Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 very fit 45 year old (i run marathons).  I have high blood pressure but everything else is normal.  Cholesterol is 135, no diabetes, no family history.  I meditate 25 minutes a day and eat a pretty healthy diet.  Is there anything other than stress that would explain my high blood pressure? ### REPLY: Thanks for consultation at !  After going through history, my advice to you is that you should undergo an ultrasound specially looking at your kidneys, a . .... You should also get done your serum cortisol levels, urine metaneprines and vinyl mandolin acid levels.... Are you taking any anabolic steroids???. U better consult cardiologist so that all possible causes of hypertension can be ruled out..... Hope your query is adequately answered .if u still get any feel free to ask.  Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi - this is my first cycle on clomid 50 mg (insulin resistant and fasting sugar high and right ovary slightly polycystic in u/s 2 months ago). today is day 12 of my cycle (average cycle length is 32) and i had an ultrasound today and right ovary is 3.4 x 2.1 cm with few follicles (2.1 x 1.5 cm and 1.7 x 1.1 cm) and left ovary is 2.3 x1.0 cm with multiple (less than 12) follicles (less than equal to 0.3 x 0.3 cm. endometrium is 0.7 cm (trilaminar). when do you think i will ovulate and chances of conceiving. ### REPLY: Hi, What is your age and BMI? This ultrasound report is good. You have one good dominant follicle in right ovary. The follicle grows around 1-1.5 mm each day. So in all probability you should be ovulating in 2-3 days time. The endometrial thickness is also good for this day of cycle. Considering that other factors are normal (patent fallopian tubes, normal semen analysis, normal body weight etc.) chances of conception with closed are 40% and about 29% will go on to have a live birth. Rarely the dominant follicle does not rupture and ovulate. So it is important to have an ultrasound done after four days to make sure that ovulation occurred. The other option is to take Injection  to initiate ovulation. Take one tablet of folic acid daily. To increase your chances of conception maintain normal BMI, quit smoking (if you're a smoker) and have intercourse at least three times in a week. If you have any further concerns do contact me through . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A week after getting hit in the shin with a fast pitch softball the bruise has faded but the spot of impact is a hard red lump and the skin around the lump is red. New bruises have appeared on the inside and outside of the same foot below the ankle making a line almost to the balls of my foot. The ankle and foot are swollen. The red lump is warm to the touch. Basically it hurts more now than when it happened. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have soreness in ankle and foot. Well there can be many reasons for symptoms you mention in query like arthritis, gout, sciatica or blocked blood vessels. But in your case the symptoms are due to injury, which further occur due to certain reason like hematoma, soft tissue injury or fracture. I would suggest you to consult orthopedic surgeon for proper examination. Doctor will examine physically, order x-ray or CT scan to confirm the diagnosis. Doctor may prescribe muscle relaxant along with anti-inflammatory and vitamin supplement for quick recovery. Doctor may also give plaster or recommend physical therapy. For now apply ice pack, take ibuprofen or acetaminophen for pain and keel your elevated while lying down.  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. I actually have two issues. First and foremost. I think I have allergies but cant get in to see an allergist for atleast a month. the doctor said iis likely because several people in my family do have severe allergies and get the shots and take medicine. My symptoms are itchy throat causing a cough. Stuffy runny nose draining into back of my throat, watery eyes, aches and pains, headaches, and shortness of breath as well as chest tightening. I havent been able to sleep in days! They doctor gave me a prescription for a steroid. Can you reccomend anything else over the counter that will help treat my symptoms? ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. As you have shortness of breath and chest tightening, I would agree with the prescription of steroid.2. In addition, I would suggest you to take an antihistamine like levocetirizine or fexofenadine for 5 days. I would also add montelukast for 7-14 days. They will help both running nose and watery-itchy eyes.3. For shortness of breath, I would suggest you to use inhaler albuterol or levosalbutamol on as and when needed basis.4. Please maintain your HY . 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 ahead. 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 am 34, and 38 weeks pregnant. I know what back pain is like, I have chronic back pain and have had a microdiscectomy L5-S1 in 2007. I have had a sensation but it has increased in the past 2 weeks. The sensation starts in my lower back and moves up to my head, then finishes in my chest. It feels like a pulsating electrical charge that is quite painful and stops me in my tracts. It goes away if I change my position. It feels like an adernaline rush up my spine. Im not thinking it labor pains, because it is not radiating to my tummy. I can t try and have orgasim because it causes the sensation. It is quite paralysing. I have a doctors appointment monday, but I worried because it is happened quite often if I get into the wrong position. ### REPLY: At 38-week pregnancy the baby in uterus lies in deep pelvis. This position compresses the lower sacral nerve root and causes severe back pain. Changing the position causes some relief in compression over nerve. YOU should not worry a lot .this will completely stop after delivery. Till now, you should try to sleep in lateral position and while sleeping supine use a pillow under the knee. It will help you. Hope this helps. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve got 18 years I have sexual problems I practice masturbation before puberty I XXXX and varicose penis and I relax in the testis have a problem in control when I watch film sexy out liquid metal color of the water and xxxx sleep when dreams citizenship or without I want to answer Please, I want a medicine appropriate to the situation ### REPLY: Degree understand your concerns went through your description. I suggest you not to worry much. Masturbation is not sin and it is natural. Even animals do masturbate. You will reduce the frequency when you have more engaging practices like studies and career. Night fall is also normal, and it happens due to body need of discharging accumulated semen. Nothing to worry. As for your varicose veins on penis, you need to consult a physician to get it confirmed. In my opinion, it is not varicose veins but normal ones which you are confusing with varicose veins. You might need psychological counseling., I am more than happy to provide telephone psychological counseling through . Contact me through customer care, www.ChatDoctor .com. 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: My glands in my neck are painfully swollen, it started about three days ago with a swollen lymph or salivary gland on my right side right underneath my jawbone becoming painfully hard and swollen. I know I need to see a doctor but I am curious of how long I can go without seeing one? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint the two main structures present below jaw line are submandibular group of lymph nodes and submandibular salivary gland which is a major salivary gland. A swelling under the jaw that is painful can be due to swelling of either the lymph node the salivary gland. In case if the swelling is small nodular and mobile it can be due to swollen lymph node and is commonly due to infection in head and neck region. But if the swelling is firm, diffuse and non-mobile it will probably be the salivary gland. It looks like due to acute infection, and you should not delay and consult an Oral Physician immediately so that he can do a clinical examination and investigations like x-ray or ultrasound of the area to rule out for the probable cause of infection and treatment can be planned accordingly. As of now you can take Ibuprofen or Naproxen for relieving pain and do cool compresses for reducing infection. Hope this information helps. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I m 31 yr old and have recently started exercising again after a long time on not doing any. I completed an hrs work out on Wednesday which involved a lot of press ups. Today and Friday I have experienced some chest pain, is this something I need to worry about or is it muscular. I m a smoker. ### REPLY: Thanks for your question on . In my opinion it seems muscular pain mostly. But since you are smoker, we need to rule out cardiac cause first. So get done ECG to rule out cardiac cause. If ECG is normal than no need to worry much. It is muscular pain only. Try to follow these steps for better symptomatic relief. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site. And quit smoking as soon as possible. This is not a good habit. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: They say all my pains are coming from my back problem .I don t think so I hurt in my hips in the morning I can,t even stand up at frist from hurting in my hip joint. I know my back give me problem s but now I ,m beginning to hurt all over. and night time is the wrose. I can t sleep. and it feels like all my inter bones hurt so. ### REPLY: Hello! Thank you for writing! Have you ever done a X-ray of your lower back or a lumbar MRI? What's your back problem. In cases with lumbar hernia there is pain in the lower back that runs to the hips It is associated with other signs like numbness? Usually hernial pains are worst at night and patient cant find a good position. So you can do a lumbar X-ray or MRI to rule out the diagnosis, and also visit an orthopedist. Thank you. Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello I fell down about a week ago and twisted my ankle and ruptured a vain on the top of my foot. It has been a week and my foot is still swollen and heavily bruised on one side.I can apply pressure on it and walk a few small steps but it still hurts. I went to the doctor and took some X-rays but he said I would be fine in 5 days. It s been more than that and I still can t apply almost any pressure on my foot without having help from my crutches. If anyone could give me some advise I would appreciate it. Thank you. ### REPLY: Hello, I read carefully your query and understand your concern. Your symptoms seem to be related to a twisted ankle. I suggest using anti-inflammatory medications such as Acetaminophen to relieve the pain. I also suggest using cold compresses for local application. Furthermore, I recommend maintaining a spilled to avoid movements of the ankle that can trigger the pain. Hope my answer was helpful. If you have further queries feel free to contact me again. 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: When I get a cold with a cough - coughing spells frequently go to the point of gagging and bringing up frothy saliva.  This can last for several minutes and with the cold I have now - several times a day - usually at night or early in the morning.  This gagging becomes very painful in the neck.  I am 57 yrs old - generally good health and not on any regular medications ### REPLY: Hi thanks for asking question. First coughing with cold can be because of viral influenza infection of respiratory tract. It should be treated symptomatically. Here if cough with expectoration and low grade fever chest x-ray done for pneumonia or sputum examination for tuberculosis. Chronic irritation to respiratory tract can bring cough like chronic smoking or allergic bronchitis like condition. In allergic condition CBC might show eosinophilic ... So avoid smoking if habit. .  Onion, ginger like herbal remedy good for respiratory tract. Avoid excess spicy food. Cough spells sometimes might be neurogenic. If needed throat swab can be taken and tested in laboratory for further work up. I hope my suggestion 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: Hello, My name is Mandy. I am 31 years old. I have been having pain on and off for about 4 days in my pelvic area. I have the symptoms of a UTI, but am also having symptoms of pregnancy. the pain is getting more prominent, and I am feeling bloated. My stomach feels swollen. I have endometriosis, and I had an ovarian torsion on my right ovary in 2009. with the removal of my right ovary. weve been trying to get pregnant for 4 years. with 1 miscarriage in Jan. 2010. after researching my symptoms, its saying it could be an eptopic pregnancy. My period is 2 days late. I know thats not much, but it is late. I feel pressure also. the reason i am worried about this. is because the pain I am experiencing is different from the other pain that I experience. and the pain is different than a uti also. but I have that pressure feeling like a uti. along with a sharp nagging pain. and cramping. Do I need to seek emergency care? or wait to see my doctor in 2 weeks? ### REPLY: Hi, Please do a urine pregnancy test urgently and if positive see a doctor immediately. History of endometriosis and previous surgery in pelvic area makes the chances of adhesion and thus chance of ectopic pregnancy more common. Also, if pregnancy test negative, test for urine routine microscopy and if infection present take appropriate antibiotics. You cannot neglect sharp pain and so should get medical help as soon as possible. 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: Please, my question or worry is: I took a capsule of ampiclox during a late dinner--about 21:30 hours--whereas my ovulation began the next morning. At 05:30, I had sex with my partner targetting conception as he reached ejaculation; and yet a couple rounds of sex within the next 18 hours.Is conceiving in peril on my part? ### REPLY: Hi, Thanks for discussing your concerns with us. Actually this period of ovulation & fertilization is very sensitive. At this stage if an insult occurs to an embryo it usually gets sometimes aborted without coming into our knowledge i.e. without a clinical pregnancy. If the insult is below a critical threshold it may not affect the fertilized egg at all. That is an "all or none law" is applicable at this stage. Simply speaking if pregnancy occurs this means the insult was below the critical level & has not effected your pregnancy. If God forbid it has affected your egg at this early stage it will be lost without you being aware. I hope I made my point clear. Best of luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For the last two days things have been swollen up. Two days ago I woke up and I had pain with itchiness on the bottom of my right foot after an couple hours it went away then it was my left foot. The next day I woke up with a boil looking thing on my bottom lip after a couple hours it went down and then my right had started to swolle up and itch. What is wrong with me? ### REPLY: Hi, Thanks for asking the query, Boils on the lips can be because of many reasons it can be due to ulcerations, allergic reactions, bacterial and viral infections. A viral condition known as Hand Foot and Mouth disease is characterized by itching, boils on the hand foot and mouth, fever, malaise, sore throat. Get a clinical evaluation done by a physician to know the exact cause of itching and boils. Maintain a good oral hygiene. Start with a course of antibiotics and analgesics. Take vitamin supplements. Hope this helps out. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hELLO: I VE HAD LOW POTASSIUM SHOWN ON BLOOD TESTS FOR ABOUT 8 YEARS - WITH BODY ACHES AND PAINS. i M ON 40 MEQ DAILY AND HAVE TAKEN MY POTASSIUM SUPPLEMENT AFTER THYROID MEDICATION AND THE DOCTOR YESTERDAY TOLD ME TO SWITCH THE DOSAGE TIME AND BE SURE MY STOMACH IS EMPTY WHEN I FIRST TAKE THE POTASSIUM, SAY 2 OR 3 A.M. AND THEN SEVERAL HOURS LATER ABOUT 5 A.M. TAKE THE THYROID MED. IS THERE ANYTHING ELSE i CAN DO AFTER ALMOST 8 YEARS OF TRYING TO GET HIGHER THAN 5.2...... ### REPLY: A 5.2 value is alright as far as potassium is concerned. If you are on medications such as diuretics that may be a cause for low potassium. If you also suffer from high blood pressure called hypertension with low potassium values we have to rule out a condition called hyperaldosteronism. For this you have to get a plasma renin and aldosterone test done. Another cause for low potassium also called hypokalemia is that you may be losing potassium through problems within the kidney. To detect this we do tests such as 24 hour urine volume, urine osmolality, urine sodium, urine potassium and chloride. These tests are done in most laboratories. As your current treatment seems to be quite effective you may continue the same. You must be alert to excessive exhaustion and muscle weakness because they are symptoms of low potassium. A very low potassium can affect the heart, so you should periodically get the potassium tested. A very high potassium is also dangerous so do not exceed the prescribed medications. From the point of view of dietary modifications, fruits contain potassium especially fruits such as bananas so that's a natural way of getting our daily requirements. However, overconsumption of fruits is not recommended if you are diabetic or have any kidney ailments. Should you require more information about your query please feel free to post them here, and I would be happy to assist you in acquiring more information? 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 son, age 6, has always been a finicky eater and until recently, on the verge of underweight. Hes almost always had dark circles under his eyes. He has been diagnosed with allergies and asthma, both of which are being managed. But he is also always very pale, which is not something I would consider hereditary. His father is Polish, therefore fairly dark complected. I have a lot of Cherokee ancestery myself and am not exactly fair skinned. Hes been sickly since entering the world, seeming to have a low immune system, but the doctors brush me off and say hes fine. NOW, since February of this year, he has had two seizures. He has an appointment with a Neurologist, but not until July of this year. The symptoms may all be totally unrelated, but he just doesnt seem like a normal, healthy 6 year old little boy. Anything in particular I should be looking for or checking up on as far as diseases, syndroms, infections, or just any specific conditions I havent mentioned weve already addressed that sound like they could be of concern? ### REPLY: Hello, To put all the problems in perspective: Your son aged 6, has allergies and asthma, but also pale and gets recurrent infections having now had epilepsy and waiting to see a neurologist. Blood tests that will be helpful include:Complete blood count - He if low, requires treatment especially if iron deficiency anemia (pale with dark circles under eyes)Liver function vestige levelsSpecific IGE tests against aeroallergen panel (foods as well, if indicated)Thyroid function testing, IGA, IGM - to know if antibody levels are normal He will need an EEG and/or MRI Brain at some point depending on what the Neurologist feels. Do not go into syn . I hope all his immunizations are up-to-date. Try and broaden his diet to increase his weight, with protein  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 right swells up on the shin and ankle red like bruising and it s sensitive to touch. It also get lumps in it. I did fall down the stairs a few years ago. It usually last for a few days to about a week then goes away and comes back over and over again. The doctor has no idea. ### REPLY: Hi, I have studied your case, There can be skin discoloration/bruise due to blunt injury on calf, and there can be hematoma near ankle. As x-ray is normal indicates soft tissue injury due to acceleration and blunt trauma. I can not compare swelling, but if swelling is there, you need to take rest and use splint or compressive crêpe bandage to reduce swelling. On ankle, you can apply thrombhophobe ointment. Watch for increase in redness, infection. Take precaution to avoid infection around hematoma. Do not use hot fomentation or massage. If required you may need to do blood investigation for prognosis and recovery. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I have a question about possible pregnancy. Today is tuesday and this weekend I had unprotected sex. I had it on friday, saturday and sunday morning. Friday was my first day of the period and the guy also pulled it out. Though he did have some pre cum and im not exactly sure if he did pull out the last time. It was also my first time to have sex. On monday morning I took a plan B. Is it possible that I could still become pregnant? ### REPLY: Hallow Dear, Since you had intercourses during menstruation, there is no possibility of any pregnancy. There was no need of plan B pill also considering then timing of your intercourses. The egg is formed 14 days prior to the next menses. Egg has 24 hours life and the sperms are active for 72 hours. Hence, a period of about a week around the day of egg release is a fertile period. Your intercourses were far away from this period. Hence, there is the least possibility of pregnancy. However, I would like to advise you to avoid sex during menstrual period lest the risk of infection. I hope this helps 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...I am 62 yr old male with non insulin dep diab mell. Though mother is diabetic, am viet vet and found to have agent orange exposure and so given presumption of service connected disablity. I have peripheral neuropathy both feet. Getting worse rapidly. ques #1...can this reverse? #2what is likelyhood of progression? ### REPLY: Hello, Already you're suffering from diabetes along with this Agent Orange exposure may aggravate neuropathy. 10% of the population disabilities is exposed. In mild cases and more due to diabetic component than there are chances of recovery. The disease appears within one year of exposure to a degree of at least 10 percent disabling by VA's rating regulations. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I cut myself with an orange peel and now my finger hurts really bad it burns and has infection coming out of it and ive washed it quite a few times. I dont now if this is a serious problem but my hole hand hurts what should I do? whats making this little cut so bad? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concern. As per your complaint in case if there is infection in your injured finger, the pain is being caused due to infection and pain in hand is radiating pain from injury site. I would suggest you to start taking a course of antibiotics like Sulphamethoxazole and Trimethoprim. Take painkillers like Advil or Motrin or diclofenac. Clean the area with an antiseptic solution and try to . . Apply Triple antibiotic ointment along with steroid ointment over it. You should avoid exposing the area to water. Keep it  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 3 year old son has had diarrhea for over a week.  Even in his sleep.  Today the diarrhea is very oily.  Last night his fever was over 102.  I am controlling his temp with tylenol.  What could be wrong with him?  He had surgery the middle of May for t and a and tubes. ### REPLY: Welcome to the ChatDoctorI understand your concerns but don't worry. The long-lasting diarrhea episodes with high spikes of fever and mucus in stools can be due to bacterial or amoebic gastroenteritis. So, go for a stool examination and give him a course of ofloxacin-ornidazole along with Zinc supplement such as Spy And or Zirconia and entertogermina for early relief. Hopefully it will be of help. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is 17 years old, and her BP is 85 over 73 with heart rate of 100.  Should I take her to an emergency room?  She has a history of severe anemia that required blood transfusion that resolved.  