Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My upper back in the spine area hurts when i turn my head or try to get out of bed. I fell on my neck on a trampoline yesterday. I have no tingling sensations anywhere and everything moves fine. Could it just be a bruised or pulled or sprained "something"? ### REPLY: The most obvious cause of the pain is the trauma from the fall.  That is a delicate area to injure in the way you did so, any type of movement or manipulation of the neck could cause pain and discomfort. I would recommend having a doctor check it out to be sure you have not seriously damaged anything.  At the very least they will be able to give you specific instructions to rehab, possibly use ice to cool the strain down, and provide temporary immobilization IF that is considered appropriate for your condition. Please rate this encounter with a 5 STAR choice and if you have further questions please contact me at: XXX ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter was bitten by our puppy last august and went through a series of anti rabies injection...she finished her last injection in sept 18...and now she got a dog scratched in  her shoulder?  do i need to bring her to the hospital for anti rabies again? ### REPLY: Hello, Welcome to , Rabies is 100% fatal, but it is 100% preventable with proper and adequate treatment as she was bitten by a dog previously for which she was given full course of antirabies vaccine and now once again scratched by the dog, according to WHO classification it is classified as Re-Exposures. The Re-Exposures prophylaxis includes two doses of antirabies vaccine on days 0 and 3. The vaccine should be taken to the shoulder by intramuscular route. Even it is a cat III bite it will not require the antirabies serum. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , i am suffering from hyperpigmentation on my cheeks. Actually before 4  years ago was using betnovate-n but now i have stoped  use of it. please suggest me how to get rid from this problem. i am very much worried about my skin please tell me that  is this will go permanently.. ### REPLY: Hello and welcome to  Sun protection with a broad spectrum sunscreen is a must, throughout the day. A sunscreen with minimum SPF 30 would be good. You need to re-apply it every 2-3 hours for maximum efficacy At night you could use a skin lightening cream containing one or more of the skin lightening ingredients like comic acid, HY .  Chemical peels can be taken along with the topical treatment, and together they can produce remarkable improvement. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi....I have had bleeding gums for a very long time already but it usually bleeds not daily. However, recently, my gums have been bleeding almost everyday and the gums on some teeth are red and eroding . It doesn t just bleed when I brush my teeth. It bleeds just anytime. I am really concerned. Why is this happening and what should I do? Yong ### REPLY: Hi Yong, as you had already mentioned that you had a problem of bleeding gums from long, and you had not taken any treatment for that. Now, the problem has aggravated. I suggest you to get an appointment in dental office and get the teeth cleaning done. There is a problem called pyorrhea in your gums that's why it is bleeding. Get the scaling and polishing done, if the problem still persist then go for blood examination.  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: This morning when I awoke, my right arm was completely paralyzed. There was no tingling like when your arm falls asleep, it was completely paralyzed, I couldnt move a single finger. I picked up my arm & started shaking it with my other hand and within a few minutes it came back to life. I could not even feel the touch of my other hand picking it up ### REPLY: Hello, It is common and mostly due to nerve compression. It can happen due to pressure on nerves, and it is called as neuropraxia. I would suggest you to start taking Pregabalin m tablet one at nighttime and get your serum B12 estimation. If there is low B12 then you need to take 10 injection Intramuscular for ten days. Also, you need to take green leafy vegetables and pulses in diet. I hope this answer will be useful for you. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Can lisinopril make you dehydrated or have heat exhaustion while working outside in constructon? I am taking 10 mg and today while working I was dizzy, severe muscle cramps in arms, legs and jaw area, I could hardly walk, and felt like throwing up. I had been drinking water all day. I rested for a couple hours in the shade and then felt ok. I have been doing this type of work for over 25 years. ### REPLY: Hi, Thanks for writing to , I am . Lisinopril is used for multiple purposes like in Heart failure, for hypertension, diabetic nephropathy etc . Its side effects are hyper Alma, cough, angioedema, confusion, dizziness n so on.... as you are working on construction site . The sweating due to heat are more likely the cause of your dizziness rather than lisinopril, BCS it doesn't causes heat exhaustion, it is due to BCS of sunny day that causes it . I advise u to  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 severe sharp pain above my left ear. Like a vein in my brain is going to pop. its not costent. its sharp and im worried. ### REPLY: Hi, Thanks for asking the query, Pain behind the left ear can be because of different ailments. Tooth pain , Temporomandibular joint disorders , Bruise , Jaw injury, Neurological disorders like Glossopharyngeal neuralgia, Bells Palsy, Facial nerve paralysis. Visit to an Oral Surgeon and get complete evaluation done. Pain can also be because of ear infection like Otis media . Consult an ENT specialist and get checkup done. Hope this helps out. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir, I m AAAAA .My friend is suffering from a disease actually we were sleeping in a train suddenly he woke up ,cut me and laughing, after that i reached our destination and now again he was talking like sycho person and pick up bread from ground and eating it and lauging again and again. Please suggest me. Thanks & Regards AAAA mail id:- YYYY@YYYY ### REPLY: Hello and welcome to . Thanks for your query. This kind of abnormal behavior could be indicative of a psychotic disorder. However, your friend needs a detailed psychiatric assessment to make a correct diagnosis. Please take him to a psychiatrist for further evaluation and treatment. The earlier psychiatric disorders are detected and treated, the better is the prognosis. If he is refusing treatment and if you feel that his abnormal behavior may be dangerous - putting himself or others at risk, then you need to inform his family and appropriate authorities about this. Wish you all the best.-  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi me and my husband are currently trying for a baby. My usual cycle length is 31 days and we had sexual intercourse on the 13,14,15.18 and 19tg of July. My period was due to come on the 31st of July but didnt i am now 16 days late and have took 3 hpt all of whicChatDoctore back negative. Im a bit worried something is wrong as this evening i have had very sharp pains at the left side of my lower abdomen for around 3 hours it is not easing of but im feeling very worn down and tired. What could this be? And not sure whether to go to my gp about my period not arriving as i am not even having my usual pains to suggest its on its way. Please help! Many Thanks. Tanya ### REPLY: Hi. Thanks for your query. Since you have had sex during the unsafe period and also trying for a baby that means these were unprotected sex; Now that you are late by 16 days and urine pregnancy tests are negative, but there is a sharp pain in the left lower abdomen, the ectopic pregnancy in the Fallopian tube has to be ruled out. This can be confirmed by ultrasonography and the further treatment be continued as per the ultrasonography reports. You may need an urgent exploratory Laparoscopy if tubal pregnancy is suspected and confirmed ... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pulled my big toe cuticle and the root also came out. i could barely move for 3 day and then it got better. a week later i realized theres an infection so i started using fucidin 2/3 times a day. pain did get better but it wont go. if i press my toe or apply pressure it hurts. what should i do? im a male aged 34. ### REPLY: Thanks for asking in  forum In short: You may be suffering from parochial(infection of nail fold)Explanation: When ever there is injury to nail fold, this may happen. Continuous pain may be due to infection and abscess formation. So, go to our doctor for check up whether there is pus formation or not.  