total IGE is high (>1000), confusing the picture. If you definitely have any food allergies, it is worth mentioning to your allergist before the test is done. Eczema can flare due to house dust mite or animal allergens, so it is important these are also checked at the same time. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My upper lip became oddly splotchy and seems to be really dry and darker than usual. It feels numb and when I run my tongue or finger over it, it feels spotty. It s been like this for a week now, and I ve tried a few lip balms but it doesn t seem to do anything. Peeling at the dry bits causes some tingling/slight burning sensation. Read some other answers below and I did suspect some mild allergy although I m not sure what it could be and whether an allergy could last more than a week as this has ### REPLY: Hi welcome to  forum.  Thanks for choosing . Forum.  You have got a rough upper lip, splotchy, dark, spotty, With tingling and burning sensation.  It appears to be a fungal infection, Or as you suspect it may be an allergy to some cosmetics, or .  If the allergy causing things are not stopped the allergy can continue, and may lead to infection.  I advise you to consult a dermatologist for diagnosis and treatment.  Wishing for a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have hd severe back pain for years. I am 26 with two kids and overweight at 5 7 and 265 pounds. I also have polycystic ovaries.. I am taking adipex and had xrays along with blood tests for thyroid work done. Results have not come back. For my pain my doctor perscribed tramadol which made me sick so instead she perscribed napoxin for pain, but I have read numerous bad reports of this medication. Is it safe? I need something to cover the pain until we see xray results. What should I do? ### REPLY: Dear-thanks for using our service and will try to help you with my medical advice. First, Naproxen should be taken with some food to avoid more damage to the walls of the stomach. It is a safe . If that is the case, then avoid it. You can take Acetaminophen to avoid the side effects of Naproxen or just alternate with both for the chronic pain. It depends on the X-ray results, you might be a candidate for physical therapy or epidural block. Weight loss will help the back problem too. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 question I would really like you to answer. I woke up 2 days ago with a hard lump on my wrist under the thumb On top of my bone it hurts to move my wrist in a certain way And when I put pressure on it it also hurts. do you possibly know what this could be ### REPLY: Hellos per your description of the lump it seems to be a Neurofibroma. Need not worry, it's a benign condition, and it is mostly a cosmetic concern rather than pathological. The common sites being the fore arm wrist back etc. it causes pain only when pressed deep, otherwise it only causes mild tingling or mild pain. It may be single or multiple. Definitive treatment for this is only surgical excision of the lump. Need not worry about this too, as it is only a day care minor surgical procedure. Thaank 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: 12 days ago, i rcvd 5 stitches in my upper lip.  the cut did not go above the lip line.  the dissolvable stitches are still showing, and there is a hard lump, both on my lip and above the lip line and it feels bruised.  Is there anything that I can or should be doing now to make this lump go down?  (Cut looks really good and healthy, good color).  How long should i allow the stitches to stay in before seeking medical attention to remove them? ### REPLY: Hi. Thanks for your query and an elucidated history. The stitches should be removed immediately and a short course of an antibiotic, anti-inflammatory medicines and steroids should be taken for 3 to 5 days only. The problem will get solved. If there is a small collection of fluid or pus, it will .  Do not fiddle with the lump with finger/ teeth/ tongue as usually happens as this will delay the healing and resolution. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently noticed a painful lump on the joint closest to your hand on my middle finger. It s especially painful with pressure to the lump. I m guessing that the size is probably about 1/4 of an inch diameter. What could this be? Will it go away on its own or is it any cause for concern? ### REPLY: HI, Dear,Welcome to . Based on the facts and data of your query, you Seem to be having -Ganglion / or could be rheumatoid nodule. Treatment-Consult orthoSurgeon-Get the X-ray / if need be CT of Handset Compresses/ and Infrared Heat therapyAnti-inflammatoryPainkillersIf no relief Rheumatologist opinion, who would do RA/CRP and would evaluate and would give needful treatment Ganglion on the hand on middle finger extensor tendons-Ganglion Excision by Endoscopic Laser Ablation of the Synovial Histiocytoma around the joint line and tendon near it. Other causes need to be ruled out by Second opinion from your doctor which would help you to plan treats in the future. Hope this would help you to resolve your sever anxiety. Welcome for any further query in this regard Will appreciate writing your feedback review comments, to help the needy patients like you at . Good Day!!  . S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son had heart ablation surgery twice this year.  He has had a very tough recovery, and has had continuous issues with his blood pressure dropping.  Tonight, his blood pressure dropped, heartrate dropped to 42.  But tonights episode was different.  His lower back is all bruised.  Should I be worried about the bruising.  Could this be related to his blood pressure drops?  (He is being seen by multiple doctors.) ### REPLY: Hello, Thank you for your query. I will add .  1)low heart rate - yes a rate of 42 is low and a cause for concern especially if it associated with low blood pressure. This is most likely due to the medications and needs to be monitored by his treating doctor for adjustments in dosage. 2) bruising is not normal and means that there is a clotting problem. Large bleeds can cause a fall in blood pressure. This again is most likely due to the medications (blood thinners). This again needs to be monitored by tests and dosage needs to be frequently titration to suit his needs. Please talk to his physician and cardiologist. Certain medications, interact with each other and when taken together have an additive effect. Please discuss this with both clinicians. Please consult his doctors right away as massive internal bleeding can cause life-threatening complications as does a very low heart rate. Hope this helps. Please let me know if there is anything else I can help you with. Wish you both good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, im lara, 21 y/o, height of 51 feet, 49kg. ive undergone urinalysis yesterday, and found out that i have UTI. but i dont want to take antibiotics because last time i took antibiotics i noticed that my tongue and vagina have yeast. and according to my research, yeast infection may occur after taking several antibiotics. ive got scared because this yeast infection is a STD right? but now, there is no more yeast on my urinalysis. im just afraid that it may come back if i take antibiotics. what should i do? thankyou. ### REPLY: Hi, welcome to  forum. I appreciate your concerns. But, it is not common to get yeast infection on a single antibiotic course to treat UTI. It usually follows administration of multiple antibiotics simultaneously, that too for unusually long course. If you get it even on a single antibiotic course, definitely we have to look for any underlying cause for immunosuppression(like diabetes, HIV etc.). And, leaving an UTI untreated is not that good. It can lead to ascending infection leading to pyelonephritis, and may even affect our reproductive health. I usually give antibiotics like definite/norfloxacin(should not be pregnant) to my patients. Also, take plenty of fluids, and keep good oral and vaginal hygiene. I hope you will find this information useful. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor,My brother is suffering from Schizophrenia, he was on medication from last 9 yrs, but now he has stopped taking medicines. And his abnormal behavior is clearly visible to all, but still he is not willing to take medicines. I want to know what we to do now as he is not taking medicines? Please recommend the best doctor/ hospital to deal with this problem? ### REPLY: I don't know where u r from, so I can not recommend u any doctor or hospital, but I can give u some possible therapeutic options for your brothers' illness. If symptoms are severe n causing problems then following are the options:1. Give mouth dissolving antipsychotic medications like risperidone and olanzapine. These medications can be added to fluid like water n other liquids, can be given with food, without patients knowledge. It is odorless, colorless, tasteless. So it can be used when pt is denying for the illness and refusing for the medications.2. Patient can be given long acting antipsychotic injections.as for example, in.Capitol. Two types are available depending upon the dose and acuteness of illness. Inj.Capitol anaphase [50 mg] is given intramuscularly and after 3 days of this patient shut be given in.Capitol depot [200 mg] which releases . . Depending upon the symptomatology the depot injection is repeated every 14 days or 21 days... apart from this u can sedate your brother with the anaphase injection and take him to the nearest psychiatry hospital and get admitted there. The treating psychiatrist will guide u and manage your brothers' illness in the best possible ways. I don't know where r u from, but electroconvulsive therapy could be a good option when everything else fails... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 tingling pain (more of an annoyance) in my buttocks which will occasionally extend upwards into my lower back and down the backside of both of my thighs. It s extremely uncomfortable when I lay down, I cannot find a comfortable position to fall asleep. What is wrong with me? ### REPLY: Hi there. Thanks for your question. Pain in the buttocks radiating down your thigh can be a manifestation of pinching if a nerve in your spine. Usually at the lower level that is L5 S1. Since it's affecting your routine, you should get an X-Ray of your spine followed by MRI if required(depending in what's seen on X-ray and whether u have relief with pain meds). Depending on severity of pinch u will need pain meds, injection or surgery. Hope this helps you. All the best. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have an 82 year old female that suffered a stroke 5 years ago. She recently (yesterday) developed an open would at on her bottom. what could I use to treat it? It is located in the top of her butt crack. (sorry don t know a better way to describe its location) ### REPLY: HI, thanks for using  It is possible that it is a bed sore especially if her movements are restricted due to her stroke. If this is the case then one of the main aspects of treatment would be to limit the amount of time she spends in particular positions. She should be turned at least every 2 hours while in bed. She should sit out of bed regularly. The bedding may have to be changed to those that exert less pressure. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Helo sr, we r trying for a child since last two years but there was a problem with my wife egg formulation is not proper and endomaterial thikness also. And when i go through for seman analysis it was poor. 10 to 20 /hpf pus cells r found thats why sperm count and motility also poor.75%of sperm r non active.Dr suggest us fr IuI how much it safe. kindly guide me. Thsnks &Regards Ravindra ### REPLY: GUI means intrauterine insemination. In this fast moving sperms are separated from the abnormal and slow sperms and prepared. These are then inserted into the women womb close to ovulation. Before GUI, a patency test is done to ensure both the fallopian tubes are open. As such no risks are associated with IU. Apart from the fact that this is not a sure shot method for conception, it is usually done under guidance of an ultrasound to know when the egg has matured. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I WAS ON THYROID TREATMENT 3YEARS BACK BUT NOW IM NOT TAKING ANY MEDICINE AS MY TSH T3 T4 LEVELS ARE NORMAL .I HAVE A 5CM BY 4CM IN MY RIGHT OVARY .THE DOC HAS ADVISED ME OVULOC ID FOR 21 DAYS.MY QUERY IS THAT CAN THERE BE ANY SIDE EFFEC ON MY BODY DUE TO THIS PILL? ### REPLY: Hi, Ovuloc-LD is a combined two female hormones, namely progestin and an estrogen and is most commonly used to treat symptoms associated with polycystic ovarian disease. It is generally well tolerated by most women however its short term side effects include mood changes, nausea/vomiting, headache, breast pain, spotting or breakthrough bleeding and weight gain. The long term side effects include clot formation in the leg veins, increased blood pressure and increased risk of cancer of breast or uterus. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I m a 35 year old female with problematic ankles. I always get swelling when I am near the ocean and my doctor told me this was normal and explained the reason why. I am in Florida on vaca right now and only my left ankle is swelling up really bad. This has never happened before. Could it still be due to being near the ocean? Why would just one ankle swell? What can I do to treat it? ### REPLY: Hello, I have studied your case, and It is not common to have swelling when you go near to sea. I would recommend you to get MRI of the ankle joint to see if there is any synovitis or loose body in the ankle.Also, I would recommend you to wear anklet or crape bandage in nighttime. Take Discern tablet one daily. I hope this will take care of your ankle swelling. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For about two weeks, usually only in the morning (as soon as I exit the shower) but sometimes during the day my feet and legs will itch. Most of the time it s only my legs, but sometimes my arms and butt will ich also. There are no visible bumps or rash, I went to Florida last day for a few day, and the last two days I was itch free, but once I returned to Dallas I almost i started itching once I got back to my car, is this just an allergy to something in the air? I have been taking Benadril and that seems to work... Usually. ### REPLY: HI, thanks for using  It is likely an allergic reaction. Allergic reactions can occur to different agents such as lotions, creams, soaps, foods, dust, medications. If you wish to determine the exact allergy, you may want to consider allergy testing. This can be in the form of blood tests or skin prick testing. If you can determine the allergen then you can limit your exposure to it. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a circular rash on the palm of my hand which is now on the sole of my foot. They come and go but are very itchy. I have now found a raised rash in the pubic line which is not itchy. The rash seems to be like an insect bite and is more yellowish in the middle. Im male 28 and have not had any problems of this klind in the past and have not yet tried to treat this problem.Please help thank you. ### REPLY: Hi, As per your descriptions, it could be due to eczema, tinea, psoriasis, insect bite etc. You will require topical corticosteroid like beclomethasome or clobetasol or mometasome with antifungal cream like itraconazole or fluconazole with oral prednisolone and fluconazole with antihistamines. This type of skin itchy rashes are required to be seen by naked eye of a doctor for confirmed diagnosis. So, better you consult dermatologist and start the treatment. You will be alright after that. 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: So I have this flap of skin over my molar . I have no wisdom teeth . It appeared after a Ians fillings put in . They said they nicked my cheek not my gum .. anyways , its a flap in the back on my left side . Its extremely tender . What is it and what should I do ? ### REPLY: Hi. Welcome to . As you mentioned you have problem of tender flap after filling a restoration that may be because of infection or trauma or other reasons. Final diagnosis can occur after clinical examination of oral cavity. Painkiller can use for pain relief. Maintain proper hygiene of oral cavity. Avoid trauma by using soft brush. Topical anesthetic gel helpful. Consult your dentist again for further treatment. I hope this will help you. Get well soon. 