Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 10 days ago I had unprotected sex with a prostitute for the first time ever, after exactly 30 mins after I had sex , I saw this redness on between the head of my penis and shaft, its been there ever since, it usually turns white and starts peeling off in a way but when I take a shower its red again, I dont feel any pain, or itchiness in any way, I also did use a condom but the then didnt use one for about 3 mins. ### REPLY: Thanks for asking in  forum In short: Mucosal erosion may have caused this. Explanation: Getting redness within 30 min of unprotected intercourse with anyone is not infection. As per my opinion it is the mucosal erosion for having sex without lubrication or having sex when both are .  So, abstain from sexual activity for now and visit a doctor to get yourself examined for your lesion and for HIV/STD as you had unprotected sex with a prostitute. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Thanks you so much Doctor. I am Mrs. Pillai and 57 years old, the problem is my left leg at the Knee are some swelling and while changing direction some pain is there. Accordingly I met Ortho surgen and taken Xray and Blood Test(CCBC, ESR, RBS, RA (QUANTITATIVE). All the reports was o.k. in the range. Xray report is with doctor only, but he said there is no fracture, but in side little scratch there. following medicines prescribed: (spelling error might be there) ACE PROXYVON gastracid liquid -opain -knee cap When I have seen the side effects of the Ace Proxyvon, I am very much tensed eventhough our doctor prescribed, for a 2nd opinion I was searchin on the internet, this is what I want to know... ### REPLY: Hello Mrs pillar. The pain medicines are best taken under cover of an antacid or anti-acidity medicines like pantoprazole. Your medicine Procyon is indicated for severer pain and may be stopped in 2-3 days or taken SOS, it can be replaced with simpler medicines like veteran (Diclofenac), there is no need to change doctor unless there is mistrust, I see no reason at all, rather confide your fears in this doctor -he will explain what to do best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir,My brother is of age 23 and studied till 10th standard. he is helping to father in your grossary shop ,but suddenly he is doing myschef things like tearing the bags breaking soaps if we avoid him he do the more he got more anger and his eyes got red and ... he do ### REPLY: Hi, I can understand your concern regarding the behavior of your brother. His behavior is definitely of concern, and he will need complete evaluation for proper diagnosis and management. More details in form of duration, pervasiveness of behavior, sleep and appetite, etc. is required. Some of the conditions that might be suspected includes depressive episode. In addition, I will also want to rule out any intake of .  I would suggest you get a psychiatric evaluation for your brother at the earliest. He might also need certain investigations like a brain scan. Management will be done only according to the underlying condition. Hope this information was helpful. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a heart attack just over a year ago. I now have a stent, my local GP wanted me to get the flu shot ( but i didn t) Now i have the flu bad.. Am i at any greated risk of becoming really sick due to heart problems or will i be ok ? ### REPLY: Hello, I understand your concern and would explain that considering your past medical history, it is true that you are more prone to cardiac or pulmonary complications from flu, compared to other healthy individuals.  Nevertheless, I recommend taking painkillers, having some rest and staying in a warm place, taking plenty of fluids and vitamins. Antibiotics may be needed in case of bacterial infection. This will help maintain the situation under control.  Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son 2 years and 10 months a angelman syndrome kid had seizures from last month dr, advised to take an EEG it showed an normal report but yet he had seizures and they advised to take valparin 3ml twice a day but he had seizures after taking medicines also and now dr. prescribed valparin 4ml and lobazam 5 twice a day.is it the right medicine? What are the side effects? HE is 11 kgs now. ### REPLY: Hello, he medications are right, and your doctor has appropriately increased the dosage when it was not controlled with a lower dosage. The highest doses can not be given right from the start and so gradually these medications have to be adjusted. If seizures are not controlled with 1 medication then others have to be added. For some patients it is a long and truly frustrating experience to reach at the correct dose and combination. 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 having chest pain in front and back and even in shoulders.I feeling pain in throat when swallowing as well.Today morning I felt completely breathless.I feel mucus is stuck in throat and chest as it is coming out every 2-3 minutes.What could be the reason and what can I do to cure this. ### REPLY: Hi, Thanks for writing in to us at . The symptoms are suggestive of lower respiratory tract infection. Kindly consult a physician and get a Chest X-ray PA view done. Is there any history of fever? The following medications shall be helpful1. Tablet Augmenting 375 mg thrice a day for 10 days.2. If you have fever take Tablet paracetamol 500 mg thrice a day.3. Guaifenesin cough syrup - over the counter cough expectorant which releases mucous plugs and relieves congestion. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 3 year old grandson was diagnosed with Hand, Foot and Mouth Disease today...I m supposed to babysit for his infant brother tomorrow and then for 2 of my other grandchildren in the evening. My daughter is in her 9th month of pregnancy. Do I provide any risk of passing on the H,F and M Disease to the others (including my pregnant daughter)? ### REPLY: Hello, Welcome to , Hand, foot, and mouth disease is caused by a group of viruses known as retroviruses. This is a condition which can lead to fever, blisters on the hands and feet, mouth sores, sore throat and a poor appetite. It can spread from one person to another through direct contact with discharge from the nose and throat, saliva, infected stools, or fluid from a blister. There is no specific treatment for HFMD. Medication may be given for relief of symptoms such as fever and aches. I would suggest yo to follow1. Good personal hygiene2. Oral NSAIDs3. Topical anesthetics to minimize the pain caused by the blisters.4. Wash your hands frequently. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My name is Bahni.I have a five year old son.We live in Hong Kong.The problem i am facing with my son is he is very unattentive in is class and usually does not stay focus when the teacher is explaining something and because of that he can not follow direction properly.Moreover he usually stay hiperactive when he is surrounded by his own group.Can you help me? At this point i have started doing meditation with him. Am i doing the right thing? ### REPLY: Hello, If a similar patient comes to my old I would suggest that what you have started to do is good for him. Take him for walks, talk to him in between and tell stories and slowly make him tell it back to you.  Tell him things of his interest and make him slowly repeat. Parenting is an art. You need so much patience for this.  After trying this for a month or two if still, he's not improving I would suggest you meet a psychologist because they can assess your kid directly and guide you better.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been taking Seritide Acuhaler and Flixonase for over 10 years for what I am told is Asthma. I am choked with catarrh all the time and these inhalers don t seem to help at all. Am I better taking a daily antihistamine , as the congestion is affecting my sleep in a big way ? ### REPLY: HI, thanks for using  The congestion may be related to allergic sinusitis or allergic rhinitis which may be associated with asthma. The use of topical steroid nasal sprays along with your other medications would help to reduce your symptoms. Eg of sprays are Flonase, rhinoceros, alone, nasocortIf you can identify the source of the reaction and reduce your exposure then it may help as well. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 3 year old son has had fever and complains of pain in his belly which is localized to one spot about an inch above his belly button. I will point to other areas and he will say no... Right here and points to same spot again. At times he will cry and say again that his belly hurts. This is the 6th day. Fever has been as high as 102.8 under his arm. I ve been giving him ibuprofen to keep it down and ease him. Without that he lays around. With it he is able to get up and play a little bit. He is not eating. Not even finishing a sucker or Popsicle which is very unusual. He is drinking. He is not doubled over in pain. Just acts miserable and will cry/whine on occasion that it hurts ### REPLY: Hi. Thanks for your query. The most probable diagnosis of such a pain in a child of 3 years can be inflamed lymph nodes at the base of mesentery (the curtain-like thing which supports the intestines and gives blood vessels, lymphatics and lymph nodes). I would suggest you to have an ultrasonography as soon as possible to find out the reason so that antibiotic treatment can be started. Continue the Ibuprofen. Get started on an antibiotics there is no relief : go for the tests of Blood, Complete blood picture, ESR, Manitou testX-ray chest blood Tidal and all other tests as may be directed by your Pediatrician or Pediatric Surgeon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is Bharath, i got married on may-11 at age of 29 same as with my wife.After 6 months also my wife did not concieve pregancy.We have consulted doctors who inturn gave folic acids medicines and said to come  2 or 3 days after periods.When visited at the said time they gave medicines and said to have sex in a paticular period.This is repeatedly going for 2 to 3 months but still my wife is not concieved.Kindly suggest ony situation as we worried about hospitals whether we are on the right treatment or not. ### REPLY: Hi, Welcome to . I am . I will be answering your concerns today. Don't be worried. Your wife will conceive. Among couples trying for pregnancy, 80% of them conceive in the first year and 90% of them conceive by the end of second year. As it is almost a year since your marriage, I suggest that you both consult gynecologist and get hormone tests, Fallopian tube patency test for your wife and semen analysis done for you. Based on these test results further treatment can be planned. To increase the chances of conception, you both should maintain normal BMI, stop smoking (if smoker) and have sex 4-5 times in a week. Your wife should continue taking a tablet of folic acid daily. I hope this is helpful. If you have further queries, do contact me through . 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: forst let me say im a 16 year old guy thats in shape/healthy and i have anxiety issues.  From 10-11 i had a series of panic attacks, at around 10:45 my chest started hurting once i got up from bed to go to the bathroom.  I figured it was just more anxiety, then i realized i had only gotten 7 hours of sleep last night and 5.5 the night before.  I went online and eventually read symptoms of a heart attack. I woke up my parents and told them about all this.  They pointed out that i had taken excedrin at 6:30 and i had been complaining of heartburn.  I took pepcid and i calmed down and its gotten better.  But did anxiety cause this or am i looking at warning signs of a heart attack??? ### REPLY: There are many causes of chest pain. Anything from musculoskeletal, ribs, lungs, esophageal, and everything in between can cause chest pain.  At your age it is very unlikely that your chest pain is related to your heart. It is more likely related to musculoskeletal pain such as a sore muscle.  Heart pain also does not last for more than a couple of minutes. If the pain persist, I would recommend seeing your doctor to get an x-ray as well as some blood work. You can take some anti-inflammatory pain medication in the meantime to help with your symptoms. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 friend had a seziure 2 weeks ago. He never had one before. The Drs. think it was from medication. Now he is experincing short term memory loss, change in personality, and cant remember information.  He will be following up with his drs this week. They say he was fine after the sezuire and there was noyhing to be concerned about. ### REPLY: Hi, Thank you for posting your query. The first seizure in your friend needs to be investigated, to find out the underlying cause of his seizure. Identification and treatment of the underlying cause could prevent the recurrence of seizure in the future. Evaluation would include doing a brain scan (CT or MRI of brain), electroencephalography (EEG), blood tests (sugar, calcium, sodium, etc.) and screening for toxic substances or . If his MRI or EEG shows any abnormality, then, long term anti-epileptic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 there. I am a 56 year old woman and in good health. About 2 weeks ago I was diagnosed with a kidney infection but, the doctor was unsure. So they gave me antibiotics and the pain in my back moved lower on both sides. Now I have mild crampy pain on both lower back sides and front. sort of like period cramps but, I went through menopause 8 years ago. This morning i had quite a bit of blood in the toilet when I went poop this morning. 2 other times in my life i had a slight tear that caused a little blood on the toilet paper. This was different. There was a lot of red blood. I could not tell if it was in my stool or on my stool. I have had no blood when I have urinated throughout the day today. However the cramping is persisting. Any suggestions? ### REPLY: Hi sir/madam, Thanks for your question on . Common Causes of Lower Left Back Pain:-1. Bulging or herniated discs.2. Muscle spasms.3. Pulled back muscle.4. Muscle imbalances.5. Muscle strain, injury or trauma to the back muscles, ligaments or joints.6. Trigger points.7. Stress / Negative emotions. If lower left back pain is particularly severe, it may be an indication of a herniated or ruptured disc, or sciatica. Recommended Treatments for Lower Left Side Back Pain:-1. Muscle Balance Therapy.2. Massage Therapy.3. Trigger Point Therapy.4. Inversion / Decompression Therapy.5. Acupuncture / Acupressure.6. Use a Back Support or Cushion.7Relaxation, Meditation.8. Dietary improvements (i.e. reducing foods that cause inflammation like dairy, wheat / gluten, sugar, nightshades).9. . Left Side Back Pain Prevention:-1. While walking and sitting, keep a relatively upright posture2. When lifting objects (heavy or light), always lift with the legs-never bend from the waist3. Exercise; focus on working out the muscles in the core (abdomen and back)4. Daily Stretching. Hope I was helpful. Have a healthy 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: My daughter is three months old, and has been in and out of he hospital for almost a month and a half now, first the doctors said she had the rhino virus, then she started having seizures a few days later, then an mri was done and they found bleeding in the back of her brain. all CT scans prior to this were normal and blood work was normal too. About a week later a skeletal survey was done and the doctors said she had two broken ribs. I was shocked to hear this and she was taken into cps care. she was in the hospital for two and a half weeks before they found the broken ribs, and now three weeks have passed and she just had a shunt put in this morning because of fluid building up in her brain. I dont know what is going on, or what could be causing this, they say she was tested negitive for shaken baby syndrome and there are no other signs of trauma. My baby has never been mistreated or abused, do you have any idea what could be going on? ### REPLY: OK, your baby got into stress because of flu like disease which was the rhinovirus, then started to have seizures right after she developed intracranial hemorrhage, and because of the that the small ducts that connect the fluid in the brain was obstructed and fluid build up (HY .  