Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has had a spreading itchy rash/bite type  to his chest back legs and stomach. Now I have same thing. Spots appear throughout day and itch , seems to spread from scratching one area to next. Usually 3 to4 bumps in each area of outbreak  Does not look like scabbies , im a nurse and have no idea what it is, but itches very bad then burns and hurts when you scratch ### REPLY: Hi, I can understand your concern for the spreading itchy rash on chest, back, legs and stomach in your husband. I can make a possibility of Allergic dermatitis. In Allergic dermatitis there are eruptions along with moderate itching and in more aggravated cases there is appearance of more redness which persist for more than multiple of days. The only precaution you must follow is not to touch, pinch pop or squeeze any of them otherwise it can get infected and can cause complications. You can apply medium potency steroid cream application of fluticasone cream. You can additional take antihistamine Ben . If the things are not getting better than can meet a dermatologist for further guidance. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi im27 years old and hAve had heartburn for about ten years over the last 9months I occasionaly get some tightness in my chest and occasional pains in my throat I oftwn almost choke but I ican eat everything ive aalways ate no pain swallowing I need a drink to swallow alot of foods im scared of any throat cancers ive lost some weigjt but im not on a great schedule and only eat twice a day iwhats wrong with me ### REPLY: Thanks for your question on . I can understand your concern. In my opinion we should first rule out any obstructive lesion in esophagus because you are having problem in swallowing solid food. So get done upper GI (gastrointestinal) copy. If it is normal then possibility of HERD is more. Upper GIs copy will also tell if HERD (gastroesophageal reflux disease) is present or not. HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of chest pain, chest tightness, throat pain etc. So we need to treat HERD to relieve your symptoms. So avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Take proton pump inhibitors and prokinetic .  Don't worry, you will be alright. 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: mmymy husband has a walnut sized lump between his testicle and leg. He says it is very painful and is clearly visible, and can be felt deep under his skin. Im not sure if this could be associated with it, but he is a type 1 diabetic with heart disease. ### REPLY: It could be an Inguinal hernia specially if you can feel the testicle separately. Does it change in size with posture or completely disappear on lying down? Anyway, get it checked by a Surgeon and you might very well require a small surgery for the same. But, it is important to be dealt with as it can cause dangerous complications. So, it would be better to get it evaluated and treated. Take care and let me know if I can be of any further assistance. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 query is for a dermatologist. my 2 months old baby have got dark complexion...right now, i m using almond oil for her body massage and himalaya baby soap for her bath(she z taking breast feed)...but i don t find any significant difference in her skin tone... I belong to southern part of India. So, i want you to suggest any baby oil ,baby lotion or baby soap to improve her complexion. Thanks ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query your baby have dark complexion, and you want to get it improved. Well if it is genetic chances of getting fair complexion are less. I would suggest you to :- - Apply baby cream or gel containing atelier acid twice a day, which is a natural product obtained from cereals and is save alternative.- Apply sunscreen while going outside to protect your skin from sun exposure which can cause further damage.- Exfoliate your skin once a week. If condition persist after one month then consult dermatologist. Doctor may recommend antibiotic cream or antioxidants friendly to babies skin. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, please my friend has a stomach upset, anytime he gets hungry and doesnt eat anything he feels a sharp pain in his abdominal wall, and anytime he eats, he tends to defecate. Please what are the cause for this ailment and possibly treatment? Thanks ### REPLY: Hi. Thanks for your query and an elucidated history for your friend. The history is very typical of IBS- Irritable bowel syn .  This cripples him / her socially too As a precaution the following tests are done:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen, *Colonoscopy All these investigations should be within normal limits for one to say you have IBS. Get an opinion of a Gastroenterologist and get started with proper treatment and your friend will be fine. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My name is Harshal and yesterday my doctor detected Asthama in me. My IgE level is 975.5. He has suggested me Formonide Novocart 400, Floresp AZ nasal spray, T.Emlukast. I have a left chest pain also and my throat itches and in cases when I laugh louder it stops me immediately and I start coughing. My ECG, Chest Xray, 2D echo reports are normal. Please suggest should I take these medicines? will my chest pain stop? ### REPLY: Thanks for your question on . For the diagnosis of asthma, PUT (pulmonary function test) is must. Without PFT one can not diagnose asthma. So make sure that your diagnosis of asthma is proper and based on PFT report. PFT is also helpful in determining severity of asthma. And treatment of asthma is based on severity only. Treatment you are prescribed is appropriate for asthma. Inhaled bronchodilators (phoronid) is treatment of choice for asthma. Your IGE is raised which suggest allergy. So anti-allergic (Lukas) will help in this. So start the treatment. No harm in it. Regular follow up with PFT is needed to titrate the doses. And yes your chest pain will stop after 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: Hi, ive been itching on my butt, thighs, and crotch area for several weeks now.  I went to the doctor and they said it was probably an ingrown hair but i think its something else.  i have a weird red rash on the head of my penis, and my penis doesnt hurt. It more so itches and tickles. i have several bumps on my legs/butt as well. pleasee help ### REPLY: Hello Thank you for trusting  Dear since when you're suffering from this problem? Just several weeks??? Have started using any new soaps or moisturizing lotions?? It may be due to contact dermatitis due to new cosmetics, other causes are Jack itch due to fungal infection, it may be due to Atlantis, or psoriasis etc. Use Candid b gel at local area. If symptoms not improved consult your doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is jose and iam 25 and evertime i smoke marijuana i get thuis pain in my left chest not by my heart but next to my arm but on my chest evertime i smoke and i went to check my self ut and theres nothing wrong with me well thats wat they said and i never had this before this just happen ### REPLY: Thanks for your question on . I can understand your concern. Marijuana smoking causes inflammatory reaction in airways. So bronchitis is common after Marijuana smoking. This bronchitis causes pleuritic pain. So possibility of bronchitis related pain is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is must for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). But first quit Marijuana smoking. This is not a good habit. 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: A week after taking ural medicine(for 15 days) for removal of small kidney stone , I had my kidney ultrasound and no stone was seen but my urinalysis shows that I have fine granular cast (0-2/lpf), few amorphous PO4, few squamous, few bacteria, few mucus threads, RBC (0-2/hpf), pus cells(0-2/hpf), trace albumin , sugar negative, urine PH 8.0 ,Sp. Gr. 1.005. Serum creatinine (0.89 mg/dl)(norm 0.67-1.17), BUN (8.15 mg/dl) (Norm 6-20), AST 31 (norm up to 40), ALT 32 (norm 0-41) ### REPLY: Hello, Welcome to , I am .  