Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mother is hemolytic ( auto immune hymolytic anemia) patient, taken steroid drug wysolane 10mg daily, she is also diabetic & BP patient. all under control now. from past 3 months she is having heavy hair loss. can you please suggest what might be the problem? and what i need to do? ### REPLY: Hello. Thank you for writing to USI suggest a possibility of Halogen effluvium, increased hair shedding being part of the stressful response to anemia. Hemolytic anemia causes transition of hair follicles from managed/ growth phase to Halogen/ resting phase of hair growth cycle. Once hair enters Halogen phase it is subsequently shed. Telogen usually begins 1-3 months following a stressful event (hemolytic anemia in this case) and may last for 3-6 months following which hair re-enters growth phase/ managed. Since she is on recovery path now and is on treatment with oral steroids for hemolytic anemia, therefore with time her hair fall would stop. Apart from a healthy nutritious diet I suggest that you add an Iron supplement and a Biotin supplement which would aid in faster recovery. These are prescription . Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello i have heart palpatations that come and go. I ahve worn the 24 hour holter monitor at least twice. I have also worn the event monitor amd had an echocardiogram. I have also had a few ekgs. They always tell me that they are an extra beat and i should not bet concerned. That come an waves a of a few days to a week. And may not happen for up to six months. Lately they have lasted longer and made me light headed. Why cant they figure this out and do somethng for me. They are affecting my sleep now as they are happening regularly in bed now inftheearly ### REPLY: It is common to have occasion extra heart beats. Unfortunately for some people it can interfere with sleep.  If you happen to have anxiety, this should be treated as this will help with sleep and the palpitations should affect your sleep less if anxiety is treated.  You can take to your doctor about magnesium and potassium supplementation and beta blocker if not on one, as these can reduce palpitation ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, yes i have all my fully grown teeth but i seemed to have a baby tooth inside my gum. And my dentist said that before getting braces that I needed to get my fully grown adult tooth taken out . what happens if I decide not to get my tooth taken out and just get braces? ### REPLY: Hello.thank you for sharing your problem with . Generally over retained deciduous teeth need to be taken out. In your case its orthodontic problem .and sometimes due to lack of adequate space permanent teeth need to be taken out too. In that case you can't skip extraction and go with braces only. You can get better treatment from orthodontist than general dentist. You can consult for further queries. 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 dad has been diagnosed with Ca prostate stage IV and His liver has also been infected.He is a diabetic and has undergone the first session of Chemotherapy last week.Kindly suggest a suitable diet for him. He is 75 years old and is otherwise quite active ### REPLY: Hi, Thanks for writing in. A sample diet for your father who is stage 4 cancer patient is given belowEarly Morning cup of tea (sugarless) with 2 plain biscuits like Marie or Thin arrowroot or RuskBreakfast2 Maratha with curd (no sugar) or 2 plain Otis with egg/ paneer or 2 idles with chutney/samba or 1 bowl of PMA or Fatimid mornings or a whole fruit (apple or guava)LunchSalad with Otis (2 to 3) or rice (1 bowl) with DAL/ samba and a cup of vegetable. Occasionally you can add some light fires in lunch. Non veg can also be added (2 pieces) or an eggAfternoonTea/ juice/ milk (sugarless) with 2 biscuitsDinnerSame as in lunch with slight variation. Dinner should be lighter than lunch ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 iam 29 yrs old. I had miscarrige one and half year back.We again planned after taking break of 7 months. now iam trying to concieve from past 9 months but iam not able to get. I have visited to doctor yesterday she has given me prodcutive F tablet and some tests. Please suggest me what more precautions shall i take ### REPLY: Hi, Thanks for your query. I read your query and I understand your concerns. Following is my reply:1) Get Semen analysis of your husband to know sperm parameters.2) Please get basic tests for your self as follows: On day 2 of cycle get FSH, LH, AMH. Get Follicular scan for astral follicle count. Get HSG (Hysterosalpingogram) to test patency of fallopian tubes. I hope I answered your query. I will be available for any follow-up query you have. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi , my father is 75 yr old , he is paralysed on right hand and leg before 2 yrs in 2010 january , he is suffering from weekness and walks with help of others and stick . is it cured or not in this age . sushma Agrawal Bhilai ### REPLY: Hi, Paralysis is caused due to damage to brain tissue in which tissue may not regenerate, so function may be achieved progressively, but function and control of distal components like feet and palm, may remain in some residual problem like skill and balance, coordination in feet and palm. I will say the first 6 months is very critical, if you do exercises well then we would have regained strength and power after 9 years in 2019, its already passed 9 years, function can be regained but JOINT control and skill will be a bit difficult, you need to continue physiotherapy treatment for years if you want to make him independent in his lifestyle. Hope I have answered your query. Let me know if I can assist you further. Hem ang S Jane, Physical Therapist or Physiotherapist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: On my back right above my tail bone and to the right alittle I have a quarter size bump. It hurts when its pressed on. My lower back around that area has been hurting for the past two months. And its not getting better. Do I need to worry. They have me going through physical therapy with different exercises. All its doing is aggravating it and making pain worse. What do you think? ### REPLY: Hi and welcome to . It is questionable is it subcutaneous lump or this is caused by bone pain. If you feel lump that hurts on touch It can be perianal abscess or colonial sinus and surgical treatment combined with antibiotics is the most successful treatment. You should consult proctologist for evaluation. If you have bone ain then you must do X-ray exam to see are there any degenerative changes. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, i was diagnosed with tinea versicolor years ago. I was told that it does not go away completely but if i apply sulfur that would help. However, sulfur smells really bad and the tinea mostly appear in summer. i am wearing t-shirts to cover up and i always try to hid my body. Is there any home remedies i could use for the fungus instead of sulfur to avoid smelling? ### REPLY: Hi dear I read your problem of Tina tricolor since 1yr and not completely go away. First u don't tell about your age because your duration of disease is 1yr, so some investigation is needed.1-blood sugar PP and fasting2-Thyroid profile3-GBP(general blood picture)Precaustions-AVOID SPICY AND PROCESSED FOOD IN UR DIET.EVERYDAY BATHING SHOULD BE NECESSARY BECAUSE PROFUSE SWEATING SHOULD BE ONE OF THE PALPITATING FACTOR. U CAN TAKE LEAVES OF NEED AND BOILED IT AND USED FOR BATH.TREATMENT-1-U CAN TAKE 2LEAVES OF NEED AND DIP IN ONE GLASS WATER AT NIGHT AND . 2-U CAN TAKE GANDHI MALAYAN 125 mg Three times a day.3-TAKE REPTILIAN(HIMALAYA) TAB(2) THREE TIMES IN A DAY.4-U CAN TAKE HAEMOCLEEN SYRUP (2TSF) IN A DAY.5-USE NEED SOAP DURING BATHING.  THANKS FOR QUERY. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am taking this medicine last one month..  I was having moodout, body pain, no apitite, sleeping tendecncy, not active etc.. Now I am little OK, but still some times feeling uncomfort.  I am 57 years old full time computer oriented staff working abrod.. Please help me.. My e-mail address  YYYY@YYYY ### REPLY: HIT hanks for using  I think, you are in mild depression. In that case, you can take low dose antidepressant after psychiatrist consultation. Antidepressant would help you to keep in good mood, and you would feel better. You can also try relaxation exercise like JPMR or deep breathing exercise. You can also try lifestyle modification technique that would keep to stress-free. In case, you need further help, you can ask. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is 2 almost 3 yrs old she has been complaining for about 1 almost 2 weeks now about her tummy hurts. The other day when complaining she was kneeled down pressing her tummy saying my tummy hurts. She seems alright she still plays runs around and is happy has no fever but throughtout the day shell tell me my tummy hurts maybe 3 times. And sometimes when shes playing or whatever ill ask her wheres ur ow wee at and she touches her tummy right in the center slightly above the navel and says right here. Now since yesterday she is coughing runny nose sore throat and no appetite at all and she has reddish purple under her eyes like she hasnt slept in weeks. I dont know if I should take,her to the hospital or not. Oh and she also has it looks like warts or something on her fingers around the nails and now they are spreading and getting bigger. ### REPLY: Hi....the tummy pain of two weeks just above the navel could be due to either mesenteric amenities or it could be due to a mild stomach flu. Coming to sore throat - I feel that your kid might be having a viral sore throat or a streptococcal infection. I suggest you see your pediatrician and get a rapid streptococcal antigen test done. If it is positive then she will require antibiotics. If it is negative then it might be viral illness and doesn't require antibiotics at all. 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...a few years bck..I had rct...n filling of one tooth side by it...till now I had occasional toothache. ..which automatically gets subsided on its own. .but since 2 days..I have mild toothache. ...which is very mild..n moreover it is at night while sleeping but since yesterday. .I m having headache. .which is severe now...I know. .I can feel. .its because of tooth ache..can u please help me to guide me over this. ..thanks ### REPLY: Hi. Can understand your concern. As per your complaint pain in a root canal treated tooth is due to infection below the root tips of the tooth. When the infection is mild there is some amount of pain and the bodies immunity plays its role to wall off the infection and cure. When the infection increases there is Abscess formation below the root tips of tooth and when there is no escape way for pus it creates pressure on the nerve fibers in the region and causes pain. Pain rising during lying done to sleep indicates that there is pus formation which causes more pressure while lying done causing increased painHeadache can be due to radiating pain from tooth and to cure it treatment of tooth has to be done. I would suggest you to consult a dentist and get an x-ray done to check for the level of infection. In case if there is abscess formation a 10 days course of antibiotics like Augmenting 625 mg twice daily and painkiller like Ibuprofen twice daily along with Pantoprazole 40 mg empty stomach in morning can relieve. But in case if there is no relief and the symptoms of pain aggravates or swelling occurs you need to get the root canal treated repeated, or the tooth needs to be extracted. Hope this information helps. If you find the answer helpful please write a positive review and click on found this answer helpful as a token of appreciation. Thanks and 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: yes my mother is 86 and have been on loritab for sometime for arthris, what is a naural herb that she can take without the narcostic affects that she is getting I dont get much rest at night from her having talking out of her head dementia. others have told me this is from long term use of loritab. ### REPLY: Dear, thanks for consulting, here r some domestic remedies which are very much helpful and free of side effects-1) METH powder- 1 tablespoon daily after breakfast 2) garlic - 5 gram sunthi-5 gram Burgundy- 5 gram make decoction of these three in 500 ml of water till it approx 125 ml of liquid is left, take this twice a day empty stomach3) SERPENTINE OIL MASSAGE4) HOT water+ salt- fomentation of the affected partREGIMENINDICATIONS(PATH)steam bath, fresh hot and easily digestible diet, carrot, meth leaves, green vegetables, garlic, onion, Karla, ginger, sushi, buttermilk, Tulsa, curry leaves, black pepper, hot water as . PREVENTIVE ASPECTS1. USE OF HOT WATER AFTER MEAL AS  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear sir, i had done my semen test as per the advice of doctor . its upto 40 to 50%. doctor advice me such medicine to take like ubi q 100, carnisure 500, beneficiale capsules and zifexim. sir i m taking this medicine but it affect adversly . so sir pls suggest this medicine are safe for my health or not. ### REPLY: Hello It is good that sperm motility is improving but still it is low. Normally total sperm motility should be at least 55 %. Your findings suggest 50% motility, so it is mildly low. Ubi q 100, carnivore 500, beneficial capsules are multivitamins and protein supplements, and you can take it safely. It is good for overall health.lifetime is an antibiotic, and it is used in infection. Besides clinical evaluation, you may need investigations like routine hologram, random blood sugar, ultrasound of scrotum. In your case, sperm motility may also be increased with general methods. You should take healthy and nutritious diet. Take anti-oxidants in your diet. Avoid smoking, alcohol if you take these things. Avoid wearing tight undergarments. If findings persists then you may need assisted fertilization techniques like GUI etc. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a interview this month and im already worried about it so if you could please advice if i can take any anti-anxity or any tablets which can help me to calm myself on the interview day. i usually get nervous,gt slurr voice and start shivering so please help me out. I do not have any medical problem im all fit. thankyou ### REPLY: Hi, welcome to  probably you are suffering from an anxiety disorder. Standard treatment includes counselling, and medicines like paroxetine, sertraline, fluoxetine etc. But these medicines may take 6-8 weeks to provide a relief. For an interview you can not use anxiolytic like alprazolam as they will make you .  A better alternative is propranolol (market name-inderal) 10 mg before the interview, (but if you have any other medical illness then it should not be used without consultation with doctor). Federal will be very helpful in relieving stress of interview by stopping symptoms of nervousness. Meanwhile, you should consult a nearby psychiatrist for treatment of anxiety disorder. Best of 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 Doctor, I am getting married on 30 Nov and i have started on Femilon medicine as an oral contraceptive . However, in this cycle i will get my periods on exactly my wedding date i.e. 30 Nov. I do not want that to happen, as it will be very uncomfortable for me during day-long and night-long festivities. Can i prepone my periods by stopping femilon now, so that i finish my periods before 30 Nov? Please help. ### REPLY: Hi, I understand your concerns. Stopping Felon to advance your periods may not always give you the anticipated results. Instead of advancing your period, I advise you to postpone them. After completing the 21-day pack of felon, start the new pack the following day without any gap. Continue to take the pill until all the functions at home are over. Once you are free you can stop the pills. You will get your period in 3-4 days time (within a week). I hope I have answered to your satisfaction. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was brushing my teeth there was one spot that I felt just a tiny bit of discomfort.  Now, it is a little swollen behind and between one of my teeth, upper.  It almost feels like I burned it with something hot, but that did not happen.  I was just at the dentist for xrays, cleaning etc a couple weeks ago and all was fine.  Is this something that will most likely go away? ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have mentioned that you have swollen gum between upper teeth it can be due to periodontal problem or due to gingival Abscess. Do warm saline gargle two - three times a day.  You can apply ointment Gum paint on painful gums twice daily. Consult dentist and go for Curettage, if it is carious then go for Root canal treatment. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell 4 days ago landing on my right knee, I had a very large lump forming as I was sitting on the floor and skun my knee in the process, I can walk on it but is getting stiffness, and is still warm to touch even though I ve been icing it. I now have bruising forming around my ankle. My knee is very dark purple still and red around the knee cap... what else could I do, maybe I did tear something but am walking ok, just having trouble bending it. ### REPLY: Welcome to ChatDoctorDue to your injury there must have been some bleeding in the joint(arthrosis) which can cause knee swelling, pain and redness. Also, some small fracture or ligamenta tear can cause same problem. You need to take x-ray knee and see an orthopedic surgeon. This requires rest to the knee, anti inflammatory tablets and antibiotics if required as per examination and x-ray findings. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my father-in-law recently dyed his hair at a salon yesterday & today he has clear fluids coming out of his scalp continuously with red blisters. Is there anything over the counter we can purchase for him? He does not want to go to the doctor because he doesn t have health insurance. He s experimented with hair dye a few years ago with the same allergic reaction , but he said that time there was a stream of fluids coming from his head and even his nails fell off? Why he chose to dye his hair again? Who knows. Is there an indicator when the problem is serious enough to seek medical attention? ### REPLY: Hello, It is obvious that he has a delayed hypersensitivity to hair dyes (Type IV hypersensitivity) that takes a few hours/days to manifest and lasts for several weeks sometimes. He must take oral corticosteroids and can also apply topical steroid creams plus antihistamine tablets to control the current situation. Patch test MUST be done after a few weeks to know which chemical is causing this reaction as the same chemical can be present in several other substances like toothpastes, detergent, mouthwashes etc. 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 am 57 years old and I am a BP patient. From past few days i feel people laugh at my face. I feel that my lips are protruding out,but when I ask my wife and children they say your face s normal. I feel scared to face people as they laugh at me. Blood pressure is also increased. I had consulted a psychiatrist , he has prescribed nexito 20 mg,. Can you please give me a detailed explanation about the problem I am facing and is it fine to take this medicine? ### REPLY: Hello and Your whole problem is related to the psychiatry because you feel that all the people around you are smiling on you, but they are doing their job or talking with each other. It's only the feeling that was created in your mind, and you are tensed due to it and ultimately cause harm to you. Just forget about the world the live you life happily because there is nothing happened that changes your face. So just be relaxed and thing that every thing is already. The medication you are taking is quite effective for your problem but if you can change your mind and thing positiver than why we need medication. Hope you understand and help yourself. Best Wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been prescribed 14 days of Norethisterone prior to starting IVF stimulation. My husband and I tried to conceive on our own this month. There is only a small chance that I can get pregnant, and it s too early to tell. Is there a non synthetic alternative to Norethisterone that I should take instead, just in case? ### REPLY: Yes definitely. If you are sincere towards your notion to non-synthetic alternative, Ayurveda can help you. Ayurveda has some herbal and mineral scientific and time tested combos which help in maintaining appropriate functioning of reproduction systems which help in conception. Stepwise approach is cleansing the endometrial layers, regulating cycles and creating apt environment for conception and then nourishing the embryo. No invasive methods, no synthetic . ...only hero mineral Ayurveda. Yes, if you want your current regime to continue, you may do so but by giving some gap between two kinds of medicines. Ayurveda doesn't interfere or counteract in functioning of other  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 have 11 months baby boy. Now a days we had problem with his diet. His intake food was very low as previous.He hates to take food and prefer only lactogen milk that also very low content.One of my family doctor prefer "cypon syrup". Is this adviceable? please help me in this regards........ ### REPLY: Hi... At his age interest in play increases and interest in food decreases. This is quite natural. If he is active and playing around you need not worry. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed him and also make whatever you feed him calorie dense by adding good amount of ghee to it. PLEASE DO NOT GIVE ANY SO-CALLED APPETITE STIMULANTS LIKE CAPON AS THEY ARE NOT VERY SCIENTIFICALLY PROVEN AND THEY HAVE THE SIDE EFFECT OF EXCESSIVE . Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir am 22 yrd old, and i hav got tan on my forehead, chin,also there are dark patches encircling my eyes due to specs .m using clearxmax(hydroquinone,tretinoin,fluocinolone acetonide),hav noticed bit of changes bt red patches are cuming along with bit of burning sesation..is ti abnormal?? ### REPLY: Hi, If burning sensation is marked cream may be stopped and follow up with prescribing doctor or a dermatologist should be done. Retinoid and Acetone may cause these side effects. Meanwhile, OTC analgesics like acetaminophen can be used for anti-inflammatory response or pain suppressants unless the lesion s reviewed again. Hope I have answered your question. Let me know if I can assist you further. Wishing you a speedy recovery.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I developed a cough in December followed a few days later by cold symptoms. Chest pain and coughing up mucus so went to the doctor who said i had pharyngitis. 2 weeks after and still coughing i developed really sore ribs especially when laughing, coughing, sneezing deep breathing and lying down in bed. Went to the doctor who said it was the intercostal muscles and gave me pain relief and an inhaler due to shortness of breath. 2 weeks later due to not breathing properly i developed a chest infection given anti biotics. After a month of pain relief and still not much relief she wondered whether the pain relief (diclofenac) was causing reflux making the cough worse so prescribed some tablets to go along with it. The night time cough did disappear. Rib pain is still present when deep breathing especially when exercising. A week ago i really overdone it strenously walking and then 3 days ago developed a cough, that is progressivley getting worse. Last night it caused throat pain whilst coughing and a feeling of a lump in my throat and struggling to breathe took my inhaler and it actually relieved it all. Rib pain is now alot worse again and this is 14 weeks since the illness started. I dont understand why the rib pain hasnt gone and why this cough keeps reoccurring. ### REPLY: Hello After reading your query, these symptoms may be due to these possibilities, these include:1 Pleural effusion, diagnosis can be confirmed by X-ray chest and blood examination for CBC, ES R .2 Thickened pleura, diagnosis can be confirmed by X RAY chest .3 Asthmatic allergic bronchitis with tuberculosis. Since you are having these symptoms for December and continue for 14 weeks. In my opinion consult a pulmonologist and get his opinion (2nd one). Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doc, I was diagnosed with a cycst in my right ovary and also endometeriosis , I was prescribed a birth control pill border e for 2 months , my ovary cyst was gone in right one but again developed in the left , finally I was prescibed Diane 35and chrominac A my three month course is completed , What are my chances of conceiving now , I am trying for a second child my elder one is 10 and I am 35 years of age ### REPLY: Hi, Cysts in the ovary do not pose a very big problem for conception unless they are multiple or large; cysts due to endometriosis and polycystic ovarian disease may cause infertility. Your chances of conception depend on the ability to ovulate, normal tubal function and uterine response. If everything is normal, you stand pretty good chances of getting pregnant. You should get instructions from your doctor as to the need for induction and further follow up and follow the treatment carefully and with patience. 