Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Respected doctor, I am a female with mild controlled epilepsy, aged 30. I got fits at the age of two and then I havent got till date. I would like to know what are the medicines (generally popped in by the general mass for fever, cold, stomach ache etc) which epilepsy patients should avoid? ### REPLY: Hello, With all the new and ever-increasing numbers of remedies and treatments that are on the market and coming to market including a whole variety of homeopathic and natural supplements that were never things we worried about patients taking before it is virtually impossible to give you a list of things not to take. It is much safer and foolproof to simply learn the habit (if you are epileptic) to always check with your doctor or pharmacist when considering taking anything which is over the counter or prescription while taking anti-epileptics medicines. In that way, you can guarantee never missing a potentially bad reaction for EVERY .  That I believe, a much more efficient and guaranteed way of never having to worry about ingesting the wrong thing. And that is exactly the advice I give all of my patients when I educate them for the first time on their new epilepsy  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 medial PKR 8 years ago. The xrays show it is still intact and not worn. My leg hurts below the implant and I have pain on the medial side of my knee. I m not sure what this pain can be from. Do xrays detect everything? I ve done lots of backpacking so the PKR held up well. I have lots of pain under the knee cap and on the lateral side of the leg. I can walk for an hour then have to stop due to pain. Sunrise views show both kneecaps are touching the femur and are off center. I believe it is time for a TKR. Are there reasons for a TKR that aren t visible? The xrays don t show it is bone to bone. A doctor says it s time for a revision and my knee really does hurts and limits my activities. I m 62 not fat. ### REPLY: Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and I feel, you are aware that medial side pain along the joint line is very common with degenerative arthritis, and thus osteoarthritis cannot be ruled out. The x-ray in such cases may not give the whole picture, but is quite good at showing the changes in the joint that may occur as a result of osteoarthritis. So get yourself an x-ray done at the earliest. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. 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: about 3 weeks ago I steped on a thumb tack. it has not crusted yet however no infection is apparent I am a 65 year old male type 2 diabetic. Is there any thing I can purchase over the counter to speed up healing ?.Should I refrain from drinking alchohol.? ### REPLY: HelloWelcome to ChatDoctori understand your concern. As you are a diabetic, you need to be extra precautious about these small things.I would advise you to follow these steps:1. You need to take a tetanus toxic injection as soon as possible.2. Also keep the area clean and . 3. Apply antibiotic cream thrice a day on the area. Above all these, your blood sugars should be under control, for the hastening of wound healing. Hope you are happy with the answer. 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: sir, I have taken 5 doses of rabipur. after fourth dose i felt chocking sensesion , difficult in breath. neck stiffness. i reported to doctor. he advised me for MRI Brain, Blood test ECG etc. I have undergone CT SCAN, blood test, urine test , ECG , Nothing abnormal . Lastly I have been referred to psychiatric for opinion, nothing abnormal found. I have taken last dose on 07 may 12. still I am having breath problem,neck stiffness, confusion like feeling . sir advise me what to do and tell me for how many days these side effects persists. Last and final dose of rabipur taken on 07 May 2012. ### REPLY: Since all the investigations have been done and even the Raipur vaccine dosing is also over according to the schedule, I would suggest you to wait for a couple of weeks. These symptoms may reduce in the next few weeks. Avoid unnecessary anxiety. Mind relaxation techniques can be useful at the moment. You can take all the investigations again after one or two months to detect any abnormalities. Hope I have answered your query. Let me know if I can assist you further. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having severe depression and major stress! I am 20yrs old and have 3 kids that are 4, 3 and 13wks! I cry all day every day and stress over simple things! I feel like I cant do anything because im so depressed and stressed over everything! My 13wk old has severe acid reflux and hardly sleeps and im so easily frustrated and dont like it at all because my baby needs me! What to do? ### REPLY: Hi and welcome to . Thanks for your question... You seem to be going through a post-natal depression. Now, there are very good treatment options available for this and you don't have to be suffering in silence. You may need anti-depressant medication for a short while to help you overcome these symptoms. Alternatively, certain talking therapies like CBT can also help you effectively. So, please consult a psychiatrist at the earliest and take help. Wish you all the best. -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I received a message from my son, 45, in Atlanta. He reported that his AST=53 and the ALT = 58. He also has reported a lump under his left arm. I suggested that he stop taking all his various supplements and drink lots of water for the next two weeks before repeating labs. I recommended that he see a hepatologist for the elevated AST and ALT but don t know who to recommend for the swollen probably lymph node. I am a PhD in the biological sciences, worked for Baxter Healthcare, and am a 16+year bilateral lung transplant recipient and 2+ year kidney transplant recipient so I have learned a lot about lungs, kidney and pancreas. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He has only mild increase in AST and alt level.  It could be due to some viral infection, alcohol, .  He should repeat his liver function test after a week.  He may have some enlarged lymph node.  It may be due to reactive hyperplasia, tuberculosis or lymphoma.  He should go for fine needle aspiration cytology of that lump.  It will give perfect idea regarding cause.  Then he 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: Dear Doctor,I had a burn on my face just day before yesterday. I was trying to open a cooker and then the hot water spilled on my face near eyebrow, side of my neck and behing my head. What treatment shud i follow? there are blisters as well. Pls advise ### REPLY: Hi ! Good morning. I am  answering your query. If I were your doctor, I would advise you not to puncture or debride the blisters. In case it bursts of its own, I would advise you for an antiseptic ointment to apply over it which ideally should also be safe to the eyes in case it goes inside the eye. Obviously it would be an ophthalmic ointment for the wounds and blisters near the eyebrow. In the wounds behind the neck and scalp, I would advise you to get it .  Usually blisters caused by hot water are not very deep burns, and it would heal in about two to three weeks time unless it gets infected. For the pain or burning sensation, I would have advised you for any anti-inflammatory  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 constant pain seemingly related to my shingles. Now originally the site of my rash, though unusual, is a spot at the end of my tailbone with which it caused shooting, tingling, burning pain before and continue for months and months after. I really cant say that I actually ever got relief, I m just being optimistic!! Is this possible #1? #2) I have been having recurring pustules that do not ooze or pop, that seem to be directly related to a nerve ending in my scalp and hairline along with constant headache and nausua. Could these flares be also related to shingles because it really feels to me like a shingles rash. Oh and there may be a slight clear substance I could get out if I tried but very little and very tender to the touch. If not shingles, what is your best guest. This is very painful, irritating and distracting condition, please help... ### REPLY: Hi, I have read your query & yes the recurrent pustules, itching, pain, prickling skin, rash are symptoms of Shingles. Visit ER, get physically examines, get STD tests done.  