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 have a really itchy red rash on the top of both of my feet . One break out about an inch below my pinky toe , and another opposite of that, below my big toe. It is the same exact thing for both feet. I showered last night with the same soap I always use, and woke up with this rash. ITS SO ITCHY!! I don t know what to do :( ### REPLY: Hello, Thanks for the query, You have developed an allergic reaction to any footwear, Rash on both feet and itchy suggests of this. I would like to know if you have changed any footwear? A photograph would also help me in giving a closer diagnosis. Apply a mild steroid lotion like demonize, Also take an antihistamine tablet. This will give you some relief. Please meet a dermatologist for exact diagnosis. Let me know if you have any other doubt. You can ask a direct question to me on this forum, following the below link.https://urldefense.com/v3/__http://www.ChatDoctor .com/doctors/ . Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? Please type your query here... My 8-month old had a fever of 100.2 at 7p.m., gave her Tylenol, woke now at 3 a.m. with 103 temp. Has cold- cough and congestion. Took down bottle. Is flushed. ER or wait for doctor s office tomorrow? ### REPLY: Hi, As per your query your baby suffering from cold, cough and fever which is mainly because of lower respiratory tract infection, and it could be due to granular pharyngitis.  Need not worry about it. Symptoms resembling flu and normally takes 3 days for viral fever to go. Visit pediatrician once and get it examined. Mussel Plus and spy. Deacon is the right medication, but you should give a mild dosage of it to your child. If the cough is exaggerating go for chest X-ray, blood and sputum test of the child. If it is bacterial infection start with a proper course of antibiotics. Till then give Cronin 4 hourly. Acetaminophen is also effective, and you can give that as well. Give the child a proper rest without any discomfort. Give water after every few mins. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes, I have a high lymphocyte count of 74, my neutrophils are low at 17, but my wbc count was only at 14.4, could this be a sign og hiv? my doctor has ran many tests including a bone marrow biopsy but didnt find the CLL she was looking for. I am tired of waiting and wondering and this is all I want to know? Thank you! ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You have high lymphocytes count.  There are many cause of high lymphocytes count starting from viral infection to CLL. You have high lymphocytes count does not mean that you have HIV. So don't worry about that. And you also don't have CLL, so it is also ruled out.  Some time persons have high lymphocytes count without any cause. So don't worry just be relaxed.  You should go for related complete blood count examination.  If your total count increase or platelets are reduced then consult your doctor. Otherwise, no need to worry. Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 3 year old and she had cough and cold frequently.dr. told me she have sum allergy problem.our dr. prescribe her montair tablet & colvincold tonic & advent antibiotic. in last 6month i m visting every month for the same problum.when ever im giving her antibiotic she is fine but after 15 days she had caugh and cold fever again .i m looking for sum permenant treatment for this.ayurvedic treatment is good for this age? ### REPLY: Hello. Thank you for asking at . I went through your daughters history and would like to make suggestions for her as follows:1. I would suggest her allergy testing which will you to identify the substances she may be allergic to. Avoidance of the allergy-causing substances is the best treatment of allergies.2. If she does not have fever or other symptoms suggestive of bacterial infection, I would not prescribe her antibiotics. Too much use of antibiotics without actual need is not advisable. 3. For her symptoms, I would suggest her montelukast and levocetirizine.4. In general, please avoid exposure to dusts, smokes and air pollution to her.5. I have seen patients getting benefitted by Ayurvedic treatment. Of course, you can consult an Ayurvedic consultant. Hope above suggestions will be helpful to you. Should you have nay further query, please feel free to ask at . Wish your daughter 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 have been having a lot of pain in my neck, shoulder and shoulder blade area on left side. I also have pain in my left forearm and sometimes my wrist on left side. I have had a couple of instances where my hand has gone cold while sleeping. I have a lot of pain in front of my neck above clavicle, and it is extremely sore when I press on the area as ell as base of my skull. I have had headaches along with these symptoms. What is going on? ### REPLY: Hi, thank-you for providing the brief history of yours these symptoms looks more of a pinched nerve in the cervical spine and needs a thorough clinical assessment along with MRI of cervical spine to visualize the level of nerve compression. Also, due to the pinching of the nerve in the cervical spine, the pain radiates to the head and lower below it like - shoulder blade, shoulder, arm, forearm and hand. Physical therapy like - Therapeutic ultrasound therapy and TENS therapy will help to reduce pain and inflammation. Also, exercises on later stages will help improve the strength in the muscles of the neck, upper back, shoulder, arm, forearm and hand. In my clinical practice such cases respond well to physical therapy. 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: I had lithotripsy last week and still have pain in the same area my stone was in.  I also have a rash on my back... does not bother me.  I am not taking anything for pain and am not passing many fragments.  I have one kidney secondary to donating one to my mother in 2008. ### REPLY: Hello and welcome to . As a Urologist, I fully understand your concern. As your Urologist would have advised you, you must be very cautious against any problem, in the one kidney you have. Some larger fragments may cause pain, due to impaction. To prevent this, and for smooth passage of the smaller fragments, a stent is usually placed at time of ESL/ endoscopic lithography, depending on site of stone. If your pain persists, get an ultrasound scan. .  You can send a copy of reports, for expert opinion here in my name.  Wish you well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 64 year old female in what I thought in pretty good health. I am taking Toprol for blood pressure among other vitamins etc. A week ago, while on vacation, I notice I was having an irregular heartbeat and was getting dizzy while standing. I have had pvc in the past and they would go away when I stopped caffeine. My cardiologist told me today that the EKG done i his office a few minutes ago I was in v fib. He said if we had caught this within 48 hours of its beginning, shock could have helped. This afternoon he has put me on Pradaxa for he feels I may have formed a clot in the heart. My pulse irregular is about 80 beats a minute. He has scheduled an echo and stress test tomorrow. There are so many questions I have and did not ask. Is this condition treatable, am I being ultra scared that I think I will die very soon from the silent killer , what about stokes? I know you may not be able to answer this questions, but any information may help. Also, would a couple shots of Scotch hurt? ### REPLY: Dear Mrs, If it is the first time and there will be no significant abnormalities on your echo, then it is possible to try to restore your sinus rhythm. But you have to take Grafana for about a month before the cardioversion to be protected from stroke.Don't panic, nowadays thousands of people live with atrial fibrillation for years and have normal life. The major adverse events of atrial fibrillation are strokes, but when people take blood thinners appropriately, the