She has chronic abdominal pain, and has been a bit worse the last few days. ### REPLY: Hello! Welcome on ! Regarding your concern, I would explain that in case your daughter experiences such a low blood pressure for the first time and can not tolerate such conditions (she feels extremely exhausted and is not able to perform her daily physical activity), then you should take her to the nearest ER service for a timely fluid HY .  It is necessary to investigate the real nature of her chronic anemia (hemolysis, a chronic inflammatory disease, etc.) as it may explain the reason of her chronic abdominal pain (visceral organs' enlargement, etc.) Several lab tests should be done:- complete blood count,- PCR & ESR,- thyroid hormones level,- liver and renal function tests,- abdominal ultrasound,- fasting blood glucose,- hemoglobin electrophoresis, etc. You should discuss with her attending doctor on the above-mentioned issues. Hope to have been helpful to you! 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: Is it possible to Grow Taller even after your growing age has passed? If it is, can you please tell how? And do you know the ingredients of the height boosting cocktail ? If you do, please tell. Thank you for your attention and for taking the time to read my question, and hopefully send an answer to it. ### REPLY: Hello, It is difficult to grow after growth plates are fused. Growth in males not accuse after 18-20 years. But pull-ups and hanging with ankle weights under your physical therapist is useful. Use calcium and magnesium supplement. Get exercise regularly, .  If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir my father is with me, i am married since 7 years but i have no child, sir most of the time the events of the death day of my mother revolve around my eyes, i always feel that i was not good to my mother, some times i think that i not love my mother but i am afraid of god that he punish the people who not do good with their parents , so due to this fear i am always remembering my mother and think that i have not take good care of her otherwise i have no love for her, i frightened from god , these feelings i have most of the time, now i feel that every thing which i done in past is wrong and i was totally wrong. most of my time spent in thinking that how these thoughts came into my mind that mother should die and always try to justify myself that these are not my thoughts but than i cant beleive that these are not my thoughts,, i always feel that i did bad with my mother and i cant bring her back, when i was taking care of her when she fall down , i some time got angry with her and show aggrestion to her , i think at that time i do that for her good but now i think that my intentions towards my mother was not good, i feel her burden so i show agression to her, i tottaly loose confidence on me, when ever i will go for some good deed, i feel that a person who was not good to her mother he has no right to help any one, such person do any thing allah will not forgive him, i did very big sin, i loose my mother and my jannat, she loves me too much but i did nothing, now i cant bring her back and ask her to forgive me, she left me, and those people who are bad to their parents never find peace in this world, same is the case with me, my punishment is started and i deserve it, ### REPLY: Brief Answer: I can understand your problem and concerns. You are going through grief reaction that occur following the death of a near relative. You need grief counselling and some medicines to help you overcome these problems. Detailed Answer:People develop guilt feelings after the death of a near relative. You are also experiencing the same. Your grief is being complicated by depression, and you must seek professional help. It will help to overcome the symptoms. Professional help is in the form of medicines and psychotherapy. Selective serotonin reuptake inhibitors are given for depression and grief counselling and workup is done for improving other symptoms. Please feel free to ask if you have any followup questions. I hope you find this helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 work in a hair salon where i do spray tanning, i have respatory problems and when i have done spray tanning i find it difficult to breath for 3 or 4 days and have to use my inhalors more frequent.my question is can sray tanning affect breathing problems ### REPLY: Hi, thanks for using  There are different triggers for an asthma attack and the triggers can vary from one person to the next. The chemicals associated with the tanning are triggers for you. Optimally it would be best to avoid your triggers but if this is not possible then you may want to consider speaking to your doctor who may alter the dose of your preventer to reduce the likelihood of an attack. 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 daughter has had low abdominal pain with indigestion, we have been to the er a few times and they have done cat scans and ultrasounds. They said she has free fluid in the low peritoneal cavity and thought she had PID. None of her cultures came back positive and she has been on antibiotics for several days with no improvement ### REPLY: Dear Ma'am, Sorry to hear about your daughters' problem. You should also get a urine culture done as PID is often associated with urinary infection and that is often neglected.Also, PID and UTI require a prolonged course of antibiotics (for at least 5-7 days). If her pain is still persisting, she should also undergo an abdominal ultrasound, which will give information about the rest of the abdomen as well. Hoping for the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son 2 months and 6 days suffer from yellow color in skin and found conjcted probilin initilly 2.9 and after 2 weeks we found the spleen is large 7cm and the liver is large than normal. we stopped breast feeding and he is in milk without luctoz doctor ask to check for hepetis c and b but result negative. i am the father suffering from hemoglobein high. i denote blood every 6 months . is this effecting my child case. please till me why this enlarge and analysis said too much toxic material in blood ### REPLY: Hi, Thanks for writing in. There are a number of causes of an enlarged spleen and liver and a high bilirubin in child .  The fact that you have high hemoglobin or are donating blood has not affect on this. I would suggest that a bone marrow examination and a liver biopsy be done for your child. We should be looking to rule out a metabolic disorder and a problem in the bone marrow. In these conditions, the liver and spleen frequently enlarge. 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: Good day Sir ! My colonoscopy report shows that i have mucosal oedema with granularity,friability,tiny superficial ulcers seen from the rectum to hepatic flexure..Is it a bad sign?? will i be able to recover by proper medication??Please suggest me sir.as i am really worried.. ### REPLY: Hello! Thank you for the query. Such colonoscopy result can indicate inflammatory bowels' disease like Ulcerative Colitis. This type of disease are autoimmune. Due to immune system hypersensitivity and activation, intestine cells are attacked by host immune system. This causes chronic inflammation and can lead to intestine narrowing, fistulas, bowels obstruction. This is not a cancer, but it is chronic disease. The final diagnose can be established basing on histopathology result. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been diagnoise with hep c  should i take this new drug they have to treat it with other medical issues like high-blood,diabetes taking insulin. My brother had this treatment in the past 6 mos. and had terrible side-effect and had to be hospitalized and   still        recovering,also he has not drank any alcohol in 20 yrs.? ### REPLY: HI, thanks for using  There are potential side effects for any medications. These are effects that may or may not occur. Though your brother may have experienced side effects related to the treatment, you may or may not. Hepatitis c effects on the liver can be worsened by liver damage secondary to alcohol, but it is a viral infection and is not caused by alcohol use. You can speak to your doctors regarding the possible pros and cons of the treatment and any risk associated with not treating it. From the information given you can then make an informed decision. 