You should start on the antivirals & antibiotics without delay. The rashes on the scalp often cause a headache, nausea & then fever.  If neglected the immune system will further get weakened may complicate to Herpes Zoster spreading & affecting the eye. Such infections cause corneal damage & vision problems later in life.  Get connected to your PCP, he may need to give you stronger nerve blocks, medications & painkillers. Take nourishing diet & Vitamin supplements. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i am suffering from jaundice from a month now . it started with mild fever following by vomiting .the way i was diagnosed was blood test and a physical test .my BILIRUBIN LEVELS and ALT levels were 5.3 and 2900 respectively i was prescribed urso 250 mg and a vitamin supplement for 20 days and advised complete rest with a rich carbohydrate diet.those weeks the stool became normal coloured and yellow urine also dissappeares but itching was there few nights. after 20 days when the results came my BILLIRUBIN was 9.9 and ALT/SGPT 384 SAP 264 AND HBS ag NON REACTIVE.my eyes are still yellow but rest are normal like urine and stool and very less itching .no pain in abdomen or fatigue or nausea or appetite problems happenned from start . but there is mild craving for tobbacco but i avoided it will it effect my jaundice?.i followed each and every step recommended by doctor, family and friends yet the condition worsened now the doctor changed urso 250 to 300 mg 2 times a day again for 20 days.he didn t tell me the cause of jaundice but it is not pbc he told me. i don t know what to do now should i consult other one? ### REPLY: Hello, Based on your symptoms and initial laboratory report it seems you were suffering from viral hepatitis (probably hepatitis a or e). Your last report shows significant decrease in ALT but rise in bilirubin. This can happen in viral hepatitis. Bilirubin initially increases, and it decreases after the ALT levels have decreased. In your case the symptoms have also improved. I would advise you to have your serum bilirubin and ALT rechecked after a week of the last test. If bilirubin is not showing a decreasing trend then you should consult a gastroenterologist for detailed evaluation. If there is significant decrease in bilirubin you need not worry, but just to be sure repeat the test weekly till the values are normal.  Though tobacco will not have effect on your current illness, it is best you give it up altogether.  Hope that helps.  Wishing you 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: if any patient s CA-125 result is showing 465 U/ML . how swear it is? is this result is cureable ? ### REPLY: Welcome to  CA-125 465 U/L is quite high. It is not possible to interpret the meaning of an abnormally high CA 125 without additional information about the particular patient being evaluated. The reason is that blood levels of this protein can be increased in many benign and malignant conditions. In the patient who is being evaluated for a pelvic mass, a CA 125 level greater than 65 is associated with malignancy in approximately 90% of cases. However, without a demonstrable mass, the association is much weaker. If it is due to ovarian cancer treatment depends upon stage of cancer. Treating gynecologist/oncologist will be in better situation to comment on prognosis(curability). 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 my name is John and I m a 31 yr old male. for about the past year or so I ve been experiencing severe coughing that pretty much drops me to my knees and when I m done my entire body is basically numb afterwards. Now sometimes I cough up blood which varies between bright red to like an in between that and a rust color. I do get bronchitis maybe twice a year, which I treat myself by smoking between a pack to a half pack and it s gone( God s honest truth) don t ask me how but it s gone, normally I am a non smoker. I was wondering could this be the bronchitis or something else? ### REPLY: Thanks for your question on . In my opinion you are having bronchitis only. And we should rule out infection first as infection is the most common cause for hemoptysis (blood in sputum) and worsening of bronchitis. So please get done chest x-ray to rule out infection. And get done PFT (Pulmonary function test) for the diagnosis of bronchitis.  It will also give you idea about severity of infection. And treatment of bronchitis is based on severity. You may need inhaled bronchodilator and antibiotics. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i have been wearing my hair up and with a headband on for about 5 years now. its getting to the point where i get dizzy very easilly, i can not do my work because of the computer. nausea and major headaches. i know the headband will give me the headaches but since ive been wearing it so long can constant pressure to my scalp cause any major head/brain problems besides headaches? ### REPLY: Hello ! Thank you for your question. In my opinion you have nothing to worry about it. The headache you have is caused by the contracted muscles of the scalp due to hair traction by the band in this case. It may be also aggravated by a wrong position of your head (during staying or writing, working at the computer), from psychological stress, etc. Dizziness is another feature of this kind of headache (Tension type Headache). Nothing is going to happen to your brain if you continue holding the band. Your brain is well protected! We have seen in patient who underwent brain surgery, that the bands very straight to the head can cause damage to skin in the pressure point, but it is not your case. Your band is not so tight, also you don't have it on during night. You may just make pauses (remove it) remove it during the day, so your muscles get a little relaxed. You will get pain relief. Hope to have been helpful to you.  Thank you for using ! 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: Hi, i had sex with my bf, he ejaculated inside my vagina on his third cum, he twice precummed only on his third we had intercourse and also he recently masturbated three days before. I m neither on pills or used condoms, is there any chances of pregnancy, if so recommend some pills and it was on my 14 th day ### REPLY: Hello dairy understand your concernThere is high chance of the pregnancy as you have done unprotected sex in the fertile phase of cycle. Now Take following advises step by step:1. If 72 hours after sex has not been crossed then take emergency contraceptive pill like unwanted 72, or I pill to prevent the pregnancy.2. If 72 hours has been crossed then Wait for the period. If your period will delay by the 8-10 days from the normal expected period date then go for urine pregnancy test and or blood  to confirm the pregnancy. If you will be pregnant then still you can terminate it by abortion pill under the advice of gynecologist.Meanwhile, avoid stress, take healthy diet, do regular exercise and . Hope this may help noncontact  for further health query 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 terrible pain & pressure in my head, and a whooshing sound in my ear,. I have a posterior fossa arachnoid cyst and had a endoscopic 3rd ventriculostomy to treat aqueductal stenosis 6 momths ago, but the cyst is still there and the pain is bad, yet my neurosurgeon says my brain is normal now, so I am looking to see if I should be examined by an ENT doc... ### REPLY: Hi, Thank you for posting your query. If your neurosurgeon is convinced that the arachnoid cyst is not the cause of your symptoms, you can get an ENT check up done, especially as you also have a whooshing sound in the ear. The signs to look for, which may suggest that the posterior fossa arachnoid cyst is the cause of your problems are: early morning headaches, vomiting, double vision, imbalance while walking, etc. Wishing you good health, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Female, 37, 5 ft 5 about 170 lbs.  Medical History. I smoke about 10 cigarettes a day, have never done recreational drugs and only drink occasionally. 4 months ago I passed 3 kidney stones.  I gave birth to 3 children and had 3 late term miscarriages (4 to 6 mo along).  2 of my children I had to have progesterone shots in order to carry them to term.  After the last one I had severe bleeding issues for over a year causing me to have a partial hysterectomy, I still have my overies.  4 years ago I was diagnosed with high blood pressure and have been on and off medication since, at times it would be under control without medication.  