You may continue to use your ointment with some painkiller for the time being till you visit your doctor.  Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My step daughter is visiting on vacation.  We were having our nails done and the place smelt strongly of chemicals.  Here finger got a small cut and they put something on. At that moment, she says she got dizzy, couldnt see and got nautious.  I took her outside and had her sit on the ground.  She lay down for at least 10 minutes until her dad arrived and we took her home.  She has low blood pressure and anxiety, and she has had panic attacks in the past. When I Googled her symptoms, it came up with panic attack. I had just finished telling her that when my husband showed up, asked her what was wrong, and she began to cry.  Does this sound like a panic attack to you? ### REPLY: His understand your concern. It is basically stress reaction due to injury. Everyone has that type of reaction for a while got injured.These symptoms arise due to sympathetic hyperactivity and nor epinephrine dishrags from brain. But gradually it will decrease by time. No need to do extra treatment. It is not panic attack. Just do support to her and explained to her how this all occurs and common reaction. Strengthen her confidence. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 21 year old son stopped smoking over a year ago. He used to smoke 1 to sometimes 11/1 pack a day. he was also on medicinal marijuana at the same time. When he quit he had severe chest pain and a hard time breathing. He had 2 chest x-rays done and both were fine. He also had an EKG which was fine. Now a year later, he is still having chest pain and a hard time breathing. It is not as bad as it used to be, but it is still there. Any advice? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should rule out bronchitis in your sons case. Bronchitis is inflammation of airways and this is common in smokers. Symptoms like chronic chest pain, breathing difficulty etc. are commonly seen with bronchitis. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PUT (pulmonary function test). PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease and treatment is based on severity only. He will improve with inhaled bronchodilator and inhaled corticosteroids (ICS). Don't worry, he will be alright with all these. First diagnose him and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your son. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 4 year old .... yesterday he passed his stool after 2 days .... and did not eat anything after yesterday s lunch as he was very tired as we where travelling so he dossed off & woke up straight away at 7 in the morning & since then he s complaining abt stomach ache ### REPLY: Hi, There are many causes of abdominal pain in child .  These include: Pneumonia, dietary indiscretion or intussusception of the appendix (when one part of the intestine folds into an adjacent part) or blocked kidney.  To narrow down the possibilities additional information is needed. Does he have fever, vomiting, cough, runny nose, sore throat, skin rash, pain in other parts of his body?  Has he been exposed to others who are ill? Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI i am 36 year old, in a routine mri i was found non alcohalic  fatty liver with following liver test with sgot 139, sgpt 86, ggtp 97, bilrubin is normal , with mri i am found fatty liver with  mild hepatomegaly. my all hepatitis test is normal, wilson test is also normal. after taking medicine like usyles & NE 400 for six weeks and loosing 6 kg with very rigorous exercises my liver function test came back to border line like sgot came down to 36 and all other are also under normal. now my querry is  what is the current position of my liver whether have i got scarring in my liver due to 139 sgot and sgpt 86, ggtp 97 or i am still safe or i have reversed fatty liver or their cannot be scarring so early, what does it actually indicate, if scarring has happened what are the physical symptoms of scarring, how to reverse it completely , what are the therapy and medicine to heal scarring completely and how long it takes to develop chirrosis and how can i avoid chirrosis.how can i make my liver very strong. what nutritious food i should take and what should i avoid. i am doing lots of stomach crunches for weight loss in belly is there any risk.  pls help ### REPLY: Hi and welcome to . This is not some serious liver damage and this is just the beginning of liver fibrosis. The most common liver disorders are fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar. If ultrasounds didn't find anything and viral markers are negative then you have no reason to be concerned. You should treat it by changing dietary and lifestyle habits. Do exercise, avoid alcohol, smoking, fats, fast food and carbonated .  Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be prescribed, but I suggest going step by step. Sacrring is manifested by fatigue, jaundice, hepatomegaly abdominal pain and many other nonspecific symptoms. But you just need frequent follow up and you'll prevent serious liver damage. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mom has ascites and she is 74 years old, what other options of treatment are there to keep the fluid from coming back.  She has drained 3 liters of fluid off twice. she doesnt want to go through that procedure again because of the pain.  when the weather changes she can feel where she was stuck to remove the fluid.  they are also saying that she has a tumor on her ovaries and think it is some form of cancer.  she refuses biopsy because she is too weak.  she has no pain other than where she was stuck by the needle to drain the ascites. ### REPLY: Hello user, The ascetic fluids your mother is getting, are due to the secretions from the layers around the tumor, whicChatDoctores back sometimes, and the pt may require regular ascetic tap !! You are hereby advised to meet with an oncologist for terminal or palliative treatment for her tumor, according to type of tumor, which can be detected by biopsy/ excisional biopsy of the ovarian specimen. Hope my advice helped you. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has been having high blood pressure issues in the last few months. He has been seeing an internal medicine doctor for this, but we are not sure about him. My husband has had an EKG which was normal, a stress test that was borderline (showed some changes, but recovered quickly per his doctor), and lab work. He is taking Hyzaar/HCT, Cardizem, Baby ASA, and Amlodipine. Most recent BP was 156/90. He recently had blood work (last week) and his cholesterol was 300, his Triglycerides 1500. The doctor said he does not need meds for these levels. Here are my biggest concerns: My husband is becoming increasingly fatigued. He feels as though he cannot breath when laying down and sleeps sitting upright. He loses his breath easily and cannot do simple tasks such as climb the stairs without taking a break most days. We have gone to his doctor three times to express our concerns, however the only thing he has done is a chest xray. The doc told me it was normal, but upon reviewing is medical records, it actually showed Mild perihilar/bibasilar subsegmental atelectasis and parenchymal scarring change with associated volume loss. I looked online and it defined this as small areas of the lung collapsing. Should I be concerned and finding a different doctor? My husbands symptoms are not improving, just slowly getting worse. His doctor said it is only related to the high BP and will get better when they can get that regulated. ### REPLY: Thanks for your question on . I can understand your situation and problem. Following are the possibilities for your husbands CT thorax abnormalities.1. Chronic congestion due to high blood pressure and cardiac diseases.2. Lung infection3. Pulmonary fibrosis. So better to consult pulmonologist and get done1. Clinical examination of respiratory system.2. PUT (pulmonary function test)3. Recent 2d echo4. Bronchoscopy as and when required. If chronic congestion is the cause then he may need more diuretics to remove congestion from the lung. Antibiotics are