One of the inborn error of metabolism can cause this and this disorder is triggered by stress (like the flu) and causes intracranial hemorrhage which usually is mistaken as child abuse, which is called glutamic acid Urea type 2, a rare disease but can explain all these symptoms, and there is available test for it .but it doesn't explain the broken ribs, unless the child develops cardiac arrest and in trying to save the baby ribs broke.doctors will keep abuse in their minds because it explains all of the above symptoms, but it's a very sensitive, legal and diagnosed by exclusion.  I hope she becomes better soon ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,its been a year im trying to have baby with my husband. A gynaecology told me that i have polycystic ovaries. for the treatment he gave me norgestrel fisrt, and asked to return after 2 months. Id like to know if theres no other special medecines that i could combinate with it for better results. Thank you for your answer. ### REPLY: Hi, there are medicines available for that. Actually the problem in PRO is with ovulation.  So, you can take some medicines like camphene for the growth of your follicles and track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband every 2 to 3 days after your periods stop.  Take progesterone for next 2 weeks like Austen or phaeton.  These are better than largest.  Do a urine pregnancy test at home after that.  Discuss with your doctor regarding this.  You can try like that for 3 to 6 months.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: IHAD ALLERGY LAST WEDNESDAY FIRST I HAD RUNNING NOSE SOUR THROAT AND CHEST CONGESTIONi HAD TAKEN LEVOFLOX 500, WIKORYL FOR FIVE DAYS AND BRO ZEDEX BUT STILL I FEEL CHEST UNCLEAR DO I HAVE ASTHAMA WHAT SHOULD I TAKE ?  WHEN I BREATH FULLY  I FEEL LIKE COUGHING ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. Were I treating you, I would suggest you montelukast, levocetirizine and albuterol for 5-7 days.2. I would suggest you to have a rest and take plenty of fluids during the day which will help you to recover early.3. I would suggest you to complete the course of the antibiotic (Aeroflot).4. If you are experiencing the chest symptoms for the first time, I would suggest you not to worry at present about asthma. But if you have repeated chest symptoms/wheezing/breathing difficulties, I would think of asthma. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health and a great recovery. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i will like to know if herpes 1 is something serious, i am a 29 year old female, my practioner called with my blood test results and said it came back positive. I will like to know if this type is contagious and if its an std, she said its due to sun, dehydration and low blood count. So is this true? ### REPLY: Hello, herpes virus type 1 (HSV-1) is a virus which means that it is contagious. It's been transmitted to you by somebody. Most people have HSV-1, and they may experience exacerbations from time to time (cold sores on the lips). The virus lies dormant inside your nervous system. This is nothing very serious to worry about unless the exacerbations are very frequent (many times per year). It's not due to the sun or deny . I'll be glad to answer any further questions you may have on this subject. Kind Regards! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been to the dentist for a sore tooth that was recently capped.  Everything looked fine.  I then noticed a swollen lymph gland in my throat and went to my doctor who put me on antibiotics.  Its been about 5 days and the tooth is still bothering me.  What do I do now? ### REPLY: Thanks for your query, I have gone through your query. The pain could be because of the tooth infection if the root canal treatment has not been done for the capped tooth get it root canal treated. Consult your oral physician for complete examination and rule out any gum infection around that tooth or neighbor tooth. meanwhile take a course of antibiotics and analgesics, 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 very prem babies 3 months early twins the hospital thought one had menigitis.bout done lumber puncture and was not.but said he had small white spots on his brain that they didnt know what they were ....hes getting blood transfussions.and antibicotices p could it be e..d.f / LACK OF MYOLINE! ### REPLY: Thank you for asking on . Although the details provided by you are not adequate, I will try to explain the possibilities. Newborn brains are in the process of development especially in preterm. The inner lining of the brain is very thin. As the development of the brain progresses, a substance called myelin is formed and acts as an insulator of the nerve fibers and helps them in functioning. But in preterm sometime bleeding may occur below the thin lining or due to meningitis and as there is healing, the deposition of myelin occurs improperly. Myelin appears while on the imaging of the brain and hence probably the white patches over the brain have appeared. The blood or blood fraction transfusions may have been given for anemia of prematurity or in order to control infection. Hope that helps. Feel free to revert in case of further queries if any. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 went to the dentist with mild pain in my back upper teeth and I was given amoxicillin for I have metal wires from my jaw being broken back in 1983 and Ive been having problems; the amoxicillin has made me have a sinus headache and my jaw and teeth to hurt very bad and I dont understand. Could the amoxicillin cause this? ### REPLY: Hi. Thanks for the query. Well, Amoxicillin is not the cause for headache or pain in jaw and teeth, rather the pain can be related to sinus infection. So if there is suspected sinus related problem, you should consult an Emergency room and get evaluated. A sinus x-ray or PNS View x-ray can be done to rule out the cause. You can be advised higher antibiotics like Augmenting along with anti-inflammatory painkillers like Ibuprofen and decongestants like Xylometazoline. Along with it doing steam inhalations and using a humidifier in your room can relieve the symptoms. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is a terminal pancreatic cancer victim , and he just started vomiting a black green vomit this evening. Everything I ve read says it is the start of the end, is there anything I need to watch with his medications that could help or make things worse?Regards, Mark ### REPLY: Hi Mark, How are you? I am so sorry to hear about your fathers' diagnosis. Omitting in pancreatic cancer can occur due to two reasons - the tumor has grown sufficiently big to close of the lumen of the intestine and hence causing a mechanical blockage of the intestine or that it has affected the nerves supplying the stomach causing it not to clear the contents efficiently leading to vomiting. But by reading your description it looks more like the first scenario where there seems to be a mechanical blockage. The green colored vomit is due to the bile which is refluxing back into the stomach. This can cause severe stomach pain and also bitter taste in the mouth. Certain medications will help control the symptoms - antacids (pantoprazole, omeprazole etc.) and syrup sucralfate has helped a lot many of my patients get relief from the symptoms. Also, if there is indeed a mechanical obstruction, you should explore the possibility of getting a stent placed into the blocked portion of the intestine. This will help him a lot especially allowing to eat normally. Hope this helps and hope your dad starts to feel better. Please do not hesitate to contact me for any further clarifications needed. . Liver and Pancreas cancer 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: Hi. My blood pressure was 154 over 76 2 hours after lunch time, and was 146 over 72 this morning after waking up. I have pain on my left kidney area, some pain in my left rib cage, and sometimes dizziness. My mom had a history of Diabetes, high BP, CHF, and I am 44 years old, 188 lbs and 5 ft 11 inches. ### REPLY: Hi, your blood pressure is certainly high, and you need to monitor blood pressure frequently. Have low salt diet, low fat, sugar, diet. Regular exercises and get your lipid profile and sugars tested once. You need to start on medicine and I usually start my patient on tab Telmisartan 40 mg once a day. You can discuss this issue with local doctor. Still you need to keep track of BP so that its should be controlled and will not affect kidney and heart. Regarding your pain it can be gastritis and kidney problem is less likely. However you avoid spicy, oily food, avoid alcohol, smoking if any, and try tab pantoprazole 40 before breakfast once a day. You can do one ultrasound abdomen done which can make picture Clear. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 can t stop thinking about some people I knew about 22 years ago. Those people did something bad to me and my mother. I rarely ever thought about them untill recently. In the last 6 months I cannot stop thinking about them. They don t live in my town. I never kept contact with them. One day 6 mos. ago they popt into my head and I cannot get them out of my mind. What is wrong with me? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. There is nothing wrong with you. These are obsessive thoughts about your past. When you try to take these as serious problem and try to evade the thoughts, they repeat. The more you try to avoid them or try to escape from them, the more they disturb you. They come back again and again. Instead, you need to simplify the wrong doing you are terming here as their way of reaction. Pardon those people from the bottom of your heart. Be in their shoes and justify their doing as natural one in their circumstances. (These are for your wellness. If you have any revenge mentality, it can be ad .  Once you simplify these obsessive thoughts and once you never try to escape from them, they stop. Do try this easy method. 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 some psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,  I feel fine, but my chest is super tight.  My upper chest, almost where my neck meets my chest.  I dont cough much, but if I do nothing mucChatDoctores up and it kind of hurts to cough.  I researched it, maybe bronchitis or URI?  What do you think, and what should I do to treat it? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of bronchitis is more likely. Bronchitis causes bronchospasm and this in turn causes chest tightness. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease. You may need inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Quit smoking if you are smoker. 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: Hi,My father is 66 years old with two stents placement an year ago. He had his regular quarterly checkup done fortnight ago where cardiologist said he s fine and his BP usually stays below 140/85 for the last couple of months which was not the case earlier. He experienced slight pain in the chest for the past few months (probably due to gastric problems as the cardiologist said its not related to heart and more of muscular pain). Couple of days he experienced similar pain along with a BP of 150/90. He got the chest x ray and EKH done with x-ray perfect normal with normal cardiac size and contour. The doctor said the eck was also normal. He had a heart rate of 64/pm but the report said presence of no p-wave and left axis deviation (qrs axis of -30 degree). Do we need to be worried with these results? ### REPLY: Hello welcome to . I have gone through your description. To summarize your father is a hypertensive and a heart patient with two stents implanted and getting intermittent chest pain. Since the ECG and chest x-ray are normal as per your cardiologist there is nothing much to worry about. A BP of 150/90 is high but is acceptable given his history of heart disease. He must continue on the blood pressure medications which over time will achieve good control over his BP. only matter that requires attention here is presence of no P waves. No P wave means the heart impulses are not coming from where they should actually arise. But since this is a machine interpretation it can be ignored, taking into consideration that your cardiologist has cleared the ECG as normal.  Heart rate of 64/min is optimal. Left axis deviation may be due to long-standing hypertension and does not require any attention at this point. Please continue on his regular medications. 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: MY USG REPORT SHOWS: 1. MY BOTH KIDNEYS ARE NORMAL IN SIZE. 2. PROSTATE IS ENLARGED IN SIZE, MEASURES 48 X 45 X 41 mm & APPROX. VOLUME IS 47.7 cc. 3. URINARY BLADDER IS NORMAL AND LUMEN IS EHOFREE. 4. PRE VOID VOLUME IS 325 cc; POST VOID VOLUME IS 9 cc (INSIGNIFICANT PVRV). 5. IMPRESSION: GRADE II PROSTATOMEGALY. PLEASE SUGGEST ABOUT TREATMENT. ### REPLY: Hi, many thanks for the query! You should do- Sr. creatinine, Sr. Uric acid, Sr. PSA, X-ray PUB, Urine (R&M). You haven't mentioned your age which is important. Get Per Rectal examination gone by your Urologist, it must, specifically to know about malignancy (cancer) in which case it is HARD in consistency. If collectively it turns out to be benign (non-cancerous), i.e. BEP, then medications should be started with your doctors' opinion. Operation may not be needed as you are asymptomatic. Wish you a good health. Take care. 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 started with a caught, when I couldnt get the mucus up to spit out. Soon after my lower left side (a little below the bellybutton) is in great pain when I do caught, laugh or move to play w/ my dogs....I am going threw menopause, but I don t think this is part of the many symptoms that come w/ that lovely old lady syndrome...Mucus is finally gone, but still coughing makes me buckle over for lesst pain. Whats join on w/me? Any suggestions are appreciated! Thank you~ Sorry, I am unemployed.... Im sorry to waste ur time.... Thank you again ### REPLY: Hi. Thanks for your query and an elucidated history. The most probable cause of the pain on coughing in the belly button area is either a sprain in the muscles in this area, or tear or a hernia. This is best diagnosed by an examination done by a General Surgeon. Ultrasonography may or may not help unless the Radiologist knows what to see. Once a proper diagnosis has been made the treatment will be according to the exact problem. If sprain or so, muscle relaxant, anti-inflammatory medicines, complete bed-rest and of course the most important is the control of the cough. Take products with codeine which needs a prescription as this will control cough as well as the pain. Take laxatives to avoid strain at passing bowel movement. Hormonal changes at menopause have indirect effect as the psychological overlay causes more pains, stress, anxiety adding to the already existing problems. The lovely old lady syn .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was scracthing my left arm and i notcied a small bump that appeared to be on the inside of my left arm to the right and slightly lower then the crease in my arm. Is not noticable by sight. I feel one on my rifght arm aswell. I bekive they re lymph nodes. But im not sure ### REPLY: Hi, The location you mention is more likely to have lipomas or lumps with fat cells. This is a very common condition, and they can appear at almost any place but are harmless and do not trouble. No treatment is required for them usually. But, if you feel they are hard or firm, or they seem to be lymph node swellings then you should get an appointment with your GP. Let him examine you and advice whether any further investigation is required. Take care and do let us know if we can help you with any other queries. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: we were just in a car accident and we suffer from a pretty bad whiplash we were given novalgin from sanofi aventis and it doesnt seem to be strong enough to take the pain away! we were told that 3 a day should be enoungh but I would like to know if we can take more ### REPLY: Hello, As there was an accident there is always a chance of Whiplash Injury. This injury occurs due to sudden thrust to the head and leading to an impression of damage to the spinal cord at the cervical region.  I will advise the first foremost thing to do is taking up an MRI. Because that will provide more light to the injury by revealing the internal structures of the cervical spine and spinal cord. It's good that you have not developed any major injury. Because in whiplash injury things can go otherwise. Thank god that you are all fine and there is only pain. Once MRI is done you will be able to notice the extent of soft tissue involved in whiplash injury. Based on the soft tissue injury, painkillers along with physical therapy will be advised.  