Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a vasectomy 1 week ago.  I had two incisions and one had been healing nicely.  The second is located on the side of my scrotum so the stitch location is up against my thighs.  Of course wearing tighter underwear, jockstraps keep things in place but it is still on that side.  I find that as my scrotum relaxes and contracts as it always does through the course of the day, it moves a little and the stitch area on that side is sore.  It seems to almost swell in the shape of a small round bump about a centimeter in diameter at its max.  After a while it will go back down again.  I was worried at one point as I have always been very sexually active and have had an erection in the last week as well and worried even that may be aggravating it.  Im very attracted to my wife and find myself getting excited with her by my side as I usually do but nervous to proceed with this soreness.  Honestly though I feel more relaxed when Im turned on and the swelling seems to be nonexistent during erection.  what is the cause of this swelling?  is it just irritation and should I wait longer to have intercourse? ### REPLY: HelloThanks for your query. Swelling at the site of incision of vasectomy is common and is due to local inflammation due to injury and handling of the tissue during surgery. This normally gets resolved within two weeks with antibiotics and anti-inflammatory medicine like Diclofenac twice daily. Refrain from having intercourse at least for three weeks as there is possibility of flaring up of 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: Hi,i m now 21 year old Buddhist monk from Myanmar. Whenever I am checked my pressure condition, my pressure is under 100 (High) and under 65 (low), breathe is normal (71). Why am i not like other whose blood pressure is above 100 (high) and above 75 (low)? ### REPLY: Hi, I understand your concern and would explain that low blood pressure could be related to different possible causes: genetics, normal constitution, deny .  Coming to this point, as you have no other symptoms like shortness of breath, dizziness, lightheadedness, etc., there is nothing to worry about! You can consider it a normal variation of blood pressure in a healthy person.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i hav started my carrier after my post graduation,after joining in the industry my health problem has started, i dont why daily i wake up at 7 and i vl try to sleep after completion of my dinner, but im having some family tension i thought due to dat iam unable to sleep well please provide me some guide line to overcomek it... ### REPLY: Tithe stress at your work place and at home could be one of the reasons for your sleep disturbance. If you are having 7- 8 hours of undisturbed sleep and feel fresh in the morning it is not a cause of worry that you wake up early at 7. You can consider following a similar sleep pattern every night and indulge in light reading before you sleep. This might help, or you can also take help of a counselor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 on Acitrom 4mg because of mechanical Aorta Valve. Does consumption of raw onion interfere with the effects of Acitrom? Please advise. Thanks Since I am a vegetarian, please advise what food should I avoid. Thanks again YYYY@YYYY ### REPLY: Hi, Citron is an anti-clotting (blood thinner) medication commonly prescribed to prevent and treat thromboembolic diseases such as venous thrombosis, pulmonary embolism, atrial fibrillation and patients on artificial heart valves. Citron helps prevent blood clots or keeps a clot from getting bigger by decreasing the levels of vitamin K. Whereas vitamin K helps make your blood clot when you are bleeding.  Increased intake vitamin K in the diet decreases the blood-thinning action of Citron. Thus, vitamin K and Citron work against each other in your body. So, you must avoid foods which are rich in vitamin K such as green leafy vegetables-spinach, turnip greens, collards, mustard greens, parsley, and green leaf lettuce.  Vegetables such as brussels sprouts, broccoli, cauliflower, cabbage, raw onions and garlic also contain good amount of vitamin K. Certain .  Avoid or consume only small amounts of cranberry juice and alcohol while on Citron. While eating small amounts of foods that are rich in vitamin K should not cause a problem, avoid consuming large amounts of certain foods or  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yesterday I was walking and saw this big icicle I then ran up to it and I tried to hit it but as I jumped I realized there was a patch of ice I slipped on the patch and landed on my lower back/butt area it hurts standing up and walking. Do I need a docter? What do I do? ### REPLY: Dear patient Well said health is wealth.  Since you have fall on back there might be muscle spasm, but possibility of minor fracture cannot be ruled out. I would advise X-ray of lumbosacral spine anteroposterior and lateral views to rule out bony abnormalities.  If its. Normal take rest for 3 days. Take tab diclofenac plus thiocolchicoside combination twice a day for pain relief for 5 days. Do hot water fomentation for 2 days.  If X-ray report shows fracture need to consult expert spine 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: Hi, Im suffering from tooth pain since last two months and my doc prescribed augment 625mg 2 times a day for 5 days then again he added plus two days.. It was cured but again I started the pain from last 2 days should I counting e the same tablets or wait till I go back to India n see my doc or just have pain killers till then ### REPLY: Hi welcome to ChatDoctorYOU THAT YOU ARE HAVING PAIN IN YOUR TOOTH SINCE LAST TWO MONTHS. IT IS A LONG PERIOD OF TIME. IT IS FOR SURE THE YOUR PULP IS INFECTED. YOU ARE PRESCRIBED WITH CORRECT MEDICINES BUT UNTIL AND UNLESS YOU GET YOUR TOOTH TREATED FURTHER YOU WILL NOT GET RELIEF. SO I WOULD SUGGEST YOU TO PLEASE GO TO A DENTIST AND GET AN X RAY DONE FOR THE TOOTH... MOSTLY THE TREATMENT GIVEN IN SUCH CASE IS ROOT CANAL TREATMENT... AND I THINK YOU SHOULD ALSO OPT FOR IT ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir, Hope u r doing good. Sir, I am planning for baby since June13 but I am not getting result. I consulted doctor.She advised for fertile 50 mg tablet to take on 5th day of my period. but unfortunately I didnot get this tablet till my 6th day. can I take from 7th day onwards to get the result or I should try from next month?? ### REPLY: Hello dairy understand your concernFertile tablet will help to maintain fertility by inducing the ovulation. Clomid should be started on day 3 to 5 of your cycle and continue to take it at the same time every day for 5 days. You will likely be started on a low dose of Closed, such as 50 mg a day. This is to reduce the likelihood of developing cysts, side effects, and multiple pregnancies. If you miss the pill then take as early as possible. So I would suggest to start from the next cycle form day 3 or 5 for better effect. After taking pill must to sex on the ovulatory cycle to increase the chance of conceive. Avoid stress, take healthy diet, . 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 back pain, not sharp but continuous. also experiencing extreme fatigue and pain in my lower abdomen. also light pain on the left and right of my womb. I have had 4 miscarriages, the last one in April. Have had very regular period but are much lighter now since my last miscarriage ### REPLY: Hi, thanks for posting your concern in the . A dull aching back pain along with pain in lower abdomen and a bad obstetric history warrants further evaluation to rule out underlying uterine or ovarian pathology or pelvic inflammatory disease and ectopic pregnancy. Before any other test, please have a urine pregnancy test done at the earliest. You should have a transvaginal ultrasound scan to rule out any ovarian or uterine pathology. Urinary tract infection or any other pathology should also be ruled out. Therefore, you should have a routine urine examination also. You should also have a KOH test of vaginal secretion. NAT is done to rule out other causative organisms of PID. A complete blood count with ESR, urea, creatinine tests should be done. You should also consult your local gynecologist for clinical examination and further management. In case you are diagnosed with any infection, appropriate antibiotic treatment will be needed. A USG of PUB should be done to rule out any renal, ureteric or bladder pathology. For the time being you should maintain good oral HY .  