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 exhusband fouud a large ball shaped lump on his shoulder blade and a few lumps on his neck in diffrent areas, he has also has been coughing up blood. Can there be any other things this can be from. He has been a smoker since he was 14 and is now 37 and not in good shape. He s about 5 10 and weighs about 300 lbs. ### REPLY: Hi.it is best if he will consult with a physician especially with the clinical picture you have given me. If the coughing up of blood is in significant amount, persistent and increasing in frequency, this is a matter of urgency. Further investigation should be directed to know the primary source of his coughed out blood. A complete physical examination (including his neck and shoulder area) will also be done. Other diagnostics and management (medical or surgical) will be directed accordingly. Blood examinations (such as CBC) and initial CXR will also be done. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had 2 nack surgeries a fusion in lower back and a laminectomy before that. I am in chronic pain and need help in the Wisconsin, Milwaukee area. I am currently taking methadone and need to find a new doctor within a month... please help.-Andrew ### REPLY: Hello, I have studied your case. If your new MRI shows disc bulge with nerve compression then surgery may help. For these symptoms analgesic and neurotrophic medication can be started along with methadone. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and TENS therapy will help will advise checking your it B12 and it D3 level. You can find doctor in your locality in our website. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a daughter, 9 years old. Red blood is coming with stool from 2 days. She does not like green vegetables. She always like to eat chicken. She is taken histacin from 4 month due to allarge promlem. Pl give your valuable suggesstion to the blood.Thanks ### REPLY: Hello dear. I would like to have mire details regarding the history. Is it painful defecation?does the blood come with hard stool and It's painful to pass?if yes then its probably anal fissure due to constipation as you have told she doesn't like vegetables, so she is lacking fiber in her diet. Give her plenty of fluids and fiber containing diet like fresh fruits with skin and vegetables along with whole wheat bread. If she has fever also and blood comes with loose stools and abdominal pain then it might be infection, and she should see a pediatrician for medications. Hope it will help. Wishing your child 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: why is it when I do something as simple as comb my hair or pick up a trash can, my muscles feel like i ve been working out. it s like a burning soreness type feeling or i could hold my arms out in front of me for ten seconds and the burn of like i was doing weight exercises? what is going on? ### REPLY: Hello, I have studied your case and your report. Due to cervical stenosis burning soreness may remain persistent to compression of nerve root there can be tingling numbness in your arm and pain.Also, there can be large disc bulge which is compressing over spinal cord. For these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. If nerve compression becomes symptomatically severe then surgical decompression will give permanent relief. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have bronchiectasis and cough a lot but do not bring any mucus up. just lately i have felt in the evening i have been coughing more and have a feeling of liquid creeping up my chest that will not go and coughing last for many hours.please any suggestions - help! ### REPLY: Thanks for your question on . Bronchiectesis is chronic, structural disease of lung causing dilated bronchi. In this dilated bronchi, secretions tend to accumulate and cause infection and inflammation. These in turn cause more coughing and difficulty in breathing So treatment of bronchiectasis is antibiotic, Multics, cough expectorant and inhaled bronchodilators. Better to consult pulmonologist and get done chest x-ray to rule out infection. Newer Multics and expectorant are N Acetyl Cysteine (NAC), aerosol and bromine. You may need inhaled treatment also. So consult pulmonologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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! This morning I was doing a split on the barre at the gym and heard 2 loud pops come from what sounded to be my right hip. It hurt pretty bad but I could walk on it just fine. It has been about 7 hours and I can still feel pain in the hip/butt area on the right side, and I can sometimes feel it in my hamstring area when I walk. I am limping a little bit, and it hurts to sit down/stand up as well. It isn t shooting pain but pretty dull and deep. What should I do?! Thanks!! ### REPLY: You probably had a pulled hamstring and adductors (straddle injury)apart from the injury to hip ligaments(overfull)within the first 24hrs on injury you can use ice on stand celecoxib 400 mg once a day to decrease the swelling, pain and the overall recovery time. Beyond 24hrs it should already be warm compress total recovery time for a pulled muscle and ligament is 21 days so don't be surprised if the symptoms last even up to the 3rd week. Though recovery faster than that can still happen on a case to case basis. Forget about nerve injury or complete fracture BEC your symptoms are very far from it. You won't even be able to walk if you broke a bone in your hip I assure you. Advanced merry Christmas ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi Dr how are you? my 8 weeks old son have a fever. His temp runs from 101.8 to 103.4. He in the hospital for 48 hour and the doctors couldn t find anything wrong with him. They said it s viral but they don t know what viral it is and where is comming from. ### REPLY: Such high fevers are generally caused by viral infections, but typhoid fever also could be a cause. These viruses are always around, and we catch them whenever our immunity gets depressed as with lowering of temperature. You need not bother about the source of such viruses. Please give the child paracetamol .  In viral fevers, blood parameters are otherwise fine. Antibiotics are not required if the child is active at times other than with fever. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 never had a check up with the ob im 31 yrs old.ive been in relationship for 6 years with unprotected sex but still i cant get pregnant..im afraid to hear that im infertile.i really want to have a baby thats my biggest dream. i got period every month but always 1 week late but still have every month.. ### REPLY: Hellos you mentioned that you are in relationship 6 years and still not getting pregnancy and till date no tests were done. Your menstrual cycle is very regular but of 35-37 days according to your query (as you mentioned that period is regular but of 7 days late) . Without any history of illness and clinical history you are not INFERTILE. So get in blood for LH/ F ST hormonal tests, ultrasound of both ovaries with uterus and cervix. If all tests are normal then get in SEMEN analysis of your partner. Still every test is abnormal then call as infertile and consult a INFERTILITY specialist and get his opinion. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend is having Kidney Cyst problem. He is admitted to a hospital, done sonography & ultrasound, Doctor said that his kidney is enlarged and he will have to burst some of the cysts. Please let us know how safe is it to burst cysts and let us know the best doctor available in pune. ### REPLY: Hi, Your kidney cyst might lead to some complications to you or symptomatic. Then only treatment is indicated.  Your doctor can inject chemotherapy into kidney, or he might .  Sometime surgery also required in some case.  You can attach your reports to comment further. The best doctor will be urologist consultation for examination and further management.  