Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was walking and a friend said hi so I turned around and not know that there was a brick post in front of me I slammed into it with my forehead there is now a very large bump with a red line down it on my fore head how long will it take for this to go away and why is there a red line in it and how can I make the bump go away ### REPLY: Hello and welcome... No need to worry about.It's a kind of normal body response to the injury called inflammation... It is characterized by pain, redness, swelling,hotness if the effected area. This bump is due to accumulation of extracellular fluid which contain useful products for maintaining the normal structure... You can say that your body immune system is fighting for down there in the bump. It will disappear in one week... For pain, you can take ibuprofen 400 mg twice a day... Hope you'd understand... See you back in good health...bye ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 41 and have been diagnosed with fibromyalgia, possible dercum s disease and now I am experiencing cheeks swollen with knots or lumps on cheek bone area and the whole face is swollen. My nose and chin have actual sores from where skin has cracked and clear fluid comes out should I see primary care, my rheumatologist or e. r. tonite ### REPLY: Hello, You have a history of Fibromyalgia & Drums disease (rare disease). Presently, you are sick with facial swelling & fluid coming out of the cracked skin. The symptoms that you have commonly occurred due to an allergic reaction, sinusitis, a side effect of certain medication/ .  You are suggested to take non-sedating ant histamine like Levocetirizine, analgesic to reduce the inflammation. You can apply Lac to calamine lotion or Newsprint ointment at skin cracks. Keep your skin moisturized,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i fell 3 days ago and my foot is painful, i have no swelling or bruising. my little toe and outside of my foot feels really numb. underneath my foot is tender. the outside of my foot is painful to touch.im not sure how to help myself. dont really want to go to the hospital if i can help it. ### REPLY: Hello, X-ray of the foot should be done to rule out fracture which may because for pain. X-ray do the foot anteroposterior and oblique views should be done from radiology center nearby you.  Meanwhile, tab Diclofenac twice a day can be taken for pain relief. Visit orthopedic surgeon is recommended if X-ray report is abnormal. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor,am based in Shillong right now,I have allergy issues and face regular sneezing, itchy eyes.But from last few days I am facing severe nose block plus chest congestion,am unable to sleep.Tried Otrivin it helps but for sometime then again nose gets blocked.Please help as the place am right now doesn t have any good ENT specialist.Also I am on low carb diet now can it be the reason ### REPLY: Hello, For symptomatic relief of rhinitis, take tablet Levocetirizine 12 hourly. For prophylactic purpose, take Montelukast daily before coming into contact with triggering factors. For proper management of allergic rhinitis, find out factor (allergen) responsible for allergy. Or else you can contact allergy specialist to do skin allergy testing which will help to find out known possible allergens. Have a habit of taking antioxidant rich food like onion, garlic, dark chocolates, kidney beans etcetera. Do early morning Panama and yoga which will help you to boost up your immunity. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi I have a lump above my belly button on the left hand side. it hurts when pressed. My whole stomach and tummy area have been sore for a few weeks now....anything i eat hurts my stomach, and I cannot hold food. this pain is a 9/10. IT seems to be getting worse. do you know what it could be? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have umbilical or para umbilical hernia.  Or some soft tissue tumor.  You first need examination to diagnose hernia.  If needed go for ultrasound abdomen. If mass lesion is there then you should go for fine needle aspiration cytology. Then you should take treatment according to diagnosis. 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: Hello, My son (4 years old) has been throwing up once or twice a day for 7 days. He had one day (Sunday) that he did not. Our family doctor has assumed it is probably a virus. He shows no other symptoms and doesn t lose appetite or show dangers of dehydration. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query your son have symptoms of persistent vomiting which seems to be due to food poisoning which caused electrolyte imbalance in body leading to acute gastritis. Sometimes it is due to underlie systemic pathology. I would suggest you not to panic at all. You should start treatment witChatDoctorbination of fluoroquinolones and ornidazole. Avoid hot, sharp and spicy food. Visit gastroenterologist once and get it examined and start treatment after complete examination.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, we have been prescribed diof-ds for our daughter aged 5 years since it was evident from the x-ray that she is suffering fron constipation. there seems to be an accumulation of motion at the lower abdomen. pls suggest if it is advisable to use Diof-Ds ### REPLY: I don't think so. You understand Differs is antibiotic: ofloxacin+ornidazole, side effect is diarrhea. Cause is constipation, some bacteria can do constipation, like as Klebsiela, PS.aeruginosus, but you do stool culture and sensitivity to antibiotics, then .  1.  I advise to your daughter Evener diet number 4, give to her fiber rich food:raw salads with cucumbers, tomato, onion, sunflower or olive oil, boiled beetroots with onion and oil, rubber carrot, apples beetroots, carrot juices, fresh Dali, soup and ETS, plenty of water.2. Dufalac 5- 10 ml before night 14 days3. Darolac 1 capsule 1 time for normalization of flora intestine 1 month ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 name is matt and last year i was in a motorcycle accident. i was un able to walk and because of that i drank about 3 fifths of wine all day everyday for about 3 months. my doc did blood work and my ast level was 155 and my alt was 268. i was able to teach myself how to walk again then exercis alot. can my numbers go back to normal and if so how long will it take? i was neg. for hep. my glucose was normal and thyroid good too. ### REPLY: Hi, Thanks for asking. Based on your clinical history and query, my opinion is as follows:1. The rise in ALT and AST is due to hepatic damage.2. If you stopped your alcohol, then the damage should stop and the enzyme levels would come back to normal, within a month.3. The liver injury due to alcohol intake, will take much longer, maybe six months. If there is plenty of fibrosis, it cannot be reversed. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello I have a 17 yr old son who has complained of abdominal pain and fatigue. Took him and had some bloodworm drawn 1st set of labs showed total bilirubin of 2.2....I recently took him back for followup labs to see if the total bilitubin went down but it increased up to 2.6 and now his ABC are low at 4.1! I am very worried! Any suggestions as to what this may be? ### REPLY: Hi, Thanks for asking. Based on your clinical history and query, my opinion is as follows:1. Increased hemolysis is probably the cause of raised bilirubin and low hemoglobin.2. The RBC count could have been reduced due to similar reasons. However, do get a peripheral smear and reticulocyte count done to identify any abnormal cells in smear and whether the bone marrow response is present.3. Also check, if it is conjugated bilirubin, which is raised. It would indicate hemolytic anemia. If conjugated is raised, possible liver cause or gall bladder obstruction needs to be ruled out. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a epididymal cyst , have recently met with a surgeon who confirmed this is not harmful and was advised to have a urine microscopy for testing infection , which turned to be not infected. Was advised with painkiller sumo course as a pain killer after which issue with cyst pain was gone . it still pains once in a while , during wrong positioning of legs in sleep which may put some pressure on it . Is it a matter of concern ?? is this a normal behavior with cysts on epididymis ??  