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 am manzoor..recently i had a root canal on one of my tooth.. before root canal i had swellings on one of my cheeks.. but the problem is the swelling is on opposite side to the cavity.. My dentist told that it is because i was eating food oneside for a longtime... The problem is still there after my root canal.. kindly suggest me something..... ### REPLY: Hi manor, Thanks for asking query, As the swelling is on other side there is very little chance of the swelling due to that tooth cavity, so it is not corrected even after the root canal treatment. There are many other reasons for check swelling like inflammation due to tuberculosis, syphilis , infected cyst, celulitis, perotitis, so should go for complete clinical and radiographic checkup. Until then take the antibiotic, analgesic course. Hope it will help you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had a pea-sized lump just under the skin on my upper arm for about a year now. It wasn t discolored or painful at all. The other day, I noticed that it was a bit larger and the skin around it had some redness to it. It doesn t hurt, but it feels sore to the touch. What could it be? ### REPLY: Hello and welcome to . I am . I have read your question and can understand your concerns. If I were your treating physician I would have examined that lump and looked for its mobility under the skin. LIPOMA is usually mobile under TGE skin and one can pinch the skin above this swelling. In your case inflamed lipoma would have been top on my list. Lipoma is benign condition and can be treated conservatively. If it is causing problems then surgical excision is done.I would have prescribed non-steroidal anti-inflammatory  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi I have 2 very small wart like skin tags when i pull back my foreskin in the centre of my shaft. I got full tested for STDs at my local clinic, including an examination and blood test but they appeared afterward, I have only had unprotected sex with my current girlfriend and we both got tested before having unprotected sex and we were deemed clear. I do have warts on my hands and on my pubic area that were there when i went for the test but nothing was mentioned. My partner hasnt noticed/had any appear, is there any chance theyre not genital warts? ### REPLY: Hello misunderstand your concerned small wart like skin tags in the center of the penis shaft mostly due to genital warts. It is transmitted sexually and cause by human papillomavirus. You should consult the dermatologist and need biopsy test and DNA test, STD screening that help to diagnose. Treatment is below:Topical: 80% Trichloroacetic acid gelid not respond you can do excision by nitrogen cryotherapy: very less scar after ablation other are electrocauterization and simple excisional take following advice:Avoid sex till you clear from infection, Use safer sex practice: Use condom, Dental dams, Maintain safe hygiene after settable ibuprufenHope this may help you Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am  a 61 year old female working in a professional field in the Midwest. I recently had injections for sacroilliitis that havent worked. I have a 10 year history of back pain include g a l4 l5 herniated disc and sciatica. Injections of kenalog and radio frequency nerve ablation worked well 5 years ago.  What can I do now? ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. Usually sacroiliacs pain will improve after corticosteroid injections locally. If not improving then it is not your cause of pain. For Lumbar herniated disc and associated back pain I advise NSAIDs like diclofenac muscle relaxants like thiocolchicoside and neurotrophic . Lumbar supporting belt is also helpful in many. I also send them for physiotherapy along with this. If there is no improvement or worsening of pain a surgical correction can be considered after an MRI of Lumbar spine. Hope this may help you. Let me know if you have any further query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a paranoia that i may be pregnant, I have a small lump on the lower left side of my abdomen, weight gain and im tired. I am also a college student who only gets about 7 hours of aleep a night. could I be pregnant or could it be something else? ### REPLY: Hi, Dear,thanks for the query to . I studied your query in full details. I understood the concerns you have. By no means the lump in the lower left side of your abdomen and weight gain suggests pregnancy. I would advise you to consult ER Surgeon for opinion on left lower abdomen lump and ER Gone/Oust Doctor and ER Psychiatrist if your doctors advise you so.Don't worry and things will be right after this check up. Your doctors would rule out pregnancy and would take all due care to investigate and treat it accordingly. Hope this would help your query to satisfaction. Write excellent review and hit thanks if this reply helps you out. Welcome for any further query to  and to me in this regard. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 very scanty hair and have grey also. But my hair dresser has advised me to use inoa hair color over henna. What should i do? i am 27 years old, 53 in height and have a heridatery of scanty hair. I started loosing hair after my baby was born and now my hair looks patchy. what do i do about my greying? ### REPLY: Hello and welcome to , You seem to be suffering from halogen effluvium or excessive hair fall, post delivery. This is normal and takes time for the hair to get back to its normal cycle of growth. In your case, the hair fall, maybe prolonged due to other factors as well, such as poor nutrition, stress, lack of rest, low iron and hemoglobin levels, hormonal changes, also any history of thyroid disorders etc. Dan . Also, since you have a family history of hair loss and thinning, you will be more prone to similar problems. These causes need to be considered and treated as they affect hair growth. You can consult a dermatologist regarding any tests that may be required to diagnose the causes. They can assess your hair in person and advise accordingly. For now, you may start a Recite solution or Tress go to scalp, along with hair supplements daily like VB7 Forte. This needs to be continued at least for 2-3 months to see results. Use mild shampoo and conditioner. As for grain of hair, it is better to avoid harsh chemicals. Hair supplements may also improve the grain. Natural dyes or ammonia free colors can be tried, after checking for allergies. Do start with the treatment as advised and see a doctor. If your hair is very thin and scanty on the scalp, and medical methods do not work well for you, after a few months of observation, certain new surgical procedures can be considered such as PRP, as will be advised by your consulting doctor after observation, if they feel that it will be a good option for you. Also get a good nutritious diet, avoid stress, pollution, get good rest. Hope this guides 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: stone in my mothers gall bladder has been detected 1year earlier.we tried a lot to convince a lot to operate stone but she is not ready to have this operation before december of this year.today she is suffering from pain in upper abdomen & backbone and also having the feeling of nausea......what to do???is it for gall stone??? ### REPLY: Hi.noted history of gallstone for over a year now. Yes, her symptoms may be attributed to her gallstone disease. It is best if you bring your mother to a doctor, preferably a general surgeon, for physical examination and clinical evaluation. Other things that must be ruled-out are muscular strain and stomach/intestinal problems. Diagnostics (such as ultrasound, liver function tests, blood count, etc.) and management (medical and surgical) will be directed accordingly. If it is indeed of gallstone in origin, definitive treatment is cholecystectomy (surgical removal of gallbladder) which may be done, laparoscopically (gold standard) or through open technique. Low fat low salt diet is also advised. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, I had unprotected sex with my bf 10 days ago.i took ipills.for the past 2 days am having my period but am not able to know whether its period or just bleeding due to ipills because less amount of blood is coming out. Could you please tell me how am i suppose to check it whether am pregnant or not. ### REPLY: Hello misunderstand your concerned you took I pill with in 24 hours of unprotected sexual intercourse then chance of pregnancy is only 4 to 5 %. Slight bleeding after I pill is common. It is breakthrough bleeding due to high progesterone in the pill. Period may be delayed by I pill by 7-10 days. If period will be delayed by 14 days from normal expected period date then go for urine pregnancy kit and or blood  to confirm the pregnancy. Hope this may help noncontact  for further health query Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: about a mnth ago my bottom right wisdom tooth was coming through and i ended up with what looked and felt like a blister on the gum. it disappeared after a few days. however for the past 2 weeks i have started biting my cheek on my right hand side whenever i close my mouth due to eating, smiling or talking. is this due to my wisdom tooth and what i can do to stop it as it is very painful when it happens ### REPLY: Thanks for your query, I have gone through your query. The cheek biting and the swelling of the gums over the wisdom tooth could be because of the peritonitis. Consult an oral physician and get a radiograph done to rule out whether sufficient space is there for the wisdom tooth to erupt. If the space is not available then you have to get the wisdom tooth removed. You can take a course of antibiotics like amoxicillin 500 mg and metronidazole 400 mg TID for 5 days (if you are not allergic). Do saline gargling. 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 have fatty liver grade-3 and my SGPT is high(63), and cholesterol level is ok. I have a slight pain at the right upper abdomen.My liver stiffness is 5.3 kpa. Doctor suggested to take Ursocal 300 twice after meal. I have read out the literature of Ursocal. It works on gall stones and also on cholesterol.I have not   taken the medicine yet. Will it be good if I take the medicine Ursocal 300 for the treatment of fatty liver? ### REPLY: Hello! Thanks for putting your query in . I am a Gastroenterologist (DM). Treatment of fatty liver:1. Avoid alcohol if you take2. Regular aerobic exercise at least 30 min/day3. If overweight or obese do reduce your weight by exercise and diet4. Avoid fatty meals5. Protocol is helpful. Apart from above measures which are must, tablet ursodeoxycholic acid that is protocol is found to be helpful6. Also take Cap Evian 400 mg OD. has some proven role in fatty liver hope I have answered your query and this will help you. Remain in touch and 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: I am a 32 year old male suffering from constant wheezing / asthama since 10 years and i am on a dose of seretide 125 mg daily . For four years I worked in the middle east(saudi arabia) and i never had an attack nor was there a need for inhalers.I have asked this question to a couple of doctors but the only answer i get is that you stay near the coastline in and more over in an indian metropolitan city with high levels of pollutions.This has always puzzled me since even in the middle east i stayed near the coast line with frequent dust storms . What might be the actual reason? ### REPLY: NOBODY CAN TELL YOU EXACT CAUSE NOT EVEN YOU CAN JUDGE WITH IMAGINATION SIT CAN BE ANYTHING ALLERGY CAN START AT ANY TIME WITH ANY SUBSTANCE AT ANY ANGELOU CAN GO FOR ALLERGY TESTS ONLY TO FIND OTHER ARE COMBINATION F MANY ALLERGENS WHICChatDoctorE AFTER TESTATOR FOODS YOU HAVE TO ELIMINATE THEM FROM DIET AND FOR DUSTS AND POLLEN YOU CAN HAVE Desensitization THERAPY TO CURE ALLERGIES MUST TELL YOU THAT ON COSTAL AREAS THERE ARE DUST MITES WHICH ARE MAJOR CAUSE OF ALLERGIES IN WORD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 son is 10.6 year old and has fever 101 but Paracetamol 250 is not improving the situation even after 2 hrs i mean fever is not coming down so Meftal P is the other option ... need to know the permissible time Gap in dosage between Paracetamol and Meftal P .... His weight is 25.6 KG ### REPLY: Hello, You are giving very little paracetamol to your son. At this age he should be taking 500 mg up to 4 times a day (every 6 hours) and not 250 mg. Give your son the right dose of paracetamol, and he will be fine. Do not use metal medicine for your son as he is too young for that. You can give him Ibuprofen instead, 400 mg every 8 hours, always in alternation with paracetamol, if paracetamol alone will not do the work. For example, If you give paracetamol at 14 o'clock (2 p.m.) and the fever is high (next dose of paracetamol will be at 20:00), then you can give ibuprofen at 16:00 (next dose of ibuprofen will be at 24:00) and so on until the fever will be dominated. 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 ws sufferin from.typhoid 1/320 10 days agobut afyt medicinal.course it comes norml 1/40.But still i am having fever fluctuating from less den nrml in mrng to 99.2-99.4F in aftrnoon.to night.What cud b d resonshud i go for test?My test fot malaria urine widal all are normal. ### REPLY: Hellos you mentioned that you took treatment for typhoid fever (which was positive) for 10 days. After the treatment still fever present though low grade i.e. 99.4 degree, this is the cause of concern, that too in the afternoon and in the evening. So such type of symptoms may be due to these possibilities, these include:1 Tuberculosis, as the duration of fever is more than 15 days, so get in chest X-ray as well sputum for AFB and tuberculin PCR test.2 Jaundice is another most common cause. Get in blood for HBase for A B C E (hepatitis 03 Dengue, because after initial stage in dengue causes low grade fever. Get in blood for platelets count as well as serology test for dengue. However, there are so many other reasons of such fever but physical, clinical as history of illness is important so consult another physician (2nd one) and get his opinion. 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: hy sir hope u doing well today i have a question for u... my name is usra and i am 21 years old married . i got married about year ago and had a miscarridge as well the miscaridge was 2months old and later i had periods problum now im ok n desperatly wants to concieve i wanted to kno about my cervical mucus or im fertiling or not i had periods on 4 of this month my doctor told me to start having intecourse on 15th onward i had found raw egg white cervix on 13th and now im wet from vigina inside biu not any sticky or raw egg white substance im wet whn i insert finger insite i get only white jelly bits wit wetish thingy but nt a proper cerix musus is it to early inmy cycle or im nt proper fertiling?please please please help me in this matter i will be very very thankful to you. Many thanks in advance ### REPLY: HI, I understand your concern.  Cervical mucus changes throughout menstrual cycle. So it can indicate fertile days.  Cervical fluid is scanty / . Becomes sticky & creamy before being fertile.  *. When it becomes watery & egg white type fluid.it's an ovulating & more fertile stage. Ovulation is mostly on the last day of most fertile type cervical fluid.  For conception to have sex 3 days before & 3 days after ovulation is recommended.  * LH surge home test also helps in knowing ovulation.  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 have3 year old daughter who has repeated colds atleat 1 cold a month or sometimes 2. Had ear infection in May last year. pediatric Doctor treated her with amox. Now again in month of jan she had another, again treatedwith amox. After 15 days she had a cold again with ear infection. This was treated with omnicef . Immediately had a cold again after the15 day. pediatric doctor said she is having a viral cold again. So this cold seems like it is there for a month now since it was back to back. Now the cold is gone for 7 days now, but she wakes up with a stuffy nose every morning.Also compalins of itchy ears every now and then ### REPLY: Hi, Your daughter might need tonsillectomy with or without adenoidectomy if:1) she has difficult breathing while she is a sleep 2) 3 rounds of ear infection per year 3) 5 common Cold that required antibiotics per year she needs a careful evaluation of her adenoids and tonsils to avoid the development of rheumatoid fever due to recurrent infection as for now she could use an anti-histaminic to cure the runny nose and the itchy ears as Cetirizine once daily before going to bed. 