risk is minimum especially when there are no other risk factors. I would advise you to avoid alcohol for some timetable fearsome back if you have further questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 28 year old male and I have been sexually active for many years. Recently I started to having an issue keeping an erection hard for long periods of time. I can get it up during four play but then loose it in the transition to sex. I can get hard when I pleasure myself but loose the erection quick if I stop. This has never been an issue before and I normally can stay hard pre, during and even post without any issues? Can this be ED? I just went through a tough break up after 9 years and also went from not using condoms ( partner was on BC) to now using them again? what is the issue here? How can I solve it? ### REPLY: HelloThanks for query. You seem to have facing problem of secondary ED due to Psychogenic factors about which you are not conscious. In absence of any major health issues the cause of secondary ED is mind related and due to psychogenic factors beyond your knowledge, or you are not aware about them. You need to consult qualified Psychiatrist for evaluation and counselling. Following measure will help you to boost up your confidence and getting good erection.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc3)Take anti oxidants like Almonds 5-6 every day.4) Avoid alcohol and smoking. Taking Sildenafil (Viagra)as on demand will help to get good hard sustainable erection and to have enjoyable sex. . . You need ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: have pain aver right side of stomach extending around the right side of bidy to the back almost to the spine.  During an IVP I felt something give way in right side of stomach.   Cannot tolerate being touched in these areas.     Thankyou for your help. ### REPLY: Hello and welcome to .  As a Urologist, i can understand your anxiety. Your pain is most likely due to a stone in right kidney or ureter or a POJO. A POJO is a pelvi-ureteric junction obstruction. After an MVP, both can cause pain on the flank, where its present. So without seeing the MVP, its difficult to comment. With a block in the kidney, due to either condition, therell be pain on touching. You may send all the reports to me, as a direct question, for an expert opinion. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After I started having sexual intercourse with my current partner, I was diagnosed with a yeast infection, which I took antibiotics for. About two weeks after I took the antibiotics, I got a brownish-clear fishy-smelling dishcharge (the discolored discharge was a one-time thing, but the smell continued). I went to the doctor, who told me nothing was wrong so I took a medication I got from sprouts for balancing of yeast bodies and bacteria. It seemed to clear up. Then, about two months later, I got the coppery-clear discharge again (just once with a strange odor). This went away. I went to the doctor again for a UTI, again, she told me I did not have one. This discharge and smell reapearred two weeks later, and again another week later. The odor is only present with the discharge (which only happens once at a time). Also, I dont know if this is relevant. . . sometimes sex is painful (usually only at the beginning, but their have been two times where it was throughout and I experienced burning with urination. . . but only after intercourse. The doctor is not at all helpful and has suggested nothing but more visits. Do you have any idea what this might be? ### REPLY: Hi, Thanks for posting in . I understand your concern. Symptoms of experiencing recurrent yeast infection may be due to poor hygiene or due to transmission by asymptomatic partner during sex. If the infection recurs again and again, the following things need to be done: 1. Maintenance therapy like a regimen of oral fluconazole tablets once a week for six months or clotrimazole as a vaginal suppository used once a week for six months can be used, along with a course of metronidazole.2. Treating partner too if the partner has symptoms needs to be treated. Other measures which needs to be taken care are the following: 1. Wash the area with warm water and mild antiseptic twice daily until the symptoms subsides. 2. Abstain from sexual activity till your symptoms subside completely. 3. After using the toilet, wipe from front to back to avoid spreading yeast or bacteria from anus to the vagina or urinary tract. 4. Wear loose fitting cotton undergarments that helps keep your genital area .  5. Change pads or tampons often during periods. 6. Use vaginal antifungal medicines which are available for 1-day, 3-day, and longer courses, depending on the strength of the medicine. 7. Along with it, she can use vaginal boric acid capsules, which are available over-the-counter. Do not use this medication if you are pregnant. Hope the information provided would be helpful. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Thank you! I have pain in my right back leg where I bend it. It has several small lumps there like maybe at a vain, I cannot see this but can touch it. It has some soreness to it at times my leg swells, only when I keep it elevated does the pain ease. Hope it s not blood clots or worse. Can you help me with this issue? ### REPLY: Hellosmall lumps or swellings behind the knee may be bursitis- a condition in which small protection pouches of membrane called bursa get inflamed and there is collection of fluid there. The usual treatment is by anti-inflammatory medicines and compression bandage, rest till the inflammation subsides. If it doesn't then diagnostic aspiration is done to rule out infection and cause of swelling followed by suitable antibiotics and . So consult an orthopedic surgeon who will decide and treat thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was just told that I have a-fib.  I had a normal EKG a year ago, but also had treatment for breast cancer that included doxarubacin and cytoxin, then taxol, followed by radiation.  The cancer was bilateral, and I had lumpectomies.  Could the a-fib be a result of the cancer treatment? ### REPLY: Yes Treatment for cancer can cause atrial fibrillation. Radiation and medication for cancer chemotherapy like Duxoroubicin, Taxa and to less extent other medications are cardio toxic, such that they affect the Heart muscle causing inflammation.  When this inflammation subsides there is some residual fibrosis in between the heart muscle. This fibrosis acts as substrate for rhythm disturbances, common among them is a trial fibrillation.  A 2 d echocardiography more precise Cardiac MRI is suggested to know extent of any damage to the heart. In many causes though there is no decrease in pumping of the heart (mechanical) , still arrhythmia may happen sue to electrical disturbances.  Let me know if any clarification needed.  Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my wife has been experiencing sudden weakness on her right arm and right leg. This had happened 4 times during the last two years. Every time she would just all of a sudden feel dizzy and just faint. She would then wake up about half an hour or so later. What s wrong with her? ### REPLY: Hello, As in females, it's become off late common to faint and lead to tension in the home. But this is totally related to lower hemoglobin and low iron levels. Having a blood routine to check the HE will be good as an oral supplement of iron and calcium medicines or through diet can be helpful. Indulging into physical activity will be on a positive note. 