needed for lung infection. So better to first diagnose him and then start appropriate 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: I have had a nri 4yrs. ago and have a broad based c5-c6 osteophyte complex with out focal disc protrusion or central canal stenosis. My neck pain is worse and it hurts to even hold my head up at times. My head feels so heavy. it is very sore in the back of my neck and i can not sleep with a pillow. Could it have gotten worse maybe need another MRI? ### REPLY: Hi, The symptoms which are getting severe are indicative of progression of cervical spondylosis. You will need a repeat-MRI scan and have it compared with the previous scan to measure the canal diameter and look for disc protrusion or nerve compression. A nerve might have got pinched as it emerges out from the spine which is causing the severe pain. It needs to be looked at and basing on the severity of symptoms you may need to undergo surgery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son is 18 months old he has been having bowel movements 4 to 6 times a day the past week and has developed a rash and is now bleeding because he poops so much its not getting a chance to heal and i keep putting a&d ointment on it. im thinking maybe not give him as many fluids and not feeding him as often and give more things like cheeze and things like that to maybe slow his bowels down but im not sure can u help me ### REPLY: Hi...it seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 painful lump upon palpation about 1 inch above adams apple on the left side. I have the same lump on the right side that is only slightly painful. This pain began 3 days ago. The location of the two lumps seem to be in the same anotomic region on both side. Any clue what this could be. ### REPLY: Hi, Dear,Welcome to . Based on the facts of your query, You seem to suffer from-Submandibular lymph amenities and could be due to intramural infective focus/ or could be due some viral infection lately. Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. suggests Good Day!!  . S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am trying to conceive a baby but no luck since last 1 year. So i started a treatment. Doctor studies my whole cycle starting from day 11th. After egg came to 17mm size, it still didnt ruptured so my doc gave me an injection for this and egg ruptured after injection. She told me to take dubagest-200 (progesterone soft gelatine gapsules 200mg) for 10 days asked to test pregnancy after another 4 days whicChatDoctores out to be 30th day of my periods. Today i tested and is negative. Is it possible that i might get positive result after 1-2 days? or will i be able to conceive baby? ### REPLY: Hi I think you can wait for 1 week and redo the test again. There is a chance of pregnancy in this cycle but its low around 5 percent. If egg has ruptured you can definitely become pregnant. Just do a semen analysis of your husband. You can try with medicines for pregnancy after consulting your doctor. These increase the chance of pregnancy. Hope I have answered your question. If you have any other query I will be happy to help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lastnight I got into a little fight I head butted the boy and his tooth cut the top of my head, where there was loads and loads of blood as much as covering my too and my face, I carried on the night and today have had a really bad head ache I didnt lose contious, the cut seems to be clean but is a bit of puss on the outside of the cut, is a deep open cut, I was just worrying about the tooth in my head and infections ect? ### REPLY: Hi, Thank you for posting your query.First, I would like to reassure you that with the description above, there is no possibility of any internal brain injury. I agree with you that there is a chance of infection in the scalp, as teeth are common sources of bacteria. So, you should start a course of antibiotics. For pain relief, you may take diclofenac tablets. Please get back if you require any additional information. Best wishes, . 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: I have a fallen metatarsal head in my right foot 2nd toe. I have seen a foot doctor about it as it hurts enough to have stopped me from running. I am in pain most of the time and am currently wearing a toe separator since my second toe is now leaning to my first and have begun wearing DANSCO shoe. I am also a hairstylist so I stand all day. Is there a fix for this problem or do i need to just adjust my lifestyle to prevent pain? ### REPLY: Hello, It looks that most probably you may have fracture or ligament injury. Both of them need some time (At least 3 weeks) for recovery. With present treatment You may also do following to have relief- -Take a good analgesic like aspirin, ibuprofen or paracetamol.-Do warm water fomentation over affected area, at least 3 times a day.-Do not bear weight over affected limb, at least for 3 weeks. 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 what i thought was a broken blood vessel on my stomach and turned out to be like a red blood mole and i scratched it and it was bleeding for like 2 hours last night and it stops when i tape gauze to it.  I was just wondering if i should just keep doing that tell it heals or go see a Dr ### REPLY: HiT hanks for your queryBased on your query, my opinion is1. Bleeding on skin should normally stop within three minutes. If it persists it indicates some bleeding problems maybe decreased platelet counts/ defective platelets/ vascular disorders.2. In your case it persisted for two hours which is abnormal. So you need to consult a doctor to evaluate the cause of bleed and appropriate course of action.3. You are not sure if it's a mole or just a tear. So It's important to know the type of lesion. That will help the lesion to heal faster as a mole can be excised so that you would not have this problem again.4. If its any other lesion, this would be confirmed with biopsy. 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 dont know, anxiety , pressure , thyroids, hypoglucemy, please help me im desperate My problem is quite long so please read it all, im desperate for an answer. Ok, it all started once when i was taking a shower, i almost faint because of the steam. This happened in november, and i could be fine in school until december, although i had some weird feelings which were related to the fear. Well, this fear wasnt that big, but when i finished school (december, i live in south america) i started to think: Anything can happen anytime, i better take care of my body and i started to overprotect it, like a hypocondriac, i felt some days i couldnt breath , one night, i really couldnt breath, i couldnt move, i was sweating, i was shaking, but yet, i dont know why i didnt ask for help. Ok so i managed to fell asleep and when i woke up i didnt have any of the sypmtoms just a little bit of nerviosism. After this i felt good for 1 week, when it started again, the feeling that i couldnt breath, so i told my mom and she took me to a doctor, he examinated me and said my heart and lungs were ok, very well, i was so happy it wasnt something physical but i told my dad, and instead of saying Thats great son!, he just told me But i dont think its that, i think its because you spend too much time on the computer This saddened me. Ok, i kept with my live until one day, my feelings returned, but this time it was in the morning, couldnt breath, sweating, etc. And my parents were crying because they said Oh how can we help him, we do not have money That worried me and the symptoms got much worse, we had to go to urgency, the medic who first examinated me, told me my problem was in my mind, and just to be sure, i got torax x-rays and an ECG because i had some discomfort in the left armpit. Both exams were ok, and i went home. Since then i felt better, but other symptoms appared, this time, weird feelings when i stood from a chair, like a pressure going up from my chest , it dissapeared in 3 seconds but it was discomfortable, i also had some discomfort at the sides of the forehead, i couldnt stand up sometimes. The worst of all is that my parents didnt believe me, they thought i was creating all this because i wanted, AND I WAS ON VACATION, why would i do that? But they kept not believing me, i didnt know how to act, if i showed a sign of my discomfort my parents would ground me. Some time happened and those symptoms dissapeared: the feelings on the