For 2 years now I have continually been told that I have a high red blood count and have had to undergo a phlembotomy several times because of it.  I currently have high blood pressure, sometimes as high as 190/140 or so.  I have a head ache almost all the time.  I have noticed times that my heart seems to beat very very hard or flutter for short times and it causes tension in my chest.  Different doctors have run so many tests and cant tell me why any of this happens.  They dont know what has caused the high red count.  I also have leg pain and swelling which worsens in cold weather and it doesnt really change with activity or rest, they feel very heavy at times.  Most doctors dismiss this.  I am constantly being asked if I have a sunburn even though I dont.  I sweat horribly bad very often even from the slightest activity such as vacuuming in a 70 degree house.  I am constantly tired no matter how much sleep I get.  I have been diagnosed with minor sleep apnea but the machine doesnt seem to help me.  I deal with months of diarrhea and then turn around and am severely constipated for a couple weeks.  I have an increasing amount of facial hair growth that the doctors also dismiss, where I pluck about 200 hairs a week.  They all tell me that my hormone levels are normal although I question that.  I have gone through all of this with 3 different doctors now and get no where, I end up getting frustrated and stop going and then end up running out of my blood pressure medicine for months at a time until I finally decide to give another doctor a try.  I am lost of what to do since no one can tell me what is wrong. ### REPLY: Hello, You have provided a details' history who h would help me narrow on some diagnostic possibility.  The reason for headache is both high blood pressure and higher RBC s which would cause th3 blood to be more viscous and this per se can cause bad headache. .control the blood pressure and keep your hemoglobin and Packed cell volume under control.  The reddening in cold weather may be as a result of Reynolds phenomenon.  The miscarriage, Reynolds phenomenon, hypertension, hormonal changes can all be explained by some autoimmune disease, So a rheumatologist opinion is worthwhile, get an ANA done and if positive evaluate it further. Smoking can cause polycythemia which can in turn cause other symptoms.  So try omitting the same. Do send the investigation done till now, so I can guide you better. 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 mom has had catscan, colonoscopy, capsule endoscopy, entroscopy and yet they still cant find blood cause. She drops numbers every 5 th day and needs to get 2 pints blood. She also has schleroderma, , thyroid, pulminary  hypertension and crest issues. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She definitely has some cause of bleeding.  Without searching the cause it is very difficult to treat.  She should go for ultrasound abdomen and gynecological examination.  Search for the all possibility of blood loss. If you don't find the cause then bone marrow examination is needed. Consult your doctor and 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: I feel like I have a charlie-horse in my chest and down my arms. I have hypocalcemia and I know that my levels are slightly low right now. Can that be why I am having this intense chest discomfort? It will not go away..Ive had it really bad for about 3 days now. There is a tightening feeling in my back too. Please help! I am a 30 year old female with two small boys to take care of! ### REPLY: Yes my friend, hypocalcemia can cause muscle aches and chest discomfort. If your calcium is extremely low, and you are symptomatic, you should consult her doctor as soon as possible and get your calcium as well as her magnesium and potassium checked. It is unlikely with chest discomfort that you will have heart disease at your age, however there are some rare causes of chest and back pain that can happen in younger women including pericarditis, pancreatitis, and aneurysms, which can cause chest pain radiating to the back. Probably consult the doctor as soon as possible to rule out more serious causes and do not assume it is just because of the hypocalcemia. Have a great day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 14yr old daughter has what looks like 1 blister above her front tooth.  It will occasionally pop releasing blood but it will fill up again and repeat the process.  I took her to the dentist who prescribed amoxicillin two treatments and it is still the same.  Can you give me an Idea of what we might be looking at? ### REPLY: Hi, Thanks for posting the query, I would suggest you to take an x-ray of the tooth and see if there is any infection if the blister causing discomfort could be removed surgically, if the tooth is infected could be treated with root canal treatment I would suggest you to continue with the course of antibiotics and analgesics, at home take lukewarm saline and antiseptic mouthwash rinses. Hope you find this as helpful, Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my gallbladder removed in April of this year and my appendix removed in 1998. I have gained 35 pounds since my gallbladder removal and I am finding it difficult to lose the weight. I also have been experiencing cold sweats and pains going up and down my arms and back. I believe this is due to my weight gain . I am 38 year old female 2 children and I need to figure out what is going on with my weight gain and pains. ### REPLY: Hi welcome to  forum. So far my knowledge is concerned there is no possibility like this. The weight gain could be due to over care post operative and pain of back and arms may be due to previous gastric pain not treated completely or may be due to sutures given intro abdominal.  I advise you to consult the surgeon who have operated. You may have to get MRI done besides other routine tests for confirmation.  Besides I advise you to follow some diet recommendations as avoid fatty foods' oil sweets potato and other tubers fleshy fruits and juices to improve resistance. Wishing for a quick recovery and thanks for calling. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Today I have diagnosed with Liver Fatty Grade 2 with mild hepatomegaly. My age is 36 and I am non -alchohol. My height 5 6 and weight is 64 kgs. I have pain in right side chest near ribs it is a continuous pain. I have started taking Liv 52 tablets. (Himalaya) 1 tablets thrice a day. Which seafood is good for me. Also what about spicy food consumtion ### REPLY: Hi & welcome.Seafood is an important source of Omega-3 fatty acids which have liver protective action. It can be either in form of fresh, canned or frozen sardines, salmon, mackerel, tuna, trout, blue mussels, calamari, etc. Fish oils like Cod liver oil also contains a good amount of Omega-3 fatty acids hence can be consumed. Along with seafoods listed above eat plentiful amounts of raw fruits and vegetables, especially dark green leafy vegetables and orange, yellow, purple and red colored fruits and vegetables as they contain various vitamins, anti oxidant substances which protect the liver. Avoid taking spicy foods, cigarette smoking, fatty meals, etc. Hope this answers your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Before one and half month ago I suffered from Dengue Fever.At that time my SGOT & SGPT Levels were 79 & 129 respectively.Now I am fully normal.Please let me know whether I have to test my SGOT and SGPT levels again.I am 19 years old girl and College student.I am free from alcohol. ### REPLY: Hi thanks for asking question. Because of dengue infection you had elevated liver enzymes. Now according to history you are fully recovered, so enzymes will be normal now. No need for doing liver enzymes profile if clinically no symptoms are present just now. If you developed abdominal pain and jaundice then liver enzyme profile should be done ... As a routine check up and no problem of money then liver enzymes can be done but at just now it is not needed. I hope your concern is solved. Take care. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with Moderate hepatomegaly with grade 2 fatty liver.  It has been recommended (by a doctor specializing in Metabolic disorders) that I follow a very strict diet that begins with a liver detox for 6 weeks....and no exercise.  