do we have any non surgical cure of it ?? ### REPLY: HelloThanks for query. You have been diagnosed to have Epididymis Cyst (Spermatocyte) and having pain in leg occasionally. The epididymis cysts are benign in nature and does not any treatment unless it increases in size or gets infected. The pain in leg that you have is not due to Cyst per se but may be due to other cause which needs to be traced out. There is no medicine that can cure or resolve the Spermatocyte. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i just want to ask regarding my right cheek swelling after tooth removal a week ago.actually its not  from the extraction its from the site of the anesthesia injected.the swelling is increasing inspite of my antibiotic capsule.how long i will wait to subside the swelling?my doctor advise me if not decreased the swelling he will open.im afraid.is there any option?please need your advise or opinion.thank you ### REPLY: Hello Carmen, Thanks for choosing  forum. The cheek swelling post extraction may be due to-Overdose of anesthetic solution injected. Deep penetration of needle inserted. Needle breakage. Facial nerve paralysis due to faulty site of administration of local anesthetic solution injected. I would suggest you to apply frequent cold and hot packs at the site of swelling. Avoid stress and anxiety. Physiotherapic exercises has to be done for cheek movements. Take complete course of antibiotics too. Maintain good oral hygiene. If symptoms persists, please do visit your dentist. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor my father is type 2 diabetic is under insulin his blood sugar is under control . he had his all the investigations from delhi gangaram hospital around 1 years back he had this diabetic nephropathy but his creatinine at that time was 1.9 recently i asked for hid blood checked and his recent reports shows GLucose F 97mg/dl pp 156mg/dl UREA: 169 mg/dl Creatinine 6.62mg/dl Na:132 potassium: 4.5 uric acid 4.0mg/dl cholesterol 100mg/dl calcium 7.8mg/dl phosphorus inorganic 5.9mg/dl tsh 28.88uIU/ml hemoglobin 8.2gm% Total count 8400/cmm Urine R/E Ph acidic Albumin +++ sugar trace M/E RBC 0-2 pus cells 1-3 epithelial cells 0-2 IRON PROFILE Iron 91microgm/dl TIBC 311 microgm/dl Ferritin 362 nanogm/ml IMMUNOLOGY PTH 100.5pg/ml We have planned for the ultrasound and 24hr protein and Creatinine Clearance He is completely asymptomatic no nausea vomiting his urine input output charting is normal we are still under investigation wat do you think do we need to investigate more ? Do prostate also have any role in the above mentioned values? please tell me the best possible investigations that could be done i am from nepal but recently i am in japan so please tell me the best possible management for him as i would like to do every possible thing available . thank you ### REPLY: Hello and welcome to . Kasthu CIA. Ramro ?.. As a Urologist, let me advise you, that your fathers Diabetic Nephropathy has increased from 1.9 creatinine, to 6.62. He has anemia, Hb of 8.2gm/ml, with luminaria (urine-alb:3+). Now, his HbA1C, is not done.  But other reports are as expected. But treatment taken at present isn't mentioned to give you proper advice. You can reply to me with the reports of US scan, and 24 hours protein and Cr.clearance. It should show proteinuria as expected. Dietary advice is important. You may contact me with all reports, as a direct question. . Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i am a 30 yr old female pulse rate is 79 blood pressure is 125/70 family history of heart disease. (grandmother on fathers side had 6 heart attacks last one large. my father had 2 heart attacks 1 when he was 41 then 11 months later the second which killed him) i was on duromine and had tachycardia my rate went up to 125 and blood pressure was up and had some palpitations which did not show up on ecg just wondering if i should wear a monitor for 24 hours. had blood test recently and my cholesterol is up. ### REPLY: Hello, Based on your family medical history, which gives you a higher risk for possible cardiac problems, I recommend you to do cardiac sonography and a cardiac stress test to see if everything is ok.  You should keep in contact with a cardiologist. I don't think that an ECG Holder monitoring is important from what you are writing. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has 3 dark purple veins on his scrotem and what appears to be a spot by one of them. They have been there quite a while and sometimes are uncomfortable but not painful. The spot is on the left side and gets caught in his underwear and can occasionally feel achey. Should we be worried. ### REPLY: HelloThanks for query. Based on your statement I would say that your husband has three prominent superficial veins on scrotal sac, These are dilated, prominent superficial veins over scrotal skin and nothing to be worried about it . He should use soft inner wares or soft pads over scrotal sac before putting on inner wares. These are harmless and there is nothing to be worried about it. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 51 a female who had to work in a car parts factory I was having to lift 20 to 50 lbs. every 30 to 45 minutes to make the car parts. My problem is the muscles between my right scapula and spine seem to go numb and feel like they go to sleep. should I be worried? ### REPLY: Hello thank you for writing us here. It's because of fatigued muscles. You should message your back and take some rest. Avoid lifting things for a week to 10 days or so and see if the symptoms have any improvement. The symptoms are more likely to improve but in case it doesn't, you should go for a checkup and investigations should be done including X-ray of your spine and CBC along with the neuromuscular examination. God bless you Best regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m ten weeks pregnant . Unfortunately a gallstone is also growing along with my baby. The right upper abdomen pain is severe now. My doctor advised to choose which is important to me, either stone or baby. I m afraid. I need my baby in addition to get rid of the stone. I m coward even to take injection. Is there any medical advice with out surgery that should not harm my baby. If necessary I ll be ready to surgery (which one is best for me) that must protect my baby. Pl suggest. ### REPLY: Hello, You can solve this problem by the following solution. You will undergo surgery for cholecystectomy, but this should take place in the second trimester (i.e. after the 13th week). For now, you must follow a conservative treatment plan as follows:- No eating + intravenous fluid administration.- Administration of an analgesic.- Administration of antibiotics that are safe for use during pregnancy. After the pain subsides and inflammation resolves, you will be allowed to have a normal diet. The above steps should be done under medical supervision by your doctor. If you need more help, please visit: www.med50.blogspot.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am working in night shifts and my intake of water is less. At present i am suffering from typhoid fever and i am suffering from constipation too can i take Cremadiet. I am scare because as it is fibre content the person who is suffering from typhoid can take or not please suggest. ### REPLY: Dear Friend. Welcome to . I am . I have read your query in detail. Furthermore, I understand your concern. Typhoid fever is very high in fever. You might have got Tidal Positive. That has no significance. Only its rising liters are significant. So, give details about your fever and also attach the reports. For constipation, you can take high fiber diet. Take medicines if it doesn't respond to dietary changes. This is my best opinion for you based on available details. If you have any further query please. Stay Healthy. ChatDoctor, MD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: once i had a fit/seizure ibecame faint for 10 minutes and felt weakness at that time. doctor gave me eption 300er dose once daily for six months. my problem is that i am having its side effects of rashes red round small spots causing itching. iwant to reduce its doses and finally want to quit it. please advise me. ### REPLY: If you're having red rashes with itching, it can be 1) allergic reaction to some . Even you have already been on option for last 6 months without any reaction, still there is chance of allergic reaction to option. You should consult dermatologist. If dermatologist conclude it to be allergic rash and if you're not taking any medication other than option, you should stop option and switch on another antiepileptic medicine (Better to avoid carbamazepine, phenobarbital also as they have some common properties as with option in causing allergic reaction). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is there another way to determine a pregnancy test without going in to a clinic? I took an hpt and it is negative. I started with this bulge above my mons pubis then it seemed to disappear, but now I have a hardening in my middle about my belly button. Not certain if it is a pregnancy or something I should be concerned with. Currently, medically uninsured. ### REPLY: Hello, and I hope I can help you today. An over-the-counter, home pregnancy test is over 99% accurate when performed correctly after a missed menstrual cycle. Therefore, you really do not need to see a physician to confirm the negative pregnancy test, as the ones in the doctor's office are just as accurate. Your uterus does not enlarge the level you can actually feel it abdominal until you are at least 3 to 4 months gestation. So if you are feeling an abdominal bulge, this is definitely not due to pregnancy. There are other things that may be gynecologic that can enlarge your uterus, and a GUN doctor would be able to diagnose these problems. However, in your case, if you feel a bulge in your upper abdomen, there is a possibility that your intestines can also be a source of the bulge you feel. So in summary, I think you can count on the result of your pregnancy test but if at all possible, it would be helpful to get a medical physical from a general physician to make sure that there isn't anything concerning going on. I hope I was able to adequately answer your question today, and that my advice was helpful. Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My name is chhotelal Gupta. i am 24 years old. i AM Software Engineer. Some months my memory has come down Who does not remember anything. and 2 years, I sometimes HEAD pain remains.I also have a pair of -0.5 glass. but i wear sometime because 4 to 5 hours and 2 days later I head and Eye hurts after wearing. PLEASE give SOME BEST Suggestion TO INCREASE my Brain memory POWER AND REDUCE MY STRESS. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The brain never gets full. You start learning from the day you are born and it continue until you die. Throughout these period brain accumulates and stores information. This information always stays there. Remembering is recollection of what is stored. This is not easy. The more you recite, the more you remember. Your remember recent events most. You remember vivid and interesting events most. Furthermore, you remember images and videos most. The best method to remember and recall maximum is to remove stress and anxiety from your life. Clear thinking can give good recollection capacity. Practice meditation. If you are interested in more information in this regard, you may post a direct query for me.  Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my two year old is complaining of stomach ache and had hard pale yellow stool, shes not been eating or drinking well,I took her the doctor yesterday and was told she had a food allergy we r still waiting on the blood test cause along with the above symptoms she had hives earlier, so is the pain in stomach and pale stool all part of allergy? ### REPLY: Hi, Thanks for writing to . I can understand your concern. Even hepatitis may be associated with lack of appetite and change in the color of the stool. Are the eye of the child looking yellow? Did your doctor order investigations like liver function tests including GOT, SEPT, Serum bilirubin etc. These investigations may help to identify if hepatitis is present or not. Further investigations may be required to identify the cause of hepatitis. Continue to ask further queries as required. Hope this helps. Take care. . D.(Pediatrics)Associate Professor of Pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? Please type your query here...my 17 monthold daughter has been to the doctors 8/9 times since september of which 4 times has had antibiotic with no cure!!! been to hospital had xray they said her lungs are clear!! im so worried please is there anymore i can do!!! ### REPLY: Hello, Kindly elaborate your problem. Was she admitted to the hospital due to respiratory tract infection? If yes, then please provide a detailed history like is there any history of allergy or asthma in the family? How many times she has been given oxygen in the hospital? Was she delivered vaginally or through c-section? Was she admitted ever in NICU or given oxygen? I would recommend starting home remedies like one teaspoon honey in lukewarm water daily especially when having a cough and cold. Avoid cold .  Start montelukast sachet once at night for two months at least along with some good anti-allergic if there is a family history of allergies and asthma. 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: In the past 6 weeks I have been hospitalized for sudden spikes in my blood pressure. I get terrible headaches with them and so far my doctors are not able to tell me why this is happening. The last time it happened was last week and it spiked the highest ever, 198/108. After this last time it took about a day for it to come back to within a normal range. My doctors are stumped and so am I because this doesn t happen on an everyday basis and nothing seems to be in common with them other than the headache. ### REPLY: Welcome to . My dear friend, first important thing is that you should take you antihypertensive(blood pressure medicines) regularly and as advised by your treating doctor. Headache and dizziness is very common in high blood pressure patients. I advise you ask your doctor(if he/she did not do same) for 24-hour urinary catecholamines and metanephrines to rule out pheochromocytoma. Because such type symptoms are very common in pheochromocytoma. Thanx for query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I woke up in a hot sweat with a stomach pain so I went to the toilet. After a few minutes I began to vomit repeatedly and got diarrhoea. I then began to heat up profoundly and started to shake. I tried to make my way to the shower and must have collapsed as I woke up about 30 mins later on the floor. I have had a similar experience once before about two years ago. It is also worth noting that I am on my period although I never usually have any problems with this and throughout today I have been sick and to the toilet numerous times. ### REPLY: Hello, Thanks for posting a query, I understand that your periods are going on right now, and you are having these sudden onset pain in abdomen with sweats and diarrhea and vomiting. The most common possibility is that you are having a gastroenteritis or a gastritis, and you are also having a low blood pressure cause of volume loss and that has led to your fainting spell.  You should immediately visit the ER and get your BP checked and if its low then some IV fluids should do good to you. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Not sure how many doctors are familiar with Reiki . When I had my first attunement my teacher let us know our bodies would be going through changes. Some of us had emotional changes, some changed their diets to suite their bodies changing needs, I however have become very sensitive to many things. I have terrible skin reactions to most chemicals , exposures to metals, a label of a snapple bottle touching the skin of the arm, and even things that are hypo allergenic or designed for sensitive skin . (Triple antibiotic ointments and other commonly used products) I cannot eat red meat anymore, something I enjoyed as I now have severe migraines even with the smallest of portions. The smell of cooked meat is unbearable whereas before I had no problem with it. I can still eat fish and fowl, but have noticed my sense of taste is not as strong as it used to be, and have had strong chocolates without being able to taste them. I have been on so many antibiotics in the first year since the changes they are no longer effective. My doctor asked to have blood work to find the cause of the severe rashes (they covered from my abdomen to my neck, my ears, and my arms. The whole left side of my back, and from my hip to my knee on one side of my body at different times, always in large areas.) I tested negative for diabetes, and negative for HIV. I was told the only thing notable was that a small part of my thyroid left in me after surgery had formed nine cold masses around it, and that my liver levels were slightly elevated. (Was on seizure medicine for many years which stimulated the liver, no longer taking medication). My thyroid levels were normal. I am at a loss of the cause of the rashes, and intolerance to foods I used to be able to eat. Each doctor I have seen just tells me, dont eat that anymore, dont use neosporin, and dont touch the labels of bottles, or dont wear jewelry. I feel disheartened knowing I will get the same shrug and very specific restriction from the latest thing I came into contact with instead of someone telling me where the common thread is and how further reactions can be prevented. ### REPLY: Hi dear tranceaiglatson thanks for the query after going through your query as per my knowledge your body is showing reaction may be known as idiosyncrasy (this is individual hypersensitiveness as to . .homeopathic remedy will take you to your original constitution. The homeopathic physician will have to give you right constitutional minimum which can be given to you by only a homeopath who is expert classical homeopath practicing as per laws of homeopathy remember homeopathy will consider all your physical, mental symptoms and all your past medical history your likes and dislikes, and your sensitivities' homeopathy will act on immune system and will cure this hypersensitive response hope for best ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor i am male suffering from leg pain can you please suggest some good treatment for the same. ### REPLY: Hello, Treatment depends upon the cause of pain.  Is it muscular or skeletal or neurological or vascular or functional to be confirmed by history and examination? You may use tablet Tramadol with Paracetamol twice a day for five days.  If symptoms not improved please consult your doctor he will examine and treat you accordingly. 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: I have a rash on my outer thighs that becomes very itchy during the night. I put lotion on that helped for a few nights than it stopped working. I went to a dermatologist with the VA and they gave me some ointment to put on it. That worked for a few days and now has stopped. ### REPLY: Hello, Thanks for the query, You might have developed fungal infection. Please get a KOH mount done, This can confirm the fungal etiology. Treatment can be with oral antifungals as well as with topical antifungals. Please meet a dermatologist for exact diagnosis. Let me know if you have any other doubt. You can ask a direct question to me on this forum, following the below link.https://urldefense.com/v3/__http://www.ChatDoctor .com/doctors/ . Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hii doctor sir i had so much piple on my face in 2011 but i did nt do any treatment tht time but frm 4 month of using alovera in home my pimple is 85% clean now i have very small on face and some scars and i thought if using alovera reduce 85% of pimple in 3 mnth thn the balance cn be reduce in 1 or 2 month whts ur suggestion sir i dnt eatoily food,non vegetable,sweet,icecream,resturant food and home oily food also i dnt eat vegetable tht is make with masalas and oil i eat this by boiling i totally tk care my skin from sun,dring 4 to 5 ltr of water i m 53 kg,17 years,5.4 height. ### REPLY: Hello. Welcome to . Thanks for writing to us. Pimples are normally seen in teenage. As you have mentioned your pimples have reduced considerably after using algebra, and you do not expose your skin to sun or eat any oily food, continue applying the same. Tips to reduce Pimples. -Clean your skin gently with a mild, non . -Wash once or twice a day, do not wash more than thrice as it  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell and hit my head a week ago huge lump formed took a couple of days to go down as it was going down I noticed my whole right side of my head was hurting from the my neck to my ear anyways as its been a week now I m feeling around and noticed it feels almost tingly when I touch it the is a very small bump and maby an indent I wanna say its a weird bump like its like stretched out or something I slipped on hard wood hit it on the part of the cair you sit on ( wood chair)and yes I think I was out for a second because it took me a moment to realize i had hit my head . ### REPLY: Hi,Reply-1-Plz give clear demand you intend to get with more detailed info of the lump,2-Mail photograph of the head part-in question, 3-any x-ray or CT done till now-4-Any medical reports of treats taken -if so taken.5-Follow up queries after I study these reports.6-Tb-NSAID-1 BD -5 days till the problem is fixed.7-Waring-Be caring and fast -as its head -a critical organ-brain is at risk. So act fast and report by follow-up queries. Thnks Welcome. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: when i get up in morning i have strong urge to have bm with mild upper right abdominal discomfort (under right rib cage). when i do it floats and most of time eventually sinks. if i dont go in morning and wait till the evening it sinks 90% of the time. its also more formed in evening than morning. still formed in morning just softer. but either way i always have to wipe excessively with quite abit on the paper after first wipe and thick. also normally have alot of partially digested vegtable matter in stool. i have had stool tests for parasites and fat. altho fat test was not the 72hr one. also had normal colonoscopy , hida scan, gallblader ultrasound and ct scan of pelvis and abdomin. have gerd and mild gastritis determined after upper endoscopy . my question: is this something to worry about? ### REPLY: Hi, you may have irritable bowel syn .  This kind of symptomatology may be found in number of gastrointestinal pathology. As almost all imaging are within normal limit any sort of malignancy can be ruled out. Even more detailed history regarding your lifestyle, dietary habit, special type of food intolerance, occupational history to be taken. You should consult a gastroenterologist. 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 fell last Wednesday and hit the inside of my upper arm on the corner of a wood cabinet. As expected, I ended up with a horrible purple and red bruise the size of my fist. However, now there is a welt about the size of a quarter under the skin of the impact site that is extremely tender. Do I keep applying ice and heat? Can I wrap it lightly during the day so that it does not directly rub on my side? ### REPLY: Hello, I have studied your case.  I think you have developed collection of blood under the skin. It is called hematoma. It is very painful and needs to be treated. Furthermore, it would be better if you get x-ray of the hand also as some time it can be a hairline fracture. You should apply hot water fomentation and take Broken tablet if pain is there. Also, you can apply compression bandage. I hope this answer will be useful to you. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was recently admitted to hospital for severe pain in my midriff area blood tests showed my liver enzymes were 325. I then had blood gasses taken and an EUS scan done which revealed my gall bladder was inflamed and full of sludge. I had gall bladder removal a couple of weeks later  I had more blood tests done recently which showed my enzyme level is now 137 just slightly elvetate and also Alk Phos slightly elevated. I had previously not had any alchol for two months to this episode and was also on a low fat diet. I have now not had any alcohol for five months. I am going on holiday soon and would like to know if I will be O.K. to have a drink. If I cant it is no big deal. Thankyou Maisee ### REPLY: Hello Mr Maisie, I must congratulate you on your abstinence of seven months duration. Not a lot of people would be able to do that. Looking at your lab results, I would say that you had a bit of sludge travel down to your bile duct as well causing blockage of the bile but (raised ALK Pros). This could have potentially injured your liver cells as well, causing increase in the level of your liver enzymes. Your most recent set of labs does show that the liver injury seems to be resolving quiet well. As a doctor I would strongly advise you against .  