Firstly, granular cast may be found in many conditions like in case of urinary tract infection, chronic kidney disease, blood in urine, and others.  As, your renal function test (Creatinine, BUN, ) and liver enzymes are within normal limit, the possibility of a chronic kidney disease is ruled out.  As RBC and Pus cells in urine are within normal limit, the possibility of any infection and blood in urine are ruled out.  So, over all, the finding is due to the previous history of stone.  You do not need to worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: First of all I have asthma,  my left side of my chest has been bothering me for a couple of days and also in the middle of my chest and this might sound crazy but it feels like my left lung is swollen and rhis happens every nite. Im 47 yrs old and frmale ### REPLY: Thanks for your question on . I can understand your concern. By your history and description these are two possibilities. 1. Worsening of asthma 2. HERD (gastroesophageal reflux disease). So get done PFT (Pulmonary Function Test). If this is normal then no need to worry about worsening of asthma. Possibility of HERD is more in your case because you are having central chest discomfort. HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of central chest pain. So avoid stress and tension. Avoid hot and spicy food. Avoid large meals. Start proton pump inhibitors. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. Don't worry, you will be alright. 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: Where a wisdom tooth should be their is a white spot (soft) and my lower jaw hurts as if something is pushing on my teeth (mainly in the back of my mouth). My dentist told me that I do not have any lower wisdom teeth around a year ago. Could it be wisdom teeth or an infection? ### REPLY: Hi! Read your query. Your dentist must have told there is no wisdom tooth based on the x-ray. Check if there is a decayed tooth giving you pain. A sharp tooth in the upper jaw can also be hurting the soft tissue. In that case, the sharp tooth must be rounded. Any infection in the upper jaw also can also be radiated as pain to the lower jaw frequently. Wish you good health. Feel free to write any further queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, so recently on the left side of my body just below my breast, it feels like I have a fatty lump on my last rib. When I lift up my shirt, the left side is clearly bigger than the right side is. And it feels sore when i push on it in a certain spot. also when i sit it just feels uncomfortable sometimes. when i rub it, it feels a little numb. What could it be? I dont have health insurance so Im trying to avoid that if I can. ### REPLY: Hello! Thank you for the query. It is very important to determine if this lump comes from the breast or is a separate thing. In case of breast lump it can be even a cancer that is why it should not be ignored. If you are sure this is separate thing, most likely it is a lipoma or other benign lesion. The best way to find out what it is, is to have soft tissues' ultrasound of this area. 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: For the last 2 weeks I have had issues with tightness in my lungs can t get a full breath, have Asthma been put on prednisone 2 times now taking symbacort, singular and anything else that might open up my airways. the only thing that seems to help is when I take adivan to calm me down when I can t breath. all I want to do is take a deep breath. the doctor I have seen says my right side is not good. I did clean up mouse droppings several weeks ago. It did seem that all winter my asthma was getting bad but it usually responded to my ventolin. Now nothing seems to work. I have no weezing or coughing. just feel like there is a vise around my chest. Could this be a lung infection? ### REPLY: Hi I did review your conditionInfact infection can precipitate and worsen your already existing asthma and may lead to condition known as status asthmatics where a patient does not respond to standard medications of asthma. I would advise you to consult your doctor and review your medications and probably add an antibiotic to your medications for some days, If it's an infection your symptoms might relieve. I hope this helped me know if you have any more questions or concerns. Wish you all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband was diagnosed with CLL in 2005 and has been in remission for the last 5 years or so.   He seems to be coming out of remission..  He is being treated with IVIG and Retuxin.   Hes running a fever that comes on and then breaks after taking tylenol, but it was 105 today before it broke.   He doesnt seem to have much energy and is frequently short of breath.  Whats going on and what can I do about it? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. There are high chances of infection in CLL.  He may have some secondary infection.  He should go for x-ray chest also. Furthermore, he needs higher antibiotics and antipyretic to control infection. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doc, My daughter (16yrs) in a catfight with her twin sis got scratched with nails. she used savlon to clean it and i gave her Soframycin Cream to be applied. we continued this treatment at home for two days. red rashes had started the very first day around that area then by third day the pain was unbearable and there was inflamation so we took her to a Pediatrician closeby... He said its Savlon burn as savlon was not diluted before application... He gave her B-Bact ointment for application, Clavam 625 mg twice a day, a painkiller thrice a day and a multivitamin. Today is the second day. Yesterday afternoon there was pus ozing out of that area also its itchy. Are we on the right track ### REPLY: Hello, THX to contact us. I understand your concern. If I am your treating doctor I advise you that your treatment is right, you are on right track. Its second day of your treatment and so the improvement is not seemed. But maintain the local hygiene by proper cleaning and .  Prevent further injury to infected parts. I will be happy to answer more of your concerns, kindly know me, Wish you a very good health at . . Infectious Disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir we r having an autistic kid 5.8 yrs old. 4-5 days back he had 4 episodes of vomiting and 1 loose stool at night. we gave him ondanecetron,nutrolin B.He was completely fine after a day. But he has become quite restless and is not sleeping at night. after consulting pedeatric,ENT and gastero-enterologist; we found nothing. the they hav prescribed him lonazep 0.25 half tab for a day to calim him down. I it safe to give him? his EEG is normal. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query your child have symptoms of vomiting and loose stools. Well there can be many reasons for symptoms you mention in query, but in your case it seems to me that the symptoms are due to viral infection, and it could be due to electrolyte imbalance in body. Need not worry. I would suggest you to do warm saline gargles several times a day, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 32 year male. i am having hypertension. now i am taking TELISTA-H & RAMISTAR 2.5 mg TAB MORN AND NIGHT RESPECTIVELY. Still my blood pressure is maintaining 90/140 mmHg. i have taken doppler test twice. one report is showing about renel artery stenosis and another is showing normal. i want to reduce my blood pressure low. for my problem what to be done. Other body condition is normal. i am a smoker.pls give me a sujjestion to solve my problem. ### REPLY: Hello, Regarding your concern, I would explain that it is not safe taking Melissa H and Amistad concomitantly, as losartan and April may have a lot of interactions.  Coming to this point, I would recommend stopping Amistad and switching to lercanidipine 10 mg daily, in order to help control your blood pressure values.  Regarding the renal arteries, I would recommend an Anglo CT scan of the renal arteries, to help examine them better, considering the controversial results of the two ultrasounds.  