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 to all, I am 28 years old; I am suffering from lower back pain (right side) for the last 4 months. For first 3 months I feel the pain only at wake up time in the morning and it exists for 2 or 3 hours but now it exists for almost the whole day. In this connection, I have consulted the Doctor and conducted Ultra Sound as suggested. However, the report was found normal and there are no any symptoms of Stone or any other medical problem. Doctor told me it should be Gas problem and gave me Medicines i.e. Diclo-SR & Rentec. I take these pills regularly for about a week and after that I feel no pain but now even these medicines doesn t work an pain is growing day by day. It is therefore; kindly send something helpful suggestions, as I am still suffering from the back pain. ### REPLY: Hi, Ashwaniji, Thanks for query, You have not mentioned your age. If you are elderly then it is possible you might have degenerative changes in your spinal vertebrae giving rise to low back pain. Go for X-ray lumbosacral region and find out that is there any compression of vertebrae or any osteophytes producing this problem. Consult orthopedic and get examined. Go for back extension exercise and physiotherapy. Take calcium, Vit A, D, and other B.complex medicines. Ok and bye. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 severe back pain that started two years ago and has gotten worse in the last year. I had a surfing accident last year where I face planted in the water and my legs went backwards over my head (like a scorpion) The pain has gone from just lower back to now all over nearly and sometimes il get very sharp stabbing pains that will stop me from walking for a few minutes. It s hurts a lot to bend backwards, even slightly It s uncomfortable to stand, lay down and walk . I ve had x rays and it s shown nothing Please help me, I m only young and I want to solve this problem ### REPLY: Hellowelcome to ChatDoctorthe pain you are suffering from is certainly from a condition called as PIED i.e. PROLAPSE OF THE PROTECTIVE DISC FROM IN BETWEEN THE 2 VERTEBRAL BONES, these discs works as a protective cushion and their prolapse from their place causes compression of spinal nerves and spasm of the surrounding muscles which in turn lead to pain n at times numbness in that region your X-ray was normal but its common not being able to diagnose this condition from a X-ray, so you should get a much more specific investigation to diagnose your condition i.e. MRI OF LOWER SPINE n than you can consult an orthopedic with your MRI REPORT who will prescribe you the appropriate treatment for your conditionregardsChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a wall unit fall and hit my outer elbow. Later I noticed a knot the size of a golf ball on it. I went down after two days. This happened in May and my whole elbow joint is still sore. I hurts to do bicep curls or to carry anything heavy. Is it just going to take time? I think I just bruised it. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have history of injuries and lump on elbow. You may have soft tissue injuries or bony injuries. Trauma leads to extravasation of blood and hematoma formation. You should go for X-ray once to rule out any fracture or bone injury. If it is normal then nothing to worry. Give rest to that arm. Ice massage & anti-inflammatory plus analgesic .  You will be normal within short time. Consult your doctor and take treatment accordingly. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Had breast cancer and masectomy 14 years ago.  Has a lump removed under collarbone but was negative 6 months ago.  Now i have a hard pea shaped lump under incision that does not move around.  Could it be stitches or is is something else? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some fibrosis, or it can be breast cancer recurrence.  You should go for excision biopsy and histopathological examination of that lump.  It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 8 month old developed what was diagnosed as impetigo on her bottom/after using fuciden cream it cleared apart from one spot which quickly became swollen and developed into a deep abcess after a few days.she was admitted to hospital and was unwell with a high fever.after 4 days they brought her in for surgery and drained the abcess. they took a swab and it tested positive for mrsa.they gave her antibiotics to combat this for 24 hrs. since surgery she has been well apart from a lot of wind .its nearly 3 weeks since surgery and the wind is no better.also today i have noticed a couple of the same impetigo like spots on her bottom again.should i be concerned.i ave made an app with my gp for tomorrow. ### REPLY: Hello, welcome to , Impetigo is an acute highly contagious disease affecting superficial layers of the epidermis, and it is caused by Staphylococcus aureus and Group A beta hemolytic streptococci. Treatment of impetigo involves1. Local wound care with chlorhexidine or sodium hypochlorite will prevent the transmission of impetigo.2. Topical antibiotics cream like TB act Ointment.3. Oral antibiotics covering both Staphylococcus aureus and Group A beta hemolytic streptococci. 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 doctor, My age is 30 years, I have never conceived. I had a follicular study. The reading as follows. From fourth day of my cycle I had taken Adova tablet for 5 days (twice a day) 11 day ROF measured 16 X 17 mm & ET was 7 mm. Advised to take Optithick & endothick tablet for 3 days (twice a day) 13 day ROF measured 20 X 17 mm & ET was 8mm. Take ChatDoctor 500 units injection. please let me know is there any chances of getting pregnancy? ### REPLY: Hello dairy understand your concerned have 20 X 17 mm follicle, and it will release the best quality egg. You already take  injection. It will help in rupture of ovarian follicle. Its effect will occur in next 24-36 hours. Unprotected sex for next 2-4 days after ovulation is must. Hope for best. There us high chance of pregnancy. You can also ask of progesterone pill after ovulation. It will help in implantation and support early pregnancyAvoid stress, take healthy diet, . Hope this may help noncontact further if follow up needed 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: Can leukopenia be caused by B-12 deficiency?  Would this possibly cause low neutrophils and Lymphocytes.  My question actually relates to my 8 year old adopted dog who started running a fever very suddenly and his blood work showed a dramatic drop in WBC.  He had normal WBC 2 months ago and had no symptoms of illness until Saturday December 10.   I want to ask for a check of his B12 level along with all the other tests he is having. ### REPLY: Hi, Thanks for asking. Based on your clinical history and query, my opinion is as follows:1. It B12 is known to cause pancytopenia as it can affect nucleic acid function of all cells.2. The blood cells are rapidly proliferating and are usually the first to get affected.3. Along with luekopenia, you can have anemia or thrombocytopenia or both.4. Therapy with It B12 will improve the levels of hemoglobin. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife s bloody sputum culture was cultured with Streptococci growth after 24 hours of incubation on April 3, 2014 susceptible to Erithromycin, Ciprofloxacin, Gentamicin and Augmentin. She was placed on Augmentin 625mg for 7 days thereafter. She got better for like 2 months but she is coming down with the symptoms once again... smelling blood, fatigued, chest pain, abdominal pain, distress and confusion... Now the Doctor says her pulse is high so placed her on Atenolol and Nitrazepam... Not significant improvement... Can you help if we can again place her on Augmetin 1g for 14days? can she combine this antibiotics with any antifungal or anti-parasitic and can she still continue with the atenolol and nitrazepam along? Please ### REPLY: Thanks for your question on ChatDoctor.in my opinion you should not start augmenting without reports. I advise you to first consult pulmonologist and get done chest x-ray. As chances of lung infection are high in your case because your symptoms like bloody cough, fever, high pulse rate are all suggestive of infection. So better to get done chest x-ray and sputum culture and sensitivity for guiding antibiotic therapy. You may require bronchoscopy and BAD (BronchoAlveolar Lavage) for identification of organism. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mum has alzheimers in the middle stage. Recently she has developed swollen feet and refuses to put them up. Walks or wonders around a good part of the day till sh gets tierd. She is eatin well and drinks tea but no medications except for vitamins. Any cause for alarm? ### REPLY: I think that the swollen feet are a direct function of her walking about as much as all day long possibly. Because she is in the middle stages of Alzheimer's she is likely not easy to keep down or to get to stay still for any length of time in order to elevate her feet. It doesn't sound as if she has a primary congestive heart problem or kidney failure from the way you're describing things. She simply walks over abundantly and does not take the time off to get her feet up. There are specific medications for Alzheimer's disease (non-tremendously affective I might add) but all the same you may check with your doctor to see if any of them may be of some benefit to her in terms of getting her to be a little more settled so that she can take appropriate breaks and help the swelling of the feet down. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im eighteen years old and about two weeks ago, I had a sinus infection that lasted about two weeks with a lot of mucus. The infection was gone for about a week and a half, but in its wake I was left with an odd sensation of intense burning in my nose when laying down or bending over (a lot like inhaling water). This is typically accompanied by headaches and dizziness. In the last few days, my nose has become congested again, but there is rarely any mucus, and if there is, its clear. Mostly just inflammation. Is this normal? What should I do to remedy this? ### REPLY: Hello dear, welcome to Ask a doctor service. I reviewed your query and here is advised. I think this is sinusitis. You can use Loratadine as an antihistamine to help inflammation. Also rinse nose frequently with saline water. You can use Striving or pseudocode . Your doctor may prescribe you Corticosteroids spry as Budesonide for it. 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: Had an echo to diagnose shortness of breath on exertion and at night. Only irregularities were as follows : mitral leaflets are mildly thickened in appearance. Mild to moderate mitral regurgitation is detected. Mild tricuspid regurgitation detected. Right ventricular systolic pressure is slightly elevated consistent with borderline mild pulmonary hypertension. My pulmonologist said its a normal echo and not the reason for the shortness of breath. That the methicoline test revealed asthma. Yet asthma does not explain the edema in my legs I take dyazide for. Am I being paranoid about this echo? Is it really no big deal? ### REPLY: The symptoms of shortness of breath with mainly nocturnal symptoms are suggestive of small airway disease due to Asthma.Hence, you must take precautions to avoid allergens causing symptoms.Also, if symptoms are persistent then inhalers may be started on daily basis. The 2D echo report is suggestive of Pulmonary Hypertension which itself is due Asthma leading to high resistance flow towards right side of heart and the same increases the breathlessness and pedal edema For the same you must follow1. Salt reduced diet2. Breathing exercises daily 3. Work involving minimal exertion 4. For acute onset swelling Tab Furosemide 20 mg twice daily for 3-5 days after BP are suggestive of normal values ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 2 year old may have swallowed a tiny lightbulb from a miniflashlight. I wasnt there, so I dont know for sure. Its been 3 days and no sign of it in his diaper. He previously swallowed a coin whicChatDoctore out in about a day and a half. Because of food bits, I know the stool he has passed has been since the alleged swallowing incident. He is unusally irritable, but I think he may have an ear infection (taking him in tomorrow). We did an x-ray for the coin, so I hate to expose him again. Is it possible to use an ultrasound to check for the lightbulb? ### REPLY: DearWelcome to ChatDoctorWe understand your concerns went through your details. Please understand, you should not keep waiting for it to come out through evacuation. You should have visited a health center where a doctor will give a stomach wash and laxatives. You should do it now. The light bulb, however tiny they are, may cause cuts and scratches on the membrane through which it passes. You can even now consult a child specialist for necessary action. 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: Hi, I have lower left abdominal pain (usually a 3 on 1-10 pain scale), my stomach makes noises and I often have to fart, I have constipation.  The pain has recently started to move to the right side.  But mostly it just stays in the same spot and nothing makes it better or worse.  Im more tired than Ive ever been, but I figured that is just because Im in Physical Therapy school.  Ive had more coffee and my very healthy eating habits have slacked a little, but still I dont eat fast food.  I was eating bananas often, so Ive stopped that and tried to reduce my caffeine intake.  At first we thought it might be an ovarian cyst, but it is more constant and doesnt feel like the pain when I had to have an ovarian cyst removed.  I also did not have GI issues with an ovarian cyst.  Any suggestions?? ### REPLY: Hi welcome to  forum.  Thanks for asking a question to . F.  You have got lower left abdominal pain it is mild. Sometimes it is on right side. Tired, Using more of bananas, and take coffee, now you have stopped them. Still pain is continuing.  Left lower abdominal pain is usually due to urinary tract infection, stone in the urinary tract, meiosis, tuberculosis of iliocaecal junction etc. I advise you to consult a surgeon for diagnosis and treatment. You may need to have M.R.I. besides other routine tests foe confirmation.  Wishing for a quick and complete recovery.  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: hello sir, i m student of engg. & my age is 20 year and hight 5,2 & wait is 55 Kg.sir my problem is my penis groth is not processed & my penis is very small and i have in weak 2 day nights discharge probles and when i excited then in penis water type chick flows..so please give me solution sir,... ### REPLY: Hi, I can understand your concern about penis size, night emission and discharge during sexual excitement. This kind of curiosities is common at your age and I will add .  The size of penis has no relationship with sexual satisfaction of the other partner by pen vaginal contact. Only outer vagina is sensitive. Inner 2/3 is largely insensitive. So penis size more than two inches is enough. There are small glands in the way of urine tube (prostate and bulbourethral glands) which produce the fluid during sexual arousal. Just alike food causes salivation in mouth. This is also a normal response of your body, not a disease. Do not worry. Night falls are normal response of body when semen accumulates in the pouch and not utilized in sexual intercourse or masturbation. It will stop when you regularly remain active sexually. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell down the stairs a week ago I hit the bottom of my back and under my arm and around my heart area hurts when I breath. I can feel a pulsing pain in the centre of my upper body it s inside me and hurts a lot. I was given chest X-ray and radiologist asked me which side was most painful I told her left side and she said ok. Doctor said he couldn t find anything on X-ray. But I can put any pressure on centre of my back or chest it s really bad. Also I can t sit down on my bottom av to lie on left side. Please can you help ### REPLY: Hi, thank-you for providing the brief description. As you had a fall this can be a past injury issue leading to soft tissue pathology and the pain symptoms. I will advise you to undergo a thorough clinical examination and MRI based on the examination like the lumbar spine. This will help us understand the old injury and treatment choice will be painkillers in combination of a physical therapy. Most fall injuries have pain on a later stage, and they need proper clinical examination and physical therapy. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, im 14 years old, male and have no medical history regarding illnesses. 