As with physical therapy like Ultrasound therapy and TENS therapy the pain will reduce, and muscle spasm will be reduced too leading to less pain.  Any muscles which have gone wasting during the resting phase may need to regain some strength. Please use the cervical collar for time being to avoid more compression of the soft tissue. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have 2 two year old twins that both have tiny white head type pimples on their diaper area. I was told at their day care that they think it may be chickenpox? I brought the one that first had the rash to doc. She was not convinvced that it is chickenpox? That is what they are going with for now?My mom who is a skin specialist nurse thinks it may be impetigo? The one little guy that I brought to doc today has been complainig of back and head pain and has had a bad cough for over 3 weeks and had a fever as high as 102.00 two days ago. The other twin has had no fever , but has the cough as well. Any info would be great! I m thinking about taking them to er tomorrow if the rash stays around that area. Thank you! ### REPLY: Hi, these are diaper rash, if diaper rashes are present for some time then chances of candida (fungal) infection. I think that the diaper rash has worsened, and fungal infection has occurred. I suggest you to apply candid-b cream three times a day for 5 days. Avoid use of diaper for some time. Your smaller child has also got fever, I think he needs to be examined thoroughly so take him to doctor. I can assure you that this is not chicken pox. I hope this has helped you. Wishing your child 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 have had pain and discomfort in my lower left abdomen for about a week now. It started as a bulging discomfort now more of a shooting pain. I went to the ER and they took blood, urine sample, and did a CT scan. CT scan was normal and the doctor said there was some bacteria in my urine. I went to a GI and he spent all of 5 minutes with me and scheduled a colonoscopy. Prior to this I took some Pepto Bismol and Kaopectate to control diarrhea. Im starting to wonder if maybe its an infection since all tests have come back clean? Any ideas? ### REPLY: Hi. Thanks for your query. Noted your history of discomfort in abdomen which now is shooting pain. You went to ER and this all the tests other than the stool test. I would advise you to go for stool test for 3 consecutive days as this may be giving a proper diagnosis. For the urinary tract infection: I would advise the test of culture and sensitivity of the urine so that an antibiotic which is effective at both the infections can be given to get you the proper relief. At the same time you can take anti-spasmodic, probiotics and other symptomatic and supportive treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is Marie, I have been having these symptoms for quite a while and no one seems to know the answer. I will get the erge to have a bowel movement and then once in the bathroom the erge turns into severe abdomnal cramps, my heart starts to pound, I feel lightheaded, break out in a cold sweat and become very weak. When all starts to disapate I`ve had a large loose movement and I am so weak and lightheaded that I can hardly walk the 10 feet to my bed only to colapse and sleep for about an hour or so. For several days after my sbdomanal muscles are sore and I am very weak. I am 65.7 yrs. old. Thank You for any help or advise tyou can give. ### REPLY: HI Marie Madam. The urge-ramps- weakness, sweats and associated symptoms-large loose motion - very weak-all are suggestive of the following. Severe form of Enterocolitis. In this the symptoms are classical as you have. I would advise :::To get admittedComplete investigations including that for diabetes, kidney function tests. Stool tests Ultrasonography of abdomen Intravenous fluids and antibiotics. Colonoscopy, biopsy. CT scan abdomen if required. You have to get treated and investigated simultaneously so that you are cured. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I dont know if I got thrush, but got similar symptoms very itchy and abit sore. I went to the pharmacist, they gave me the thrush cream. After using it, the itching is gone but after using for a day, I started to get alot of white discharge and there abit of blood not alot when I clean my vagina with tissue. So I stopped using the cream. Help! Am i having a thrush or what? Should I go see a doctorr? ### REPLY: Hello, Welcome to , Your symptoms requires physical examination to confirm the diagnosis, I would suggest you to consult your doctor for physical examination for proper diagnosis and treatment. The history is suggestive of fungal infection, but it should be confirmed by lab investigation like KOH mount. For your symptoms I would suggest you to follow1. Keep the genital area clean and . 2. Topical application of antifungal cream.3. Oral single dose Tab Rifleman, 150 mg. 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: Hello.  About 2 weeks ago, my daughter noticed a smooth rash like skin condition that was covering her  groin and upper thigh area.  Aslo behind one knee.  It doesnt itch or bother her in any way.  She said she wouldnt know it was there if she couldnt see it.  Her skin is very sensitive and she has a severe case of karatosis polaris, so I figured she was just having a reaction to something.  However, it has not gone away.  It has lightened some and looks sort of like light brown bruising...like could be caused by gripping the skin too tightly.  The skin looks like it has tiny, faded blood dots..like its been pinched.  Can you please tell me if this sounds at all familiar.  Thank you!! ### REPLY: Hi, Welcome to  forum.  It appears to be the ring worm, or eczema, she may need to use antifungals, and steroid combination creams.  So I advise you to consult a dermatologist for diagnosis and treatment.  I usually prescribe to my patient with such symptoms grisofulvin 500 mg, and dexamethasone, fluconazole, and Neo main. For local application.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is 2 and has a rash on her belly, back, neck and underwear line.They are hundreds of tiny flesh colored slightly red bumps. She has no fever and says they do not itch. I gave her a little benadryl.Should I still take her in or wait for the morning? ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. You probably did right in giving her Ben .  If the kid is having intense pain abdomen or joint pains or strider or breathing difficulty, then you take her to the nearest emergency room. 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: my son has been having pain in his right side and more into the middle of his abdomen.  He constantly feels like he is going to get sick.  He has missed 9 days of schoo counting today.  he has had a CT scan and an Ultrasound.  BotChatDoctore back fine.  They found enlarged limp nodes in that area.  I have heard many people say that they had the same thing and the results came back with these test that they didnt need their gallbladder out.  then they had a HIDA scan and it showed differently.  Once the  gallbladder was removed, they felt much better.  Help me please. more importanly, how can i help my son? ### REPLY: Hi. Thanks for your query and concern for your son. Young boy missing the school due to pain in abdomen on the right more in the middle of abdomen. Constant feeling of sickness. The CT scan and ultrasonography are not normal as there are few enlarged lymph nodes in the abdomen at the same site. The gall bladder must be normal and removing the gall bladder without any evidence of inflammation or stone is no reason to remove it for a school going child. The reason for the pain in abdomen is obvious. Get the relevant tests of blood, urine and stool, Tidal for Typhoid, Quantifier gold test for Tuberculosis, Ultrasonography guided FNAC ID the nodes are just bellowed the anterior abdominal wall. Give him a 7-day course of antibiotic, metronidazole, probiotic and anti-inflammatory medicines, review the size of the lymph nodes by ultrasonography. Give additional course of 2 more weeks and see the results. He will be fine by then. If there is no regression even after 3 weeks course, he needs Laparoscopic visualization of the abdomen, biopsy of the lymph nodes and then a definitive treatment as per the reports. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A few days ago, one of my toes started itching, then swelled up and turned red at the tip. Then, 3 days ago, I developed a hives like rash covering pretty much my whole body. Today, I have blisters on the affected toe and also smaller ones in the area around it. Went to the doctor and she had me get a blood test for uric acid (testing for gout, I guess). The uric acid test is in normal range - 6.1. The toe is not painful, but itches like there is no tomorrow. I am a 60-yo male, and active - I do water aerobics and walk 2+ miles. Also have been hiking recently. Any ideas? ### REPLY: Welcome to  I have gone through your query and understand your concern. You can discuss with your doctor about it. I think you should exclude any cold exposure, diabetes and circulation disturbance. It can be something like cold allergy and circulation disturbances. You can get it clinical examination by general surgeon for better understanding. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. 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 have a painful lump on my scrotum, just at the base of my penis. I think its an ingrown hair or a large pimple, but im not 100% positive. Is there something more sinister that I should worry about? There are no other symptoms present. Im 29 years old and married, with no reason to suspect an std. I dont have a picture to upload, but it just looks like a red lump roughly the size of a kidney bean. it is freely moveable, and it travels from the top of the scrotum to the bottom of the base of my penis when im erect. Its only particularly painful when I poke or squeeze it. I have no reason to suspect an STD, and Im 29 years old with no other health concerns, sans being overweight. ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have what is called as Sebaceous Cyst over base of the penis. Scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac) .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sinking feeling in my chest and I don t really know how to describe it. It s as if my heart is beating slower than normal. This has happened to me a lot before but it usually ends after 1 hour but this one has lasted the whole day. I am a female 5 feet 4 inches and a teenager ### REPLY: Hi welcome to . I understand your query and concern. Bradycardia in your case needs good assessment to rule out sinus node dysfunction. Complete thyroid assessment is needed to know the associated dysfunction and needs external hormonal supplementation if needed. I advise you to have a baseline 2 dimensional echocardiography, ECG and lipid profile to assess the basic cardiac reserve of your heart. Restrict the intake of salt to less than 6g/day. Regular physical exercise in the form of brisk walk for 20 min a day for 5 days a week is pretty useful. . Reduce the intake of fatty and fried food. One pomegranate will help to keep your heart at good pace without clot formation. Overall prognosis is good in your case. Consult a Cardiologist for further expert management. Post your further queries if any. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have been sick with chronic lyme for about four years now. Im still having symptoms of chest pain, nightmares, fatigue, joint pain, heavy limbs, anxiety, depression, SOB. I have been on many doses of abx. I just dont know where to go from here... ### REPLY: Hello, Welcome to , Lyme disease is a bacterial infection transmitted by a tick, and it is caused by a bacteria Cordelia burgdorferiLyme disease can be effectively treated with antibiotics. Antibiotics, such as doxycycline or amoxicillin should be taken orally for 14 to 21 day. Intravenous (IV) antibiotics may be used for more serious cases and for someone whose nervous system has been affected. The IV antibiotics should be taken for 2- 3 weeks. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my B/P was 142/122, pulse 40 last night, shoulder sore, very sleepy, arms dead weight oh & lower lip tingling.  I thought about going to the ER, but take care of mom who had major stroke & depends on me for ALL her needs.  Respite will be starting in a week or two and then I can go for testing.  This morning my B/P was 114/90, pulse 54, left arm funny feeling and real tired feeling, still sleepy.  Can this wait till I get respite for Mom? ### REPLY: Hello, Your actual blood pressure values are indicative of diastolic hypertension. Besides your heart rate values are really low, indicating bradycardia. The funny feeling in the left arm could be related to a pinched nerve caused by a wrong position during sleep or a stroke. Coming to this point, if the numbness persists in the left arm, I would advise going to the ER for a physical exam, a brain CT scan, and some other tests: a resting ECG, a cardiac ultrasound and blood lab tests (complete blood count, blood electrolytes, etcetera). If the numbness and tingling improve, it can wait until consulting with your doctor and performing a cardiac ultrasound, a resting ECG and some blood lab tests: - Complete blood count-Thyroid hormone levels-Fasting glucose-Kidney and liver function tests-Blood electrolytes- PCR, ESR for inflammation Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have constipation and after stool analysis all values is normal except pus cells 2-3 and RBC s 0-1 and fat globules (+) and pH is alkaline and few yeast can you help me please to know the reason of this constipation. ### REPLY: Barbarically low fibrous diet is the main culprit for constipation. Having IR regular and IR rational meals makes the system upset. More non veg leaves no residue thereby compounding the problem, use of certain .  Having irregular time for visiting toilet fails to make any reflex. Working late in night and improper rest, tension stress all contribute to constipation. Have rich fibrous diet and add asylum husk as laxative this will also clear pus cells RBC etc. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 six month old has had a change in color of his scrotum. I noticed it thursday evening but he had no pain. When he woke up friday morning it was normal color. Friday night I noticed it again but this time it has lightened but I still see a difference. ### REPLY: Welcome to the ChatDoctorThe reason for sucChatDoctorplaints can be nappy rash or fungal infection. Regular change of nappy, application of thin layer of petroleum jelly before using nappy and keeping area open for some time in between each nappy change will help in prevention of nappy rash. You may use nappy rash ointment such as rash free if rash is present. Hopefully this 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: does my 17month old need to see a dr tonight! she been getting worse all day, chesty snotty, puffy watery eyes that are also a bit gunky, high temp! she had diarrhea last night but a bit constipated today! she is very unhappy in herself & has been crying most the day! i thought she was just teething as her back teeth are coming through, she s chewing alot & dribbling but am worried its something more serious as she has so many symptoms & is so bad! ### REPLY: Hi... Thank you for consulting in . I understand your concern. All the non-specific multi systemic involvement symptoms which you are coating are suggestive of viral illness. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. 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: Hey, so once a week I get these awful stomach pains that make it hard to move I get alot of gas and diarrhea. It for some reason it usually happen at least once a week. I m only 16 and I m in so much pain its killing me that I can t keep up with everyone when this is happening. Any advice? ### REPLY: Hi Gone through your query regarding stomach pain gas and diarrhea It is a matter of concern. Dear Cause of these problems must be your irregular lifestyle, eating fast, processed foods constantly or skipping meals , use of alcohol, smoking lack of exercise and proper sleep. Remove the causes. Take balanced diet having all essential nutrients, fiber, fruit, veges a lot of water .and proper exercise yoga, Panama -deep breathing , as you are young lad , run a few KMS to energize your self, sleep well Avoid mental mention, worry, anger, alcohol, smoking and constipation . Do meditation, Be positive, and do your duty, whatever you are doing, do sincerely In present situation take lemon juice in a glass of warm water and a little of salt and black pepper, in sips, It will be digested and give you relief from gas and pain. After half an hour again take water same was and add a spoon of honey in this. Take 1/2 spoon of bishops seeds and a pinch of salt and black pepper with warm water, twice a day when you feel stomach pain, gas etc.;Take some liquid diet , porridge veges soups etc. , when you feel hugely .  