You should discuss with your doctor on the above treatment options.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi This past weekend I rode with a friend for 5 hours to go to a Casino. When almost there I started smelling smoke. Then it was gone but I started selling it again when we were driving back those 5 hours. It was gone this morning, now for the last 3 hrs I smell it again. I do have acid reflex and pro to sinus infections, as well as seasonal allergies. My nose has been itchy, tonight I have a little drainage and it taste yucky. Could it be a sinus infection? Or mold spore from my friends car causing this. I had this happen a year ago and after a few days it went away. I started taking Zyrtec today. I also take a prescription for gerd/acid reflex for a couple of years now. I am puzzled, any insight? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of nasal allergy is more likely. No need to worry about Sinus infection. Smoke inhalation can cause allergic reactions in susceptible individuals and your symptoms like itching, nasal discharge etc. are more suggestive of nasal allergy. Zyrtec is good .  So continue with Zyrtec. Also  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 tongue was sore on the left side, I thought it was because I bit it in my sleep, a day to two later I developed a1.5cm canker sore there overnight, within a day I had a couple more smaller canker sores on the top and sides of my tongue and one on my inner lip. The same day I noticed that I had what appeared to be small areas of inflammation on my gum line where the gums were red with brownish edges in some places. When the first sore appeared I saw my dentist who referred me to an oral surgeon who recommended coming back in a few weeks if it didn t heal. Now I m out to the country and although the first one is less painful, the fact that so much of my gums are now effected concerns me. No fever or other symptoms, I am just getting over a long bout of bronchitis . The ulcers all look like photos of canker sores, not herpes or squamous cell carcinoma . Any ideas? ### REPLY: Hello, Acute gum infection can also lead to swelling and soreness of gums and canker sores. There is no definite cause of canker sores, but it is known that bacterial infections, vitamin deficiency, allergies etc. can lead to canker sores.  Without clinical examination, it is difficult to give definite diagnosis. If there is throat infection present, then you can visit your physician for treatment. If there is acute gum infection present which has lead to these symptoms, then dental cleaning and or periodontal surgery will be required to correct it. In case of gum infection, maintain good oral hygiene by brushing and flossing regularly and also use a mouth wash. You can also do warm saline rinses 3-4 times a day to reduce the gum swelling. Canker sores are self limiting and will heal on its own in 7-10 days. If canker sores are causing pain, then you can apply travel over it. Take OTC multivitamins and take plenty of fluids and rest. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Couple of minutes ago I was laying down on my phone my brothers were in the corner just sitting and out of nowhere I ran out of breath I stood up and couldn t breathe very well it was hard to breathe and I had very strong pain in the chest... What is wrong with me? ### REPLY: Thanks for asking your question completely understand your problem no need to panic but need is to consult a pulmonologist and to come to a diagnosis after some investigations needed like ECG, spirometry, chest X-ray. This type of breathlessness and chest pain can occur in bronchial asthma, pulmonary embolism and many other diseases. So better to get yourself checked.thanks/regardsfeel free to ask more questions may god bless you with good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear doctor i am 33 yr old i have been diagnosed with pcod i am taking treatment since 8 yrs my follicle growth is also not good i had 2 miscarriages. currently iam taking metformin twice daily and ovigyn d tablet 3 times a day from past 4 months.I want to get pregnant please help what r the chances of me getting pregnant. ### REPLY: Hi, Thanks for your query. I have read your query & I understand your concerns. Your chances of getting pregnant are good. Please undergo regular follicular monitoring and ovulation induction if necessary. Metformin and origin -D would definitely help you. Please see an infertility specialist for the same. I hope I answered your query. I will be available for any followup queries you have.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doc,Im having a really bad pain in my neck, particularly in the upper half connect the lower part of the head. I recently went to the doctor and was informed that I had acute muscle spasm. I have been taking medicines for the ladt few days but the pain hasnt subsided yet. It hurts even more after I go out for a drive. Could you tell me whats the best way to get rid of it? ### REPLY: Hi... Your neck pain is due to reduced mobility in your neck vertebra... This could be caused due to poor posture and imbalance of muscles...Don't worry. I suggest you to kindly do. Lot of icing frequently...maintain posture...support your neck while sleeping... Gentle massage over neck muscles... Gentle stretching of neck muscles...continue anti-inflammatory medications as per prescription.... Support your neck with soft collar while travelling...once pain subsides you can start with chin tucking exercises... Neck isometric exercises for back and side neck muscles... Hope this is helpful for you... Kindly revert in case you need any further help in this regard ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Blood test revealed Vitamin D3 level is 25, and my understanding is the acceptable range is (30-100 ng/ml; and my Doctor instructed me to take two (2) Vitamin D (ERGO) 50,000 IU CA per week, for the next four (4) weeks. First, is ERGO a Vitamin. D3 supplement or Vitamin D2? Second, is this too much Vitamin D supplement to take, even for this short period? Finally, should I expect my levels to increase and stabilize going forward if I take 2,000 IU of Vitamin D3 going forward. Thank you, Pat M ### REPLY: Your It D levels are in the insufficiency range and not really in the severe deficiency range. Anyway, the dose advised by your doctor is fine. Some doctors advise 60000 IU once a week for 12 weeks. The dose prescribed to you should normalize your It D levels. You can repeat your levels after 3 months to check on that. Post normalization of the levels, it is advisable that you expose yourself to early morning sunlight before 9am, like take a simple walk for half an hour. Alternatively you can take It D 1000 IU daily. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 involuntary dystonic movements oo left side of face deviating left angle of mouth it is disturbing to me Dr has told me it is facial myokimia or facial dystonic movements pls suggest me treat ment ct scan,MRI brain normal pls let me know tretment thks sir ### REPLY: Hi there. Myokymia is abnormal twitching of the muscles. Since half your face it's twitching, your Doctor suspects brain disorder and is asking you to get a Brain CT done. I would advise you to reduce the stress in your life. You seem to be in a lot of stress, Do deep breathing exercises, meditation, Yoga. Get 6-8 hours of sleep daily. Avoid working long hours. Eat healthy. Keep well HY .  Exercise regularly. Avoid coffee, chocolates, smoking, alcohol. All this will help to reduce stress induced myopia. Once the CT scan is done, according to what abnormality in the brain is there, the treatment will work accordingly. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I had an operation on my left side of the head in 2012 because I had a lump that was so painful now after the op I always have these pains especialy when Im stressed my whole left side will pain so badly plus I need to know can I be pregnant since I have these pains in my breasts not on the nipples but on the side of the boobs? Ive had my periods last month but Im stressed now ### REPLY: Hi, Head surgery has little to do with being pregnant If your periods are regular and don't have any problem regarding the flow then you can definitely conceive. As you have mentioned that you have pain around your breast, thoroughly do a self-examination of them by lightly but firmly palpating on all sides of breast to see if there is any lump (normal breasts should feel soft on palpation). If yes then you need to visit a gynecologist or a physician for a check-up. Regarding your pain on the whole left side of the body, since you haven't mentioned any of your reports I would suggest visiting the doctor who did the operation as a follow-up procedure. Hope you find this helpful. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my MRI report states the following: 1. Degenarative disease in spine 2. Diffuse disc bulge at L3-L4 level causing mild effacement of thecal sac witChatDoctorpression over bilateral descending nerve roots 3. Diffuse as well as left paracentral disc bulge at L4-L5 level causing compression on bilateral exiting and descending nerve root (left right) with ligamentum flavum and facetal hypertrophy 4. 3. Diffuse disc bulge with right paracentral protrusion at L5-S1 level causing compression on bilateral exiting and right descending nerve root ( right left) with ligamentum flavum and facetal hypertrophy. Please explain the issue and provide with the possible cure ### REPLY: Hello, Thanks for the query, I will tell you that the MRI findings need to be correlated with clinical data. Further one must note the clinical context in which the MRI was done. If you have clinical signs of nerve compression, then the options will be to go for surgical treatment. If there are no clinical signs of nerve damage, then conservative management with either Gabapentin, pregabalin and physiotherapy will suffice. Please donor worry about the MRI findings. I suggest you to get clinically evaluated by a neurologist. Best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Since I arrived from my trip to Mexico City I have an epic stomach flew, I can even walk my stomach hurts so bad. I have sharp Bain ruining along the right side of my navel, under my right rib cage, lower right abdomen. It hurts to drink water, now my stool is loose black (diarreah). No fever. ### REPLY: Hello! Thank you for the query. Your symptoms are most likely caused by gastrointestinal infection with urinary tract infection (which appears very often when diarrhea is present). If your stool is black like a tar, and you do not take iron supplements, this can indicate bleeding from stomach. I suggest you to visit a doctor. Blood work, abdominal ultrasound and urinalysis should be done. Antibiotics might be necessary. In a meanwhile please start probiotic supplementation and keep yourself well HY . 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: Hi doctor I just wanted to know,I am asthmatic and my chest has been quiete tight for the past 2 months iv neen prescribed a weeks prescription of cortizones and a week of allergex once a day, just wanted to know  how often should I take the allgergex and could I take another course of cortizones after this week course is over?thanks ### REPLY: Two months of asthma exacerbation means that you probably need to be taking regular steroid inhalers to control symptoms and prevent attacks. Anti-histamines are not really part of the initial treatment of asthma, although there are some people with clear allergy-induced asthma who do get some benefit. Steroids taken by mouth are usually only for asthma "attacks". If you are feeling tight then it would also be reasonable to take a reliever (B2 agonist - albuterol, albuterol) inhaler as necessary for temporary relief until you get the symptoms under better control. Remember that using a spacer with a "puffer" metered dose inhaler is crucial to ensure effectiveness. (or alternatively a .  In any case, it's best to manage asthma under the direction of a family or respiratory physician, at least until you have formulated together a clear management plan. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 in generally good health and today I was told by my dentist that I may suffer from TMJ, after a week of discomfort in my jaw. I have no throat or ear infections, and my only discomfort is in my jaw. After knowing what is wrong with me I was finally able to relax last night and the discomfort today is very minimal, the best Ive felt in a week. Should I still be worried with any heart concerns? It does worry me. ### REPLY: Hi and thank you so much for this query. I am so sorry to hear about these worries about the heart. TMJ is very different for a heart attack. The only similarity is the jaw pain in both. However, the pain in TMJ can be provoked during eating or talking while the pain in heart problems can only be felt there but not provoked. I think there are really no reasons to get too worried about heart disease as you have not reported any concerning symptoms about that. I hope this ad .  Thank you so much for using our services and do feel free to ask for more clarification or information if need be. I wish you well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have Large granular T-Cell lymphoma, Now have an US of Throid showing Left lobe appearing heterogeneous with mult. nodules and shadowing calcifications poss. multinudular goiter. 1.3x1.0x1.0cm hypoechoic solid appearing nodular area with ill-defined borders and microcalcifications within left lobe superior. Left lobe appears well vascularized. SAG LT: 4.85cm TRV LT: 2.01cm AP LT: 1.75cm isthmus AP: Right 0.305cm Right lobe surgically removed ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have large granular T cell lymphoma.  Treatment of choice is chemotherapy.  You should go for chemotherapy according to stage of your cancer.  For thyroid, you should go for fine needle aspiration cytology.  And take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: during the start of winter season my face becomes dry and corner of mouth(that point where the upper and lower lips come together) becomes so so dry, after that color of that area changes from white to black and persist upto summer.... please suggest something to permanently cure this dryness... right now i am using Lobate-GM .. please suggest.... ### REPLY: Hi, kindly do not use Locate Gm as it's too strong to be used for face and besides the cream is not meant to treat your particular condition. For your excessive .  Use a good moisturizer like detail moisturizing lotion or detail restorer. At the corner of your mouth apply fluticasone cream twice daily till the cracks at the angle of your mouth disappear. Hope that treats your problem. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a rash on my left shoulder area and a gel feeling lump at the middle of my collarbone.  I had Rotator Cuff Surgery on my right shoulder on 11/4.  I have a strong history of cancer.  Lung cancer in 2002 and bladder cancer in 2009 and many basal cell cancers.  I am concerned with these two symptoms.  Thank you ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have rash on shoulder and lump in middle of collarbone with family history of lung and bladder cancer.  Your lump may be enlarged lymph node due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma, or you may have some soft tissue tumor. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact idea. Then you should take treatment accordingly. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I recently had sex and used a condom that contains spermicide. The next day my penis felt extremely sensitive to touch at the tip and also feel a slight burning sensation in my urethra. I have read online that some people have reactions to spermicide and I feel some may have entered my urethra. I went to urgent care and was given a cream to help. What can i do to reduce my pain? It s not agonizing pain, but it is very discomforting and feel a burn at the tip of my penis. ### REPLY: Hello! Thanks for using .come read carefully your question and understand your concern. I think you had allergic to the latex condom spermicide. Perhaps you are allergic to the latex condom, one of the most common allergic reactions caused by sexual intercourse. Although they say it affects only 1% of people, you can actually develop the allergy or sensitivity to the condom with the progressive contact with the latex or the material from which the condom is made - and / or the lubricants and spermicides it contains. Generally, the symptoms of the allergy to the condom appear within a few minutes of penetration, but then they may get worse. In cases of irritation, hives and more severe dermatitis occur hours later. For example, the formation of blisters on the skin that has been in contact with the latex is common. I see similar cases amongst young people who visit my clinic. In the first meeting, I advise my patients to avoid using latex condoms to prevent these symptoms, but obviously always remembering the important premise of practicing safe sex. If you are sensitive or allergic to latex, you can resort to polyurethane condoms or animal skin condoms. Polyurethane condoms work in the same way as latex condoms: they offer protection against pregnancy and prevent sexually transmitted diseases. Animal skin condoms, however, do not provide protection against STDs. While commonly allergic to condoms is not too serious, exposing yourself to such symptoms over and over again can be both annoying and harmful and can compromise not only your sex life but your overall health. And here the situation can be worse. So the best advice I can give you is to consult with your urologist properly diagnose your case, analyze what risks you have been exposed to in contact with latex condoms, and of course know what other contraceptive methods you can use that are harmless and comfortable. Kind regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother suffered from aplastic anemia . her age is 60 she suffered from it 6 years ago and received atg immunosuppressive therapy twice . Her problem is mainly low platelet count only 0000 . Is there any treatment to help her out . ### REPLY: Hi, Bone marrow transplantation remains the standard of care for younger patients. Another option is Immunosuppressive therapy which might help to resolve cyclopedias in a majority of patients WI, but relapses are not uncommon, and some patients remain refractory to this approach. Your mother might require platelet transfusion support but bleeding complications still occur despite prophylactic platelet transfusion. Hope it helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my father is suffering with pain at spinal cord . He has gone under some tests and as per reports they said that there is flesh on spinal cord which is unwanted. THey also said that it is not anything related to cancer but should go under surgery to remove the flush and it costs 2 Lakh indian rupees. Is that the real price for surgery like that? Thanks hafeez ### REPLY: Hi, Thank you for posting your query. Most likely, there is a benign tumor, causing compression over the spinal cord. As the doctors have suggested, surgery is required to remove it. Otherwise, it may lead to weakness of legs. Surgery is expensive, and the costs range from 1-2 lakh rupees. If you get it done at a government hospital such as AIMS New Delhi or PRIMER Chandigarh, then the cost would be on the lower side. If done at a private hospital, it would be on the higher side. Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi , i m 27 male. did weight lifting 6 yrs ago.due to back pain i quit but started feeling pain and weakness in my major joints like shoulder knees neck. i feel severe pain in left shoulder mri is normal stifness in kness and back pain mri is clincikelly normal. hv had steriod injection in shoulder. no reilf ### REPLY: Hello, As this is a gym injury I will advise you to undergo physiotherapist close by who can assess you and help you regain the joint stability and muscle strength. The free exercises are more helpful in the initial stages of the exercise. Post which resistance band training for joint stability and correction of muscle imbalance is advised. This will even help regain muscle strength and avoid the joint inflammation and thereby avoid pains. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my child has flu smytoms since yesterday and her temp went up to 38.4 gave her calpol and neurofen she s hot and cold hasn t eaten in two days she s sleeping all day she is drinking tho and now in bed she sweating and temp is dropped to 35.2 she s 9 years old she also has small rash on chest ### REPLY: Hi... This looks like viral illness...especially so with rash occurring. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (Maximum ceiling dose 500 mg per dose) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid 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: Hello,my name is nini,i am 23 yers old,i am female,today our vet told us that my pet has a stafilococcus bactery should i be afraid of it? we share a bad,we sleep together,i guess i have swellowed her hair several days ago when eating :( should i be afraid? what should i do pleas help me. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes you should take care of the things which you are sharing with him. Staphylococcus bacteria are maintained in the livestock like dog in your case and can be transferred to the humans with sharing. Many a time these bacteria can be MRSA strain. These bacterium are highly resistant to routinely prescribed .  So you should keep distance with the pets. You can wash him regularly. If its necessary you can use antibiotics soap to bathe him. Do not share bed with him. Its food utensils should be washed and kept separated. Once infected these bacteria can cause variety of infections that include skin, respiratory and other infections. I will be happy to answer your further concern on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has a good sized lump in his perineum. It is hard and symmetrical in shape. About two months ago his doctor told him it was a clog in his epididimis. The medication given did not help. He has also been diagnosed with chronic prostititis for the past 2 years, with none of the prescribed medications helping. ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in full details updated from you. I understood your health concernsBased on your query data, In my opinion, Dear You seem to suffer from Hard lump from Chronic Prostates with Scarred and Calcified Prostate. Treatment -Would suggest a work up with UroSurgeon-1-For Intra-Prostatic Antibiotic Injection treatment with 3 measly Booster doses.2-For Planned LRP-Laparoscopic Radical Prostatectomy-if discomfort for Prostatitis is more / or failure of Antibiotic Treatment.USG n CT/MRI studies to plan the Injection or LRP treatment is needed with at Team of Ur0Surgeon and Radiologist and Surgeon working together for better results in this very resistant type of disease. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. . N.M.S. Genl-CVTS -Senior Surgical Consultant ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, 55, 160 lbs, and i was prescribed metrogel for my gardnerella, 3 weeks ago.  Then i immediately got a yeast inefction.  which ended when i got my period.  now 3 days after my period ended, i have a gardnerella infection again. why did it come back? ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. Gardenerella vaginal is infection occurs when disruption of normal bacterial flora in vagina occurs. As you have both yeast infection and gardenerella it can be treated with vaginal suppositories of clindamycin and clotrimazole. Clindamycin will more effective than metronidazole for gardenerella. You can also use intimate wash regularly to normalize vaginal bacterial flora and PH. Hope this may help you. Let me know if anything is not clear. 