Please also avoid unprotected intercourse. If your bowel habit is irregular, have spatula husk 2 SF in a cup of water at bedtime. For any further questions, please write back to me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doc my daughter is one and a half year old she is passing stool 10 to 12 time a day dr advice domcet twice a day or interogermina liqed once a day ascazin twice a day but she is passing watrey stool then i am giving Sporlac ds 120 tablet after that I am very conscious. kindly share ur experience can some side effect of sporlac ds 120 ### REPLY: A child of this age could be having persistent Castro colic reflex which could make her pass stool after each feed, and it could be entirely normal. For diagnosing a gastrointestinal infection I would have liked to look at the stool microscopy report. If pus cells are present in significant number, I would think of such an infection and would treat them with the antibiotics. I would suggest you to give oral rely .  Enterogermina and sporran are the right medicines to be prescribed and are safe to be given. You need not bother about side effects while giving these medicines. I and most other doctors prescribe these and no side effects are reported. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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,yesterday i was at my daugher graduation.i did not eat or drink whole day. at evening we had party at restorant. i had two glasses of wine on empty stomach and than big dinner. after dinner i suddenly feel weak and lost consciousness in the car and start vomiting.could you, please, tell why it can happen i am female 52 years old my height is 170 sm and my weight is 80kg i have mild fatty liver condition, but my blood tests are normal. i am pretty halthy. ### REPLY: I and welcome to . It would be easier if you've posted the exact liver enzymes findings. Its elevation is common found in many disorders must most usually is alcoholic, viral, autoimmune or toxic liver damage. The most common liver disorders are fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar. If ultrasounds didn't find anything and viral markers are negative then you have no reason to be concerned. You should treat it by changing dietary and lifestyle habits. Do exercise, avoid alcohol, smoking, fats, fast food and carbonated .  Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be prescribed, but I suggest going step by step. If you don't have any symptoms then this is just slight and reversible liver damage. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,I have been diagnosed with Chronic lymphocytic lukemia and the have been refered to a hemotologist .. my local gp doesnt know a lot about the disorder and has said not to worry as it is not a cancer..the net tells me other wise.. i am 46.. and have a 67 percent reading in my blood.. should i be concerned in regards to it being a cancer.. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  Chronic lymphocytes leukemia is a cancer. You should concern about that.  However, prognosis is somewhat later than other leukemia.  You should consult hematologist and take chemotherapy according to his advice. 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 am 61 and have had gallbladder removed as well as histerrctomy ihave sore tummy in pelvic area and in back on lower both sides I wear a light pad for normal light disgorge but have noticed in last couple of months a brown rust colour and am worried this is blood when I take a ural it clears up ### REPLY: Hi. Thanks for your query. Since you are 61 years old any bleeding anywhere should be suspected as a cancer and needs to be bothered about. I would advise you to go for:Clinical evaluation.investigations as per the cause and get all the relevant tests done under the guidance of a specialist to rule out cancer. This should not be taken lightly as late diagnosis can have bad complications. I hope this answers your query and helps for an early diagnosis and proper treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 3 yr old son has had an odd what I am callin rash for 2 days ago.. I took him to the dr and she said she wasn t sure what it was. it was nothing common chickenpox ect... it can appear and then disappear quickly or it can stay visiable for a while.. I do know that the heat makes it worse so I have been keeping him cool.... I prefer more natural treatments so I have (after researching) tried a series of things such as pure aloe, tea tree oil, burdock root, pure apple cider vinger. .all of these things seemed to dull down the itchin and redness for bit but didn t make the go away for good. it most closely looks like a very mild case of molluscum contagiosum but the descriptions to my understanding sounds more like very tiny wart like bumps that stay on the skin constantly and do not disappear and reappear.... ### REPLY: HI... I feel she is having recurrent popular urticaria. It is a type of skin allergy. It can be recurrent on and off. You need not worry, unless she has joint pains and blood in the stools or sever pain abdomen. Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine, but I suggest you get the kid evaluated with your pediatrician. If I were your pediatrician I would prefer to use HY . 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 25 yrs old and trying to conceive from 5 months this time my periods are 11 days late and i am only experiencing very light spotting, is this means i am pregnant. I took test on 6th day late of my period but it was negative. Do i have to test again ? Doctor prescribed me estradiol Valerate. Is it safe to take it as i am expecting to be pregnant. ### REPLY: Hi, Thanks for the query. Sometimes women may have spotting while being pregnant also. But just by alteration in the pattern of menstrual flow we cannot come to one conclusion regarding the pregnancy. You once go for blood test for pregnancy or for ultrasound which can give more accurate results compared with urine test. If the possibility of pregnancy is excluded by these tests, you can use the tablets prescribed by your doctor. For more details you can ask me through: http://www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? Pl ease type your query here...hello doctor i get a bite before 6 days from my puppy who has 3 months old and i didn t make any rabies shot and my dog did receive his vaccin in the same day of the bite (before 5 hours of the bite )..do i still have any risk ### REPLY: Hello, THX to contact us. If I am your treating doctor I would like to advice you that receiving shot just 5 hours before the bite will not immunize the dog. There is a little chance of you get rabies, because puppy is unvaccinated before five day. To develop immune effect vaccine shot approximately requires 15 days. Proper wound care immediately after bite is necessary to reduce the chance of getting rabies, if you have taken proper wound care than need to take vaccine is reduced. But mind well there is a little chance still remains if you do not take the vaccine. In other case if you take vaccine, you are safe from the rabies. So in my advice you should start with the vaccine shots. If you have anything else to ask please contact me. Than.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes. thank you.  how do i increase the wbc count by consuming ayurvedic medicines or some foods / fruits etc? I am 41 yrs, height 4.9 ft, weight 45 kgs. I have  weak immune system since child hood. I always get lot of burps and many a times feel vommitting and now my WBC count is showing around 3500.  I need ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. WBC count is dependent on nutrition. 2. Improve protein intake along with vitamins B12, A, E. 3. As the nutrition improves, so does the immune system. 3.5 thousand is on the lower side of normal, however, if there is no recurrent infection, not to worry.4. Recurrent burps and nausea is usually due to inhalation of air during food digestion and gastritis. Take proton pump inhibitors to reduce gastritis, it should reduce the symptoms. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi sir/madam my liver profile is as follows SGOT/AST-1610 U/L SGPT/ALT-1820 U/L ALKALINE PHOSPHATASE -1018 IU/L SBR(total)-8 mg/dl Conjugated-6.3 mg/dl Unconjugated 1.7 mg/dl i would like to know how do SGPT and SGOT affect in jaundice? Apart from that what i should take in food? ### REPLY: Hi. Thanks for posting query at . Its most likely due to acute viral infection. Blood tests should be done to find the cause. HEPA is a self - limited and common cause of acute hepatitis. Usually ALT or AST values higher than "two times the upper normal limit", is considered abnormal (in some countries, ALT or AST values of more than 100 are considered abnormal). Advice:- abstinence from "Alcohol" - LOW fat diet should be followed, AVOID junk food and beverages-decreased oil consumption (oily food)- NO red meat-green vegetables should be ingested daily-use lemon juice (lemonade) once in a day-reduce weight if overweight/obese-"recheck liver enzymes after 6 to 8 weeks" and/or ultrasound.- bed rest for at least a week to 10 days any further questions are welcomed. Hope to answer your concern. Wish you good health. Regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi....after 2-yrs of our marriage we are planning for a baby, but we both are worry bcoz my husband is getting problem in pennis, he had not any pennis problem before 2-yrs. but now he does not get his pennis strong enough while intercourse......plz guide us wht to do..... ### REPLY: Hello, It may be due to performance anxiety. For further assessment you may require complete hologram, lipid profile and electrocardiogram after physician consultation. Along with that Avoid stress and strenuous activity. Take balanced diet and proper rest. Avoid smoking and alcohol. Till then, you can take tablet sildenafil one hour before sexual act. Hope I have answered your question. 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: Dear Doctor, This is Diptiman Chakravorty age 32 male, obese individual height 5ft 7 in, weight 122 kgs. Two years back, I was diagnosed with fatty liver. Last month, I started feeling extremely weak and consulted a Dr. Blood tests revealed low Haemoglobin levels of 10.8. Last year it was 14. I was advised upper GI endoscopy, Colonscopy and stool for routine and occult blood tested. Upper GI endoscopy result:-Gastritis in antrum and healed duedonal ulcer. Colonoscopy report :Normal. and occult bleeding in stool negative. Dr prescribed Vivolib 500, Omez 500, Kinpride, Pibizyme, ursocol 300 and mild iron supplement Livogen(once daily at night). Within a week my hb levels went to 12.2 which Dr says is not bad.Other drugs described above are being used to treat gastritis and fatty liver. II have also been asked to loose weight. I am not diabetic and do not smoke or drink alcohol. My query is does gastritis cause such types of anemia, and how long should I continue to take Livogen (iron supplement)? Moreover, I am worried whether taking iron supplement will damage liver(fatty liver)further and am I in the taking the right medicnes for my condition? MY SGPT and SGOT are at normal levels at present..my present energy levels are low, yet I am walking 20 minutes daily.My doctor loosing weight gradually through exercise and diet modifications will help, but I am worried about anemia :-too much iron :-liver damage, too less anemia. How do I strike a balance. Please advise accordingly. I am still young and keep worrying constantly due to my helath conditions. ### REPLY: Hello, You are definitely a high risk for Fatty liver disease. If you don't consume alcohol then it is Non-alcoholic fatty liver disease. Weight reduction and restricted intake of Refined carboy .  No specific medications are available to manage Fatty liver except for vitamin E intake. You need to monitor you Serum lipid profile and blood sugar profile. Now coming to your anemia. I would need to know your complete blood profile to check for the nature of anemia.  If it is iron deficiency anemia intake of Iron intake will help. Only in specific conditions like Thalassemia (even carriers) and Haemochromatosis oral iron intake is to be restricted.  Once the hemoglobin level is normal you need not continue Iron intake. Astral gastritis usually does not reduce He levels.  Only severe erosion in the GI tract, bleeding ulcers and vascular malformations can cause low He levels. Usually Stool for OBT is positive in these cases. I would suggest you to monitor your He levels and check stool for Routine examination (as worms are a common cause for anemia). You may discontinue your iron supplements once your He level normalizes and monitor henceforth. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I have been diagnosed UTI from e. Coli but appart from typical symptoms (since this is far from my first UTI) I have severe leg (upper thigh) muscle ache which gives me pain while walking.Could this be connected to UTI and does it mean that the infection is more severe than usual?Thank you,Sandra N. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes, it is possible that the infection with E.cold has spread the toxin to the whole body. It is the effect of this vaccine which is causing the muscle ache. I advise you to do Culture and sensitivity done for these bacteria. It can cure the infection rightly and accurately. Please take plenty of water. As it can help you flush the bacteria through urinary system. Please maintain hygiene as it can help you recover earlier as well as future infection can also be prevented. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 while having my last period i tried using tampons and it hurt my lower abdomen when it inserted it and even when i took it out it still hurt.  its been a couple of days now and when i sit down i still get pain going from my bottom to my tummy and im not wearing a tampon, why it this? ### REPLY: Hello! Thank you for the query. Tampon is not a natural thing. So you insert something that does not belong to your body. Sometimes it can cause an irritation or even an inflammation of the uterine or urinary tract infection. Pain while inserting a tampon can be also a symptom of uterine cancer. With urinary tract infection you may also have frequent urinating and burning while urinating. Uterine infection can give bad smelling discharge. I suggest you to consult gynecologist, have transvaginal ultrasound. Urinalysis should be also done. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello my name is Penny. I got home from work I took my shoes and sock off, changed clothes. I sat down and my toe was hurting, I tried to figure if I hit the toe on something or dropped something on top if the toe but it hadn t happened. I tried to ignore it but in a few minutes I took a good look at the toe, it felt warm, looked to see if I could find if it looked like I had some type of bite but didn t find anything, that s when I noticed a red ring around the big toe.I googled ring around the nail and the first thing I did was soak in warm epson salt and it said to do it 3 to 4 times a day. Will this heal the toe in a few days and it s all healed, ### REPLY: This should be looked at by a foot and ankle specialist. You didn't mention your age or vascular status. In the worst case scenario this can be a gangrenous situation setting it. Assuming you are young and healthy that should not be the case. If your nails are too long they can bang into the front of your shoe causing a separation of the nail from the nail bed or bleeding under the nail which causes pressure and pain. If there is blood under the nail the blood would need to be released to relieve the pain. Another cause of a ring on the toe is ringworm which is a fungal infection-though, that is usually not severely painful as you describe ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, doc I m having this problem for last 6 years,I m very prone to cold and  cough.every year during winter or if I get exposed to cold  atmosphere ,I catch cold and cough,it makes  me sneez alot and my nose starts running very badly.it also happens when I get exposed to dust.I have tried normal cold medicines but they didnt help me much and colds keeps coming back. ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of allergic rhinitis is more likely. Seasonal variation, dust allergy, recurrent cough, cold are characteristic features of allergic rhinitis. You will mostly improve witChatDoctorbination of antihistamine (levocetrizine or fexofenadine) and anti-allergic (montelukast) once a day at night. Fluticasone nasal spray twice daily should also be started. Do steam inhalation and warm water gargles 5-6 times a day.Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My spouse is experiencing painful abdominal cramps which lead to her needing to go to the bathroom. When she releases the gas, she has a few tiny stools followed by yellow, oily discharge. Is this potentially serious? What can I do for her? Thank you! ### REPLY: Hi! Good morning. If I were her doctor, after a clinical examination I would advise her for a routine stool test for ova and cyst and treat it if positive for meiosis. In addition, I would also advise her to avoid eating from outside if she does to avoid intestinal infections creeping in from outside. She had to add more of roughage and liquids in her diet and go for a regular routine exercise program. For the present, I would advise her for an anti-spasmodic along with a proton pump inhibitor .  I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had bad chest congestion for a little over two months now.. I have been to the doctor twice and they gave me two different antibiiotics, nothing has helped. I am 14 weeks pregnant and I am worried it will affect my babys breathing. What can I do? ### REPLY: Hello rearward welcome to .come have evaluated your query thoroughly.* These are best remedies to get better - Deep breathing exercises, walking in fresh air, YOGA regularly.- Gargles with salted lukewarm water added peppermint oil 3 times a day.- Strict dietary control with avoidance of excess sugar, oily, spicy.- Avoid exposure to excess cold.- No smoking ( active / passive) - Basil leaves , turmeric powder in boiled water have excellent herbal properties to control any dam cough. Hope this will help you. Regards dear 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: So, my 30 year old son and I were out, at a buffet. He was standing at the buffet, and he explains something popped in his back. It took his breath away, and he was having a hard time standing up. It is about an hour later now, and the pain is still there, not as intense and no effect on breathing. The pain is actually to the far right side of his back...closer to his side (lower back). Any ideas on what would cause that kind of pain...with sudden onset, when he was not doing anything that would strain a muscle? ### REPLY: Hi there. Looks like your son with the prior history of pain over the far right side of back and difficulty in standing up has developed a spasm of the back muscle. These muscle spasms need not be always related to what the affected individual was doing at the time of having the onset of pain, but can be related to any abnormal posturing such as bending for a long time prior to the onset of the pain which would have fatigued his back muscles. The pop sound he heard or felt could be probably a disc problem that may lead to a secondary spasm, so if he is having a persisting pain radiating to the right side alone and not subsiding with rest and pain medications, kindly get an MRI scan of the spine and get him evaluated. So in the acute setting a few days of bed rest, local analgesic ointment, a 3-day course of tramadol should be enough.  In case of pain radiating down the leg or the hip, or any weakness of lower limb on one side, get additional scans and get him checked. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 m a 31 yr old female. Recently I had what I thought was a boil pop up in between my breasts. I tried popping it, but it only got very little thick white pus out of it. It looks like a small pimple now, but under it I can feel a rock hard pea sized immovable lump on my sternum. Is this cause for concern? ### REPLY: HI. This is a sebaceous cyst which you have popped. The hardness is the remains of the cyst and as the skin is tight over the sternum in this area and the tissues are more prone for the development of scar in this particular are. Leave it as it is at the moment as mishandling can cause a bad scar particularly in this area. Consult a Surgeon and get this removed and to undergo further management to tackle the scar formation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 crown 7 months ago and the area on my gum over my crown became purplish color now two months ago I felt a piece of gum hanging but still attached from the top. When I lift the gum a little with my tougne I see its little purple. Its the top jaw the last inside tooth on my left side. What about to my gum and is it something serious? I dont remember cutting my gum with anything. Can you please help ### REPLY: Hello there, Thanks for your query. You did not tell about any pain in the related area or related to crown any problem. It may be normal but I would like to suggest you that maintain good oral hygiene and rinse your mouth properly after each meal, if you feel any pain or any other symptom please visit back to your dentist for thorough examination including x-ray. For your gum piece you can go to your dentist for its correction. Nothing to get worried. 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 4 year old girl baby is effected with Phylone phritis a year back we have done all the tests.She does not have Reflux,But now she has pain in the vaginal region We have done urien complete test now,but there is no bacterial infection,But still the pain presits.Pl advise me ### REPLY: Hi, Thankyou for your query. Since pyelonephritis is itself inflammation in kidney part (infection),which can be caused by previous bladder infection and if the sensitive antibiotics are not given for treatment. For that get a urine culture first and if culture is positive then sensitivity of antibiotics according to infection type (bacterial, viral and fungal) will be known. As girls are more at risk, because urethra is closer to the anus, which makes it easier for bacteria from bowl to travel up the urethra. Not only infection can cause pyelonephritis, if there is malfunctioning kidneys it can also cause pyelonephritis, for that she needs to be got checked by a nephrologist and discuss further. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am male 28,on my infertility work up diagnosed with bilateral grade 2 vericocele, i had semen analysis 4 to 5 times. at first 40 million motility normal after sperm count deceasing to 25, 15, 20, 05 in further tests with all normal motility. i have no stress and psychological problems, all my harmonal reports lh,fsh,TT,TF, prolactin are normal but having elevated E2 is 92.29 pg/ml, having good erections but suffering low libido and no that much plesure in intercouse and while ejaculating. what to i do now doctor suggested surgery for vericocele is it required for bi lateral grade 2? ### REPLY: Hello and welcome to . As a Urologist, i can understand your anxiety. Surgery for varicocele, isnt guaranteed to reverse your low sperm counts. Your semen analysis, showed decreasing counts of 25 to 5 million/ml. With normal hormonal levels, you should consider ART.ART is assisted reproductive techniques, like GUI (intrauterine insemination), or CSI, whichs a type of IVF (invited fertilization), or test tube baby. Medical treatment with camphene citrate, Co-Q and lycopenes needed. If you've any doubts, send all reports to me, as a direct question.  .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, When i was in High school i got typhiod and lost my hair, i used to have very thick hair until then, later i moved to a very hot place and hostel, hence lost even more, now i dont have even 30% of thickness of what i had before. its been years now,. is there a possibilty of regrowth? ### REPLY: Hi, As per your query you have symptoms of hair loss which seems to be due to compromised immunity of body, stress, systemic conditions, fungal infection, hormonal changes and improper hygiene. Need not worry. I would suggest you to - Do massage of hair scalp with olive oil on daily basis.