Is this a common "treatment" and does it make sense that they want to do blood work every 5-6 weeks as a follow up? ### REPLY: Hi thanks for contacting . Our main aim in fatty liver is to cut off oily diet as liver is site for lipid metabolism. In liver detox diet fatty diet avoided and main focus Is providing zinc, antioxidant etc...so to prevent effect of free radical that has role in fatty liver pathogenesis. So yes this liver detox diet can adopt.Meanwhile, more fruits with green leafy veg taken. Refined food avoided. Cheese, Burger, meat, baked pastry etc.avoided. In addition, crushed carom and cumin seed powder one tsp with water can take daily. Take care.... Avoid alcohol strictly.... 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 been on eglynyl for two years now and am gradually stopping by taking one day on and one day off. I have never felt worse, tired, nauseas, disorientated, disillusional and very depressed towards the end of the day. This has been for 10 days now. Please advise if there is anything that can assist in making this process a little easier? ### REPLY: Hi, Regional contain sulphide. It is used in several psychological problems like anxiety, depression, aromatization and psychosis etc. Dose vary according to symptoms and patient profile. Your current symptoms are not appeared to with .  In my view it is better to continue regional and meet your physician. I hope this information has been both informative and helpful for you. Wish you Good Health.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dr. Myself pankaj working with escorts faridabad as a engineer having 7year exp.my problem is that when I speech from a group I feel uncomfortable and my body is get vibrate and my face and lips are also make vibrate,and when I meet a new person or a girl I feel very uncomfortable such like that.Dr. I want to become frank. So pls tell me what did I do? ### REPLY: Hello, welcome to . From the symptoms' description it appears that you have problem of social anxiety. This problem lead to significant socio-occupational distress. For treatment, you can meet nearby psychiatrist. Medical treatment like SSRI medicines and nonmedical treatment like routine CBT sessions are helpful for this condition. Wish you good health and all the best. . 99doctor.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lump between my lungs at skin level it is not painful however i never noticed it before right at my sternum .I am 64 years old and in pretty good health have been very tired as of late and have a lot of mucus build up. I am concerned as i have had some dificulty breathing at night and have had night sweats of and on just wondering if it is normal feels like about 4 in long ### REPLY: Hi! Welcome to , and thanks for sharing your recent health problem with us! Well, if I were your family physician or the treating doctor for this case of painless sternal area soft tissue lump with tiredness, mucus, difficulty breathing at night and have had night sweats of and on, I would like to examine it first carefully and then plan the treatment according to the report of a fine needle biopsy; In such cases, the possibilities are:1. Benign lesions like lipoma, neurofibroma, dermatofibroma or benign cyst: 25% possibility2. Inflammatory or infective pathology like lymph nodes, tuberculosis or an abscess 35% possibility 3. Neoplastic or malignant pathology like cancer, lymphoma, plasmacytoma or metastatic cancer etc. 40% possibilityTherefore, it is very urgent to see your doctor ASAP for some investigations and then discuss the line of management accordingly!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 experienced chest pain in my mid sternal area with hot radiating pains across my chest. These pains were like in when you have an injection for a x-ray that you can feel filling up ypur veins(warm, hot and speads). These pain lasted approx 2 hours one day and returned the following day. I went to the ER and they ruled out an Acute MI. ### REPLY: Hi, Dear,Welcome with your query to . Studied your query in full depth of its details. Reviewed it in context of your health concerns. Based On the facts, You mostly seem to suffer frogger WITH ACID REFLUX with underlying acute on chronic gastritis. This is because the chest pain cant persist for 2 hours and if so would present with so many other factors with it.Also, Your doctors in ER, ruled out any Acute MI. Causes of this hot/ burning pain in chest are related mostly with the causes of the gastritis you have, which is hidden and unattended by you for quite some time.Most common cause would be frequent street/ hotel food/ or alcoholic frequent intake for quite some time. Second opinion by Physician or Surgeon would fix the cause in your case. Stool occult / with ova cyst would fix many causes of this Acid Reflux with Gastritis.OGD-oesophago Castro duodenoscopy would help in resolving this dilemma. Hope that, This reply would help you to plan further treatment soon with your treating doctors. Best of Luck and early recovery. Welcome any further query in this regard, which would be replied in next session. Good Day!! . N. Senior Surgical Specialist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My blood reports are asUric Acid  7.1Cholesterol 235HDL 36LDL 139Triglyceride 522Total Billionaire  0.9SGOT (AST) 50SGPT (ALT)  67Alkaline Phosphates 67Kindle advise diet and medicines how to control Cholesterol  and Lever , plz also tell me either lever readings are harm full ### REPLY: Hello. Elevations of liver enzymes(GOT and SGPT) and cholesterol are not worrisome, but triglyceride levels probably should be treated with medication by mouth (fenofibrate is the most commonly used . About the diet you must avoid intake of alcohol and fat products (bakery products, fried foods, pastries, red meat). Please consult your local doctor for a prescription. I wish you good health.(If the answer has helped you, please indicate this) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi well on sunday i had sex with my boyfriend and well we did it twice and the first time we did it and he ejeculated by masterbation and he took of his condom and well the second time we did it like 2 minutes after he took off his condom the tip of his penis was wet and we had sex for 5 minutes with no condom can i be pregnant? ### REPLY: Hello dear, I understand your concern. In my opinion there might be very less chance of pregnancy in your case. Usually a minimum of 2 ml of semen might be needed for pregnancy. Though the semen was on the tip of penis whicChatDoctore in contact with vagina, the very little amount of semen might be rare to cause pregnancy. So anyway I suggest you to wait and check for the period. The first sign of pregnancy is missed period. Avoid stress. If at all the period is delayed I suggest you to consider doing a urine pregnancy test a week after missed period for accurate results. But the chance of pregnancy is very less. Relax. Hope this helps. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I HAVE HAD SURGERY ON THE MIDDLE BACK OF MY HEAD FOR A CYST (3 TIMES). 1ST TIME LASTED 8 YRS, 2ND TIME 2 YRS, 3RD AND PRESENT 2YRS, BUT NOW I CAN HEAR IT BUILDING AGAIN. IF I SLEEP WITH MY HEAD LEANING BACK, I BELEIVE MY NECK FILLS WITH FLUID. WHEN I AM WAKING UP I CAN HEAR THAT FLUID MOVE UP TO THE SPOT IN THE BACK OF MY HEAD. SOUNDS LIKE FLUID BEING SHOT FROM A WATER PISTOL. SO FAR THE DOCTORS THINK IM CRAZY, BUT BEFORE LONG I WILL NEED SURGERY AGAIN, BECAUSE OF THE PAIN AFTER IT BUILDS UP. ### REPLY: HIT hank for asking to ChatDoctorI really understand your concern, this could be hallucination effects because of your extremely reactive and apprehensive behavior you have to take it easy, first thing I would like to say you that any kind of fluid accumulation in brain first manifest the clinical symptoms and that could be medical emergency but nothing such thing happened to you so why to worry still if you have strong doubt then better go for MRI test this will clear your doubt, have nice time ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: what are the long terms effect of acute pancreritis (sp?) ,if any. Six months ago i had a reaction to a sulfar drug, It fried my pancreas and went to ER. It was  not an enjoyable experince. Now I am back to normal but my heart rate tends to be higher (approx 80-100). I do regular cardio vascular exercises and have always eaten healthy. What gives ### REPLY: Hello Effect of acute pancreatitis depends upon severity of infection. Acute pancreatitis patients recover in the majority of the cases.However, some may develop abscess, pseudocyst or duodenal obstruction. Acute pancreatitis can be divided into mild and severe pancreatitis. Ranson Criteria is used to determine severity of acute pancreatitis. In severe pancreatitis, amount of necrosis determine the further clinical outcome. You may have repeat ultrasound to assess pancreas. It is good that you are so active physically. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: age: 26    height: 5 4  weight: 138lbs     Three  nights ago I fell and slammed my face into the ground.  The outside surface of my face and lips are already healing up nicely.  I am concerned about the inside of my mouth though.  The space where my lower lip attaches to the gums of my lower teeth is extremly sore.  (there was a lot of blood there the night it happened) now it is all white inside.  Is that scar tissue? is that normal? I have no feeling in my chin right below where the white part is inside my mouth. It is as if my chin is numb and I cannot feel anything. ### REPLY: Thanks for your query, I have gone through your query. The soreness in the vestibule could be because of the break in the mucosa secondary to trauma the whitish appearance could be the slough covering it or the food debris. The numbness or loss of sensation could be because of the injury to the nerve supplying the chin area particularly branches of inferior alveolar nerve. So consult your oral physician and take radiographs like OPG and rule out fractures and get the wound cleaned and irrigated if needed suturing can be done. I hope my answer will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my calf muscles and ankle muscles are hardening and swollen until the skin below my knees have turned silky smooth and red. I ve tried laying down with my feet elevated but it doesn t help. It is now getting harder to move my ankles to walk. I have taken a prescribed diuretic and that is not relieving anything. What would you prescribe or inform me to do or try? ### REPLY: Hello, Among the various possibilities poor blood circulation could be the cause of this swelling. This may be an inflammation of the veins (thrombophlebitis) or hardening of the arteries. In addition, if you have any kidney damage or weak pumping of the heart(congestive heart failure)this will aggravate your problem and should be appropriately treated. Tests for checking the blood circulatory status of the limbs are available and should be done.meanwhile take a low salt diet, avoid long-standing, use elastic stockings. While sleeping elevate the lower limbs above the heart level keeping the knee slightly bent. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 53 years old and having severe knee pain to the point where I am afraid I could fall simply by walking The pain is only when I walk and I can hear grinding.Sometimes I run approx 1 to 2 miles at a time and don t feel the pain This came on suddenly. I also have body aches and lower back pain but only when I am horizontal and sleeping or trying to...other symptoms include cold sores in my mouth and very stiff and tired ### REPLY: Hi, Thanks for your query. Although it isn't possible to diagnose your condition without an examination and a few tests, your history is suggestive of osteoarthritis knee. Often called wear-and-tear arthritis, osteoarthritis occurs when the protective cartilage on the ends of your bones wears down over time. Osteoarthritis treatments can slow the progression of the disease, relieve pain and improve joint function. I would suggest getting this evaluated by an orthopedic for detailed examination. You may get the X-ray/MRI, some blood tests and joint fluid analysis under his/her guidance to reach the accurate diagnosis. The following measures will help with the paid regular Exercise. Exercise can increase your endurance and strengthen the muscles around your joint, making your joint more stable. Stick to gentle exercises, such as walking, biking or swimming. Lose weight if you are obese-Being overweight or obese increases the stress on your weight-bearing joints, such as your knees and your hips. Even a small amount of weight loss can relieve some pressure and reduce your pain. Use heat and cold to manage pain. Both heat and cold can relieve pain in your joint. Heat also relieves stiffness and cold can relieve muscle spasms. Apply over-the-counter pain creams. Creams and gels available at the . Take diet rich in calcium, vitamin d3 and minerals. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doc, im 29 years old having hard time to conceive. I consulted gyne and had transvaginal ultra sound , my gyne said i have 13mm egg and capable for pregnancy, she prescribed me duphaston for 10 days and come back after 3 days.. But now, i have spotting and i guess i have my period. Do i lost my capable egg for pregnnancy? ### REPLY: Hello thank you for your query. The spotting could be anything from your period to implantation bleed. You have to visit your gynecologist and confirm what exactly happened. A 13 mm egg would not lead to a pregnancy. Only a mature 18 - 20 mm follicle can rupture and ovulate. Please consult a proper Infertility specialist. Have proper follicular monitoring and documentation of ovulation. Get your partners' semen analysis behave your basic hormonal profile done, and status of your fallopian tubes assessed. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Grandfather is aged 82. He had blood vomit due to one of the oral antidiabetic medicine. The haemoglobin levels had dropped to 6.6 and he was transfused with 2 units of whole blood raising the levels to 7.8. Doc had stopped his delayed release asprin to prevent any internal bleeding . It was further descontinued for 4 months unknowingly. He later had a bruise in the toe which developed a dry gangrene and periferal angioplasty was conducted to restore the blood flow. The toe fell off on its own and additional anticloting medicines were started ( Clopidogrel , asprin and cilostazol) post angioplasty. The blood haemoglobin levels had risen to 9.5 during the course (about 8 months post-vomitting) and now it dropped again to 8.7. He is currenly taking Multivit tab Supradyn (Morning), cilostazol (morning), Asprin-clopidet (afternoon), atorvastatin + fenofibrate (night), escitalopram (night) and Folic acid + B6 +B12 tab (night). The diabetes is managed with insulin 8-8-8 units/day. The sugar reports are 103 and 138mg/dl (fasting and PP respectively) and never above 180 (PP). When he was on antidiabetic tabs (voglibose, glimepiride, metformin, glipizide and some other) sugar was between 130-150 (F) and 170-240 (PP). The recent CBC has Erythrocytes 2.9 mil/cumm Hb 8.7 gms/dl Lecocytes 6000/cumm Platelet 2.15 lac/cmm PCV 26.9 % MCV 92.8 Femto lt MCH 30.2 pico-gm MCHC 15.1 % Neutrophils 42% Lymphocytes 56 % Eosino 02 % Monocytes 00 Baso 00 RBC morphology Hypochromia + Microcytosis+ / Anisocytosis+ Creatinin 1.6 Sugar (F) 103.6 mg/dl Sugar (PP) 138 mg/dl I wold like to know if there is any correlation withe drugs related haemoglobin drop and what should be the solution? ### REPLY: Hello Vishal and thanks for writing in at ChatDoctorFirst of all thanks for giving complete and detail history of the patient which is required by any physician for a better advise. I have studied your mail in detail. The cause of anemia is many, but in your case and the detail provided by you, it can be due to:1. Kidney disease related anemia: S. creatinine is 1.6 which is higher than the normal value. Kidney releases Erythropoietin which is required for formation of RBC's.2. May be due to anticoagulant .  Try to investigate it by urine R/E, stool for occult blood, Done your INR test which will confirm your blood thinning and helps in managing your dose of anticoagulants. 3.  As you are taking all the supplements which cause anemia, so it is not nutrition deficiency anemia.4. Other causes to be ruled out for anemia are bone marrow related anemia, G6GD deficiency anemia or Hemolytic anemia. Please consult your medicine doctor and get rid of it. Best Wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just recently received an ultrasound and the findings were that I have subcentimeter ovarian cysts and a 1.6x1.26x2 cm right sided fundal fibroid. I have had this very painful dull pain in the lower right side of my abdomen, sometimes I bleed when I have intercourse, I have very painful periods with alot of clotting and severe cramps. I have incontinence issues and the list goes on and on. One of the PCT from my gynecologist office called me and said everything is fine. How can that be when I am in SO MUCH PAIN? ### REPLY: Hi. You are absolutely right, everything is not fine. The bleeding during intercourse can be coming from the uterus or there can have a lesion on the cervix. Fungal fibroid can cause the pain and bleeding if it has eroded the internal wall of the uterus and clots and cramping. Ovarian cysts of this small size usually do not cause problems. I would advise you to go for another opinion. Possible chances of betterment are from Laparoscopic diagnosis and removal of the fibroid if there is a facility nearby you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have been feeling some strange sensation on the back of my teeth , on the front bottom ones... i looked at them and i found out some yellow n blackish stuff on them which wont go away by brushing..  