But since you are going on vacation, a couple of beers wouldn't hurt. Hope you enjoy your vacation, and please do not hesitate to contact me for further queries - rxsuresh@gmail.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello me and my wife had a baby whom she miscarried, however we have over time tried to get another baby and failed, last month a prolactin homone level was carried out and it was 3600 ml/u and the last one we had was 15.3ng/l  after treatment 0.5mg of a certain drug given to us, what could be the problem should we try again shall we be able to get a baby ### REPLY: Hi, I think you can try with some medicines.  Your wife can take some medicines like camphene for the growth of her follicles and track the follicles' growth by repeated ultrasound.  When follicles reach a size more than 17 to 18 mm, injection will be given to rupture the follicles. Be in contact with your wife for next 2 to 3 days.  Progesterone will be given for next 2 weeks. Do a urine pregnancy test at home after that. You can try like that for 3 to 6 months.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had mitral valve repair done 1.5 years ago. Initial symptoms were elevated heart rate with minimal exertion. Dx with severe mitral regurgitation. Surgery was successful. Recovery went well for several weeks, then the symptoms of elevated heart rate minimal activities has come back. Lately symptoms beside elevated HR include fatigue, chest tightness/flutter feeling, leg pain climbing stairs. Recent holter monitor showed highest HR 143 with minimal activity, echocardiogram normal, EF 50%. My resting heart rate is good 60-70, 40 when sleeping. Have been given betablockers which lowered my bp, dizziness. No further answers or treament. Also have rate induced LBBB. ### REPLY: these complains could be a presentation of Paroxysmal Atrial Fibrillation, Paroxysmal Atrial Tachycardia, or arrhythmias, which are often common with progressed mitral reg urge, and after surgery. Rhythm assessment is very important for us to discuss on such problem, which seems missing here. Your resting heart rate appears to be in good range, the reason for your palpitations on slight exertion could be arrhythmias (which engraves due to tacky induced LBBB). I recommend thorough holder review, or use of event recorder, to further guide your 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 Dr. I am a 64 y.o. Female taking Zithromax antibiotics on day 4 - one pill left.  The growth seen in my mouth and throat have decreased (kind of like the round distance colonies spread to cover upper mouth and  Individual colonies we significantly reduced -- until this morning.  There are now new individual colonies forming ( to a lesser extend) in the mouth mostly toward the tonsils with some closer to the mouth.I am also taking  Nortriotyline  for a concussion (headaches daily) 3/30/2017.  ( from a headache specialist in SF).   I still have many symptoms seemingly related more to the infection - very sore throat. red throat, tired Headache ( feels like sinus area).  It always feels like something is stuck just below my throat- Should I wait til tomorrow Sunday & got to urgent care? ### REPLY: Hello dearWelcome to  family. I have gone through your concern in depth.@ This is most probably adenoid enlargement following upper respiratory infection.@ Recommendations for better recovery $ Continue your current dose of antibiotic as per guidance.  $ Additional intake of ibuprofen will help to relieve faster.  $ Gargles with salted lukewarm water added peppermint oil 3 times a day will help for sure.  $ Avoid oily, spicy, chilled beverages, cold .  $ Refrain from smoking or alcohol if using. Hope this will help you. Always feel free to ask further doubts. Thanks for kind evaluation of my answer. Regards dear take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is having a sharp pain behind his right ear radiation down his neck. It only last a few seconds than goes away. He has had his blood pressure checked recently and everything checks out. He is very healthy otherwise. Exercises and eats right. Watches his weight. He is 58. ### REPLY: Hi, Thanks for writing in. Sharp shooting pain in the head and neck region lasting for few seconds is a common symptom on neuralgia of nerves supplying the region. There are nerves having branches that innervate the skin in the head and neck region including the back of the ear. Once such nerve is the trigeminal nerve. It arises from the brain stem and then goes to a relay center called ganglion. From there the nerves branch out to supply different areas. It is possible that a branch of the nerve supplying the area behind the ear and the neck are irritated at some place and causing the sharp pain. Please have him seen by a neurologist and his condition confirmed. Treatment is by medication in most patients. Please do not 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: hello doctor . am vinodhini from tamilnadu .i am 21 years old doing my final year B.E. am using this skinlight cream for an year. i had good results. but now i have problems in my skin like red spots on my face. is it due to allergy or anythingelse? on account of my work i have to hang out in sunlight for long time. am afraid . please give a solution. ### REPLY: Hired spots on the face can be due to various causes.1. Allergic reactions to medication/other agents2. Solar allergy 3.systemic causes4.some infections/inflation In your cases the more likely cause is the allergic reaction. Please discontinue your cream for few days, take some antihistamines tablets like Allegra 120 mg for few days, also take care of the sun by using some other sun blocking agents. If still not right, please consult your doctor. 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, am currently using eso -kit medication and am having terrible headaches,and feeling like vomiting, am really coughing alot especially at night and its like a cough that is triggered by something.is all this part of the side effects from taking eso kit. ### REPLY: Hi1.nausea, vomiting, diarrhea;2.headache;3.vaginal itching or discharge;4.unusual or unpleasant taste in the mouth; or.5.black or "hairy" tongue are some side effects of the kit. Severe cough if still persisting, should be investigated.In case of . In case of cough with sputum, antibiotics should be taken. Chest X-ray may be required in chronic cough. Hope that was helpful. Let me know if I can assist you further. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 22 years old...healthy and fit... I can run 1-1.5 miles in a single stretch per day.....I went for pre-employment medical check-ups & found that my BP was 145/95( Fasting overnight about 12hrs)...So they said they will take another reading few hours later.. It was still high.. my kidney sonography is absolutely normal....I am awaiting RFT results....Few hours prior to giving blood sample for RFT i consumed potato wafers as nothing else was available in the vicinity of the hospital..will it affect the outcome of RFT??? ### REPLY: Hi, first regarding your BP, we need to find out any secondary cause for hypertension like renal, endocrine, renal artery stenosis cause. You are required to do some basic investigations like renal function tests, urine examination, renal Doppler and special blood investigations in consultation with your doctor to look for cause of high BP. potato wafers may not affect RFT much, but beware of high salt containing food. They will increase your BP.take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr., I have been having tailbone pain since January. I was told that it was probably due to Hemorrhoid surgery in Dec. and also in Jan. Now not only am I still having the pain in the coccyx area, but it now hurts to sit on my bottom cheeks, as well as there s a tingling, vibrating sensation that s happening in my most private areas. My question is, what could be the problem, and what type of physician should I make an appointment to see. ### REPLY: Starting with a general physician would be the normal way to proceed.  