It will be ok 1-2 days After that you take normal meals other than fast foods. If your problem persists immediately consult a doctor Hope this helps you solve your query Take care. All the best Don't hesitate to get back if you have any other query Eat orange apple pears, little at a time. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 knot that has came up on the back of my neck. I had an ultrasound an they said it was a Hypoechoic focus on or in the Lympnode and now want me to have a catscan. Other people say they have a knot and it s nothing to worry about. Some days it really bothers me some days it doesn t. Any ideas if I should just wait till it grows bigger or would that be a bad idea? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have growing not on back of neck. Well there can be many reasons for symptoms you mention in query like infected Boil, Carbuncle, reactive hyperplasia, tuberculosis or lymphoma. Do not try to even touch or pinch the area as can cause more aggravation of the problem and spread of the infection. This area is quite common to get infected very easily because of sweating and high bacterial proliferation. Consult dermatologist for proper examination. Doctor may check tenderness and consistency, order ultrasound and take sample for lab test. Doctor may prescribe antibiotics like azithromycin along with anti-inflammatory. Doctor may also recommend surgical excision. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there.  Im super close to going to the ER where someone will actually examine me.  Ive had these weird movements in my foot and my skin has thin clear worm like things coming out of my hands, arms and face.  What could it be.  Ive been to my general practice doctor who told me there was nothing wrong as well as a dermatologist who said the same and to up my zyprexa medication with my psychiatrist.  Im not hallucinating, i swear! ### REPLY: Hi Gisellpark, Forum, I can understand how shocked you must have felt after knowing that nothing wrong as dermatological. Its important that if you feel that chances that doctor might miss finding you can have another doctors' opinion. If after another consultation same findings comes out then there is possibility that you might be suffering Mono delusional disorder (characterized by having sensation which are true and real one for you but not collaborated with other people finding. This happens because of some neurochemical changes in brain which alters yours perception -sensations)In such condition antipsychotic medicine will help - which corrects mentioned neurotransmitter changes. Medicine takes prolonged time to control your problem - that might create doubt again that it's not getting cured - remember u will require treatments for many years. So then continue regular follow up and treatment as advised by your psychiatrist. Hope it helps. 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: my fungal infection started 8 years ago, when i hardly wash my underwear, it affected skin near my private part on both side of my legs, until now after trying various treatment and seeking skin specialist consultation and meditation , the same problem still remain, what can i do? ### REPLY: Hello, some of fungal infections do not respond to broad antifungal medications. They require specific treatment. If you have tried consulting multiple dermatologists already, I would suggest you to ask you dermatologist to take a sample from site of infection and get it examined in lab properly for the causative fugal strain to get the appropriate treatment for the same. Hope this helps you out. 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: Hello Dr, I am 37yrs old, 82 kgs. Offlate i have developed insomnia (not one wink of sleep full night or day) for which i was taking zolpidem 10mg for 4 days now which was prescribed by a dr. When I consulted another dr, he told zolfresh can get addictive and hence prescribed agomelatine 25mg. But tonight when took this i didn t get sleep, after 2 hrs i took one more tablet. But still not getting sleep. Can i know take zolpidem also as i am restless now? Also please suggest the long term treatment to my insomnia? Thanks Ashraf ### REPLY: As a neurologist (non-sleep specialist) I do not believe that prescribing medication in such situations ahead of specific testing and assessment of a person medical/biological/psychological status is the best approach and in my experience it rarely yields positive long term results.  I would ask the doctor to refer you to a neurologist with experience in sleep medicine in order to do a good thorough workup.  Your weight alone is a risk factor for obstructive sleep apnea which is a strong risk factor toward insomnia.  What if that were the problem?  Or at least 1 of the problems?  Secondly, I would get a set of laboratory studies to rule out other potential issues that could lead to your not being able to get to sleep or stay asleep.  These things I would do ahead of any medication which has already proven not to be the ultimate solution.  If you would like a more comprehensive consultation with me please write me at: www.bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My dads findings..He is 68 years old...There are a large lobulated soft tissue mass in the apicoposterior segment of the left upper lobe/left paravertibral (t3-t4 level with minimal sorrounding ground-glass densities the mass is closely abutting the adjacent pleura.the interior portion of the mass is likewise abutting the proximal decending thoracic aorta.It measures 4.7 x 5.1 x 8.7 cm in its greatest anteroposterior,transverse and craniocaudel dimensions.. ### REPLY: Hello and welcome to , The soft tissue mass in the apico-posterior segment of upper lobe of lung abutting the pleura is essentially arising from the surrounding structures. The mass can be arising from the lung parenchymal, connective tissue, etc. in the vicinity of the lung lobe. You need to get some more investigations. A CT scan (if not done previously), aspiration cytology of the lung mass, or bronchoscopic biopsy of the mass need to be done to know the origin and character of the lesion. Management of the lesion can be done only when the diagnosis is made. If the lesion turns out to be benign, simple excision will be sufficient and if it turns out to be malignant, extensive surgery with or without surgery may be required. Consult your pulmonologist for further work up. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,my son had an injury about 15 hours ago my son is three and half years old he fell in the street and had a small wound on forehead i cleaned the wound with detol no stiching was required now i wanted to know that is anti tetanus injection still required as a precaution. ### REPLY: Hello, Welcome to , As your son got injured to his head which has led to wound over the forehead, and it was not a lacerated wound or a contaminated wound. I don't think anti tetanus serum is required for your son as the wound is clean and there is no loss of tissue and contamination of wound. For his symptoms I would suggest him1. Syp Autoclave, twice daily for five days to prevent any infection.2. Syp Solo, 5ml, three times a day for five days.3. Topical application of TB act. These aforementioned measures will help your son to recover at the earliest. 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: When I get up fast or move my head too fast, I feel something shifting inside of my head, and as it does, there is a swirling dizzines that accomplanies it, whether my eyes are open or closed.  Then when whateverit is resituates itself, I can begin to move around normally, but the problem hasnt gone away in at least 3 weeks.  My left ear has hurt inside, even when I chew food, and prior to the pain, it was stopped clogged with wax.  