it feels very strange when i touch them with my tounge and a feeling of dryness and like something sucking my teeth ... ### REPLY: Thanks for your query, I have gone through your query. As far as the black and yellow stuff on your teeth is concerned, I have two possibilities. It can be secondary to the stains or deposits due to poor oral hygiene. The other cause could be because of the decayed tooth. Consult an oral physician and get it ruled out. If it is because of the deposits, then get your teeth cleaned and maintain oral hygiene. If it is secondary to decay, then get the teeth restored. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi About 8 weeks ago I had a laminectomy in lower back. A few weeks later I had to go to the urgent care for an appointment because my wrist pain and swollen fingers and hand were unbelievable. That MD diagnosed gout and put me on colchicine which helped the enormous pain within a couple days. I still am unable to open water bottles etc. I had blood tests the next day and they were all normal including uric acid. I went to my regular MD a couple days ago and he has put me on prednisone as pain started up again. The wrist and pain feeling a little better. Could my laminectomy surgery be causing these brand new episodes of gout? I am a female who is 62 5 feet 5 163 lbs otherwise healthy . I will be seeing my back surgeon again in a couple weeks. At onset of first attack my daughter called him, sent him blood tests and she was very concerned. I had an X-ray recently and it showed a little arthritis and a cyst on a bone. Please advise. Thank you so much for your time. Be well Deb Corona ### REPLY: Hi Debit is unlikely that laminectomy may have anything to do with gout or arthritis of wrist. Rise of uric acid may sometimes happen with certain . In your case, since you are not a hypertensive or taking diuretics, pain medicines containing aspirin may have a chance IFF were taken for pain relief after operation or before for back problem. You must avoid foods like red meat, beef,lamb, pork and soft  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 take warfarin for a blood clot, My fingers and hands get red and the palms show redness my finger tips and nails are blood red. my left hand is minimally numb. After 4 to 5 weeks on warfarin my  left leg and foot is still swollen. I have some pain in my legs. What is the reason for this and how do I defeat it. thank you ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern, the symptoms that you have discussed here may not be due to the warfarin this seems hypersensitive reaction I would advise you to wait for some days this will go away, if it does not subside then I would suggest the following treatment1) Tab Levocetrizine 10 mg there times in day hope this information helps you, take care and have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir iam suffering with typhoid from last 5 months .....still now iam in same state when i found that i am suffering with typhoid ...i consulted many doctors and taken many antibiotics nearly (50-60) tab ....when will my disease cure is there any other disease under this ### REPLY: Reclothe entire of treatment of typhoid is 2 to 4 weeks depending upon the nature of .  Previously salmonella type were sensitive to chloramphenicol 500 mg four times in day for 15 days. Nowadays when such type of patient visit in my clinic I usually prescribe ciprofloxacin 500 mg twice in day for 14 days. If the patient had already taken Cipro I prescribe levofloxacin 750 mg once in day for 28 days. Still no relief I advise my patient for  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 grandmother died at 26 of RA I feel i might be at risk ..at 46 i have DDD in Lumbar n Neck serve waiting on surgery but they wont till i stop shacking w anxiety n get it under control buy i think they r missing something??? I can hardly type i feel like like i have parkinsons???? ### REPLY: Hello! Welcome on  ! You should know that tremor is not the main typical sign of Parkinson disease. A thyroid dysfunction or anxiety could be the cause of tremor. Anyway, I recommend consulting with a neurologist for a careful physical exam and performing some tests (complete blood count for anemia, thyroid hormone levels for thyroid dysfunction, blood electrolytes for possible imbalance) to exclude other possible causes. A DAT scan would definitely help exclude Parkinson disease. Hope you will find this answer helpful! Kind 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 son is 5 years nd 10 months old. He has got fever on last wednesday and after that he has been sent for diagnosis for dengue. The result was negative. However on sunday he as got fever again in night 101 deg F & as instructed my doctor we had given him calpol, After that on monday he was normal an after half day (after noon) he starts itching his leg and now at night the itching is so severe that we are sitting there and itching his leg, basically near toe,bottom most part. Please advise. ### REPLY: Hi dear, If you had given him paracetamol in the past without a rash or itching, this is unlikely related to paracetamol. It is probably a part of fever itself. If he does not have any other symptoms, fever and itching indicates a viral illness. He may also develop a rash in coming days. If he is active and playful, we need not worry. Just continue paracetamol 3 times a day for 3 days. Also give antihistamine to relieve itching. Syrup HY . If he is not getting better by 2-3 days, kindly take him back to his doctor. Hope I have answered your Quertle me know if I can assist you further ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my wife is in her 30th weak of pregnancy, and she is suffering from Pruritic urticarial papules and plaques of pregnancy, n god its terrible, she cant sleep whole night. We had visited a skin doctor and is said that it will cure after the delivery and he prescribed one tablet Avil 25(Pheniramine Maleate) twice a day and a Lotion named Ciala (Calamine and Light Liquid Paraffin), are they safe to take and what else she can do to get relieved from the itching? ### REPLY: Hi,Avil-25 is not known to cause any harmful effects on the baby hence can be taken safely during pregnancy. In addition to the prescribed medications I would suggest her to:* Take an oatmeal bath or use baking soda during her bath* Avoid hot showers and hot baths (at least lower the temperatures)* Avoid wearing tight fitted clothing* Not to scratch her skin as it itches* Take plenty of oral fluids and* Avoid stress and practice relaxation techniques Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 8 yrs old and has been complaining of difficulty breathing and tightness in her chest. I had her evaluated by a Dr. for asthma, and the physician does not think it is asthma. Could it be anxiety? She also has been experiencing stomache problems like cramping periodically throughout the day. The pains start out in the morning and continue on. I have been giving her prevacid so that she may eat without problems ### REPLY: Thanks for your question on . I can understand your concern. Since pediatrician have already ruled out asthma, possibility of anxiety related symptoms is more in your daughters case. So better to consult pediatric psychiatrist and get done clinical examination and counseling sessions. Try to identify stressor in her life and start working on its solution. She may need mild anxiolytic .  Encouragement and rewards are also beneficial in pediatric patients with stress and anxiety. Don't worry, she will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good morning. My daughter 23 yrs old now pregnant. 