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: Secondary to a automobile accident on 08/03/12, I sustained a Stage 3-4 liver laceration as well as  other injuries. Fx (R) ribs 3-8, (L) tib fib fx. My question is...what should I expect regarding the liver lac? Im tired all the time, have considerable constant (R) side pain ### REPLY: Hi.it is best if you consult with a doctor, preferably a general surgeon, for physical examination and clinical evaluation. It has been years since your initial problem. Your current condition may or may not be related to it. Imaging, such as CT-scan, will be requested for further evaluation of your complaint. Management (medical and surgical - repair of the laceration if needed), depending on the extent of the injury will be directed accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my 19 month old baby was diagnosed with Herpangina a week ago. Although the doctor said the virus should disappear on its own within 5 days, a week has passed and my baby still has new emerging blisters. What should I do to help my baby?, she does not want to eat to drink anything lately. ### REPLY: HI...your doctor is right Deranging is a self limiting viral illness. But sometimes it can take 1- 2 weeks to settle. But Deranging blisters will only be there on the soft palate. But if you are seeing blisters on the hands and feet then it could be Hand Foot Mouth disease. His is one viral illness among all other anthems which can cause fever followed by rash over palms and soles. It is a self-limiting disorder and itching can be really worrisome. I suggest you use any over the counter antihistamine if you have one with you now. You can use HY .  This can even cause some peeling of skin in the next 4-6 weeks and do not worry about it. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having numbness and tingling of fingers and toes periodically throughout the day. I also have a siatic nerve issue on the right side hip that runs down the right leg. Would this be causing the issue in my fingers or could it be something else? I am a 50 yr old female who also is going thru menoupausle symptoms. I work with my hands a lot with my job stocking grocery shelves ### REPLY: Hello dear, Considering the case history of Sciatic nerve issue, the symptoms can be attributed to para-spinal spasm and entrapment of nerve fibers at the lower spinal region. Other causes can be:1. Inadequate HY . 2. Dietary deficiencies of certain nutrients like Iron, Calcium, vitamin D, Vitamin B12, Folic acid, etc. which help in blood formation & nerve conduction.3. Peripheral neuropathy caused due to any fluctuation in blood pressure or blood sugar level.4. Hormonal changes- as you are going through menopauseSymptomatic relief can be obtained by intake of cervicogenic agents (like Vitamin B6, Vitamin B12, Folic acid) as well as multivitamin & multimineral supplements including iron, calcium & vitamin D needs to be added in your diet. Physiotherapy & postural exercise will also be helpful. If symptoms still persist, kindly consult a Neurologist & get a complete Neurological examination done. Certain investigations like complete blood count, serum electrolyte estimation, fresh estimation of blood pressure & blood sugar levels & nerve conduction studies will be helpful to rule out any pathological cause for the symptoms.X-ray & MRI of lumbosacral spine can also be carried out to detect any nerve entrapment. Wishing you a Good Health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i would like to know the side effects of istamet sitagliptin i have been using the above mentioned tablet with no noticable improvement in the blood sugar level. is there any combination drugs that i could use for better sugar control. thanks bhuvana YYYY@YYYY ### REPLY: Hi, Stamen is a combination of two medicines (sitagliptin and metformin) commonly prescribed to control high blood sugar levels in people with type 2 diabetes mellitus. Generally, it is well tolerated by most of the patients, however it may cause abdominal cramps, diarrhea, metallic taste, low blood sugar, headache, and sometimes a serious lactic acidosis (metformin). For better control of blood sugar another medication pioglitazone may be added to stamen after consulting your treating doctor. 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 had a root canal and crown in January 2012. This past Thursday it was sensitivie again to cold but then that dissipated and Fri, Sat and Sun the tooth [crown area] was extremely painful and throbbing and this morning after taking amoxicillin and Advil, it feels better and I wonder if I should still go see dentist who did root canal to see what may be wrong or if there was an infection and now it is gone? ### REPLY: Hello and welcome to  forum, I would like to inform you that, pain in a tooth which has already been root canal treated if from infection. The infection can be in the tooth or even in the gums. In order to rule out the cause you should see a dentist. Antibiotics and Advil will provide a temporary relief only, therefore it is important to see your dentist. I hope I answered your query, i wish you good health, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has a lump in his head the dr, Remove this syst like twice now .The dr. wants to remove it once more it keeps filling up with fluid? The first time it was removed (taken out ).It was cancer. What can it be ?could this be cancer of the brain? Thank you ### REPLY: Hi and welcome to . Thanks for the query. Practically it can't be brain cancer since brain is inside the skull. If this was cancer then this was probably skin cancer and this recurrence may be worrying. It should be widely excised and sent to patohistologc analysis. In most cases such lesions are atheromas or fibrosis, and it can recur, but any surgeon should be able to handle with this and remove it permanently. Wish you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: In the last month I have been constantly nauseous. I have to make myself eat. I have lost 25 lbs. It all started one day when I was walking around having a good time at a casino (no alcohol). I had a terrible cramping feeling on my right side under my rib that went all the way through my back. I broke out into a sweat. This lasted about 30 minutes. I was weak and just felt like laying down. I had eggs and sausage and pancakes for breakfast that morning. I went to the restroom, and urinated an odd orangish color. I let it go until about a week later I noticed that i was passing undigested food through my bowels and having nausea. I felt terrible like I was going to die. I then went to the E.R. 3 times in 4 days. No answers. Now my pain is pretty much constant under the right rib. If I take a pain killer like hydrocodone it actually makes the area cramp more. So.....at one of my E.R. visits they checked my urine, and it showed high bilirubin level. A blood test did not show high bilirubin. I have belching (not normal for me), diarrhea, tongue coating is usually white or yellow, passing undigested foods, especially items like beans, yellow stool color, nausea, and bloating. I also have tenderness to the touch under the right rib area. Tests I have had.....CT no dye, upper abdominal ultrasound, Hida Scan with CCK, blood tests, urine tests. The only thing that ever showed anything it shouldn t was the urine have bilirubin. The rest of the tests are showing normal. The gallbladder hida scan showed ejection fraction of 59%. How am I having all the symptoms of gallbladder problems, and the tests aren t showing it. What does this sound like to you? Please give me a suggestion as to what else it may be, or other tests you feel would be needed to find the problem. ### REPLY: Hi. Thanks for your query. Read and understood your history and query. You have nausea for 1 month, a long time to keep you from a proper diagnosis; lost weight, have cramping on the right side under the rib, that is referred to the back, sweating, orange urine in the beginning. This followed after 1 week with undigested food in the stools and nausea, 3 ER visits, HY . All the history together shows that there may be a problem of hepatitis or cholangitis or Sphincter of Odd dysfunction. Sometimes you need to undergo repeat tests as sometimes the tests may not show the problem. I would advise the following:Get the full liver profile including GGT, this may give a clue. Therapeutic trial with an antibiotic and metronidazole may help to get well. Avoid food rich in fat and oil. Get an opinion of hepatobiliary Specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently has a MRI and results were:There are a few tiny bifrontal white matter T2 hyperintensites which are non-specific. Should I be concerned?I am experience loss of memeory, balance problems, confusion and etc.. I am a 55 year old female with a history of Epilpesy in the past. ### REPLY: Hithanks for using  these are non-specific changes which usually seen at this age. There is nothing to worry about it. I think, u r towards dementia. All feature of put into mild cognitive impairment which is progress could lead dementia. U should consult a neurologist for proper evaluation and treatment. You’re problem may be at early stage, currently nothing to worry. Only for future aspect, consult a neurologist. 