Several features of pain can be helpful in clarifying what is going on and the next steps for diagnosis and treatment. Type of pain. Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain. Location of pain. There is a lot to this. First, if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might be going on. Obviously if there was an injury to the area and then there was pain outward from it "hit a nerve" would be a possibility. Sick nerves are MULTIPLE areas and tends to be the TIPS of the nerve not the whole nerve. So, pinched nerve, base of the spine and that is evaluated by an MRI usually ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HiMy husband (44) has recently had a sperm analysis. He had a vasectomy reversal back in December 2010. His results showed volume: 2.9 ml, density 12 million per ml, motility 35 % and normal forms 4%. He has quit smoking and is taking a zinc supplement. I have normal cycles and am diabetic HBA1C- 6.3. What are our chances of conceiving or increasing my husbands semen count further? His first count three months after the reversal was 0.6 million so we have seen fair progression already. However, we are desperate to conceive. Thanks in advance. ### REPLY: helloThanks for query. Recent semen analysis of your husband after vasectomy reversal is reported to be 12 millions per ml. It is very difficult to predict possibility of conception with sperm count of 12 million/ml though sperm motility is within accepted range for effective fertilization of female egg to result in pregnancy. Truly speaking there are no medications proved to be scientifically effective to increase sperm count.However, Following measure will help to increase sperm count to some extent. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc 3)Take anti oxidants like Almonds 5-6 everyday4) Avoid alcohol and smoking. I would suggest you to consult qualified Infertility specialist and explore possibility of pregnancy with the help of newly assisted reproductive techniques like IVF or CSI. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dad has stomoch cancer stage 4 he has extreme thirst and is vomiting blood , plus blood also present in stools, he has not eaten for two weeks, says he has a full feeling all the time and stomoch feels like it has a ball inside him, doctors have decided that treatment is not an option, what should we expect ### REPLY: Hi. It's very sad to hear about your fathers' disease. Stage 4 stomach cancer has a very poor prognosis and limited survival. A good oncologist should know when not to treat. The decision is based upon the extent and stage of disease, age of patient, patients performance status, comorbid and expected survival. I am sure your oncologist must have considered all these issues. Expected survival in stage 4 cancer without treatment is few weeks to 2 to 3 months. I hope your question has been answered. If you have any further questions I will be happy to answer. Thank you for choosing . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Do you think it is possible for a 60 year old man who has congestive heart failure and Bronchiactasis to undergo a heart transplant? His doctors are saying it cant be done because of the damaged lungs. (30 years ago he had lung cancer and the radiation caused this.) ### REPLY: Hi Thereafter going through your query I understand your concern. I would like to tell you that, yes the doctors are right as heart transplant can't be done in patients with any type of chronic lung disease such as bronchiectasis because during a heart transplant patient has to be kept on a heart lung machine which requires healthy and properly functioning lungs. So he cants undergo heart transplantation and has to be managed with optimal medical therapy. Hope to have been helpful. Kind Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i m devi. i have thyroid problem past one year. still i m taking thyronorm tablet 50mg per day. i delivered a baby last year. nw he is 1 year old. still i am giving breast milk. what the problem is, for the 5 months i have severe hair loss. i am taking combofit multivitamin tablet daily also. but still i have the problem. is there any prblem in my health or its normal? ### REPLY: Hello, It is quite normal to shed hair postpartum as the effect of estrogen on hair wanes off.  Other factors that may be contributing to your hair loss is nutritional deficiency.  Therefore, I suggest you take a balanced nutritious diet rich in proteins, minerals and vitamins along with a hair vitamin supplement e.g. tablet Reviles which is oral biotin and is good for hair. Hope I have answered your query. Let me know if I can assist you further. Take care . , Dermatologist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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! How are u.. I am 26 weeks and 5 days pregnant. On our 20 week ultrasound they found a small white spot on the heart. On the 26 week ultrasound they found that the spot was a little smaller however there was some fluid around the heart as well as a slight echogenic bowel. The quad screen and the fetal cell free DNA maternity21 test all were clear. What should we do and what are we likely facing? ### REPLY: Hi there,The cell free Fetal DNA being clear for Downs is a very good sign. It is almost certain that your baby does not have Downs syn . White spot or echogenic focus in heart is not a very significant finding and not considered as an indication for further testing. The echogenic bowel though could be an indication of various conditions, like cystic fibrosis, Intrauterine growth retardation, viral infection. Do you or your husband have any family history of cystic fibrosis? Regular growth scans to see the growth parameters of this baby will be required through the remainder of your pregnancy. Maternal blood to rule out TORCH infections, and Part virus B 19 is also required. For the fluid around fetal heart please get a fetal 2D echo done to rule out any significant heart abnormality. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had unprotected sex on June 15th, I had a period starting July 3rd but I have been experiencing symptoms of pregnancy. I have also been experiencing this white discharge that has no smell and it does not burn or itch and is only visible in the morning and before I go to bed. There have been cases of pregnancy with a full period in my family. Is it possible that I m pregnant. ### REPLY: Hi, .  I welcome you to  VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. Furthermore, I will suggest you the best possible treatment options. In a woman with a regular cycle, day 10 to 20 of the cycle is the most fertile period of cycle.  Having unprotected sex in this period, increases the risk of getting pregnant. Day of unprotected sex act that you are saying falls before that. So chance of getting pregnant are less. Secondly, as you have got your periods, it certainly shows that you are not pregnant. The vaginal discharge you are experiencing can be physiological. If you are in doubt please do urine pregnancy test on mornings first sample of urine. I will suggest you to keep the private parts clean 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: 2 year old boy vomited yesterday for a while with fever of 101.7...after a few hours up and about and feeling like normal  a dose of tylenol last night. Seemed okay all of today, but recently started vomiting again with a fever or 96.6 under the arm. Is this normal? ### REPLY: Welcome to the ChatDoctorIt seems that your child has viral gastritis. I understand your concerns. Armpit temperature less than 99.5 degrees Fahrenheit is perfectly within normal range. You can take the following measures to help him:1. In case of fever episodes, give him Spy Acetaminophen along with sponging.2. Start an antacid such as Sup. Di gene or lansoprazole dispensable tablets(Landon junior) for gastritis.3. Spy. Risperidone or ondansetron will be of help to relieve vomiting episodes.4. Keep him well HY .