3 days back we did scan and found she is having twins. one is 10 weeks 5 days with 173 hear beat and another one is 9 weeks and dont have heart beat. The Dr opinioned that this is not good and better to abort both to save the mother. we took her to another GYn dr and she advised to take a Dopler scan. after scan she found that the babies are with seperate placenta and at present there is no risk and we can decide after two weeks. she also said she treated some cases like this and they delivered the live baby and the other one reabsorb itself or come out with out making any harm to the other child. i am in total distress and dont know how to handle the situation. my anxity is is it safe to wait for 2 weeks. will it harm my daughter any way. my daughter got married last year and felt very happy on hearing the conceived news. now she is very much worried about her fate. pl reply ### REPLY: Hi, It is absolutely safe for her to continue the pregnancy. Sometimes it so happens that a twin pregnancy initially, gets converted to a singleton. It will not affect your daughter as It's too early in pregnancy at 9 weeks that she has lost one twin, this as said by the doctor will get reabsorbed, and not cause any harm to her. Ask her to go regular 2 weekly scans as this will reduce her anxiety. Also, she should not take stress as this could affect her pregnancy. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have scars rashes on face i have oily scan .. and in winter its dry .. i am looking for subscision, co2 laser, microdermabrasion in kolkata is it advisable to do .. or i should opt something like any cream or oitment i dont eat oily or junk food .. i have loads of water whn i am in gym .. awaiting response ### REPLY: Hi, As per your query you have symptoms of rashes and scars on the face which occur when there are hormonal changes, stress and clogged pores of sebaceous gland filled with sebum, dead skin and bacteria get infected.  Need not worry. I would suggest you to make use of product containing benzoyl peroxide.  .  Take Multivitamin supplements. Apply Darlene gel once at night. Also wash your face with mild soap and cold water twice a day and exfoliate your face once a week. If condition doesn't start getting better in a month then consult dermatologist. The doctor may prescribe antibiotics course and can also go for chemical peel containing Glycolic acid. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, is it common for my 3 yr old to have monthly headache, fever and vomiting? it seems to last only a day..is it just growing up pains or just the fever virus is there any way to prevent it? or should i be concerned that it could be a bigger picture here. ### REPLY: Hello, That is not typical of the usual pattern of viral infection in kids.  Of course, it could be, kids do get 4-6 infections, some would say even 10/year.  The first thing I'd suggest is that you write his symptoms when they occur on a calendar so you and your pediatrician can see if there is a pattern.  But, if it is the symptoms are really reliable, and really spaced at exactly 4 weeks, then I would take him to see his pediatrician.  More questions need to be asked and answered.  Although unusual, there are migraine patterns that could cause this, including abdominal migraines.  There are some periodic fever syn .  And finally, I would always consider stress and anxiety as a reason.  For 3-4 year olds, this is a big time for normal separation anxiety - consciously or not.  Child ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have swelling in the right upper quadrant of my stomach? No fever, no pain, no gas, no constipation. Just a noticeable swelling on the right side which extends (somewhat) across the front of my stomach. I did hurt my back several weeks ago and still have some slight pain on the right side in my back. ### REPLY: Hi. Thanks for your query. The swelling alone in the right upper abdomen with no other symptoms can be due many reasons. Since there is a history of injury to the back there is a possibility of enervation to this segment of the abdominal wall causing loosening of the muscles and resultant bulge. Another possibility is a diffuse lipoma. You have no symptoms of fever, pain, gas or constipation, practically NO symptoms at all. Get an MRI of the spine and the abdominal wall to get a right diagnosis and treatment under a care of a 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, my son is 7month and 6days old....i have started semi solid food after 7 month have few queries about external food... 1.how many meals introduce per day? 2.what can i give between the meal? 3.plan to start also formula milk once a day...which is best nan pro or lectogen? ### REPLY: Hi.  I presume you are still giving mothers milk to your baby.  If not continue to give as long as possible.  Formula milk is only needed when you don't have enough milk. Nan pro is superior but also costlier than Lactose. As far as other foods are concerned, usually a child needs to be given around 6 times a day(depending on the children intake). You can give porridge, rice with DAL, idle, vegetable soups, fruit juices and boiled fruits like apple. Avoid sugar as much as possible. Can add ghee to the food. This is presuming that you are from India. If not most of what I said applies except certain food items I mentioned.  All preparations made at home cleanly are best for the child. Non veg like egg, chicken soup can be started after nine months.  Packet or bottle milk can be started after 1 yr. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sufferinf from fever since last one month. I test my blood and found Typhoid fever. I used two times antibiotic medicine for little period but fever is still present. My fever travelling between (Normal) 98 to 100F and oftenly it rises in eveving and after some hours automatically normal. I have lot of weekness and pain in the body. ### REPLY: Typhoid fever is caused by Salmonella type bacteria. When treated with antibiotics, most people with typhoid fever feel better within a few days. Improvement may come slowly during the fourth week. Your fever is likely to decrease gradually until your temperature returns to normal in another week to 10 days. But signs and symptoms can return up to two weeks after your fever has subsided. You should take Ciprofloxacin (Cipro) or Ceftriaxone (Rocephin) antibiotics to treat Typhoid fever if you still feel sick also take Aspirin to decrease fever, joint pain and prevent inflammation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hai Dr, I would like to intimate you that i have fungal infection around my pennies and it comes not always , at times i could see ,,my skin is getting dry and white patches around that. During that time if we wash that it will be wiped off. So kindly advice me a solution for this dr. ### REPLY: Hello, Welcome to , Your history and symptoms are suggestive of fungal infection, and it is more common in the genitals, as they are the normal comedians of this area which will be kept under control by helpful organisms. Whenever there is an imbalance in the environment it will produce its symptoms. I would suggest you to follow1. Keep they are clean and . Topical application of antifungal cream like Ketoconazole cream3. Oral single dose of Tab Rifleman, 150 mg.4. Oral anti histamines. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son was born 7 weeks premature with a grade 3 IVH. The bleeding stopped soon after but led to hydrocephalus. He is now 20 months. He does not have a shunt. His neurologist didn t wanna put one in because he said there is no pressure at this time. He s been getting nosebleeds for quite sometime now and they keep getting worse. Could this be related to the hydrocephalus in any way. ### REPLY: Thank you for asking on . Newborn brains are in the process of development especially in preterm. The inner lining of the brain is very thin. As the development of the brain progresses, a substance called myelin is formed and acts as an insulator of the nerve fibers and helps them in functioning. But in preterm sometime bleeding may occur below the thin lining and as there is resorption of the blood, the blood debris often block the .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 doing the splits on top of my friends couches that are across from eachother about 4 feet apart and my right leg cracked 3 times right below my right buttcheek. Sharp pain and numbness now going down my right leg. Did I pull something or could it be serious? ### REPLY: Hello, What I understand from the history that this could be related to a muscle pull or nerve pull. You need to get it checked with the orthopedist and take some x-ray if you have damaged the hip joint.  