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: Painful skin rash on the arm. Could it be a spider bite?I have what I think is a spider bite on my thigh. It s a red ring, about 1.5 inches in diameter. It s raised and hard in the center with what looks like a white speck right in the middle. It s been there a couple of days and is painful to the touch and just a little sore. What do you think it may be? ### REPLY: Hello. Thanks for writing to us at  Seems like it is bacterial infection of the skin, since it is sore and probably has a central pus point. Spider bites are different, burning is a prominent feature in spider bite, and they usually do have some itching, as well. If you were one of my patients I would have treated you empirically with an oral antibiotic; one from penicillin group of .  That would be good enough. It is a prescription  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pain in my right testicle for a few weeks and as of tonight it seems to have switched to my left.  I got an ultrasound today and Im waiting to hear back the results and Ive already been treated for epididtymitis.  Is this testicle pain switching normal? ### REPLY: Hello appreciate your concernLooking at your description this could be due to Infection like epididymoorchitis, allergy or inflammation and varicocele you can upload me an ultrasound report, I will be able to help you better would like further information like your age, History of other metabolic or skin disease or diabetes since how long you have this problem? In my opinion you should consult a VD and Skin specialist for physical examination color Doppler of testis and confirmation of diagnosisMeanwhile you can apply any antiseptic or antibacterial ointment like mupirocin condom during sex Hope this answers your questionThanks and 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 diagnosed cold-induced asthma currently living in FL but went to cold CT for 4 weeks mid- Dec. through mid-Dec. my asthma flailed up and spent all but 4 days in bed during that 4 weeks. Back in FL now but still feel tired, coughing and heaviness in chest. I have a nebulizer, max air, and advair, also take singulair. Have also had blood work and recent X-ray , botChatDoctore back negative. Any suggestions? ### REPLY: Hi, Asthma is itself an allergic disease due to cold or dust or pollen or grass etc. irrespective of the triggering factor. You can go for pulmonary function tests if not done. Treatment is mainly symptomatic which might require inhalation steroids, beta agonists, anticholinergics as MDI or rota haler as a regular treatment. To decrease the inflammation of bronchi and bronchioles, you might be given oral antihistamines with mast cell stabilizers(montelukast) and steroids (prednisolone) with nebulization and frequently steam inhalation. The best way to cure any allergy is a complete avoidance of allergen or triggering factor. Consult your pulmonologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My grandmother just had a spinal tap done and thursday last week. She is now complaining of pain in the back of her head, nausea, and her hand is shaking very bad. She is 88 yrs old with newly diagnoised osteopenia and osteoarthritis. She has just started taking hydrocortisone and hydrocodone. Is this normal reaction to the spinal tap or medication? ### REPLY: Hello! I understand your concern. In my opinion this is normal after a lumbar puncture. It is called spinal headache, starting up to five days after spinal puncture. It may be also severe. Furthermore, it is caused by change of pressure in the spinal fluid. The shaking hands may be from the pain. Does she have fever? A routine blood test should be done to rule out infection. I would recommend indomethacine suppository twice daily for the pain. Hope to have been helpful. Thank you for using ! Best regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is Paul male 27 years of age. i was injured back on march 3 2013. i fell into a storm drain i injured my knee, and hit my back. Once i was on the crutches i seperated my right shoulder on them. I have had three knee surgeries over 10 years ago. No problems after the last acl reconstruction. Now i am having extreme pain in my right leg, mainly knee with shooting pain up and down my leg. I also have my shoulder that is killing me i can barely lift it above my head. I have been treated my an ortho who believed my knee to have rsd and sent me to a pain management specialist. They have done every test known, blood mri xrays bone scan. The pain management doc wants the ortho to do exploratory surgery on my knee. I am worried if i have rsd that will make it worse. How do i handle that. I also had problems about two months after the initial injury with my back hurting. I thought it was matress and after a month of pain it went away. The pain management doc asked if i had any back pain because he wanted to check for injuries that could affect my knee. i told him about the pain and he ordered an mri. After it came back it showed a fractured spine and a hemangioma. When i saw the spine specialist he said that the hamangioma had to be there since birth. My research shows that no one really knows how they happen some believe genetics others trauma to tissue. He also said wc will not cover that because the fracture was due to the hamngioma weakening my back. but he says that it doesnt need to come out. My back has been really hurting for about two weeks and he said hemagiomas do not cause pain, my research again shows that some do. Also wc has not approved my shoulder therapy for three months now and the pain is just as bad and sometimes feels worse. My questions should i seek a second opinion and how to find the right one to help me in my area. My knee pain is terrible if i put weight on my leg it bruises easily and swells up. I am just lost on what i should do. I feel these doctors have just traded me back and forth and just keep putting me on different meds. I am on opana 10mg which does not work all day. Lyrica 150mg, zipsor and flexiril. I am just so tired of being in pain. Please help. ### REPLY: Hello, I have studied your case. Hemangioma do not give pain, but fracture associated with it may give rise to pain. For these symptoms analgesic and neurotrophic medication can be started. I will advise consulting two specialist knee and spines again for proper opinionative time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I did blood test last night for typhoid/billirubin & cbc. Typhoid is shown positive. But i m not having fever. only i vomit whatever i eat and headache and body pain is there. So dose it mean i m having typhoid. I had fever but it was 8 days back which i treated with the help of crocin and paracetamol. ### REPLY: Hello, Welcome o , As you are having fever for last few months it may be a fever of unknown origin (DUO) which should be thoroughly evaluated to find out the causes for the fever. As you are having for last few months all the relevant investigations should be done to rule out the cause of fever. As your doctor has prescribed paracetamol to reduce the fever, this .  The source of infection should be found out by the investigations. To confirm it has typhoid after having fever for last few months you should undergo stool and urine culture to confirm it. There are many conditions which can lead to fever of more than one month which should be evaluated thoroughly. 