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 daughter is three weighs 31lb about 40 in tall and does not have any medical history.. she is up to date on all vaccines.The only thing out of ordinary she done this weekend was friday got in hot tub. sunday morning i noticed about five small bumps behind her right ear and this morning there is about fifty and they are becoming somewhat patchy... they are going upward on her hair line around her forehead.. she had a dr appt. today but like other opinions Thank you ### REPLY: Hello, I can understand your concern. It seems that your daughter has been exposed to some substance that she is allergic to and has developed an allergic reaction. I would advise you to go for clinical examination to the pediatrician as you already have an appointment for that and get prescription of the antihistamines that can control the allergic reaction. I hope this information helps you. Thank you for choosing . I wish your daughter feels better soon. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: well i went to the doctor to get my implanon out two days ago. he could not find it so he put stitches in and said he would try again next week. since i got back from the spot he dit the incision to my lower arm is tingly and has a numb feelin when u touch it. is that normal? ### REPLY: Hello, As these feelings are common of tingling and numbness post the closure of the incision and there is no nerve damage done while doing the procedure. Stay relaxed and get the implant removed by the next visit. After implant removal, do simple exercise for regaining the muscle strength to normal levels. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ok I had a surgery done in 1997 by Doctor AB Guha at Toronto western hospital on my spinal cord it was 18 hrs long and was told it was never done befor it was anterior cord herniation at t4 to t7and i had 2 in one year that did not work and i signed a paper saying i would not see another doctor abut it and i am in daily pain every day now he has past away and may be i can see some one that can help me .i am now 62 years old and i live in Chapleau on but so to Sault st marie on to see my family. ### REPLY: Hi, thank you for providing the brief history of you. I am sorry to hear you had a spinal surgery. As you mentioned the pain you are having sometimes, I am sure you physician must have prescribed some medicine to you. Along with that why don't you discuss with your physician about undergoing physical therapy session. Physical therapy is non-invasive and then use of therapeutic ultrasound therapy and TENS should get you some relief. If possible you can discuss using the muscle stimulation in the Arabic mode for the spinal muscles as well. It will give you symptomatic relief. May be if you are able enough to perform exercises then the physical therapist may help you with the same. Incase if the ability is low he may even help you gain some mobility. I have seen patients with SCI, and they have responded to pain to an extent and some responded too well. Need a thorough examination and reassessment of the spinal column. Which will provide some input to help you with pain. Also the communication between the physical therapist and the physician should be constant which will make them in planning and modifying the rehabilitation plan from time to time. Any small or big issue coming up will also be discussed, and the impact can be made minimal. Prevention is better than cure. Getting help from a physical therapist will surely help you improve your metabolism and provide some pain relief. As it will totally non-invasive you will have no side effects at all. With the grace of God I wish you a speedy recovery ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Just below my chin on the right side, I m experiencing pain. It hurts when I press on it and when I sleep on it it hurts to swallow. But when I sit straight there s no pain and I can swallow normally. Please answer this I m 16 and very afraid of cancer. I don t know what s wrong with it, because it only hurts on one side and not like a normal soar throat ### REPLY: Hi Dear, Understanding your concern. As per your query swelling under chin along with pain in it. The symptoms you mention in query are pointing towards a condition known as dental abscess. Sometimes infection travel down the tooth and cause pus formation at the tip of the root and surrounding tissues. I would suggest you to consult Dentist for proper checkup. Doctor may order x-ray, CT scan or other test to confirm the diagnosis and rule out condition like muscle, swollen lymph node or a cyst. Doctor may perform complete oral prophylaxis, perform root canal procedure and may refer you to ENT specialist. For now give warm compresses to swelled area and do not panic. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor, I am physiotherapist. my query is about consanguineous marriages, My parents are arranging marriage to my cousine only, i have a doubt about children health.Please guide whether their will be any physicall or mentall disabilities in the children. ### REPLY: Hi...scientifically seeing consanguineous marriages are not advisable as the kids may be prone for some inherited disorders which might be running sub-clinically in the family line. Another issue is that it can lead to pregnancy complications and birth weight issues. But at the same time it doesn't mean that all consanguineous marriages will lead to defective babies. It is not so. The best way for you will be that - Consult a genetics specialist (both of you) and get evaluated and then take a decision of the marriage. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my resting pulse rate is at 102 bpm...it has been like this for 2hours, im experiencing an uncomfortable uneasiness in the left side of my chest...i am also experience lower backpain that moves to both sides of my waist, i have a fever, and also have a headache all day ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would explain that tachycardia is usual during an infection and the fact that you have fever indicates that you may have an infection. I recommend consulting with your doctor for a careful physical exam and some tests: - a resting ECG-chest X-ray study for possible pneumonia-abdominal ultrasound-lab blood tests (complete blood count, kidney and liver function tests, PCR, sedimentation rate). You should discuss with your doctor on the above issues. Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have bilateral hip pain. For over 9 months I have been experiencing hip pain, tailbone pain and every morning when I have a bowel movement it starts and is relentless the entire day. My lower back aches sometimes the pain radiates into my feet. I recently had an mri and was told that there is an herniated disc but not that bad? I also have a fibroid tumor and cyst in my uterus. I am 47 years old and absolutely miserable. ### REPLY: Hello ! Thank you for the question on ! I understand your concern. The pain which aggravates by the bowel movements is not related to the bulging disk, but it may be a spastic colon(a disorder caused by irritation and contraction of the great intestine). The fibromyoma can cause similar pain, but it is more related to uterine hemorrhage. You should consult with your gynecologist for this issue. The backache radiating to the feet is related to the bulging disk and chronic degenerative changes in the bones. I would recommend a lumbar bracelet for the pain and avoid standing position and sitting position for a long time. Physiotherapy would be very helpful to you, reinforcing the muscles of the lumbar region. I would also recommend Amitriptyline or Gabapentin which are very effective in chronic pain. These .  Hope to have been helpful ! Best Wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im sam 26 yrs old from philippines i have been diagnosed for mitral stenosis due to rheumatic heart desease since 3-6 yrs old according to my cardiologist, my 4 valves regurgitation is all in moderate scale..will it be treated?what particular procedure and how much will it costs?thanks ### REPLY: Hello, You mentioned you have moderate regurgitation, so at this stage only medications are needed and yearly echos. Once it reaches severe regurgitation it will need valve replacement. You will probably need to valve replacement and cost for it in India is around 2 lakh rupees. I don't know it in your country and will come to know if you dial any hospital helpline numbers. 