- Take biotin capsules and eventually start with Finasteride preparations.- Take diet rich in supplements like vitamin A, Omega-3 and vitamin E.- Take protein rich diet and healthy food intake.  If symptoms keep on persisting visit dermatologist once and get it examined and start treatment with antifungal medication. Go for blood tests to check any underlying systemic pathology. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am a 25 years old girl and had a small fling (I saw her twice a week for 3 months i think) with another woman when I was 19 and suffering with depression (self harm, self isolation etc). I ended it because i realised that I was not gay and was only spending time with her because I loved the attention, it made me feel better. Since then she has got progressively worse and is adament that I love her and want to be with her. She gets drunk and posts things on social networking sites about me. Which I just ignored because they seemed to happen after she had seen me out in the local village. Recently she doenst need to see me, I have not seen her in over a week and a half prior to the most recent outburst. It is killing me, It took me a long time to get over my teenage depression but I can feel it taking over again and all i want to do is cry! No-one is stepping forward to help her so she is just getting worse and worse!! She is clearly thinking about me alot, and without provocation! please i have no idea what to do!! ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  The best thing you can do in the present scenario is to allow her to think so. Be with her. Be her care taker. Work with her and her family and her doctor for a cure for her condition. Slowly she will understand your efforts and your problem will be solved. Trust me, do not hurry and misjudge. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HiThis is regarding my aunt . she has lower abdomen pain But bearable pain. on sonograpy she had two gall bladder one of 16 mm snd other of8 Mm. She also had urine infection. She is being advised removal of gall bladder. Kindly suggest us are we on right track.RegardsPnmnml ### REPLY: Gall bladder stone is not likely to cause the lower abdominal pain. Rather, the urinary tract infection is indeed a possible cause. Please get the urinary tract infection treated with antibiotics and then decide upon the gall bladder surgery. In many cases, many patients have undetected gall bladder stones but never get any pain. The stones get found out incidentally while being investigated for some other problem. Opinion is divided on whether you need to remove gall bladder stones if it is not causing any abdominal pain. I would prefer to wait, but please do not make it the basis of your decision. Talk to your doctor about that. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: is my dad brain dead so to speak? just had a cows valve placed ,not sure where in his heart ........surgery w/o complications, he s 72, diabetic,low blood pressure , etc.......just saw him, on ventilator and understand that this could be for a few days up to weeks........nurse stated they did wake him up very briefly for a minute as we were very concerned due to them having a very difficult time many years ago (robotic prostrate cancer operation)thank you ### REPLY: Hello, If he could be woken up briefly by the nurse then probably he is not brain-dead. Apart from that it is difficult to comment really as to why he is in unconscious state. The treating doctors who are aware of his blood reports, scans etc. only may be able to tell it clearly. You may have to just wait and watch and pray at this moment. Heart valve replacement is a major surgery with its own set of associated risks. We hope for the best. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My dr told me i had a hernia on one of my overies about 3 years ago after i gad my daughter. I havent worried about untill now im begining to feel pain in the area & ive been  on a period for over two weeks what could it be should i go see my dr?Will i be charged ? ### REPLY: Hi ! Good morning. I am  answering your query. If you were told that you had a hernia, and you are getting pain now, then you must see your doctor for a review to avoid any complication of a hernia. It won't be possible for me to opine on the charging, as this depends on the rules and routine in the area where you leave. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have chest pain that goes to my arm and feel exhausted all the time. Shortness of breath if I do anything and feel like I can t breath. The chest pain is almost contiuous but at times feels worse or more painful than at other times and often wakes me up in the night. I am a 40 yr old female ### REPLY: Hello Continuous chest pain may be due to many reasons. It is important to rule out cardiopulmonary reasons. You need proper clinical examination and routine investigations. Investigations include routine hologram, random blood sugar, lipid profile, liver function test, renal function test, chest X-ray (PA view)ECG in all leads, TMT,ECHO. Further investigations can be done if needed. It is also important to exclude musculoskeletal causes of pain. Proper treatment depend upon findings. 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 Doctor,My Daughter aged 3.9 is having Adenoid and allergy problem- ( both tests are done). She was hospitalized at the age of 2.5 yrs for RTI and intravenous was given for5 days. there after, I tried homeopathy- it failed and since March 2010, she is under regular medication of Seroflo/ Budecort puff . When ever, the intensity of cold is high , she takes asthaline puff and steroid syrup. With that she improves- but again the problem reoccurs within a month and almost in every two months I need to give her steroid syrup. The ENT is saying to go for adenoid operation while, the pediatrician is saying not to do it before 6 years. Snoring is relatively much less compared to her earlier ages, sleep at night is normal, though she gets spell of coughs 3-4times in sleep, weight is good and activity is normal except when she gets the acute attack of cold- that time she is very irritated, aggressive--. Please suggest ### REPLY: Hello. Thank you for asking at . I went through your daughters history and understand your concern. I would like to make following suggestions for her:1. As long as her current treatment, I would agree with most of it.2. Regarding need for removal of adenoids, I would agree with your pediatrician that efforts should be made to preserve adenoids up to age of 6 years as they important for a children immunity. 3. I would like to emphasize the importance of device and technique of using inhalers (Aeroflot/Decor). If they are not perfect, the . In my opinion, for a 3.9 year child, metered dose inhaler with spacer with mask is the best inhaler equipment. Please make sure her technique of using the inhalers is perfect by reviewing it in presence of your pediatrician. Also, regular cleaning and changing the spacer every 6 months is advisable.4. Were I treating her, I would add regular montelukast in above treatment, which may improve her symptoms and reduce need for repeated steroid requirements. 5. A healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc.), avoidance of the allergens (to which she is allergic) and avoidance of dusts & smokes are also important measures for her. Hope above suggestions will be helpful to your daughter. Wish her the best of the health and a bright future ahead. Should you have any further query, please feel free to ask at . Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HelloI have an ingrown lump on the outside of my thigh. It has been there for months now, its almost the size of a small coin. It does not hurt but it sticks out of the surface of the skin and I can feel the bump from the outside. It looks like a small bruise now as it turned brown over the months. I went to see my doctor and the doctor told me not to worry because it was a benign lump. I wanted  your opinion because I feel like the doctor was rushing and did not spend to much time inspecting the lump. Thank you,I will await your reply ### REPLY: Hello! Thank you for the query. It is very hard to tell not seeing it. Generally if it's not a mole, most likely it's a benign lesion (from your description it sounds like a fibrous). Skin lesions (which are not mole like) are mostly benign, and even skin malignant lesion (skin cancer) is nothing to worry about as it acts like a benign lesion (skin cancer rarely gives metastases). The best you can do is to consult dermatologist, have it removed and checked under a microscope. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My baby is 5 weeks old and has white powder sugar looking clumps scattered throughout his stools. He has thrush and is on Fluconazole and Nystatin. Is the white in his stools possibly from the meds? Could it be yeast? What is it? He is a forumla baby. ### REPLY: Hi... it could be the yeast and if I were your treating pediatrician I would suggest you to get a stool routine examination and microscopy done and follow up with the reports. But I can assure you one thing - if the kids milk intake is good, and he is otherwise active and gaining weight as expected, then you need not worry. Oral thrush in a formula fed baby can be prevented further by sterilizing the bottles appropriately. 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 symptoms that I can t explain that come and go. First it starts out with slight shortness of breath, then my back starts hurting and I get poor circulation in my hands and feet that turn cold with purple discoloration. I get fatigue a lot. Could you please tell me what this is. ### REPLY: Dear-thanks for using our service and will try to help you with my advice. Your back pain could be secondary to arthritis or pinch nerve. However, you are experiencing cold hands and purple discoloration which could be Maynard Phenomenon or Syn . This is a symptom characterized by changes in the color of the fingers mostly purple or blue when exposed to cold or just having the hands down. This can be associated with Collagen disease or inflammatory joint disease. You are fatigued too, so I recommend you to have a checkup with your doctor with laboratory test that will evaluate collagen disease. This is an extensive workup that will help to determine the reason of your complaint. I hope that my advice has been helpful ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 3 year old son....fever of 103.7 on Saturday evening. Has had a fever of btwn. 101 and 102.5 ever since. Tonight it is up to 101 again. It broke earlier today but is back up again. Saw doctor on Monday. He said if it does not break by Thursday to bring him back in. He s just miserable. Eyes are watery. Phlemmy cough that clears up some when fever goes down. No rash on his trunk. Just paranoid I guess. Tried luke warm bath and cool wash clothes. Piggybacking tylenol and Motrin. Anything else I should be doing? ### REPLY: Hi! Thank you for choosing . I'm sorry to hear that about your son. Fever is a sign that you're body is fighting off an infection. With his cough and colds, it can still be a viral infection probably of the upper respiratory tract. Continue what you're doing with the fever medicines and make sure you're giving the right dose based on your sons weight. Give him lots of fluid throughout the day in small frequent sips. You can also do sponge bath to cool his body. Its just supportive and lots of rest at this point. Try to monitor for other symptoms that might arise like rashes, worsening of cough and difficulty of breathing. If any of this appears bring to your doctor, so he can give additional medicines and advice. Hope your so feels better soon. Sincerely, Handle Dulay-See, M.D. Pediatrician ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had three cavities filled on the bottom left side of my mouth yesterday and today I woke up to find it hard to swallow. The tonsil on that side looks like its gone. I have big tonsils and the left one is no where near the size it was before. It hurts to swallow, only on the left side though. Is this normal? ### REPLY: HelloThanks for consulting ChatDoctorRead your query as you have difficulty in swallowing don't worry this can be due to throat infection, I will suggest you to consult ENT surgeon for examination of throat and in meantime for throat infection you can do warm saline rinses 2 - 3 times a day, and you can take medicine like Azithromycin if you are not allergic to . Hope this will help 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 a newborn she is 3 weeks old. she is breastfed and feeds often with many wet nappies per day. she poos on average only every 2nd day. a few days ago her weight confirmed she has put on almost 500gms in 1 week. Howover the last 24 hours she has been very unsettled, with a bloated tummy which has been making alot of loud gurgling noises all day, accompanied by 3 soiled nappies but only lightly soiled with very watery yellow poo. she keeps wanting to feed but it seems only for comfort as her tummy seems very full and hard. she sounds like she is constantly straining which makes her bring up small amounts of milk even as long as 40mins after a feed. what do you think is wrong with her and what should i do to settle her if she is already full? ### REPLY: Hi, This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to .  Unless the air comes out like burping or flatus this discomfort will be there and next time check if the baby is sucking too fast and gulping in air too. You will be more convinced. Usually, I don't advice any medicines for this as they give only temporary relief. The two best ways to relieve this distress is -1. Do not put the baby in lying position after feeding till the baby burps out the swallowed air.2. If still crying - put the baby in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m lactose intolerant and wheat gluten sensitive. I ve be exercising a lot, running, and I ve noticed that my circulation in my arms and legs is poor. I wake up with stiffness and some tingling but no pain. Do I need to look into calcium and vitamin d suppliments? Thanks, Kathy ### REPLY: Hello, Welcome to the magical world of health care, I went through your query, and would want you to go through some tests,1, Nerve conduction test to rule out CTS.2, Doppler or CT Anglo to see the circulation of your limb, If you can get them done and tell me the report maybe I can help you better, moreover if you can find time to see a doctor, his examination may avert unnecessary investigations. 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. I hope a 5-star rating if you feel guided in your treatment, 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 take effexor XR 75 mg once a day. I have no appetite ever. Sometimes i go days without eating and don t even realize it. When i eat, i never want to be eating. Its like im just doing it because i have to. Food never sounds good. Also, i ve noticed i feel almost no emotion. Im always in a generally good mood... but when something tragic happens its like im completely immune to it. I feel no sadness. I feel no fear, no worry. When it comes to relationships.... i can take it or leave it. When me and my girlfriend of four years broke up.... She was devastated. Crying, saying how hard it was emotionally. I felt nothing. I haven t cried or even came close to crying in a very long time. Why is this happening? Is this normal? ### REPLY: Hi Cablejm2 ! You are taking Effector for your depression. Now this medicine give you depression. If you're taking this medicine for long time, do ask for change, cause like other psychotic .  This medicine made you emotionless, so you can deal with life situation. Now take the advantage leave this medicine, do exercise and make hobbies and live your life. And don't leave medicine at once give gap gradually. And get out of this medicine trap. See you again bye. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a basal cell carcinoma on my right upper ear. The dermatologist did not say that this tumor was invading the cartilege yet. I went to see a surgeon this past tuesday 10/28/14 and he gave me 3 options. Chemo for 5 weeks, radiation 3x week for an unspecified amount of time, or surgery. I have BP that spikes to over 300/190+. I chose radiation;but, I m not sure if I made the correct choice. Can you give me an overall information on this type of treatment? Does it hurt? Does it take a long time to work? Does it make the patient sick like chemo? Thank you for taking time to answer my qustion. YYYY@YYYY ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have basal cell carcinoma. Treatment of choice depends on stage of tumor.  