sides of the forehead and the pressure going up. Some days later, i started to get like a vacuum on my heart zone, it was not pain, it didnt irradiate. I had some in my lyfe, like 1 per 2 years, and i didnt really care about it, but now i had 6 per DAY, and obviously, my parents were mad at me, but one night, i was shaking and sweating again, i could breath, but those heart sensations came every 15 minutes, and my mom was yelling at me that she didnt want me anymore to be her son, that because of me she had all her problems, and i didnt cry because i was worried about my heart, after 2 hours, my mom told me she would take me to the doctor. At the next day the doctor told me my problem could be intestinal, so i had a panendoscopy, which said i had gastritis , duodenitis, and the helycobacter pyrali, i started an antibiotic treatment, and the bacter dissapeared, all good there, but now i have other symptoms BUT, i assume my problem is my mind, i know im overprotecting my body with every thing i feel, i recognize it and im with a psychologist , im getting over it, but yet, i have some feelings and i attribute them to diseases. I have panic attacks and anxiety crisis, and im taking clonazepam for it. So please, to stay calm, can you answer this please? -Whenever i try to stand, it takes me a while, because i feel like enough blood was not getting to my eye inmediatly, maybe it not that, but i feel weird everytime i stand up, when im waking up i need to sit for 30 seconds before standing up. -Weird feelings in my hands, when im really nervous, and sometimes i get them too when im not nervous but not as big. When i press and rub my arms, i get this tingling in my hands -I know the bacter is over but sometimes i still feel discomfort in the area above the heart, like on my shoulder , my medic told me they were gases but i dont believe it that much, i know its not the heart, but it scares me -I ve had palpations for a long time, when i feel palpations i dont feel my heart pumping faster, i just feel it, mostly when i stop breathing when i want to really focus on something, thats when i feel it. - Most of the times after i wake up, i touch my chest zone and i feel my heart pumping fast, i dont hear or feel the palpations, just when i touch my chest, i feel my heart is pumping fast, with some breathing exercises i calm it down, but it scares me, if i didnt touch my chest, i wouldnt know my heart is pumping faster, its weird. -Recently ive been getting some discomfort in my back neck, its not pain, could this be stress? P.S I ve been recently diagnosed with astigmatism . And i really need help, i cant do my normal activities, i cant, all these feelings are destroying my life, please tell me what to do Im 16 years old, male. As my medical historial, i ve just had random bronchitis , but nothing more. My mom suffers from Osteoarthritis and instetinal problems, and my dad suffers from asthma . ### REPLY: Your problem is panic attacks. And I am feeling you are not getting the right therapy. I really want to help you. Which medicines and doses are you taking right now? Maybe I can e-mail you some techniques and medicines that you can procure easily. For the time being exercise a lot in evening and get a lot of sleep at night minimum 8 hours. . And avoid excess tea coffee or smoking. Good Luck!!!!!!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I had intercourse with my boyfriend around 2 weeks ago and we didnt use protection. He didnt put his --- in my vagina, but in the back, but it went in for around 2 seconds. I dont think he came in my vagina, though, but I am really nervous that I may be pregnant. I really cant tell anybody. How do I get rid of any chances of being pregnant!? PLEASE HELP. ### REPLY: Hello and welcome to . Thank you for your query. I would first like to state that if you and your partner practiced anal intercourse, there is no chance of pregnancy. This is not possible. But if you think during your sexual contact, there was a chance that your partners penis ejaculated inside your vagina, then the first thing you would have to do is to rule out/confirm pregnancy. This can be done with the help of a urine pregnancy kit, which can be done at home. This will have to be conducted either 20 days after your sexual contact or on the first or second day of a missed period. The most accurate result can be achieved with an early morning urine sample. Repeat this test 2-3 times to confirm a result. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you. 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: 6 month old son is drenched in sweat his temperature is 95 he has been drinking about half the amount of formula than he usually drinks. today he has been accepting 2 to 3 oz of formula every 3 hrs he is sleeping more today and his reflux is really extreme he had his 6 month shots two days ago ### REPLY: Welcome to the  I completely understand your concerns but don't worry. The symptoms are most likely due to viral illness which improves within a few days. It needs good HY . But if the infant seems to be very lethargic and oral acceptance is markedly reduced then do go for a proper clinical examination by a pediatrician to rule out other illnesses such as meningitis which can occur as a rare complication of vaccination. Hopefully this will be of help. 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: What is treatment for piaderma? I am 61 yoa, 5"6, 155, had ulcerative colitis for approx 20 yrs.  Recently had surgery for colon removal and developed piaderma.  Have been referred to a dermatologist but until then, is there any remedy I can do?  Is getting progressively worse, ulcers increasing and bleeding. ### REPLY: Hello, Welcome to , Pyoderma means pus in the skin and can be caused by infections, inflammation and neoplastic etiologies. Any condition that results in the accumulation of neutrophil exudate can be termed a pyoderma. But in general practice most commonly pyoderma refers to bacterial infections of the skin. Normal resident bacteria of skin such as staphylococci, streptococci, Micrococcus and Acinetobacter can lead to this condition. The treatment of superficial pyoderma is with appropriate antibiotics for not less than 20 days. Fluoroquinolone group of . Topical antibiotics may be helpful in superficial pyoderma. Bacitracin and polymeric B are more effective against gram negative bacteria, if it is the cause of infection. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a hard lump on the top of my spine between my shoulder blades, causing alot of neck and shoulder pain and numbness in right arm it has been there awhile but grown the last 6 months i am 33 yrs of ageits also causes pain down my back, what could it be ### REPLY: Hello! Thank you for the query. In this location most probable is benign soft tissues lesion which gives some compression on spine. It can be a debacles cyst or lipoma. Both are benign, and do not turn into a cancer. I suggest you to consult your doctor, have soft tissues' ultrasound to confirm this diagnosis. Such lump can be removed with local anesthesia and small incision. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have genital warts and i just got this cream called imiquimod 5% cream. Well i put it on some warts on the back of my penis and it rubbed against my balls. Well now my balls feel all irritated. Its really red and looks like its oozy. What should i do? ### REPLY: Hello, As you are already diagnosed as genital warts, I will advise you to continue use of Imoquimod 5% cream. Keep it at that place for 6 to 8 hours and after that wash properly. If scrotal area is involved, then I will advise you to use cotton gauze pieces after consultation. You have to use continuously this cream until it completely Heals or going to off. Keep that area clean, wear loose undergarments, and maintain proper hygiene. I will suggest you to review here with detailed history or consult with the dermatologist. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My name is Bogdan Tiu and since friday I have the pulse high  between 83-103 with oscillation. I have made an EKG and the answer was that is nothing abnormal. Can you please advise what I should do in this case? I have take some pills based on natural ingredients (garlic). Is this enough? I should do something more? Blood pressure is also between 140/83. Thank you for your answer. ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. You should not worry. I'll try to explain you something and give you my opinion. Normal heart rhythm range between 50-100 beat for minute in normal conditions. If it exceeds 100 beats for minute in a normal rhythm we call it sinus tachycardia. Sinus tachycardia might happen in different situations. Simple emotional stress or physical activity might give fast heart beats and this is quite normal. Excessive coffee consumption, energy . There are also some pathologies like anemia, hyperthyroidism that might be the cause. So, in my opinion a frequency between 80 and 103 it is nothing worry about. The fact that you have already done an electrocardiogram, and it is normal it's a very good thing. But, if I was your treating doctor I will recommend some other examination like a cardiac echo to evaluate heart function and valves, a full blood analyze to exclude anemia, hyperthyroidism and of course a holder rhythm monitoring to see your frequency during day and night. After this we can better judge how to ménage this frequencies.  Meanwhile, avoid caffeine products and energy  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a personal trainer what sort of resistance training program should i focus on for someone who shattered their tibia, fibula and femur in a car accident twelve months ago. they are able to fully weight bear on their leg but cannot do any high impact work. ### REPLY: Hello, As the person had a fracture 12 months ago, I think an x-ray or CT should be taken before starting any high strenuous workout. In most cases, the bone heals better but always have to start with low intensity and modify to high intensity over a period of 3-4 months of time. As we need to first improve the overall composition of the bone and make it ready for the stress and strain. Understanding the biomechanics of the bone is important before doing any physical exercise which is mostly into the training program. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir/Madam, I am taking beetle pouch called Gutka since 10 years. Due to heavy load of work & tension I am addicted. Now I have bad breath and I want to wash my teeth. front 4-5 lower teeth are lose. how i can wash my teeth & cure from bad breath by myself without giong to clinic. ### REPLY: Hi! Welcome to . I read your query. As you mentioned your habit of having Gut, it leads to discoloration of teeth as well as inflammation of gums. It also leads to distinguish odor from mouth. You may have plaque and calculus deposits on your teeth that leads periodontitis as well as bad breath. I suggest you visit a dentist and get an oral prophylaxis. It may require more than one sitting due to stains. Also, you need to break your habit of chewing gut. It can lead to tightening of your cheek muscles and reduced mouth opening in the future, if that has not happened already. Maintain oral hygiene. Brush twice. Use mouthwash. Use non-sweetened gums or spray for good breath. Hope the answer helps you. 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: Last night I woke around 4 am because I had what I thought was a spasm in my lungs. It hurt so badly on my right side, it went up to my jaw and actually my gums hurt as did my ears.  I thought I had water in my ears they hurt so badly.  It lasted approx 1/2 hour and I was scared to death that I was having a heart attack, but the pain was on my sternum and towards the right.  I also have breast cancer, been going through chemo (Halaven). Had a oxgen test today - was 100%; had chest x-ray- nothing showed.  Do you have an idea of whats going on. ### REPLY: You probably had an attack of bronchospasm last night. You need to take bronchodilators at that time to get relief. Such attacks are not common either due to cancer or due to chemotherapy. You need to get pulmonary function tests to check lung reserve. Heaven is not know to cause such side effects. You probably had an allergic reaction. Re check your diet and environment and list of medications carefully and try to identify the allergen which has precipitated the attack. Be careful to avoid exposure to that allergen again ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I weight trained heavy (shoulder press) two days ago. I feel i may have damaged my tendon underneath my tricep. Straightening and bending the elbow is painless, so is flexing my tricep muslce. However when i twist my arm towards my body i get a dull painful stab in the tendom area? ### REPLY: Hello, What it appears to me is it won't be a tendon injury. Rather it will be a ligament sprain. Because your flexion and extension movements as you mentioned are pain-free we have to discard the tendon injury.  Also, you mentioned that rotational movement is painful That is because of the ligament injury or maybe muscle getting squeezed in that position. Using a hot water fermentation and avoiding doing exercise for a week or so should help it heal. Once healed you can go back to physical exercise starting with free exercise initially to gain muscle torque and then onto weight-bearing. Hope I have answered your query. Let me know if I can assist you further.  Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi ...i am a married girl of 23 years i just had an abortion due to some reason and now my doctor has advised me to take femilon for 21 days to regularise my periods.i dont have any child now and want to know about the side effects of ocp"s.please suggest me that should i start taking it or not? ### REPLY: Hello dearUndestand your concernFemilon is newer contraception pill and has very few side effects. But remember, you should take regularly at specific time. (make habit to take regular by putting reminder in mobile), So you can take it safely to regularize the period. Following are minor side effects: weight gain, change in appetite, breast changes, tenderness and soreness, bloating, nausea, vomiting. But it is different from subject to subject, and you can reduce by taking at specific time. Hope this may help southeast 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 had my first molar (upper-right side) extracted Friday morning. I have been using mouthwash (scope and cepacol) following the first 24hrs, diluted to start and now straight from the bottle. My GF told me to stop cause it could STILL dry out the clot!! I hate the taste of the saline water and have been using the mouthwash after every rinse. Should i stop? thanks ### REPLY: Hello and welcome to  forum, I would like to inform you that using a mouth wash 24 hrs following extraction is good as it has antimicrobial action which enhances healing. I would also like to advise you not to overuse the mouth wash as it can cause . Kindly follow the instructions given by your dentist and follow up after a week. I hope this answer was helpful. I wish you good healthcare care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I had Salmonilla in my blood as folloing:AH: 1/80BH: negativeH: 1/80O: 1/160However, I didnt feel any of its known indications. I stsrted remedy using cebrofloxacin four days agoo. How long should I take medicine? Is it safe to have sex with wife? ### REPLY: Hi, Thanks for writing in to . I understand your problem and will try my best to help you out. A single Tidal test donor exactly provide the right information as it interprets the antibody title to the specific antigen which may not be very high at the first week of infection. Hence 3 -4 tidal tests at regular intervals is more helpful.Hence, doctors usually recommend :1. Tablet of ciprofloxacin and tinidazole combination taken twice daily (morning and evening) for ten days.2. Proton pump inhibitors like pantoprazole 40 mg at least half an hour before breakfast daily once for ten days. These are prescription medications, so please consult a physician. Take lots of fluids and a bland diet. Yes it is safe to have sex with your wife however, I would suggest let the treatment be over. Hope this answered your query. 