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, sir  i  am 41, i  masturbation 4 or 5  or less times a year  But this last 6 month i had Testicle sweating when i go to Doctor she prescribe me Daktacort cream, when  start using after  1week my right start sweeling and pain, after this i go back to clinic and i had Ultrasound , the result is Epididmiys and still i didnt get any medication  til now  ,  i havent had sex But when i masturbat its become wars so , what it can be the reason  the , i am afraid the cream may it can Damage my Ferility,  Thanks ### REPLY: Hello, As per your history, it may be due to epididymitis. For further assessment you may require complete hologram, urinalysis, ultrasound scrotum after physician consultation. For that you may require broad spectrum antibiotics like definite after consultation. For pain, you can take tablet acetaminophen. Use scrotum support. Avoid strenuous activity. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband is in depression for last 5-6 years on account of lost of job.. at present he is at home and refuse to meet people in social life. in his depression he is being aggressive to our only 13 years old son every time and keeps on either beating or scolding. life has became unbearable how to handle this situation ? any medicine to cool down his mood? ### REPLY: Hi, I can understand the distress you might be facing due to your husbands problems. Depression can be a very distressing illness not only for the patient but also for people around him, especially for those who are involved in his care. I would suggest you seek a psychiatric consultation for your husband. Current lot of anti-depressants like Escitalopram sertraline, venlafaxine are effective options for depression. They do take time for showing their effect, and you will have to be patient about it. But they will definitely help in controlling depression and will help your husband face life in a more effective way. Hope this information was helpful. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: As an athletic 57 year old, I play competitive tennis 4 days a week and I run 3 days a week about 3 miles. Within the last 3 days I ve had ear pain ( throbbing ) and lightheadness on and off during the day.. My doc cleared out the ear wax but it didn t help. It just pulsates with pressure. Today I played tennis and had shortness of breath by the end of the hour. Could this all be due to allergies to pollen? The pollen is high here in Dallas. I played tennis yesterday and was fine. I also took 2 Mucinex tablets before I went to play today. Could that cause a shortness of breath? No stuffy nose but headache pressure and ear pressure. Help, Becki ### REPLY: HI, thanks for using  The headache pressure and ear pressure may indicate that you have a sinus congestion (which can be caused by pollen) and possibly an ear infection. The use of anti histamines, decongestants and possibly medication for an ear infection, if present, may be needed. Mucinex is not known to cause shortness of breath. If this associated with chest pain, palpitations, then you may need to see your doctor. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am an eczema patient and i have this since i was 2. I am currently 15 years old. My height is 5.5ft and weight is 65 kilograms. I would like to know if there is any way that my eczema would go away or a way to reduce it a lot currently. If my eczema would go, by what age would it? My doctors here told me it would go by the age of 14 - 15 but I dont see any signs of this disappearing. ### REPLY: Hi, Welcome to ....YOU SAID YOU SUFFER FROM ECZEMA... I think you may be having atomic diaeresis. Eczema may the presentation of atop. There may be some allergen responsible for eczema. Contact ants like house dust, housedust mite, pollens, grass,dog dancers, soap,detergent, perfume, wool.etc. may be considered as allergen. You consult dermatologist to have firm diagnosis. I would suggest as below.- application of steroid cream or tacrolimus point- antihistamines- steroids in tampering dose- antibiotics if needed- intradermal triamcinolone 10 mg injection-avoidance of contact of suspected allergensHave patience for the good result. Take long term treatment. I hope this would help you. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi im weng from philippines, 39 years old 150lbs and 53 in height,my query is,i have a round thick scaly thing or rash in  the buttocks first then now i have in my back and my legs but this round rash become pink after a few days and its not itchy,what is this thing? ### REPLY: Hello. Thank you for writing to us at  I will keep a possibility of Psoriasis Vulgarism. Psoriatic patches are red, well-defined and scaly. Scaling is white or gray, thick, candle wax type. The patches are classically distributed over extensors like back, elbow, knee. Itching is subjective. The diagnosis of psoriasis is usually obvious on clinical examination. Rarely a biopsy may be required to confirm a diagnosis. I suggest you to visit a dermatologist for a confirmatory diagnosis as well as appropriate treatment. Moisturizers are an essential part of treatment of psoriasis. Specific treatment of limited skin involvement with psoriasis is with potent topical steroids e.g. clobetasol propionate, clobetasol propionate and topical vitamin D analogues e.g. calcitriol and calcitriol. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am having a pain lower jaw after doing yoga is it a dental pain or muscle pull due to streching ### REPLY: Hello and welcome to , As you mentioned, usually yoga cannot cause any kind of jaw pain. This can be occurred due to-Muscle stretching/twitching during exercises. Dental infections underlying. An x-ray of the area will help to evaluate the cause of jaw-ache. Usually associated causes can be-Pericoronitis due to impacted wisdom teeth. Deep dental caries progressed into periapical area. Periodontal infection. Traumatic injury due to fracture of jaws. Please do visit a dentist and get further treatments based on the clinical examination. Meanwhile, maintain good oral hygiene. Avoid heavy exercises which can harm your physical health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir , o am facing pain in middle portion of stomach with burning sensation , in upeer abdomen , i am in medication for long time , more than a year , have done endoscopy also , report was fine , i am fearing that as bcz the pain and burning sensation in my stomach is still thr , can it lead to cancer , what is your advice , i have done endoscopy before an year ago ### REPLY: Hi thanks for your question.You are having pain abdomen and burning sensation. These are symptoms of acid peptic disease(APD). You had endoscopy one year back. What was your H Pylori status?(it is a bacterial infection of stomach picked up during endoscopy and is responsible for APD). Antibiotics itself can lead to gastritis (inflammation of stomach).APD usually don't lead to cancer. I would suggest you to consult nearby physician and get your H Pylori status checked by repeat upper G i endoscopy. You may need treatment for H Pylori eradication (if present) and gastritis. You should avoid other causes of APD like cigarette smoking, alcohol,spicy food and . Hope this answers your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sick since 14 started with repeated infections now 54 Diagnosed and undiagnosed with Lyme, MS, CFIDS etc. Bedridden about every 4-5 years for 6 months to 3 years. Recently added new symptoms of not being able to eat or drink without spasms in throat causing tightness and severe choking this was finally resolved after 48 days of no eating by the drug Librax/clidinium. I also have been having seizure like spells that look like grand Mal and include inability to move or talk afterwards. The now occur daily for up to an hour and start with extreme shortness of breath and nausea then some shaking and often progress to Grand mal looking spell. Also have new RA like symptoms in finger joints for last 3 weeks Any thoughts? I am considering going to Mayo clinic to get a diagnosis. Any ideas? ### REPLY: HIIT maybe some immunodeficiency. Complete blood count and immunoglobulin levels can be done to find immunodeficiency. If immunodeficiency is there, then absolute precautions must be taken to avoid any infections.  .  Also avoid unnecessary antibiotics unless really necessary and life-saving. The joint issues and brain issues may be coming from some lung infection. Kindly get re-checked for it. 