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 Sarat Kumar Varma, age 51 years, detected with PTB on 30.6.2010 , have done full course of treatment. Also have been detected with COPD and am on Seroflo 250 inhaler and Duolin inhaler,have been prescribed Potklur syrup.What could be the best treatment for this? ### REPLY: Welcome to , For treating any new case of Pulmonary Tuberculosis treatment is given for at least 6 months. For treating an old case of PTB or treating a relapse case of PTB treatment is given for at least 9 months. In your case, if you have taken the full course and if the physician has checked your sputum sample and if it was negative, then your treatment is successful, and you do not need to do anything else. But after competing your full course if your sputum is positive then you have to take treatment again for 9 months as it takes time to cure this dangerous disease. Your physician may also check if you have a resistant strain of bacteria which is called as .  Remember DOTS treatment for tuberculosis is provided by the government of India free of cost in government hospitals, and you can take treatment from these hospitals. Hope that answers your question.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, recently i had acute pain on my lower back radiating to my left leg and felling numbenss from left tight to teft leg fingers. The MRI RESULTS is L5-S1 disc show mild reduced height, moderate peripheral loss of hydration signals and medium sized posterior lefft paracentral -foraminal extrusion migrating inferiorly behind S1 superior end plate, encroaching into lefft lateral recess and neural foramen with severe compression of left S1 transversing nerve root .. IMPRESSION ---- L5-S1 disc left paracentral- foraminal extrusion compressing left S1 nerve root. i consulted a doctor who gave pain killers and ased for complete bed rest. now after one week of rest the pain has reduced considerably but there is still numness on my left leg fingers. will it go automattically? pls reply . thanks SHAJI ### REPLY: Hi, Welcome to , I m . L5-S1 disc left paracentral- foraminal extrusion causes compression of the nerve root of S1 which supplies the lower part of leg.  Presently you have to take rest, gradually start physiotherapy according to your consultant. Modify the sitting and working posture. Your numbness will go automatically but gradually.  Don't rely too much on painkiller tablet as it is not the solution. Exercise is must for you, never ignore it in your rest of life.  You will have good quality of life Thanking 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: At night I get jittery and my heart rate increases. It also comes with shortness of breath and tighness in the muscles. I did workout yesterday, nothing dramatic but I assume that s why my muscles ache. I don t know what could be the problem. Can you help me? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you're all symptoms are due to stress and anxiety. But better to first rule out heart diseases because they can cause similar symptoms especially at night. So get done ECG and 2d echo. If both are normal then no need to worry about heart diseases. You are mostly having stress and anxiety. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need to worry about. Don't worry, you will be alright. But first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About a month ago, I notice little red, pin sized dots on my lower legs. it actually looks like someone took a red ink pin and tried to color on me. they do not hurt, itch or burn . well, they went away, we went camping, so i was thinking it was a bug bite , but no one else in my family had them..........well, they came back, noticed them, yesterday and because of the rain, I have not been out side or camping......any idea? ### REPLY: Hi, After reading your history it appears that you might have developed allergic dermatitis to some contact allergen or due environmental agent. I advise you to not pinch or pop the area otherwise these areas are very prone for getting secondary infection. You can apply a steroid cream such as cortisone cream. If itching is present then can take Ben .  Apply a plenty of moisturizers over the affected area. If these increase the n consult a dermatologist for higher 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: terrrible tooth pain after  2 months of RCT. does not subsite even after having 3 to 4 doses of enzoflam in a day. why it is so? there is not fracture as seen in x ray . dentist called to remove the cap now. but pain is terrible before i go to dentist. ### REPLY: Hello, Thanks for writing to us, I would like you to know that pain after root canal treatment needs attention of a dentist soon. It could be from reinfection or even from a fracture in the tooth. But as you mentioned here that x-ray does. Not show any signs of fracture so I assume your dentist will be the best who can inform you of the reason.Also, I would advise you to take a second opinion from a root canal specialist. Enzoflam alone will not treat the pain, you will have to take antibiotics as well. Over the counter Pain killer which contains ibuprofen will be better in your case. Kindly perform warm saline rinses and apply cold packs on the area. I hope I answered your query. I wish you good health. ThanksTake care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a small bruise inside my top lip. The dental hygienist noticed it 10 days ago and it s still there. It hasn t gone away but seemed a little longer before and is now shorter but slightly puffier. I will get it looked at today but am a wreck. Can a mouth bruise take a while to go away if it was from biting, which I may have doe but don, t actually remember? ### REPLY: Hi, Thanks for posting your query Development of a bruise on your lip is suggestive of a bleeding disorder or bleeding due to raised blood pressure. In hope, you are not taking any medicines like aspirin. You need to consult your physician to get a complete blood coagulation profile checked with APT and platelet count to rule out other possible causes like thrombocytopenia. Your blood pressure also needs monitoring to find out if it is well controlled with medicines. This can also happen due to a viral infection in the recent past-decreases the synthesis of platelets from the bone marrow. Presence of any autoimmune disorders also needs to be ruled out. The treatment is based on the diagnosis and severity of the problem. Treatment is usually done by fluid infusion, steroids, immunoglobulins, etc. according to the severity of the condition. Wishing you good health... Regards.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am treated for minimal PTB f 3 years ago, nom im apllying for a working visa ni saudi Arabia, before undergoing for the medical exam of an agency, i went to the see a pulmonologist and have xrayed, the result is just a scar on my lungs..would i pass the medical exam? how will i get rid of the scar? ### REPLY: Thanks for your question on . I can understand your concern. To have lung scars after treatment of tuberculosis is normal healing phenomenon. These scars are inactive, harmless, noninfectious lesions. So no treatment is required for this and no treatment is available today remove them. But for visa clearance, we need to prove that these lesions are not active and infectious. For this, you need to get done CT thorax and bronchoscopy with BAD (bronchoalveolar lavage) analysis. CT is more superior in diagnosis of scar lesion as compare to chest x-ray. If both these are negative for active infection, you can argue with visa authority that these lesions are old, healed, scarred lesions and not active, infectious lesions. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I caught my girl of four years on phone with her ex. I was pissed off badly, she promised not to do it again. Now three years later I ve found that they never stopped communication, MySpace email txt phone calls etc. In one email she said miss u and luv u she s sent him many pics of her and in one said she is wanting to do something badly when I found all this she says they are just friends ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The best option for now is to trust her version. Make sure that you do not over do and be more emotional. If she is serious and if you be against it, your child may hate you. Play tactically. Love your child endlessly. Your love should make her rethink the strategy. Your love should make her leave the affair. That is the power of love. If you doubt her, advise her, irritate her, she will rebel. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END