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: Hi, My father is 70 yrs of age and has a cretnine level which fluctuates between 2-5 and 2.9 with Blood Urea levels between 50 and 90. For the past one month he is having on off fever which ranges from 99 to 100. Blood/Urine tests have been done and only the WBC levels are slightly higher 12.42. ### REPLY: Hello, THX to contact us. I understand your concern. If I am your doctor I advise you that you must have a Urinary tract Infection as indicated by high WBC count. Because of this infection creatinine and urea are not getting cleared up by the kidney which results in the increase of both in blood. Kindly take antibiotics to treat the infections. Also give constant look over the urea and creatinine level, increase in any parameter will be seriously taken and looked after by the doctor. I will be happy to answer more of your concerns, kindly know me, Wish you a very good health at . . Infectious Disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor, I underwent CABG in 2006 and I am taking the prescribed medication like Meto-ER, plagryl, atorlip and repace regularly. My periodic health check-up shows normal result from the hospital where I underwent by-pass. I have diabetes since 2005 for which I have been prescribed to take reclide-40 at morning and night, which was keeping me fine till 6-month back. Thereafter, my blood sugar level shot up to over 300 mgdl and the doctor changed me to Glycomet GP1 (500 mg) one in the morning and one at night. While my fasting sugar is in the range 80 - 105, my pp shoots up to 300 by 10:30 am and slowly reduces to around 200 by evening. I have continued dizziness during the day till evening and I become reasonably fresh between 7:30 pm till about 2:00 am next day when I go to bed. I am 61-yrs and 85-kg, 5 3 ht. Can u suggest ways to control my pp and solve my giddiness.Ananthanarayanan ### REPLY: Hi, thanks for posting in  I have understood your concern 1. Your post radial sugars are high so you need increase in the morning dose as a tablet or basal insulin. I can suggest you to take tab.januvia50mg once in the morning, recheck the sugars after one week and needs dose adjustment. If not getting controlled with tablets, better to take low dose basal insulin.2. Reason for giddiness may be due to hypotension or vertigo.  Or uncontrolled blood sugars, or I can suggest you to get done CZECH BP check while having giddiness tab.vermin 8 mg twice daily for 5 days3. Your weight is more and that is also contributing to uncontrolled sugars suggest you to reduce weight by regular exercise and diet control. Hope this helps you any further questions please let me know 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 took almost two weeks ago the morning after pill because the condom broke.Yesterday I did just one test because I was feeling nautious and had stomache. It was positive. Could I be pregnant or could it be a false positive? Should I try another test? ### REPLY: Hello, Thanks for sharing your health concern with us. If you tested positive with a standard test kit, you need not repeat the pregnancy test. Instead, see a specialist for a proper clinical evaluation and go for a sonogram of the pelvis, preferably in the trans-vaginal route, to confirm the gestation sac, the location, the age and the viability. Emergency contraceptive pill offers 85-98 percent protection depending on the time duration elapsed after unprotected intercourse. Please plan further management after review. 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: my-7-year-old-c/o a-stomach-ache almost-everyday-she-says-she-throws-up-in-her-mouth at times.  She is on singular 5mg daily and uses an inhaler prn. She has asthma under good control.   Any suggestions. she does pass stool almost  every other day.   Any suggestions.  Thanks,  Sandra RN ### REPLY: Hi. Thanks for your query about your 7-year-old daughter. History of asthma and treatment and present complaints noted. The commonest reasons for pain in abdomen and reg urge in mouth or vomiting are as follows:-Tummy tonsils-meaning enlargement of the lymph nodes of the abdomen.-Appendicitis- by default this has to be ruled out in every case of pain in -abdomen of a child.-Worms. The best diagnosis is a high resolution ultrasonography. Some blood, urine and stool tests. A therapeutic trial with a course of an antibiotic, metronidazole and probiotics under the guidance of a pediatrician / Surgeon always helps to solve the problem and to get a diagnosis. Also given is a dose of medicines active against worms in intestine. I hope a consultation with a Pediatric Surgeon, investigations and a course of an antibiotic and metronidazole should solve the problem. If this is indicative of appendicitis, please go for the surgery of appendectomy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffered a back injury like 9 months ago was pinned by the door of a car apon inpact ,he was a pedestrian anyway he has a total loss of 7 disks 1 buldging and herniated and is in extream amounts of pain if you put degenerative disk disease and drop foot and spinal stenosis all toghther this is what you get?????? can you help we have no insurance but the accident was covered by car insurance, we have an attorney handling it but my husband was in such screaming pain that we called an ambuluance he could not walk and they even did an m r I in the er and then did nothing gave him a script for 5 mg oxycodone 21 of them it was total bulshit and a waiste of time any suggestions ### REPLY: Answer: Hello, Thank you for using . I read your question and understood your concern. I think you may have disc problem so meet a spine surgeon get examination done followed by x-ray and if nothing found get fresh MRI now as it will give present day status of spinal cord and its compression status which helps to come to a conclusion there might be an unstable spine after trauma and needs MRI for confirming ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I feel a sort of like a narrow canyon or crack inside my mouth in the cheek part. What is this? I googled and linea alba showed up. It says that linea alba feels like a narrow ridge but what I feel is curved inward not outwards like a ridge. Both sides of my cheeks(inside the mouth) has these line. What is this?? ### REPLY: Hello and welcome. Yes the curved lines or ridges that you feel and see within your mouth along the cheek is line Alba. It is a kind of ridge between upper and lower jaw. In some patients, it is quite obvious while in others it is mild and less felt. Please do not worry, it is a normal phenomenon and present in every individual. It should bother you only if you bite on it accidentally, else not. 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: Hello Doctor,    I am presently in US(Boston) with my family having a 14 month old baby girl named Ninitha. My kid has just arrived from India . So we went for a normal check up for my kid to a pediatric consultant. As per their procedure they took TB skin test which exactly after 49 hours resulted in around 10mm of small red spot and said the baby has positive infection on TB. Then adviced us for an Xray and the Xray result was negative.    So the doctor has prescribed isoniazid syrup 10ml daily once for 9 months. I have not started the medication I am really worried if my kid is really infected. I studied that the BCG vaccine which is given in India during the first few days of birth will also result positive skin test. Please need your advice . Kindly help Should I undergo QFT Gold test which would confirm infection. None of my family members have any symptoms of TB . Also I am relly worried of the side effects of consuming the syrup for 9 months without an infection. ### REPLY: Thank you for asking quarry. Nice description, i think you studied nice for the subject. According to Indian guidelines if the child has the following then its need to beinvestigated--persistent fever or cough x 2 weeks--loss of weight--history of contact with TB Still i don't think it's necessary to start medicines immediately. If still needed to do gastric lavage/bronchoalveolar lavage as next investigation or CT chest to find any focus, then consider for treatment. Hope you find this helpful. Rate the above answer if you like 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: My father has bowel cancer and liver cancer he has impallitive care visiting at home now.  He is to fragile to have chemo any more, but he is putting on weight but his bowel movements are more frequent in the evening how long do you think he has for his journey here on this earth ### REPLY: Hi, Thanks for writing in to us. Sorry to hear about the disease progress in your father. Cancer staging is important when evaluating treatment options. If your father has been told to be taken care of at home then it might be stage 4 bowel cancer. In this stage the survival of a patient can be 6 months to 2 years. It is important to know where the cancer has spread. The survival can be increased by taking care of him better and helping him reduce the pain. Please give him adequate pain medicines and if he is unable to hake normal meals then providing small meals frequently might help. 