Having taken an extra precaution is better rather leaving the injury just idle. Hope you will take this matter to the orthopedist at the earliest for the better outcome of the treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i am 28 male and have a fatty liver. last month i had may lipid profile taken and my sgpt and sgpt results are 283 and 180, respectively. i was prescribed with livolin (phospolipid) and fenofibrate. then last week. had my lipid profile taken again and showed sgpt and sgot results 233 and 123 respectively. do you think is there any improvement as to my lab result and are there any drug which can get fast result n lowering my spt and sgot?thanks ### REPLY: HIT hank for asking to ChatDoctorI think you are wrongly understood the SGPT and GOT is not the lipid profile test, this enzyme level which shows the liver whether damaged or not, if the value of these coming high then it is indication of some kind of liver disease and that must be rule out, there is no particular medicine which can bring the value of these back to normal the under laying cause has to be treated and that bring the value to normal level have nice day ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had a question about some symptoms ive been having. I figure I should ask a gynecologist about a couple of these symptoms but Im not sure if you could help me out with the rest of them. Symptoms include: fatigue, severe abdominal pain and discomfort after eating, bloating, frequent urination, loose bladder, nocturia, swollen left outer labia, weight fluctuations, swelling of the feet and hands, frequent constipation, heartburn, heart palpitations, mood swings, etc. I work at an Urgent Care so im familiar with all of these im just a little concerned for myself I guess. I eat very healthy and exercise at least two days a week. I also have hypothyroidism but am not taking any medications. Any insight?? ### REPLY: Hi, we surely can help you though if you had mentioned your age, describing and diagnosing your symptoms could have been much easier.nevertheless, all your symptoms basically points towards hormonal imbalance which could be menopause, if you are near about the particular age. The other symptoms are pointing towards diabetes which could be confirmed by investigations. You also need to check the severity of thyroid hormones level as hypothyroidism could also be one of the culprit for the existing symptoms. So my dear, please visit your nearest physician and start with the required treatment. Hoping for the best for 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 am 39 female and i have a lump at the back of my skull on right side at base of head and neck and shoulder pain constantly it cracks when i move it i get tinglin in arms and they are fatigued even just brushin hair  i feel dizzy at times pains in my wrists and fingers and at time feels like someone bangs on chest ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have Desmond cyst or lipoma or skin adnexal tumor or lymphoma or some other tumor.  You should go for fine needle aspiration cytology or biopsy 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. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 really hope you are able to help. About 4 months ago I got a cluster of little red bumps near the lower area of my butt. Initially I thought they were heat rash because I play a lot of sports. I thought the best thing to do would be put alochol to dry the itchy bumps up. However that seemed to make it worse. Now the cluster has spread out and is up and down my butt cheeks. The bumps are not itchy anymore, but have changed. They are now not all clustered and most are bigger like the size of a regular pimple . They also look like they are pus filled or need to pop. So, I though maybe they just need to be popped and drained. This is where I get confused. Each time I pop these pimple like bumps, not pus comes out, but something that looks like a little white bead or ball or sack. Then afterwards each bump I have popped this way bleeds like crazy. Strange thing! They dont clear up, they just keep coming back. They are not itchy, just super annoying and ugly, and wont go away. I dont know what caused this but I am an athlete and also moved to a new house recently and had sat n the bathtub and noticed the bumps in a similar location to where my cheeks would b on the tub. I just kept thinking it would go away, but its been 4 months now. Ive tried, ointment, tea tree oil, scrubs, bodywash, alochol, peroxide ...no relief ### REPLY: Hi, Welcome to . The description in your query matches acne in the gluteal region. This region is rich in sebaceous glands whose pores when blocked cause bumps like these which can get infected secondarily by bacteria. Then they can form pustules. I suggest you clean the area and apply clinic cream over the bumps. You can also take Cap Roxy 100 mg two capsules stat and then one capsule once daily for five days. I would also suggest avoiding tight underwear and try to keep the area . 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 recently noticed a little small lump, inside the scrotum like by my left testicle, doesnt give me any pain nor bothers me. Id also like to mention in 15 male, Im not sure if this is normal or what? But I heard of cancer this cancer that..Im just uncertain. ### REPLY: Hi, Any lump is not carcinoma it can be plenty of things. Most common is inguinal been at that scrotum which shows positive cough reflex, after reducible, increases in size on straining n coughing.  So lump present must be diagnosed through examination n accordingly investigated including biopsy And accordingly treated.  So in my opinion don't panic n visit a general clinic get checked n treated Thanks n regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good after noon Madam. This is Divya i completed my Master of pharmacy i worked 1 year only.now iam not working any where due to family problems and i  struggled a lot because of insecurity and harrassness of my husband.now we were separated still iam out of confident.i like to do good job but iam suffering with some what mental tension.i already used psychological ulcer tablets how can tell my problem not understanding.please suggest me.                                                                              Thank You very much ### REPLY: Dear Divya, I am sorry to read about the difficulties you have had to face in your life. I can completely understand what you must be going through. You should consider consulting a psychiatrist for your problems. Ant-depressants like Escitalopram will help you overcome your stress and feel more confident. In addition, supportive therapy sessions where you can discuss your problems and burden yourself will also help. Relaxation exercises like deep breathing and progressive muscular relaxation will help you relax and feel better. I do hope that I was able to answer your query. 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: hi im jo 33 weeks pregnant, 23 years of age with my 3rd child, 53 and yesterday at my regular midwife check up she told me my baby had an irregular heart beat.She then sent me to the hospital to be monitored they found the same irregularity but its not a regular irregular heart beat. I mean the gap between the slipped beat varys.. Should i  be worried about this? What are the possible problems this can cause for my baby? ### REPLY: Hi, In this case it is very important that the baby has structurally normal heart. Usually in such cases echocardiography of fetus is done to rule out structural abnormality that may cause some arrhythmias. The grade of seriousness depends on the type of arrhythmia and if there is a structural problem. If there is no structural heart problem, the arrhythmia may be benign and have no consequences. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear sir,name-leela age-21 sex-female weight-53kgsheight-5 feet,3 inchesmedical history-fissure in ano..sometimes blood will come in stools.have to go with an internal sphincterectomy next weeki had a bp 110/50i think my diastolic pressure is low..is it so or it is normal????am i hypotensive????please suggest me ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You have very low diastolic blood pressure.  You should consult your anesthetist or physician and take treatment for that.  First you should normalize your blood pressure and then only you should go for surgery. 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