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: 43 years old had myomectomy on 9/29/10 size referred as 5 months pregnant. Just received results that it was atypical. When I asked what that meant she stated I need to be monitored every 6 months but could not answer when I asked what atypical means she said she is a NP and told me she will have a doctor get back to me. Please advise what this means ### REPLY: His have gone through your description. Bases on that I understood is, there was a lesion in uterus corresponding to size of 5 months pregnant. They resected the lesion of myometrium so called mastectomy. The lesion sent for histopathology to know nature of lesion whether benign or malignant. The report might have mentioned some atypical cells that is cells not benign and showing changes pro . That means there are not defiantly malignant but suspicious of malignancy .so they might ask you for followup.don't worry. Have regular checkups to know any recurrence of lesion. Thank youRegardsVasundhara ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: thank you on 26 jan. went to podiartrist for stubbing my right large toe by walking bare foot in house it was found that i had infection and fractured my toe .had toe nail removed and i hope source of infection on bottom of toe. Given ciprofloxacn and told to soak 2x a day with epsom salt . now i see that the swelling has moved to my angle. ### REPLY: Hi and welcome to . I understand your concerns. I hope I have answered your query. This may be a progression of infection, and you need to see doctor again and have antibiotics intravenously if you ask me. This should not be neglected since this may lead to serious consequences. Also, I think that along with Cipro, you should have metronidazole or clindamycin as antibiotic treatment to cover both heroes and anaerobes. Kindly regards. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have external hemorrhoids that I ve had since my children were born. I am a 33 year old female, healthy, hypothyroidism. Recently, I started experiencing a painful tailbone area. This is new and alarming. I thought it might be a pilonidal cyst, but doctor said she didn t see or feel one. Could this pain in tailbone be caused by the hemorrhoids? ### REPLY: Hihope this msg finds u in good health. I have gone through your complaints and understand your concern. you are right. .hemorrhoids is one of d reason for tailbone pain.but it is quite uncommon. I suggest u get a X-ray done to find out what's wrong. U can take analgesics and anti-inflammatory tablets. Nothing to worry about. Hope your question has been answered. If u have any follow-up queries, feel free to consult me anytime.  Thanks Take care god bless ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good day. My husband has had an inguinal hernia for about a year now and it is getting more and more painful and the bulge is bigger than it has ever been. He manages it very well but when it comes to sex, he produces no sperm at all. We want to have a baby soon but when he ejaculates, there s very little watery substance that comes out. He still has a strong erection and he reaches orgasm but nothing comes out. Please help ### REPLY: HelloThanks for query. Your husband has Inguinal Hernia since one year and now facing problem of not ejaculating (An ejaculation).First the problem of an ejaculation can not be due to Inguinal Hernia. This could be either due to one of the following two reasons 1) Retrograde Ejaculation 2) Blockage of the Ejaculatory duct. He needs to consult qualified Urologist for clinical examination and get following basic test done to establish cause of An ejaculation .1) Ultrasound Scanning of abdomen and Pelvis 2) Trans Rectal Ultrasound Scanning (THUS) 3) Urine examination immediately after sexual intercourse .this will rule out retrograde ejaculation.4) MRI of pelvis this will confirm dilatation of seminal vesicle and confirm blockage of ejaculatory duct. Further treatment will depend upon result of these tests and final diagnosis. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 girlfriend afew years ago inhaled Rimu dust which is a native New Zealand hardwood.Now at night in bed she has what sounds to be bronchitis or a damp crackling left lung.Wood dust does seem to pose a serious threat to lung health,she is a non smoker and the lung definitely sounds like it has fluid in it but it does not come and can not be eleiminated.What can we do about this? ### REPLY: Hi welcome to  ..... Here your physical examination including auscultation need to be done first.... Chest x-ray and if needed spirometry useful in diagnosing your condition.... It could be bronchitis or any other restrictive disease like pulmonary fibrosis or infection like pneumonia if fever and cough with chest pain associated. You have not mentioned complaints in detail. So here examination will guide about which investigation to be done. If dyspnea present with difficult breathing then bronchodilator might have given... If congestion symptoms then antihistamines . For your condition you can consult pulmonologist. 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 2yr old daughter has small pink slightly raised bumps on her trunk, arms, back of knees, back of neck up to her hairline, and hips. It got worse with hydrocortisone cream and we tried antibiotics prescribed from a dermatologist, which has had no results. She is itching to he point that she will bleed. Any ideas ### REPLY: Welcome to the ChatDoctorIn my opinion, your child seems to have an allergic episode or scabies. Both can give red itchy bumps. Don't worry. You may try following measures to treat her:1. Apply permethrin 5% cream over whole body below neck at bedtime and give a good soap and warm water bath in the morning. Wash all the clothes and linen used with soap and water. Do the same after 2 weeks. Also use it on other family members as well to eradicate the parasite completely.2. Use calamine lotion and promoting lotion thrice daily for itching.3. Start her on an antihistamine such as Spy Ben . Hopefully this will help you. For further questions, you may contact 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 sir, My 3 month old has got cold and cough from a week. Have given him Ambrodil syrup for 2 days as prescribed by a doctor. But I havent seen ant dosage instruction for a 3 mnth old on the bottle. so wondering if I should continue. My boy is doing good otherwise (no fever and is active). Please suggest. ### REPLY: Hello Sir/Madam think your son has got only a simple upper respiratory infection. I would advise you to stop the . If he has persistent cough or fast breathing or difficulty in breathing you can consult your pediatrician. If your country permits over the counter medicine availability, you can get CETIRIZINE syrup and give him 2 mg twice daily for 3 days and stop. Please calculate the dose after seeing the concentration on the bottle. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 I was told I have shingles, but in reading about it, it states that blisters will not appear on the lips only. The left jaw aches and I have a tingly/ prickly needles on the left side of my face. I have a cold sore on my lip but do not have any rash. Could it still be shingles? ### REPLY: Hello, Thanks for your query on "As"per your clinical history is concerned please follow like this in detail-1)Do a clinical examination by your Doctor to confirm it.1)Discuss with your treating Doctor about [Acyclovir, Capsaicin cream, Lidocaine spray and ibuprofen+codeine combination for pain]2)For prevention of complications you can discuss [Shingles vaccine]with your treating Doctor. Hope that helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am 25  year old. 3 year before i have got started hair fall seriously. Till now i have lost my half of my hair from the scalp. I have consulted many dermatologist and have tried many remedies like minoxidil biotin etc but all was invain. Please suggest me some idea 2 get rid from the such problems. Thank you. ### REPLY: Hi, As per your query you have symptoms of hair fall which seems to be due to improper cleanliness, environmental factors, hormonal changes, fungal infection and could be due to stress. Sometimes it is due to genetic factors as well. Need not worry. I would suggest you wash your scalp 3 times a week with very mild shampoo containing the least chemical ingredients. We have to find the exact cause and start treatment as per that.  