Radiotherapy is useful but it's also causing sickness like chemotherapy.  Surgery should be done then if needed go for radiotherapy or chemotherapy. 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 am a chain smoker for the last 35 years with thin physique. For the last few months I feel a pain in my heart occasionally. However this pain gets relieved when I used to have good diet and sometimes with the intake of milk. About a month back, I left smoking for a fortnight but I observed that the said pain occurred as usual. Due to work and domestic stress, I used to have sex almost every day. Please guide me. ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. You should know that heart pains have some characteristics. They usually are retro-sternal pains likes quizzing, tightness or heaviness. They may irradiate to both arms, neck and jaw. Furthermore, they last from 5 to 20 minutes. We suspect heart disease if we are in front of a patient with RISC factors like age over 45, hypertension, diabetes, smoker and with hereditary history of cardiac disease. Chest pains might have different causes like muscular, Celtic, neurotic or gastrointestinal. So, if you explain pain that relives after consumption of milk this makes us thing of a gastric problem. So, if I was the treating doctor I will recommend some examination like an electrocardiogram, a cardiac echo, a street test, a thorax Rx and a gastrohepatologyst consulting. After all this we can better judge what we are dealing with or if its just stress or neurotic pain that soon will disappear. Hope I was helpful. 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: what is the use of nerveup od tablets. I am feeling brain fog for almost one month(low memory, unable to concentrate, some time headache in evening, weakness in right arm and leg). My doctor prescribed nerveup od. what u feel about my condition. i have taken that tablet for 25 days but no improvement. please reply me. ### REPLY: Hi, Nervup OD contains Alpha Biopic Acid, Folic Acid, Mecobalamin and Pyridoxine as active ingredients and is commonly prescribed painful conditions such as neuropathy, nerve injury, fibromyalgia and other conditions. Based on the history, you seem to be suffering from symptoms suggestive of depression until proved otherwise. I advise you to consult a psychiatrist for further evaluation and appropriate treatment. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My name is Dottie, 47 yr female, 52, 220 lbs with Multiple Sclerosis (RRM) and A Mitral valve prolapse.1 week ago  this coming Thursday I went to my doc for pain in left bottom of my ribs when I breathe, cough and sneezing  was horrible. The week before I had a horrible sinus infection that settled in my chest and had alot of coughing espicially at night. So I thought maybe I had a pulled muscle from coughing so much.He said I have Pleurisy and put me 875 mg amoxicillian 2 times a day. The pain during the day is easing off but at night it hurts  a lot to try to lie flat on my back and on my side feels like there is a pocket sticking out of my lower ribs the  really hurts  when putting pressure on it. Now I have a stinging going around to my back on the left side. Is this part of Pleurisy too? No exrays were taken just   a routine exam listening to my chest and blood sample where he d determined I had an infection . Should I go back and suggest exrays?I still have 2 days worth of meds left. Thank you for your time. ### REPLY: Hi, I carefully passed through your question and would explain that your symptoms could be related to pleuritic. Other possible causes to consider would be a musculoskeletal pain. The fact that the pain is triggered by pressure or palpation. I agree with your doctor on starting antibiotics. But, I would also recommend performing a chest x-ray study besides blood work. Meanwhile, I recommend taking some ibuprofen for the pain. It will help against the pain and inflammation. Hope this is helpful. Let me know if I can assist you further. 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: Hello! I am a dentist.   My patient was on Amoxicillin  after I did open flap surgery to control the infection on her lower jaw.  I switched it to Clindamycin 300mg  2 stat 1PO q6h three days later because her swelling became worse.  Today is the 4th day since she took the Clindamycin.  She said the facial swelling went down a lot but  now  she is concerned  that her stomach is hurting today.   I like to know whether I need to tell her to stop taking the Clindamycin immediately?   I hope I can put her on the medication for few more days to control the infection because I do not want the facial swelling to return.  What is the minimum number of days to control infection? ### REPLY: Hi. Thanks for the query. Well, your patient has side effect of antibiotic Clindamycin and first you can start proton pump inhibitors like Omeprazole or Pantoprazole empty stomach in the morning till your patient is on antibiotics. Or else he can take the same twice a day half an hour before meals. Also advise him to take antacids. Eating plenty of probiotics like Yogurt can help. Avoid spicy and heavy meals. . . In case of still there is no improvement then switch to lower doses or change the antibiotic. Infection control can depend on severity of infection, however a week to ten days can go for severe Infection. Injectable antibiotics can be another option. 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 am taking 500 mg of Hydroxyurea for polycythemia every day 1000 mg every other day to lower my platelets. I have a drink before dinner. After dinner I experience hot flashes which are quite extreme. Is it the alcohol that is causing the hot flashes? ### REPLY: Hi, Thanks for asking. Based on your clinical history and query, my opinion is as follows:1. Hot flashes are usually due to increased circulation giving a feeling of warmth2. Alcohol is known to cause neural stimulation in mild doses leading to increased circulation all over. Higher does would cause neural depression.3. Avoid alcohol and neural stimulant medications. Hot flashes will reduce. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi I am 27 yrs old man,In June 2012 i went for a blood donation. After blood donation the blood bank people called me and told I have to give blood samples for test once again. The next day they told me I am HCV reactive. My family doctor consult me AntiHCV test. At that time result was at border line valuing 2.72. Now i against tested AntiHCV and LFTs in May 2013. Now AntiHCV result is 2.60(Borderline) and in LFTs GLOBULINS  value is 3.9 G/dl and A/G RATIO is 1.1. Do i required its treatment? Kindly advise me what i have to do. I am very worried whats going on with me can any one help me . If I have what the total cost for treatment in India. thanks in advance for reply. ### REPLY: Hello, thanks for the query to .  