Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor! I am a female aged 27 yrs from India. I have sensitive skin since birth which breaks out into rashes in contact with dust, heat, sweat, pollen, insect bite, etc. I am prone to dust and pollen allergy as well. My current problem area is my neck and the base of neck. It started two weeks back when I went out in the strong summer sun. The area became reddish-maroon, itchy and subsequently started burning. I applied ice, aloe vera and other natural cooling agents thinking its a sunburn. It healed after a few days with dead skin peeling off. However, the same problem has resurfaced two days back though this time I have taken all precaution to cover every inch of my skin before stepping out in the sun. Constant sweating due to humid Indian conditions is making my condition worse and the burns more sore. Please help!! The marks look ugly and hurt and burn every time it comes in contact with even clothes!! ### REPLY: Hi there.1. Your concern may be militia Aubrey.2. Stop using harsh later soaps instead prefer mild cleansers for body wash.3. You can try lite liquid paraffin lotion, apply it twice daily on affected areas after body wash, apply it on damp skin.4. Dust any clotrimazole dusting powder after applying liquid paraffin.5. Prefer cool places and avoid sweat provocative activities.6. Have diet rich in it C.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: Hi. I m a 50yr old healthy male and I have suffered with upper central abdominal pain for about 7 months nows that radiates to my back at times. The pain is constant, but is made worse when I don t eat and when I do. When I eat I feel full very quickly, my stomach bloats, and becomes really tight. I find it difficult to swallow when I eat. After eating I produce a lot of gas and feel nauseous. I go to the toilet and defecate numerous times a day and what comes out is soft, greasy and floats. My urine is a lot darker and I ve noticed my the whites of my eyes are yellow. I ve been to the GP a number of times but they haven t been much help, they give me medication which makes me worse and they don t know what is wrong. I ve been tested for the food intolerances but I have none, had an endoscopy which showed my oesophagus and stomach are fine and had an ultrasound which shows no gallstones. I ve lost a bit of weight but I m not sure as to whether this because I can t eat as much? Any ideas on what it might be or what I should do? ### REPLY: Dear Nicky, The duration of the pain that you mention is of concern. Even though you have had normal endoscopy and normal ultrasound, the symptoms do suggest that you do have some upper intestinal problems. The mention of greasy foamy stool suggests that you have problem digesting fat. This might happen when your pancreas is not functioning properly. Repeated attacks of inflammation of the pancreas can cause this type of damage and the condition is called "Pancreatitis ". Even though the most common cause is gallstones, other conditions can also cause this. This could be alcohol related or viral infections. I would recommend that you see a digestive disease specialist who can perform aditionaltesting to look for problems with pancreas. 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: Hey I am 18 years old and a female, for 3 weeks now I have had pains all over my stomach , it gradually seems to be getting worse. Hurts to walk and move, can t even sit down or lay doe without it hurting. I m starting to get worried. I last had a period 2 months ago, last sexual partner a month ago, I was supposed to come on period on the 18th, 3 weeks late and I m starting to get worried, I have taken a home pregnancy test and came through negative. Anyone out there who can help?! This pain is unbearable! ### REPLY: Hi ! I think the home pregnancy test is not a confirmatory test to exclude a pregnancy, specially if it is somewhere else than its normal position in the uterus. From the history of your symptoms two possibilities are coming to the mind : 1) A neglected Urinary tract infection or pelvic infection, which has spread and causing the symptoms of a peritoneum. 2) A chronic ectopic pregnancy, which might have partially ruptured and causing such pain leading to a diagnosis of peritonitis. I would suggest you to visit your gynecologist at the earliest, who may advise you for a serum  test, and an ultrasound of the abdomen to arrive at a diagnosis to decide on further course of action. 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, I m a 20 year old pretty healthy female, I m having right abdominal pain. My urine is foggy but it isn t painful. It s been hurting all day, as if I haven t used the bathroom in hours but I have. My period was two weeks ago, so I don t think that s it. ### REPLY: Hello! Thanks for putting your query in . I am a Gastroenterologist (DM). Abdominal pain on right side may be due to many causes related to liver, gallbladder, billiard tract, stomach or intestine, so I will suggest you to visit a Gastroenterologist for evaluation and management. I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my son is 2 years and 8 months old and i noticed mucus in his stool...i am worried because since few days he was suffering with loose motions and fever...but now fever and loose motions have stopped but i can see mucus in his stool? what could be the reason and what the remedy? pls advice as i am very much worried? ### REPLY: Hi.... I understand your concern. Initially it should have started as viral diarrhea. Mucoid stool is normal in viral diarrhea. Nothing to worry about it. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. 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 a family member who they believed may have suffered a TIA a couple of years ago.  She is now suffering severe short term memory loss as well as some cognitive issues.  Is there no real way to treat someone suffering from TIA.  The doctors at the time said the MRI and brain scans did not show a stroke so they really assumed it was a very mild TIA.  She was given meds for her sever BP but that was really it.  Again she now several years later is dealing with this memory loss.  Neurologist cant really say anything  other than it looks like she may continue to get worse until she may not have any memory.  Is there any hope that she could get better from this? ### REPLY: Hi, it appears that she might have ischemia of the parietal lobe where there is center of the memory lies. It may or may not have relation with the previous attack. M.R.I., and color Doppler may show some clue whether something can be done.  I to my patients with such symptoms prescribe, glutathione besides neurotrophic .  I also advise her to take green leafy vegetables, pulses, sprouts, and protein rich foods, for general neurological recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello can you please help me my father is 50 years old and he is a heavy drinker. Lately he has been having these sudden attacks of him not bieng able to brethe. It usually happens when he coughs. He coughs and keeps on coughing until he cant breathe and then he looses consciousness. He usually wakes up a few seconds after loosing consciousness and he does not know what happened. He gets really red and very twitchy when he has loss of air and im afraid these attacks will get worse but i do not know what it is and how to help it. my father did go in for a check up but they said all he has is just loss of breathe but i dont think thats it. He also has been like this for about a year or two. please if you can help me i will really appreciate it. ### REPLY: Thanks for your question on . I can understand your concern. Chronic and heavy alcoholics are prone for lung infections and bronchitis because of poor immunity. So we should get done chest x-ray and PFT (Pulmonary Function Test) first. He may need antibiotics and inhaled treatment. If all these reports are normal then possibility of chine strokes breathing is more likely. It is CNS breathing commonly seen in heavy . Treatment is alcohol abstinence. If he is won't quit alcohol now, his condition will worsen only. Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 14 year old girl with a history of unexplained medical issues. I am 5 5 and 120 pounds. Recently I have had shortness of breath along with chest pain around my rib cage. My abdomen has been rather uncomfortable with some pain as well. I have been slightly nauseous, and have started having night sweats about every other night. Also have been itching all over my body. Any answers? ### REPLY: Hello! Welcome and thank you for asking on ! I passed carefully through your question and would explain that it is necessary performing a comprehensive differential diagnosis between different possible causes that may lead to this clinical scenario: a lung disorder, an allergic reaction, a metabolic disorder, an infection, etc.  Coming to this point, I would recommend consulting with your attending physician for a careful physical exam and some tests: - a resting ECG- a chest X-ray study and pulmonary function tests-complete blood count, PCR, ESR for inflammation- thyroid hormone levels for thyroid dysfunction- blood electrolytes- an abdominal ultrasound- a urinalysis - allergy tests. You should discuss with your doctor on the above issues. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: last year my 15 year old daughter had redness and swelling in her right breast. I immediately took her to the dr. Had a mammogram...it came back benign. They tried to drain it at first but it wasn t anything there. Now the same breast is causing these same problems...What could it be? Help ### REPLY: Thanks for your question on . In my opinion you should not worry much for cancer in your daughter. She is in pubertal age. So many hormonal changes are occurring at a same time. And this changes can cause benign breast swelling which is having on and off appearance. Your biopsy report is also negative so no need to worry much. Mostly this swelling will subside by its own once hormonal imbalance settle down. Mostly after 17-18 years all the female hormone s are becoming normal and so the changes due to them are also getting normal. So no need to worry much for your daughters breast lump. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 noticed my 7 yr. old son has broken out with red bumps with open sores on his thighs, a few on his torso & a couple on his arms. He has no fever. They are itchy. My first thought was poison ivy but He has not been outside playing in the last 48 hrs. ### REPLY: Hi, thank you for choosing . The red bumps may be a local bacterial infection which has spread, apply local antibiotic over the lesions and try to give oral antihistamines to reduce the itching. If the lesions are increasing give oral antibiotic for which you have to consult your child specialist. Hope this has been helpful to you, kindly feel free to contact again for any queries. Kindly rate the answer if so. 