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: Hi,I have bow legs, and the distance between my knees is around 4 inches with my feet together. I have pain when standing or walking for long periods of time, and i read that bow leg correction surgery would fix that issue. However, would the surgery lead to a height increase? ### REPLY: Dear patient, Thank your for your question. To answer the first part of your question here is a little summary of how the operation worksite surgeon makes a small incision though the skin and a partial cut in the bone. After the leg has been straightened, the orthopedic surgeon applies an internal rod or an external device called an external fixation. The external fixation is like a scaffold outside the leg. It helps straighten and support the leg through the healing process. Bowleg correction surgery takes about an hour in the operating room. Most patients spend the night in the hospital and go home the next morning. A cast is not necessary and patients are encouraged to walk and put weight on the leg almost immediately. Most people are able to walk without crutches and have little or no pain. Some patients with bowlegs report pain in the knee that typically disappears after surgery answer the second part of your question Yes you definitely will increase in height at by a minimum of 1.5 inches I hope this helped ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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! M a famale 29 years old. My question is ... In my family there is a history of menatlly challenged male birth,so now I am married n m worried that will my child will also be the same.. are there any test which can tell me that my child will not be mentally challenged. ### REPLY: Hi, Thanks for the query. I understand your concern.  Meddles law of inheritance says if one parent has family history of any disease (& is confirmed by chromosomal analysis to be carrier) & other parent does not have it their child has 50% chances of getting the disease. In case you are not a carrier still new generation would have 25 % chances of getting the disease.  According to the law, provided your husband does not have any family history of mental illness.your would be child .  This possibility can be excluded / confirmed by chromosomal analysis of the fetus by amniocentesis during the pregnancy. So every time you are pregnant, you should exclude the possibility by chromosomal analysis & then continue with the pregnancy.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have scalp psoriasis ..I was using topical shampo...I recently went to a water theme park...after that iam finding my scalp psoraisis is returning and white patches are coming ..though noe it is in mil state...Also i have psoriasis in my elbow and knee . ...Pls suggest we what need to be done to prevent it...What ointments, medicines..i should use for my scalp and knees ### REPLY: Hi, To keep psoriasis under remission, you may try these1) scalp-use a tar based shampoo. Also apply a steroid salicylic acid lotion daily over scalp lesions2) elbow and knee-use mild soap to bathe(dove, Venusian, detail etc.). Moisturize skin by applying rotary or moisture cream. Apply a steroid salicylic acid based ointment over the lesions. It is always better to use prescription . Hope that answers your query. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I Have been having pain in my left side since the middle of july it sometimes is shooting pains and it hurts for clothes to touch it,it also burns like if it was sunburned.I take lantus,and noverlinR ,also amitiptylin 50mg,sertraline50mg and Trama-Dol-HCL50mg for pain.Could it be any of these medicines causing the pain? ### REPLY: Hi and thanks for the query, This pain requires exclusion of an acute abdomen. An abdominal ultrasound and plain film of the abdomen deserve to be done accordingly. A complete blood count in search of raised white blood cells, A C reactive protein and erythrocyte sedimentation rates for acute phase reactants could be necessary to exclude an infectious process. Acute appendicitis, diverticulitis and infectious acute abdominal syn . I suggest you consult a gastroenterologist. Thanks and kind regards. Bain LE, 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: Hi, my name is Mrs.Farhana i am 30 having 67kg wieght. My last date was 1st January,2012 I am using (Dirogest 10mg) Once a day as per my Doctor s advice .. i need to know that how long i have to take this medicine is there any side effects..? and also please let me know that this medicine be helpfull for me getting pregnant. looking forward for a positive come back .. ### REPLY: Hi, Generally it is well tolerated. Digest is a synthetic form of female hormone progesterone that is commonly prescribed for delayed period, irregular or heavy menstrual bleeding, endometriosis and other conditions. By regularizing your cycle it will help in getting you pregnancy. To regularize the period it is usually given from cycle days 5 to 25. Its common side effects include nausea, vomiting, headache, and breast pain/tenderness. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m allergic to bleach. I get really sick (green phlegm ) coughing, and feeling weak. My mother-in-law used bleach the other day, and I couldn t get away from the smell. My cough is horrible and I ve been spitting up the green phlegm after constant cough attacks. What should I take to stop this horrid coughing and phlegm? ### REPLY: Hello, You are having hyperreactive airways and may indicate you have underlying asthma. However, bleach releases chlorine that is a respiratory irritant, and it does not necessarily mean you have asthma. If you do not cough most of the time and feel breathless when exposed to other types of smoke, dust you do not need a lung function test. A Chest X-Ray is important to know that you do not have any lung patches or shadows and the source of the green phlegm. Sputum c/s is a must before starting any antibiotics. A combination of antihistamine and montelukast (Singular) with (as per sputum c/s report) +/-azithromycin 250 mg twice daily for 5 days. Avoid using cough syrups. 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 just noticed a small swollen area on the inside of my anus. It seems like it s filled with something pus or blood like. I ve been messing with it and it s gotten a little bigger. It hurts mainly when I cough or sneeze and when my anus contracts. I had sex the night before with a condom and it was not anal sex, but vaginal. I m concerned what this may be. Is it an std or is it something like a hemorrhoid or anal abscess? Please help ### REPLY: Helots swelling may be :1 Fissure in anus .2 Hemorrhoids 3 Abscess. But merely according to this history it is very difficult to establish any diagnosis. Physical inspection is important, so in my opinion consult a physician and get his opinion. In my opinion this is not an STD (protected sex vaginal) . Since this is very painful so may be anal fissure. Good luck. You can use lidocaine cream for local application for pain relief. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi I am suffering from a 2mm  stone in left midpole of kidney exactly a year later.last one 3mm same place,stent was inserted.have been on cystone for 6-7 months now.can I now take cystone in conjunction with uralyte u to try to dissolve this one.trying to avoid another stent if possible.please advise. ### REPLY: Hello and welcome to . As a Urologist, let me assure you that, 2 mm and 3 mm stones need no treatment.  They flush out in more than 90% people, just by .  Always get treatment from qualified Urologists.There's absolutely no indication for stenting, as kidney cant get blocked by such tiny stones.  You can stop the cyst one tablets and just repeat the ultrasound scan, after a month or two, to confirm, stones have flushed out. In case of doubt, you can send the scan report to me, as a direct 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: I have been having upper left quadrant back pain at the base of the rib cage and radiating around the side. I thought it was a pulled muscle but it is reduced with anti inflammatory medications or ice. It is becoming increasingly painful and makes it hard to breathe when it shoots sharp pains. ### REPLY: Hi, thank you for providing the brief history of you. A thorough clinical examination is advised as you have pain in the left qua .  