Frumpiest of all I want to explain to you that don't worry. Hepatitis C is often asymptomatic, and it is about in 90 % cases in India. If infection is persistent (10% cases) it can be treated with medication. Now note down that infection is asymptomatic but if it turns into chronic it may lead to scarring of liver and cirrhosis of liver, which leads to liver failure and liver cancer. The liver failure may develop esophageal or gastric varices, which are fatal for life. 10 % cases are symptomatic, and they have the following symptoms but in MILD forms as, Loss of appetite, Fatigue,Nausea, Muscles pain, Joints wainwright loss. In your case nothing to worry as I have seen so many cases who tested + ve few yrs ago but still they are asymptomatic. Spread due to blood transfusion (if equipment are not sterilized)Sexual relations (controversial) Tattooing (most common cause)Use of personal belongings (major of infected person)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: Dear Sir. I am 66 years. My ESR IS 78 mm/hr MCV is low and DRW is high, Platelet is high too, Please help me to diagnosis my problem ### REPLY: Hi...welcome to Mr. Sabre ., here Your Age is is important criteria.,1) Your ESR is very high (78) normal is 0 to 9 mm/hr High ESR seen in Tuberculosis, Rheumatic fever, (both conditions very high)., next normal chronic infections.,2) . .depend on the cell count only, it can assess., 3) Platelets are high generally in Chronic Myeloid leukemia (Blood cancer), Iron Deficiency Anemia, Polycythemia Vera and acute infections., bleeding conditions.,4) MTV (Mean Cell Volume) Volume of average Red blood cells are low means you are having definite anemia category... You are not mentioning duration of illness .hence consult good MD physician he can give correct advice o.k. good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m a bit concerned as I have been trying to conceive naturally for nearly 4 years now still with no success, I have consulted my doctors and don t seem to get any help. Recently I have been having what appears to be two periods a month and also signs of what I believe is ovulation on the same week as the first period. I m worried as I have been told ovulating on the same week as your period is a bad sign of infertility . Can someone please help me ### REPLY: Subfertility is a condition that should not be dealt in this way. You and your partner should consult a specialist fertility clinic together, so that you as a couple can be evaluated, to find out any problem after taking a detailed history, a detailed examination and relevant investigations. Only then can anybody label a specific factor as a cause. Your feelings alone as far as ovulation is concerned can not be relied upon. Your menstrual problem although you need investigation. God bless 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 daughter sprained her ankle this past Fri and had xrays. She stayed off it fri n sat. Sunday we had a family party n was in a wheelchair. By sun night n mon her ankle n foot were humongous. She went to another er n got xrays n they say sprain. Today she s very sick with a on and off fever. It was up to 102. Is fever from ankle? Ankle has gone down alot. ### REPLY: Hello, Thanks for writing to us, I have studied your case with diligence. As per your history and injury pattern there can be tear in ankle ligament leading to pain and swelling. Instability may increase due to laxity of ligament. Fever can be due infection and cellulitis. I will advise doing MRI ankle for soft tissue involvement. Till time, you can use supportive splint or brace. Physiotherapy like ultrasound and TENS will help in early healing. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I am 34 weeks pregnant and have something like tissue protruding from my vagina. I have been to my doctor, who says it is not a prolapse, or a varicose vein, but just hormones causing the vaginal wall to swell and protrude. He says it may get larger during the next six weeks, and when I am pushing in the second stage, he would expect it to protrude further, but that it is not a cause for concern - the midwife should just push it in again! I am scheduled to have a home birth. Do you think I should change my plans now, or is this, as my doctor seems to think, an uncomplicated issue? ### REPLY: Hi, Thanks for the query. I understood your concern.  After 7th month of pregnancy, preparations for delivery start in mothers body. One of them being increased mucus discharge from vagina... this is to facilitate / lubricate fetal head while childbirth.  For this vaginal mucus membrane cells get enlarged / sort of swell. & some part of such enlarged mucus membrane may protrude out of vagina.  After delivery, as the complete mothers body gets to normal . The mucus membrane also regresses back to normal shape.  So, please don't worry. After examining you, your doctor has excluded prolapse or curiosities. So you should believe him.  Only need is to maintain vaginal hygiene/ do not try to pull/ prick or cut the protrusion.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! I am 23 years old male, from Pakistan. 1 month back i had a sever right iliac fossa pain radiating towards my groin, I landed up in ER and was diagnosed as having nephrolithiasis. After a series of tests including U/S KUB and pyelogram . I was given no medication and was advised to drink whole lot of water. Now i m feeling a dull discomfort on my right side of the back, no urinary symptoms what so ever, I was wondering if this is due to kidney problem or is it muscular pain as I need to power my generator on which has the same mechanism as old cars which required you to pull a rope to get the engine started. Thanks ### REPLY: Hi, Welcome to . Nephroliathiasis-stones in kidney have typical presentation as severe Iliad pain radiating towards groin. Small stones usually flush on their own only .  Pain in the back usually occurs when stone produce an obstruction in the kidney. It doe snot seem muscular pain. You need to see your physician again. Do you have fever?chills?nausea?vomiting?abnormal urine color?blood in urine?you need tests:Urinalysis of the stone to show what type of stone it uric acid levelUrinalysis to see crystals and red blood cells in urine may need to change your diet to prevent some types of stones from coming back. 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: I have sharp persistant pain between my shoulder blades which seems to go right through my body to the middle i feel something heavy pressing inside which makes me slighly breathless and feel slightly dizzy on occasions makes miserable and fed up and very irratable ### REPLY: Hello, The common causes of sharp pain between shoulder blades are:1) Trauma2) Pulled muscle/ sprain3) Issue related to cervical/ thoracic spine4) Referral pain from gall bladder diseases, Acid reflux diseasesSome rare causes are aortic rupture, pulmonary embolism, I think this will not be in your case. So, I will suggest you to review here with detailed history or consult with physician. I will also suggest you to take tablet Diclofenac, do x-ray cervical and thoracic spine and follow up with physician and orthopedic. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a small mass in my groin area about 2 cm above mthe base of my shaft there is no discoloration but there is painful to touch and to stand up stright it is a dull pain most of the time but fells sharp I would rate the pain a 7 over all. I have ruled out stds and uti as well as allergys and muscle strain it getting harder to even go to sleep I need some ideas so I don t waist time and money going to a doctor that will just send me to another doctor. I fell like I m a 70 year old man and I m only 24 help ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have a tender painful mass about 2 CMS above base of the penis. Most likely this could be Boil (Staphylococcal infection of hair follicle) or a sebaceous cyst. This can be confirmed only on clinical examination by a qualified General Surgeon or Urologist. You need to take broad spectrum antibiotic like Čeferin along with anti-inflammatory . If problem persists it needs to be  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 17 years old i weigh about 115 height is 5 2.. my dermatologist prescribed me retin a( tretinoin cream 0.025) n she also prescribed me topical benzoyl peroxide every other day to use n its been 6 weeks n i dont know how it works? i use neautrogena fresh foaming cleanser in the morning i was using cetaphil to moisturize but today i started on neutrogena liquid moisturizer spf 50 with helioplex. n on evening before i put retin A i use the same face wash. an on the days i use benzoyl peroxide wash i only was my face in the morning n apply the moisturizer but at night just the wash n after that i apply cetaphil.... but i dont go out much...n im wandering if the moisturizer i have is not working cause of the SPF..? can anyone help me?? ### REPLY: Welcome to  Good Date Retinoid increases the turnover of the epithelium and helps removal of blackheads in Acne and also to prevent further episodes. Benzoyl peroxide has antiseptic and bleaching effect on the face. Sunscreen is necessary to prevent UV damage to the skin especially acne prone skin to prevent comedones. Use what the Doctor has given as advised. You should find considerable improvement. ### END