Avoid excessive stress and .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 5 year old daughter had fever for last 3 days , I was giving her meftal syrup and cepodem 100 for her cough. Today, though she doesnt have fever, the cough seems worse and she is not able to sleep with the constant coughing. In fact she puked twice and took out a lot of phlegm. She also has a runny nose. Please advice what can I give her for the cough , will sinerest help? ### REPLY: Hello, Has she ever had wheezing earlier? I think with the upper respiratory tract infection still laryngeal edema and other upper airway edema has not settled. That is why she is having severe cough. Only having antibiotic is not enough. She needs bed rest, an antihistamine like loratadine, small about of bronchodilator like terbutaline, and a steroid like dexamethasone. Plenty of warm water and gargling throat using pinch of salt added warm water will also help relieving cough quickly.  If your daughter is a wheezing better to nebulize once and give child the loratadine, terbutaline and a steroids.also. It is ok to give sincerest to relieve nasal congestion. Hope TTI s helps. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, My child is 3 year s old and he is suffering from lever problem since 2 year.I have do SGPT test and test report show SGPT is 380 url.He is also suffering from Daria from two time.Please advise me what can i do and who s medicine take? now i give xymex syrup advise by doctor.Thanks ### REPLY: Hi, I had gone through your question and understand your concerns. Before taking any medicines, the right cause of his liver marker elevation should be established. Get is sign of acute or chronic liver damage, it can be seen in Gilbert syn .  NYMEX syrup may not be efficient in most liver diseases. Only when diagnosis is established then treatment can be planned. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 8yr old girl who has had a rast test done and also a tree nut test done, both were negative but we have had allergic reactions from foods or creams nearly every day over the last month. rash, hives, feels hot and sore tummy 20 mins after eating or using products. I am wondering if it may be palm oil ### REPLY: Hello. Food allergy can be due to anything. Personally the most practical way to identify the food causing allergy is to keep a food diary. I would suggest you to keep a note of each and every food your daughter consumes with time and date and also note the time and date of symptoms. Please note ingredients of each food items too. Your keen observation will help you to identify the food causing allergic symptoms. I would like to let you know that most common foods causing allergy are - milk, peanut, tree nuts, soy, eggs, shellfish, fish & meat. However, it is possible to have allergy for any of the foods, so food diary is indeed a handy tool. Rast tests are used for diagnosis of food allergy, but they are not 100%. It is possible to have a negative Last test despite having allergy to food and also vice versa. Also, sometimes a child can have non-allergic reaction to a food, which cannot be picked up in laboratory tests. If this approach does not lead you to any conclusion, I would suggest you to consult an allergist-immunologist, who will ask you in very much detail and may suggest you some investigations. He may also advise you to keep a food diary. Hope this will help you. Wish your daughter the best of the health. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i injured my knee 6 weeks ago playing football,it has been diagnosed as crutiate injury and i am waiting for a scan,the knee is still slightly swollen and does not seem to be improving,i am icing and massageing,is there anything else i can do to improve the situation,i am 44 10stone and fairly fit thankyou ### REPLY: First you need to shows yourself to an orthopedic specialist. Stop massaging the joint and weight-bearing on that particular leg. MRI is a preferable scan to see knee joint pathology, specially ligamenta and meniscal tears if any and which may be treated by medications, physiotherapy or arthroscopy in most of the cases. Depending on the type of injury and extent of injury, knee joint takes time from 3 to 6 weeks to improve, and it generally takes months to regain the full strength. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 11 years post roux-n-y hepatico for surgical bile duct injury during gallbladder surgery.  Midline incisional hernia appx 1 1/2 inches below sternum.  recurrent dull ache in area of hernia with sporatic sharp intense abdominal pain.  should this be a concern after over a decade?  I was septic and acute bilary peritonitis prior to hepatico. ### REPLY: HI, Thank for choosing ChatDoctorOf course, you should not neglect it, Gastrointestinal disease always needs numbers of investigation right from the invasive to noninvasive procedures, because, some vital organs are there inside the visceral cavity which susceptible to infections, it is very much difficult say anything without the proper clinical examination and the all the clinical reports, please consult the Gastroenterologist and discus it, Have nice Day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hii doctor, I got married 2yrs back. We are trying for kids from last 5-6 months but iam not getting pregnancy so we went to a doctor He said everything is fine with my uterus but the only problem is the sperm is unable to reach the ovum because of fat in my body. (He didnt mention that where is the fat, is it in uterus or in fallopian tube) So can u tell me what exercise should i do reduce the fat in that place or Is there any medicine. I can get pregnancy right. Its not a problem naa.. Please help me!! ### REPLY: Hi welcome to . I have gone through your question. As your doctor said your uterus and fallopian tubes are OK that means that your path is intact. Due to fat in body, sperm is unable to reach ovum is somehow unexplained.!! To reduce fat you should do regular exercise, avoid fatty diet, take fruits, vegetables in diet. If your both s report are normal then there is no need to worry, you can conceive naturally. Do intercourse in fertile period on alternate days. Continue this for at least 3 months. Hope I have answered your question. Would be happy to answer you further questions. 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 mother in law just had stent surgery today and after been admitted back to the ward had severe breathing difficulties and had to be put on an oxygen machine.  Last week she had a silent heart attack and she also has type 2 diabetes. Is this normal and how serious is her situation.  She is 76 ### REPLY: HelloThanks for posting at . Your mother-in-law had a silent heart attack which is very typical in diabetics. Stents are put to reopen and establish flow in the arteries of the heart which are blocked. Due to the silent heart attack that she had, the heart pumping function seems to have suffered. Hence, it is not able to effectively pump all the blood it receives leading to fluid overload. This excessive fluid tends to accumulate in the lungs. This causes breathing difficulty. This condition is known as pulmonary edema. I suppose your mother-in-law is suffering from pulmonary edema. It requires treatment with diuretics (water pill), nitrates along with other medications for the stent and the heart which she is already on. Once the extra fluid resolves, she will get better. The Left ventricular ejection fraction or the pumping function is normally 55-60%. After a heart attack, it .  A 2 D Echo should be done which will show you how much the ejection fraction is in her case. Wishing her good healthRegards ### END