2-3 weeks ago i discovered a lump on the left side of my neck. I thought it maybe dangerous. My parents felt it and said it was a gland. After more appeared on my neck I rubbed them as my relatives 8 year old daughter had lumps on her neck and she rubbed them, making them smaller and they soon disappeared. Im not sure what to expect, whether they are fat lumps, glads or damaged tissue, ive no idea. Can you tell me what they are? Theyre under my skin. ### REPLY: Hello and welcome to , Lumps on side of the neck need to be investigated initially by an ultrasound of the neck. Ultrasound will determine the site and origin of the lumps- whether they are due to enlarged lymph nodes or any soft tissue swellings. After knowing the site and nature of the lumps, aspiration cytology of the lesions needs to be performed. In aspiration cytology, cells are aspirated using a fine needle, spread on a glass slide and stained with appropriate stains. On the basis of test result, the type of lesion is determined and thus management can be planned. Consult your primary health care provider for clinical assessment and investigations. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: noticed my son has a pea size lump on his left shoulder.  The lump is just under skin, and looks greenish blueish in color. and it hurts when i touch it.  it moves and feels like a marble.. He did fall off his bike a few times prior to noticing the lump when he had his shirt off last night. ### REPLY: Hello! Thank you for the query. Greenish and bluish color of the lump indicates that this might be just a bruise or blood collection (hematoma) caused by recent injuries. Pain indicates an inflammation in this area. In such area also benign skin lesions like a cyst or lipoma can be also present, however neither the color nor pain are not characteristic for these issues. I suggest you to consult a surgeon with this issue. IN case of doubts, ultrasound should be done. Hematoma should be . 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: My 10 month old baby has bright red inflamed gums. His top four teeth have broken through but are not completely out yet. It has been several weeks. He has had a fever of 101.3 the last few days with no other symptoms. Could it be in an infection in his gums? ### REPLY: Hello, I can understand your concern. When teeth erupt in an infants mouth, the gums appear sore and inflamed. Till the tootChatDoctorpletely erupts into the oral cavity, seeing the red inflamed gums is normal and should not be worried about. However, if it takes more than a week now on to erupt completely into the oral cavity, a dentist should be consulted. In addition, eruption process is not associated with infection. Thus, if the child is having fever, he might be suffering from other infection like viral infection. You should consult a pediatrician for fever and infection as it does not seem related to inflamed gums. I hope this information helps you. Thank you for choosing . I wish your child feels better soon. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My father has Psoriasis problem and it has been worsened off late what is the solution for now he consults our family doctor and takes tablets based on doctors approval but this is not a permanent fix please suggest on how to go about it ### REPLY: Hi...dear Prashanth., Thanks for choosing ., PSORIASIS...it is inflammatory disorder with genetic predisposition., So there is no cure, only control by medicines...ok., For Psoriasis, now good treatment is available.,1) Apply Nazarene cream.....retinoid....afternoon ...,2) Tab Accretion ...costly medicine but will give very good result.,3) Morning times Posturing cream... nighttimes..... Betamathsone and 6% salicylic acids cream application.,4) Tab Methotrexate 7.5 mg weekly once for 8 weeks.,5) Cap.it E and omega III fatty acids..., daily morning times 30 days., 6) Avoid spicy and non-veg items...,7) Plenty of vegetables and fresh fruits., ok...good luck., ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My lungs feel a little dusty and I cough to relive but feeling is still there , I recently had an upper respiortory infection where I was on antibiotics for a week Infections gone but this dull feeling in my breathing tubes still there and is always worse at night causing some anxiety with this my nose is blockibg up at night with no mucus but am having some mucus in morning ?? ### 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. Manytimes breathing symptoms could be related to your cardiac function. It would be wise to get an echocardiography done to rule out cardiac causes. Further anxiety can also lead to this symptom. I would advise that you should seek an echocardiography and psychological tests as well. 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: Following a mild sore throat with cold like symtoms my 17 year old son developed a cough that got progressively worse over a 10 day period. The cough is almost resolved but over the last week, when he does cough he has a severe bronchospasm and cant get air in..these episodes last about 1 minute and or horid. He is now maxed out on steroids, on albuterol, proair, symbicort, and Biaxin orally (in case it is pertussis). If his lung studies arent better this Monday the asthma doctor will admit him for IV steroids. CxR was clear and blood work is ok. At the time of these spells he coughs...then starts wheezing so hard you can hear it across the house...it is almost like an upper airway obstruction. He is a healthy, strong 17 year old without a previous history of asthma or any other illnesses. What are your thoughts? Karen kl ### REPLY: Thanks for asking your question I completely understand your question actually it seems like an exacerbation of bronchial asthma along with a severe lower resp tract infection. You need to continue with the inhalers and oral steroids and antibiotics points to be discussed with your pulmonologist are-to change the antibiotic as per sputum culture and sensitivity report to increase the dose of inhalers to increase the dose of steroids to add some more bronchodilators oxygen saturation is normal and resp rate and other vitals are normal then, no need to worry consider consulting a pulmonologist rather than a general medicine physician, he can guide you better regarding the resp illness thanks feel free to ask more questions may god bless you with more questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 started taking 100 mg Zoloft 2 years ago after losing my mother. For the past year I have been cutting the pills in half and taking 50mg. A week ago (July 22) I decided to quit taking the medication because the initial reasons for taking it no longer existed....I wanted my sex drive back as well. The first few days were fine; however I have started getting what I can only describe as quick waves of dizziness... Other people describe this feeling as brain jolts . It is worse today than ever. How long can I expect these awful withdrawal like symptoms and is there anything (maybe Dramamine) that would alleviate these symptoms? Please help. Thank you so much. ### REPLY: Hi, Thanks for choosing . I have read your query carefully and understood that you took Zoloft (Sertraline) 100 mg/day for one year, and then you reduced it to 50 mg/day since last one year. Since 1 week you have stopped it abruptly, and now you are having complaint of sudden waves of dizziness. I would like to let you know that you are having Sertraline discontinuation/with .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I got my lower right wisdom tooth removed 35 days ago. It was a impacted partial bony. Since it was removed Ive been in constant pain and still have swelling and a lump on my jaw. Ive been to my oral surgeon twice since and have been told that I have trauma to the jaw, and to rub and stretch my jaw bone. The swelling has only increased the last two days and I dont know if I should get a second opinion or whats going on. I never had a dry socket and the extraction site is healed. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint swelling and lump at the site of wisdom tooth extraction even after 35 days is not normal and can be either due to any remaining root portion of tooth that is flaring up infection while it can also be due to infection at the extraction site. Any foreign body inclusion in the extraction socket can also cause pain and swelling or lump formation. To rule out the exact cause you need to get an x-ray of the extraction site done and then only the exact cause can be ruled out. As of now take anti-inflammatory painkiller like Ibuprofen, do warm saline gargles and do cool compresses over the swelling. You can also send me x-rays here on  by asking a direct query so that I can guide you better. Hope this information helps. Thanks and regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Teenage girl, normal weight. I get chest pain if I stand for more than like 30 minutes, doesnt go away immediately, worst pain goes away after a few hours but low-level pain can linger for days afterwards. Ive had tons of cardiac tests (history of arrythmias) and they dont think its that, also Im on zegerid in case it was reflux but didnt help at all. What could this be? ### REPLY: Thanks for your question on . I can understand your situation and problem. Since your extensive cardiac work up is normal, no need to worry much for cardiac cause for your chest pain. At your age, anxiety related symptoms are more common. So possibility of anxiety is high in your case. Anxiety can also worsen reflux disease. So control of anxiety is needed. Better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and work on its solution. You may require anxiolytic .  Avoid stress and tension. Be relax and calm.Don't worry much, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I hit a volleyball this after with the underside if my hand (made a fist) it bent my wrist backward causing pain. Now about 7 hrs later it is still very painful to my hand backwards and all to put pressure on my wrist. These are fairly sharp pains. It does not hurt to pick things up or grip most objects. There is only pain when I move my hand. Thank you. ### REPLY: Dear patient You must have injured wrist ligament due to extreme stretching while playing and this is leading to pain. Still possibility of fracture needs to be ruled out, and I would advise X-ray of involved wrist with hand anteroposterior and lateral views.  Visit radiology center nearby you and get it done. If report is normal diagnosis is wrist sprain.  Avoid game for 2 weeks and apply wrist binder for 3 weeks. Start tab diclofenac plus serratiopeptodase combination twice a day for 5 days for pain relief. If X-ray report is abnormal you need to consult expert orthopedic surgeon with report.  All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Our daughter is 6 months old. She is taking an antibiotic for a sinus infection. I changed her sheets to a darker color and noticed that her head is sweating (it could have been doing this all along, but I never noticed until yesterday). It is enough to leave a large wet spot. She has also has had diarrhea. Should I be overly concerned for SIDS risk? ### REPLY: Hello, Why what you say and with a precedent history of antibiotic you say I feel that this could be antibiotic-associated diarrhea. Probiotic with saccharomyces bollards will be very useful here. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting. You need not worry. 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: hello sir,I m 30 years old and I am suffering from chronic gynaecomastia which is bilateral but the right side is much more unevenly enlarge like a spongy bag and also my tits are protruding like that of a female.to make matters worse its the right side of the breast which exerts so much pressure of my chest and shoulders that i feel lot of pain and stress in my shoulders.It has made my life hell.and I m suffering it all because of a doctors carelessness who operated on me on my testicles for hydrocele which was actually a filarial inflamation according to his diagnosis.so he operated only on on side and left the other when I was in the prime of my adolescence around 17 or 18.It then started going wrong since then.and I have been suffering ever since.to make matters worse I was also thinking if I had klinfelters syndrome or a genetic problem and added to my woes.However now I m assured that it is not klinfelters but only due to testicular malfunction leading to hormonal disarray!well I for certain know that it is irreversible but I would be obliged if whatever else can be done to better my condition though I am not in favor of surgery.I m only intersted in medicinal treatment.thanks ### REPLY: Hello, Please do a self-check and tell me the findings: First put a flat of the pals and see if you can palpate a well-circumscribed lump other than the normal fat. Secondly, try to catch hold the area with fingers and see if you can feel separate lymph. These two tests can tell whether this is gynecomastia or accumulation of fat alone. Ultrasonography of the area can help further. If this is Gynecomastia, only surgical removal can cure it. If this is an accumulation of fat, it can be removed surgically or by liposuction.  If this is due to obesity, reduction of the body fat by diet control and increasing exercises can help to reduce this. Hope I have answered your query. Let me know if I can assist you further. Take care .  Rammstein, General Surgeon ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir,I am having hair loss from past 8 years,I have a receding hair line.now I have started loosing hair from middle of head.please tell us the medicine/oil for the growth of hair.please tell me about the use of tugain in detail.Thanks in advanceMayank ### REPLY: Hello. Thanks for writing to us at  Your hair loss is due to Androgenetic Alopecia, which is essentially a genetic predisposition to hair loss and runs in families. Hair loss is mainly from the frontal scalp and later on involves the crown, if allowed to progress unchecked. Anterior hair line may gradually recede and there is widening and deepening at the angles of anterior hair line. It is important to begin therapy as soon as possible to arrest further progression. Minoxidil and finasteride are US FDA approved for this type of hair loss. Tu gain contains minoxidil. Minoxidil is to be used twice daily at scalp skin after through cleaning the scalp with a shampoo; it is never to be used immediately after bath on wet scalp, and it is advisable to wait till the scalp and scalp hair is air . Finasteride dosage is once daily. Hair oil is not advisable while on treatment with Minoxidil because oils will hinder absorption of minoxidil. Treatment must be religiously continued for at least 3-4 months for noticeable results and up to 2 years for maximum benefits. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor , I have small penis and I need penis like a man . I am not asking very big penis but it should be like a man with proper fatness as well as my testis are also small. so it it possible to have a big and fat penis. money is a major problem but I will afford if there is any hope. Please do reply if it is possible with the expenses required for surgery or treatment course along with your fee. Regards Sanjeet Jain ### REPLY: Thanks for asking in  forum IN short: There is no way to increase the size of penis(except implants)Explanation: The size does not matter, if you are having normal erection and able to satisfy your partner then its normal. Please do not fall into any ones hand who just try to get money out of you saying he knows how to increase the size of penis. Hope your understanding. Stop thinking about your penis size. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Had nexplanon 2/3/12 fine for first 6 months. periods went to every 25 days then every 6 days, heavy bleeding between periods also. Now have missed my period and havent had one since 30/10/12. I feel nauseaus exhausted, breasts feel heavy and sore, increased urination and pain on left side of pelvis and abdomen. Could the implant failed? ### REPLY: HIT hank for asking to  I really appreciate your concern the history that you gave here may not be due to the IUD, but this could be due to the hormonal imbalance, even if you have some doubt then there is only option to clear the doubt is clinical examination it is better to check it out the right position of IUD, but the chances of this is very minimal, hope this information helps you, have nice day. ### END