So to rule out this issue an ultrasonography of the abdomen is advised. Also, painkillers are symptomatic till the body becomes stronger to hold on its muscles and heal the pathology. If the ultrasonography reports turn negative then it will be related to Spine and needs an examination. Treatment:most patients in my clinical practice are advice to physical therapy, and they respond well with therapeutic ultrasound therapy, TENS therapy and exercises. Regards Jay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having trouble for about 7 months. It started out that I would get confused a little very rarely. I thought that it was just dehydration . Then about a month later I started getting dizzy and confused a few times a month. Then all of a sudden it hit hard. I could not make sense of things. When I spoke I was saying the wrong words. Finally my mind seemed to give me trouble constantly. My speech was confused, my movements were off balance, I would forget things that had either just happened or I d forget where I was, and when people would talk to me I had trouble understanding what was being said to me. I have had a ct scan whicChatDoctore back fine, an EEG that came back fine, and a balance test that showed that my left side was weaker than my right. I ve lso lost little bit of my hearing . The neruologist that I ve been seeing has put me on Welbutrin and just said to keep coming back every three months. But I keeps getting worse. ### REPLY: You must have a repeat consultation with your neurologist and possibly get an MRI scan even if your CT is normal. This is especially because you have hearing loss and weakness in one side of the body. Your symptoms suggest a possible temporal lobe epilepsy or CP angle pathology which requires investigation. If the MRI is normal, ruling out cerebello-pontine (CP) angle pathology, I would even suggest a video-EEG telemetry which, if lucky, could record one such episode of confusion. Sometimes complex partial seizures can be missed on routine EEG if the source of seizure in deep in the brain or in the temporal lobe. Video-EEG may be more useful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had contant headache and fatigue for the last 2 weeks. About 4 days ago I discovered a red bump on the roof of my mouth and the roof of my mouth is purple. There s also purple vains on parts of my gums and in my throat. It really hurts, most of the time. Any advice? Should I see a doctor ### REPLY: Thanks for your query, I have gone through your query. The bump on the floor of the mouth can be because of the tooth infection resulting in periapical abscess formation. The vagueness and headache is not related to this. So consult an oral physician for the swelling in the floor of the mouth and for the headache and fatigue, consult a general physician. Meanwhile you can take a course of antibiotics like amoxicillin and metronidazole(if you are not allergic)I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had anti rabies vaccination in November. Yesterday while feeding a stray pup got needle like prick sensation in my finger by the pups teeth . There was absolutely no bleeding and no pain at all except the prick. Do I have to take vaccination again? ### REPLY: Hi and Welcome to . I appreciate your concern for the dogs teeth prick. Since you have already received anti rabies vaccines last November, you need to take two booster doses of Anti rabies vaccine on days 0 and 3. Even though there was no bleeding or pain at all, but the fact that the saliva of the biting animal contains the sufficient amount of rabies virus, so you need to have protection again. Hope this answers your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I got married before 3yrs. we dont have baby..i had polycyst in my leftovary...taken treatment and its much reduced now..now undergoing treatment for the infertility ..last week i have taken injection for the egg ruputure as per the doctor advice. since 2 days i am getting severe back pain and a cramping pain on my lower abdomen ..please tell me whether its an serious issue or will it affect my pregnency.. ### REPLY: Hi Welcome to  PCs is multifactorial disorder which leads to an ovulation and infertility. Try to lose weight by diet control and exercise. Get your blood sugar levels done apart from other hormonal investigations. Symptoms (Pain) you are experiencing after taking  injection (for egg rupture) is suggestive of ovulation (egg rupture). It's a good sign and you should utilize this opportunity and have sexual intercourse to increase your chances of getting pregnant. Few women do not get any symptom during egg rupture and few get mild pain on one side of lower abdomen depending upon which side ovary is ovulating (egg rupture). If you can't bear the pain then consult your doctor. All the very 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: This is my mother s report. Kindly suggest what should we do: Hemoglobin: 6.1; Total Leucocyte Count: 4900 Neutrophil: 38%, Lymphocyte: 59%, Eosinophil: 1 percent, Monocyte: 2 percent. ESR (Wintrobe): 60mm, RBC Count: 249 Millions/cmm, Reticulocyte Count: 2 percent, Platelet Count: 177, MCV (Mean Corp Volume): 88.8 percent, Mean corp Hb: 24.5 pg, Mean Corp Hb Conc: 27.6, HCt (Hematocrit): 22.1 Report says: RBc s are predominantly normocytic hypochromic with mild anisocytosis . WBC s series show relative lymphocytosis. Platelets are normal in number and morphology, No atypical cell/hemoparasite seem She has mild fever from head to neck and chest congestion. Doctor has put her on folvite and iron for Haemoglobin and asked to do a repeat Haemogram after a month. Please advise what it could be. ### REPLY: Hello, Welcome to , From your blood report, it can be said that she is suffering from severe anemia. Polite and iron supplement does not give relief. She needs urgent blood transfusion. Consult with your treating doctor for this. About fever and lymphocytes, it can be said that there is viral fever.  A thorough investigation should be done to diagnose this as dual deficiency. Because in that case, in peripheral blood should show presence of hyper-segmented neutrophil.  HPLC should be done to rule out any type of abnormal hemoglobin. Bone marrow is indicated to rule out any sub-leukemic leukemia.  Consult with a hematologist for further management. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, My husband is type 2 diabetic from last 2 years. And his sugar levels are in control. he didn t take any medicine for last 2 months.. and his recent report for average blood sugar is 6.4, before fasting 140 and post food 150... what medicine is recommended to keep sugar under control.. he was taking carbophage 500mg morning and night.. He feels the dosage is more, please suggest. ### REPLY: Advise:1. Diabetic diet, i.e. no to sweets and eat in plenty all leafy vegetables, sprouted pulses and regularize timings and quantity of meals.2. Regular exercise (Weight reduction if obese)3. Check Blood sugars after 15 days, if normal; check every 6months.4. Regarding dosage, you should consult your attending physician for adjustment of the dose.5. If a good control is maintained by a very small dose, then stop the .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi;; I am suffering from burning  my tongue and dry tongue  due to radiation  to head and neck problem...I had surgery on my jaw due to cancer ...Squamuse cell carcinoma.... i had chemo five fu last year and every thing was clean but I asked for surgery and after surgery I had 30 session of radiation for 5 minutes and it was low dose but after that I start having very bad pain in the area of surgery and dry mouth and tongue with burning sensation...I am wondering may be Is  due to lack of vitamin in the body because of not eating well due to dry moth..Oral rinse does not do any thing at all... ### REPLY: Hi! Thank you for posting in . These are after effects of radiation. .  The oral mucous membrane is also very sensitive to radiation. The glands might take anywhere between 6-8 months to recover. Visit your physician to rule out any osteoradionecrosis of the bone because you are complaining of pain in the surgical site. Keep sipping or gargling water or fluids very often. Ask your dentist for a soothing mouthwash. Hope this helps. ### END