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 boyfriend had a brief sexual "play doctor" session with his younger sister when they were both younger approx 13/12-since then he feels disgusted with what happened. His sister is extremely overbearing and controlling-but so is the rest of his family. I feel like they are substituting him as "head of household". The mother babies him, his older sister treats him like a husband/father to her children, and the younger sister acts like a jealous girlfriend. What kind of psychological issues are present and how can we address them? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. From the given description, I feel unable to solve the psychological equation given. Each member of the family shows different patterns of behavior and nothing is mentioned the person in question. Dominant personality problems, erratic behavior, compulsive personality disorders etc. can be noted. But for proper diagnosis, it is always better to consult a trained psychologist. If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to overcome your problems. 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 Doc. I have a red patch like thing in my penis head lower position. Since, Its beginning so it is little itchy. Doc, i also want to inform you that this kind of infections are already happened to me earlier thrice. First it occurs then the penis gets swelling hard and liquids all over. I had earlier unsafe paid sex many times. Last one was almost about 5 months. Please suggest the cure and medecines ### REPLY: Hi, It seems that most probably you may be having candida balanoposthitis. It is a fungal infection caused by Candida albicans. Poor hygiene and poor immunity may be the responsible. You consult dermatologist to have firm diagnosis and perfect treatment. And internal diseases like DM, HIV and others should be ruled out. I would suggest taking antifungal tab like ketoconazole twice a day for two weeks along with antibiotics like definite 200 mg twice a day for 5 days to eradicate secondary bacterial infection. Apply antifungal cream like clotrimazole and have Site bath in detail water for 10 min. daily at bath. I hope this would help you. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have had dizzy spells for the last couple of years. Mainly when I first stand up it happens with a minute of walking. My vision starts to go out even with my eyes open I cant see. I just black out. My whole body goes numb including my throat. My hands some times rock back and forth.I have passed out from it before. Im alittle confused at first when it happens but I still remember everything when it happens. I just cant see anything or talk. Ive learned how to deal with this. But it seems like its getting worse. Im doing it several times a day now. Its a scary feeling. Some times its mild and other times its all I can do to lower my self to the ground so I dont fall. Everyone I have talked to about this says its because I have low blood pressure. Im not on any medication. And have no known medical conditions. I am an active mother of four. Im just wanted to know what this is why it happens and what I can do to prevent it from happening or at least control it better. And if there is anything I can do in my life style to either make it stop or at least control it better. Any advice would be appreciated thank you.Josie Gaunt ### REPLY: Hello, Thanks for the query to . Forum. I would come up with these possibilities for such type of symptoms, This includes.1 Postural hypotension, diagnosis can be confirmed by physical examination at the time of episode.2 Hypertension, diagnosis can be confirmed by physical examination.3 Anemia, diagnosis can be confirmed by examination of blood for hemoglobin level .4 Diabetes, diagnosis can be confirmed by blood sugar examination. In my opinion don't trust peoples, rather consult a physician and get his opinion as physical examination is very important in this type of cases. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 45 years old ! AND JUST FOUND A LUMP SIZE OF A PEA ON MY RIGHT SIDE BREAST UNDER THE NIPPE ! HAD A MAMAGRAM AND THEY CALLED ME BACK THE SAME DAY ASKING ME TO GO FOR AN ALTRASOUND ! I HAVE BEEN FEELING VERY TIERD THE PAST YEAR AND PAIN IN MY BREAST AND BAD MUSCLE ACHS WITH SHORTNESS OF BREATH 1 SHOULD I BE WORRIED ? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some benign breast lesion like fibroadenoma, fibroadenomas or some benign cyst.  You should go for ultrasound study and biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I am 59 years old and overweight.  I have been a choker for 20 years.   most time on spit.   Always daytime.   I dont panic, but lately the breathing is harder to get again.   I drink a lot but not straight water.   Not soda either, tea, ice tea.  any ideas ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should rule out obstructive sleep apnea (OSA) and bronchitis in your case. You are overweight and having choking history. So OSA is likely. Breathing difficulty is commonly seen with bronchitis. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PUT (pulmonary function test) for bronchitis 3. Sleep study for OSA. You may need inhaled bronchodilator and inhaled corticosteroids for bronchitis. For OSA, you will have to lose weight and start CPAP (continuous positive Airway Pressure) machine at night in sleep. Don't worry, you will be alright. First diagnose yourself and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was cleaning my shed and a chair hanging above came down on the top of my head. I was knocked down and when I came out of the shed I was off balance. I have a head ache on day 2, It may be from the knot on the top of my head, My eyes were never dialated , I feel like I have pressure at the top of my head, ### REPLY: Hello dear friend,First please be reassured and calm down yourself. Loss of consciousness(which is not there in your case)if resulting from a head trauma, is taken as a red flag and needs to be evaluated further with an imaging like computerized tomographic scan(CT scan) of brain to see for any brain damage and CT scan of skull bones to rule out a fracture. Headache and pressure you feel on your head is most probably benign. If I had been your treating physician, I would have prescribed you mild analgesics for a few days and would have observed you over the time. To add to your reassurance a non contrast CT scan of head, would have been adequate. You can visit some neurologist, who can perform physical examination on you and advise accordingly. I hope it helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr, Im 58 years old; my question is when I get nervous I have this itching and burning feeling all over my body,I take buspar, welbutrin xl 300 and 150 but never I had any problem with these medicines, please what could it be?I forget to let you know I also take synthroid, 075mg ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. It could be a manifestation of anxiety disorder. The fact that you are still having such episodes suggest that your anxiety has not been reduced. You will have to change the medications. Paroxetine or Escitalopram are the medicines which you can consider. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am at work and taking a break.  I am looking for a doctor that can help me with my daughter.  I believe my daughter has a very bad odd behavior.  She is my fourth child and I know the difference of the behavior.  She is 12 years old. Her behavorial is not getting any better.  She is always angry, sad, depressed, clumsy.  When I talk to her, its as I am a bother to her.  She dont want to be with the family.She does not communicate with the family and she blames everyone but herself.  She is not a mean child but she is not lovable at all. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. From the description diagnosis is tricky. Is your daughters' behavior like this before? If yes, she needs psychological support. If not, she must be going through the adolescent dilemma of role identity and associated identity problems. Do talk to her and if need be take her to a psychological counselor. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques 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: I have red bumps around the urethral meatus that are irritated.  I have been exposed to someone with HPV warts and I am afraid thats what these are.  Terrified in fact because I havent read about any treatments that wouldnt be horribly painful. ### REPLY: Hello, The red bump in penis head suggestive of Atlantis like penis glans infection. If you have itching and scaling complaint as well as fungal infection could be possible for which antifungal ointment can be prescribed. It doesn't seem to be HPV infection according to history. You can consult urologist for detailed evaluation Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I have a large lump or possibly a cyst under the skin next to my nose by the inner part of my eye.  Its been there for a while, but its getting bigger.  When I wear my glasses it really bothers me.  It feels like I can move it around.  What do you think this is? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some angular Desmond or benign cyst.  You should go for biopsy of that lump. It will give you exact diagnosis. Surgical excision is the treatment of choice.  If it is uncomfortable or painful then you should go for excision biopsy. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Every time I cry I tend to have problem breathing like a double breathing or so... even if I am angry in some point my whole body shakes n get cold n I usually cry n start to get same double breathing problem... For few minutes...n sometimes it s painful around my chest area..is it asthma ? And also sometime when I am stress out n shouting loudly I feel unconscious :/ is something wrong with me? ### REPLY: Hi thanks for asking question.Don't worry about your condition. Here are few possibility.1. You have difficult breath and chest pain while crying, angry or stress condition. Try to avoid stress as per history it seems to be simple anxiety induce panic attack. Better you involve your self in some regular activity, meat with friends and try to avoid anger. Do regular exercise and avoid situation that lead to stress or anger.2.second this can be because of some resp condition like bronchitis or cold if headache, cough etc. present. If resp symptoms increasing chest x-ray or pulmonary function test helpful.3. The pain might be simply muscular. It can be because of viral infection, bad sleep posture or overexercising. Simple analgesic is helpful.4. If still chest pain increasing then ECG will be done to investigate further. Just now maintain healthy lifestyle with regular exercise and avoid stress. If stress will not be controlled by these then . I hope my suggestion will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: BP of 151/101 with upper left abdominal pain . 47yo male 220lbs 5 8 . Abdominal CT from 1 year ago is clear of any issues with Kidneys, Galbladder and Pacreus. GI doc says he has no idea. Ordered a EGD for 1 month out with follow up in 3 months. Pain in daily starting Dull/achy to sharp and stabbing especially after meals. Should I take him to the ER? ### REPLY: Hello and welcome. Thanks for your query. The one symptom of pain after meals, is most commonly associated with peptic ulcer disease (PUD). Which is an ulcer found either in the duodenum (which is the first part of the intestine, that is connected to the stomach) or the stomach itself. The main differential factor is the duration or initiation of pain after a meal. In the presence of an ulcer in the stomach the pain usually starts 15-20 minutes after a meal, which is how much time the food takes to reach the stomach and irritate the ulcer.  In the case of a duodenal ulcer, the pain starts around 2 hours after a meal, which is how much time the food takes to reach the duodenum after consumption. Other findings of a gastric ulcer are: -Vomiting helps in reducing the symptoms-Appetite is usually normal-Patient usually experiences loss of weight-In a complicated or bleeding stomach ulcer, we find traces of blood in the vomits, and rarely black or dark brownish colored stools -More common in patients belonging to lower socio-economic status (lower middle class most common) Other findings of a duodenal ulcer are:- Higher socio-economic status patients-Normal or increased appetite-Normal or increased weight-Darkish brown stool is more common than bloody vomits I hope these details at least help you in ruling out an ulcer. An endoscopy would also help in visualizing the ulcer, size and location, and can also take a biopsy (tissue sample) at the same time. Please discuss the details with your doctor. For any further clarifications, you can always write back to us. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sudden Sharp pain in right knee right side of knee . No injury no fall,? Just started as a instant sharp burning pain inside the knee from front right side of knee to the back of right side of knee . To painful to walk lifting up n down my knee. And even just resting the pain is realy bad 9/10 whats wrong with me ### REPLY: Hi, Thanks for your query. Your pain is due to Arthritis. When bone is not able to take weight due to arthritis than it has to be shared by muscles. Also, some time it can be due to nerve compression. You can judge your self. If your pain increases on walking and relieved with rest, it is suggestive of nerve related pain. Arthritis pain is present even when you are taking rest. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir one of my friend got a back injury several years ago but it eventually gets healed but after those few years now he experiencing some pain at that area when he stand for a long time or do some rigorous work one at a time..so can you tell me what is the reason behind it? ### REPLY: Hi, welcome to our site. I am , MD. Read your query. That is a very significant question and I appreciate your problem. I will try my best to answer your queryWhenever there is a back injury, the symptoms may heal fast mostly, if superficial. And a person feels relieved that he/she has healed because the symptoms are gone. But many times a small defect may be left behind, like say compression of the disc that lies between the bones. Now the person feels everything is fine and resumes the normal activities. However, the pain increases slowly as the compression that the person is carrying slowly gets worse. I guess something similar may be happening in your case as well. I hope this helps you. Inform the reports mentioned above/if any other, so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my friend was diagnosed with colorectal cancer 2 months ago, recently changed to melanoma colorectal cancer, and is on her last week of treatment. She was doing ok but in the past 2 weeks she has developed what looks like a very swollen stomach that is very hard to the touch. They drained it partialy from one side once but it is growing again. Supossedly the doctor dosnt know whats causing it? What could be causing it? ### REPLY: Hi, Thanks for writing in. Colorectal cancer is cancer of the large bowel which is usually of adenocarcinoma type. Melanoma colorectal cancer is a rare type that is associated with pigment forming cancer of the colon. This is an aggressive cancer and can spread quickly to other parts of the body. If your friend has melanoma colorectal cancer then it is possible that the cancer might have spread to other organs. A melanoma colorectal cancer might spread to liver, peritoneum, lungs, bones and brain. Since she is having fluid collection in the abdomen therefore metastasis to peritoneum might be present. Melanoma colorectal cancer spreads too fast and sometimes even doctors are able to make a confirmed diagnosis only when it has reached the later stages. Your friend might require a whole body PET CT scan to know the spread of cancer and then treatment with chemotherapy might be suggested.  .  Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,my wife had PCOS prolem sice six months, from that time she is taking medication from gynae, still so far she didnt concieve, we are eagerly waiting for children, how sereious the problem is, when can we expect pregnancy and my wife details: she is 26, 5.2", 55Kg.PLZ help in ### REPLY: Hi welcome to . I have gone through your question. For POD polycystic ovarian disease there are small follicles from which no follicle develop up to the mark that can rupture. So for that for follicles stimulation .  This should be taken after consulting your gynecologist. So consult your gynecologist and discuss further management plan. Hope I answered your question. Would be happy to help you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor,My two and half year old son has loose stool with Pus Cells 5-8/hpf. Sometimes he says there is a pain in the stomach. I would like to seek your kind advise if the presence of 5-8/hpf pus cell in the stool is normal or need some treatment. Thanks ### REPLY: HI...pus cells of 5-8/HP is a normal report. Nothing to worry about it. By what you quote I feel that your kid is having a viral diarrhea. Will tell you about it to relieve your stress. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi sir........... one of my driver had come with the following problem. he had noticed yellow color in the white part of eyes.he assumed it to be jaundice and consulted a doctor at his village.all required blood tests were done.all reports came as normal.still he has yellow color of eyes. he has this problem for the past 2 years. he drinks alcohol once in a month or twice. what could be the reason for this???? ### REPLY: Hi, Thanks for posting your query. Few of the people have muddy sclera which appears to be yellow. Kindly ask him whether he has any past history of jaundice or not. Sometimes jaundice at any time of life may cause discoloration of sclera permanently. Does he have yellow discoloration of urine/ loss of appetite/ vomiting/ abdominal pain/ itching in body? He should go for ultrasound imaging along with repeat liver function test. If he is getting yellow colored stool with normal color urine then there is no chance of jaundice. 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: Yes! I ve been having excruciating neck & shoulder pain with the feeling of electricity running through my shoulder & then it will subside for a few minutes & then come back much stronger.I m at the point I can barely turn my head...It s getting much worst by the day..Can you please tell me what it could be? Thank You,Robert YYYY@YYYY ### REPLY: Dear patient your symptoms indicate diagnosis of cervical radiculopathy. This happens due to cervical disc prolapse. Nerve roots compression at cervical level leads to sharp articular pain in upper limb. This needs to be investigated with 1) X-ray of cervical spine anteroposterior and lateral views 2) MRI of cervical spine. X-ray will give idea about overall alignment of cervical spine. MRI is more sensitive and specific for diagnosis of spinal cord pathology and nerve roots compression. Please get it done from radiology center nearby you.  Meanwhile, start tab regain x 75 one at bedtime. You need to consult neurophyysician with MRI report. Further treatment van be done based on MRI report. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, I found a lump under my 5 months baby left armpit about 2 months ago. I also notice a significant appetite decrease at about the same time. Her birth weight is 3.2 kg, on exclusive breastfeeding and gained weight pretty well until last month. She has been 6.9 kg since last month, didn t gain an ounce. I have heard that BCG vaccine might have caused this. Is that mean my baby is infected by TBC? ### REPLY: Hello, I appreciate your concern.  What your baby has is called a BCG lymphadenitis (swelling of the lymph node in her armpit). Her weight gain so far has been good and if there is no weight loss or fever or pus from the swelling, there is no need to investigate. It should resolve in the next few weeks. When you should take her to a doctor:1. High fever2. Prolonged cough3. Pus from the swelling4. Increase in size of the swelling It does not mean your child has TB (M. Tuberculosis). M. Boris is a type of mycobacterium that is used for the BCG vaccine, and is nothing to worry about. Hope this helps 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: our doctor suggest for skin biopsy.so we do.result is boderline lepromatous hansens disease.we are not satisfied so we are going for another suggestion.the second suggested for another few test.LD BODY(AB CELL)-report in negative.ESR-report is 30 mm at the end of 1st hour(method-sysmex xe-2100/sysmex xt-2000i/advia 2120 cell counter)ACE-ESTIMATION-report is 182.1u/l. (method-kinetic)SKIN SMEAR FOR AFB FOR EFFECTED AREA- report is negative.CHEST X-RAY PA VIEW-report is the mid & lower zone of the left lung pneumonitis.Now we are very confiused. Please Suggest ### REPLY: Hello, Skin lesion with lung infiltration seen with connective tissue diseases (CTD) and pneumonia. So better to consult pulmonologist and get done ANA (antinuclear antibody) tier and profile to rule out CTD. Get done CT thorax and bronchoscopy for pneumonia. You may need antibiotics if it is pneumonia. You may need immunosuppressive therapy if it is CTD. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi ,In a preventive health check up,I was diagnosed with Fatty liver grade 2 also with increased level of sgot/sgpt as  135/185 ,hep b and c negative,ceruplasmin within range,ANA test negative,gloubmin within range,ASMA weakly positive as 1:20 also increase in cholestrol levels to 233 .I am an software engineer and also overweight upto 23 kgs.What could be the reason of my some values being abnormal? ### REPLY: HI, thanks for using  Fatty liver is the accumulation of fat in the liver. It can progress to cause impaired liver function. Fatty liver can be due to alcohol or classified as NON-alcoholic fatty liver.Non-alcoholic fatty liver disease tends to occur in persons who are overweight or obese, have diabetes, high cholesterol, high triglycerides and have poor eating habits. The fatty liver seen on imaging is very likely the cause of the increase in your liver enzymes (the got, Sept). Lifestyle changes can prevent any further worsening of your liver function. You may need to adjust your diet and increase your physical activity. Weight loss, though difficult, would be very helpful. 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: About two months ago myself and my boyfriend developed a rash on our arms that has spread to various places on our bodies. It itches alot and we assumed we had gotten poison ivy from the fire wood we were putting in our wood stove. We have been treating it with itch cream, calmine lotion and also tried putting alcohol on it to dry it up. It seems to be drying up in places but contiues to itch and turn up in other spots. We have tried determining if we have been using anything different such as soap, laundry detergent, etc. Nothing has been changed. What do you think  it is and how do we get rid of it. It is driving us crazy. My boyfriend recently went to doctor who gave him a steroid pack to take and he has taken all of the pills and is still itching. ### REPLY: Hi Welcome to  Forum From your clinical picture, it looks like both of you are having scabies. Scabies is a mite infestation presenting with itching popular lesions all over the body, mainly over abdomen, finger webspaces, thigh and genitalia. It usually causes more itching at night. It is a contagious condition, so proper treatment of the patient and the contacts has to be doneSteroids won't be of any help to you, so please stop taking steroids. You need to apply 5 percent permethrin cream all over your body. Single application of this cream all over the body below the neck is to be done,,,Apply it at night, leave it overnight, take bath the next morning. Use rotation cream from the next day twice a day over the affected areas. Take antihistamines like levocetrizine for itching have to take care also to disinfect all your clothes and weddings by washing them in warm water and . . And also find out, if anybody else from your family has similar lesions or itching, then they should also be treated... Wishing you speedy recovery  ### END