I kept squirting luke water into it, and the clogging subsided. ### REPLY: Hello dear, The symptoms can be attributed to pathology in the Vestibular Apparatus in inner ear (it is associated with maintenance of body posture & balance) most probably Labyrinthine or Benign Paroxysmal Positional Vertigo. Symptomatic relief can be obtained with intake of Vestibular sedatives like Betahistine or Linearizing preparations (to be taken only under the guidance of a Physician). So, kindly consult your Physician/ ENT Specialist & get a complete clinical examination done. Investigations like estimation of blood pressure, blood sugar levels, serum electrolytes & vestibular function tests will be required to rule out any pathological cause for the symptoms. There is no need to worry, you will be fine. Till then, maintain adequate HY . And also take precautions of getting up from bed slowly & avoid sudden head movements. 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: L5-s1 desiccated disk with posterial Annular tear and mild Protrusion causing Thecal Identation. C4 to C6 Desiccated diffuse disk bulge with mild Kyphosis of Cervical spine. What is this mean Help pls Recently I have been diagnosed for my back problem, i have done two MRI for my problem, First report saying that Acentric High Signal at L5-S1 with Margin Ingeriorly on T2 May likely Represent Type 1 Annular Tear, Secondly, Circumeerniation disk L4-L5 with Mild lock of Posterial Concativity identifing the Anterior Thecal SAC with Relative Ingerior Neural Forminal Compromis. Annular bulge at L5-s1 interverbiral disk with the prosterial central disk protrusion causing mild Anterial Thecal SAC compression, Traversinty Nerve Indentification with relative Neural Foraminal Comprimise. Second MRI says, L5-s1 desiccated disk with posterial Annular tear and mild Protrusion causing Thecal Identation. T4 to C6 Desiccated diffuse disk bulge with mild Kyphosis of Cervical spine. What is this mean Help pls Limited CT Sections show no evidence of Spndylolysis or Listhesis. What is my condition... I want to be pregnant soon, can i go for pregnancy or not? What care should i take for my health. My Man is healthy he has no problems, Does my kids get this problems. Please help me.Also i am unnable to feel better in my intercourse, i cant move my posture, infact he is not putting his weight on me at that time, he is using his knees and shoulders to support himself at that time. How can i get my problem solved. Please please help me doctors. ### REPLY: U need some rest. Avoid any intercourse for few weeks. U got posterior annular ligament tear. It might progress to diffuse disc bulge. Need not worry. It'll not be transferred to your kids. U need absolute lifestyle modification for 4-6 weeks. Do some physio. Lie on flat couch with soft pillows underneath your thighs n knees. U ll be better soon as there's mild disc blue. For cervical problem, avoid pillows avoid lifting heavy objects ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having bloody mucus stools for the past 24 hours non stop with nausea, severe cramping, fatigue, weakness, and it seems like I can t fully empty my bowls. My bathroom has mold in it (it has for years) and I wondered if the two were somehow linked. ### REPLY: Hello, Thank you for your contact to . I understand your concern. If I am your doctor I suggest you that it can be possible with the mold only if exposure time is more, or you have immunocompromised. But having mold in bathroom usually do not cause such a symptom because the exposure time in you is very small. I think there must be some other reason behind your symptoms. I will be happy to answer your further concerned can contact me. . Infectious disease specialist. 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 am a 21 year old female, weigh about 135 pounds, i have always had a protrusion in my upper chest, noticeable enugh sometimes that i have been asked if i have ever had open heart surgery. it never really bothered me that much but now i am noticing i have pain between my rbeasts on the right side of my chest and it also protrudes there, hurts when i lay on my stomach, sometimes to the touch, and especially when i work out. i am also having very bad upper back pain that also makes it hard for me to breath when i move my upper body. especially in the mornings, when it hurts the worst, getting out of bed i have to take a deep breath before trying to get out of bed because that movement cuts all breathing from me. and throughout the day when its hurting certain movements make it hard to breath, and deep breaths hurt my chest, coughing hurts my back. ### REPLY: Hi Dear !! Thanks for your query to . Read and reviewed your query and health concerns. You seem to suffer from-Workup Right Pectoral Strain with Pigeon Chest. Dear this occurs from childhood It D-and Calcium deficiency, or could be from accompanied chest emphysema problem since childhood. It does not develop in a day. The sternum is protruding bone in this case and the anteroposterior diameter is increased, with imbalance in respiratory rib and bone movements, causing stress and strains due to stressful body workup-as in your case. Chest X-ray to diagnose Pigeon chest and restricted Gym -for 2 weeks would fix the cause of the painful protrusion in the chest. Second opinion with Sport and orthopedic doctor would resolve the issues you have. Hope this would help you to plan further care of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following  link-Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at  services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am a 19 year old male and have moderate to sever pulsating pain in my lower to upper abdomen that radiates to lower back and hips as well as pencil like stool. I was recently constipated (lasting 6 days) and told to drink magnesium citrate a day ago. This made me produce diarrhea for about a day. That was yesterday and today these symptoms have occurred with a constant abdominal pain changing in severity throughout the day. ### REPLY: Hi. Thank you for your Question. As per your History, it seems to be more of a Renal Colic most likely due to stones in the Kidney or Ureter. I will advise you to have a X-ray PUB done to confirm the diagnosis. Constipation can be due to a lot of reasons like improper diet habit, Stress,inadequate water intake, etc. My advice will be to have analgesics for subsiding the pain, . Hope I answered your query. Wishing you a Healthy Life. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 thought my 18 month old was teething but he has refused to eat at all today i have just looked in his mouth and he has pus blisters on his gums and the gums are very red and swollen which have bled slightly the last 2 nights,what can this be?we live on a farm and he is out and about with chickens,pigs,horses and dogs has he caught something from the animals? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns... As per your complaint it seems that your son is suffering from HEPATIC GINGIVOSTOMATITIS which is a viral infection and can lead to swollen gums and sores or blisters known as cold sores. All the symptoms that you explained are completely pointing towards herpes virus infection. It is a contagious infection and the child may get it from kissing, eating or coming in contact with people who have active infection. The initial treatment is directed towards decreasing the discomfort caused due to inflammation in mouth. You should feed your son with a soft, cold and bland diet, a low spice vegetable soup, flavored gelatin, bread socked in milk etc. can be given. Avoid citrus juices like orange juice and can give him fresh apple juice. For fever, you can give him Tylenol or Acetaminophen . Application of a numbing gel like Lidocaine over the gums and other sore areas of mouth can provide relief, but care should be taken not to involve large areas of mouth as when being numb the child can accidentally bite the tongue and also damage other areas of mouth unknowingly. Sucking ice pops or a frozen apple juice Popsicle can help in reducing inflammation and discomfort... Maintain a good oral hygiene and use an ultra soft toothbrush for brushing can help by preventing trauma and pain to gums. In case if there is an outbreak of sores or blisters antiviral medicines like Acyclovir can be advised by a Pediatrician to reduce the duration of the disease and prevent further outbreaks. Hope this information helps. Thanks and regards. .  ### END