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: hello!! i m of age 23 and my height is 5 4 and my weigh is 40kg.. i want to tell u that at the age of 21 i had suffered from TB got glands in small intestine and had got water in lower abdomen ,but i gone through my doct,and had cured from that disease at the correct time and now i m healthy..i want to know that i m getting married so could i be able to conceive after curing from disease? ### REPLY: Yes you can conceive even though you suffered from intestinal TB and now that it is cured there should not be a problem. There might be difficulty in conceiving because of the altered anatomy due to fibrosis and adhesions caused by TB in the abdomen, so might need help in conceiving in the form of follicular study so that you can know when exactly you ovulate so that you can time your relationship, otherwise there should not be much of a problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 28 year old male. I ve been noticing a dull pain in my pubic region. Upon inspection I noticed that it seems like the right side of my pubis mound is swollen. When I inspect it with my fingers I am able to feel something deep under the skin; it feels similar to feeling swollen saliva glands when I ve got a cold, however sometimes I can t feel anything. On the left side I connot feel anything like this. When I am able to feel it with my fingers it feels kind of spongy. The dull pain is pretty constant even during those times when I can t feel the swollen gland with my fingers. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have pain in the pubic region. Well there can be many reasons for symptoms you mention in query like endometriosis, muscle spasms, inflammatory disease, sexually transmitted, fibroid, irritable bowel syn .  I would suggest you to also consult gastroenterology for proper examination. Doctor may order endoscopy along with stool test. Doctor may prescribe  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 multiple rashes on my body and they are not hives, the look like shingles but dont hurt at all. I first noticed them a week ago on my bottom; I did not pay attention to it because I thought that it was only a heat rash but tonight I noticed that it has spread and worsen, and also is now on both of my arms; What could this rash be? ### REPLY: HIT hank for asking to ChatDoctorSuch kind of rashes is more common in viral infection Waite for few days if it is viral infection than will go away and if it is not the viral infection then you will have be examined, but before that you can try some anti-allergic medicine and the second generation antihistamine (Levocetrizine) would be best try this I think it will be light no need to worry have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i made a mistake by taking steroids when i was younger. (17) and now i am 21. my testicles are really small and penis. is it possible they may have stopped growing at 17? can i take ChatDoctor to jump start my growth. i cant grow muscle aswell really hard. ### REPLY: HelloThanks for query. Based on the facts that you have posted it appears that you have been taking steroids since last four years and have noted your testicles to be small, and your growth pattern is slow as compared to your age. Taking exogenous steroids disturbs a pituitary hypothalamus axis which controls the production of Growth hormone and Testosterone This results in to diminished production of indigenous Testosterone causing arrest in growth of the testicles and general growth of muscles and bones. Consult qualified Endocrinologist for examination and hormonal assessment and further treatment. Do not take any hormonal preparations on your own. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lower jaw is missing 2 teeth (one from each side). Dentist did some work on one of my tooth on upper jaw. Its been couple years. Last 2 months, I had a trauma closed head injury. I hit the top of my head right into a metal door with a high pressure/tension. After that, my head has been hurting really bad, including dizziness, vision blurry, and migraine. Could my upper jaw getting bad due to an accident of closed head injury? CT scan shows negative. As of now, my tooth on upper jaw (right) is hurting, and my right side of forehead is hurting too. Please advise. ### REPLY: Hello and welcome. Thanks for sharing your concern. As per the history posted here I can assure you that, the present symptoms related to your teeth are not related to your head injury. Since your scan shows no symptoms then you can be sure of any such symptoms. You can definitely get an orthopantograph x-ray done. This will show you the condition of your jaw. Rest, it appears that the symptoms are due to decay or gum problems. Hope it helps. Thanks. 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: Im having a fluttering feeling in my chest just under my breast bone to the left.I also sometimes get it in the right side of my neck.I have suffered from anxiety in the past but Im feeling fine at the moment.It mostly happens when Im sitting or lying and Im not active.It only lasts a few seconds.No other symptoms.I had it a few months ago but it went away.Is it just anxiety or should I go to my GP about it? ### REPLY: Thanks for your question on . I can understand your concern. Possibility of anxiety related symptoms is more likely. But better to rule out arrhythmia (rhythm disturbances in heart) because you are having left sided chest fluttering sensations. So get done ECG, 2d echo and Holder monitoring (24 hours continuous recording of ECG). If all these are normal then no need to worry about arrhythmia. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You will need anxiolytic .  Don't worry, you will be alright with all these Avoid stress and tension, be relaxed and calm. 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: hiAt very random points I get a very sharp pain in the back of my head behind my left ear. This just started a couple months ago. It doesnt happen very often but when it does happen its in the same exact spot every time, and doesnt last long at all, but is very sharp. like its there and then it gone. I havent had any head trauma recently so i was wondering what it could be. ### REPLY: Hello, You may have a stress reaction with your jaw such as clenching your teeth. This pressure can cause a radiating pain. Damage to teeth, muscles and TMJ (temporomandibular joint) can occur. The condition is known as bruise. There can be many reasons for bruise like stress, misalignment of teeth or problem in TMJ itself. The pain related to TMJ radiate to the entire face and even to head and behind ear. A night or causal guard can help reduce grinding habits. Consider scheduling a visit with your dentist for evaluation. A thorough dental exam with X-rays is recommended. Doctor may also do physical examination by checking movement of TMJ and may also order CT scan of TMJ. Doctor may prescribe muscle relaxant. For now take ibuprofen for pain. Hope your concern has been resolved. Get Well Soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear All, I had tiredness over the last three months and slight fever once / twice in a month. Last week i had a hight fever and when i went to doctor, after doing the physical examination, Doctor has told that my liver is a little enlarged and suggested blood test along with Liver Function Test. Test results shown that my AST, ALT and GGT levels are two times higher than the normal level. And doctor has suggested to stop animal oils and meat for a while and have give a tablet Livopill once in a day for a month. Now i dont feel fever but feel tiredness and a giddyness. Is there anything to worry or should i change anything in my lifestyle to come back to normal.Regards,Dinesh Sukumar ### REPLY: HelloIncreased ALT, GGT and AST with slightly enlarged liver may indicate liver injury, and it may be due to many causes like hepatitis, altered lipid profile, alcoholism,metabolic disorder etc. You may need few more investigations like routine hologram, random blood sugar, lipid profile, urine RE/ME and ultrasound of abdomen. I suggest taking tablet ursodeoxycholic acid 30 mg twice daily for three months. It helps in regeneration of liver cells. You should avoid alcohol if you take it. You should avoid high fat food like red meat, high fat milk products etc. Take a lot of fibers in your diet. You should increase your physical activity and go for brisk walk regularly. Get well soon. Take Care .  ### END