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 just undergone a salpingectomy 7 weeks ago, L tube. My R tube was removed in 2005 with the same problem i had fluid in them, I an still having chronic pelvic pain and now i seem to be finding Intercourse painful too! ;-( which wasnt a problem before.....what do you think it is and i should do? Many thanks Amanda kay x ### REPLY: Hi welcome to  forum.  Thanks for calling . F.  As you describe you had salpingectomy of right tube in 2005, and left side 7 weeks before, for the same reason. Still you are having pelvic pain, and pain on intercourse.  First thing to be considered is whether only tubes are removed or along with the ovaries, (salting oophorectomy) Including second operation you might have got both ovaries removed, probably. It causes lack of estrogen harmony, and .  Which cause pain during intercourse. If it is the case Harmony replacement therapy may be needed.  If ovaries are not removed the pain during intercourse might be due to infection.  Cause of pelvic pain could be remnant pelvic infection, or adhesions of the disease or operation.  I advise you to consult your gynecologist for diagnosis and treatment.  Wishing for a quick and complete recovery.  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: Dear Doctor, I observed a friend who called me for help who has a history of alcoholism since age 16 who has battled this addiction off and on for 39 years. He lost his father and went through a horrific divorce while having issues at work with his manager and started with panic attacks which he was hospitalized for around 4 years ago. He is a retired veteran with 20 plus years serving in the Air Force. He only has Tricare insurance and has been unable to get into alcohol rehab. He has never been to rehab to date. Now he is on Claritin 10 mg qd for allergies, Propranolol ER 60 mg qd for HTN and Venlofaxine ER (Effexor SR) 150 mg and 75 mg each qd for major depression despite drinking vodka heavily. I observed him today and he was coherent and interacting appropriately without slurring of words. He stepped into another room to retrieve some paperwork for possible alcohol rehab and returned and I observed him rapidly decompensate in front of me within 10 minutes to the point he was unable to converse and became incoherent staggering and tearful and fearful loosing all rationality and on the verge of paranoia. Unable to be reasoned with and verbally hostile and blaming me his best friend for messing up his life. I suspected he gulped some vodka because I found empty vodka bottles in the room where he retrieved the papers from. I have never seen anyone go from sanity to beyond intoxicated that quickly. Could the Effexor be contributing to the potentiated effect? His PCP was informed of his alcohol consumption on more than one occasion by his son and told my friend s son who accompanied him to his PCP visits. The Nurse Practitioner (NP) said that the patient s alcohol consumption it was not an issue to be concerned about relating to the Effexor and any interactions. the patient was encouraged to decrease his consumption , but I believe the anxiety is worsening therefore he is increasing his self medication (vodka consumption) which is a depressant. The NP also said she had done some sort of special mail out blood test that indicated that Effexor was the proper medication for the patient. I believe this to be hogwash. He is now missing work and risks his livelihood because he has progressively become worse since starting on the Effexor which his PCP continues to increase. Can Effexor exacerbate alcohols depressive effect and increase anxiety and contribute to a near hallucinatory condition to the point he babbles, repeats himself, talks nonsensical and acts like he is going insane? No ability to process information or interact with another person, lashing out at those closest to him? I almost called 911 today, but instead after 2 hour got him called down to wear he fell asleep. I watched him until he awoke nearly an hour later and got up and then laid back down to sleep. I called his son s who one is staying with him and another who looks in on him daily. If this happens again we, his son s and I plan to take him to the ED for an emergency assessment. Also we plan to get him under the care of a physician PCP with appropriate training, a MD or DO. Is this a reasonable plan? Thanks, RJ ### REPLY: Dear serve understand your concerns went through your details. Effector is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class. This does not cause anxiety. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. 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: hello, im 22 years old and last year i was dignosed with kidney stones.  The CT scan showed a slight fracture in my lumbar of my lower back.  I thought nothing of this for awhile, when a couple months back I started waking up with real bad pain in my back every morning and at random times during the day do you think it has gotten worse? and what should I do? ### REPLY: Hello and welcome to .  As a Urologist, i can understand your anxiety. More than the kidney stones, its your lumbar fracture giving you the pain. You will need to do an MRI scan of the lumbosacral region. See an orthopedic or a spinal surgeon and he'll decide on treatment. The stones can be treated later or a stenting can be done simultaneously, with the spinal surgery. If you've any doubts, you may send a direct question to me. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A recent Sono showman anechoic cyst at the right renal upper to mid pole measures 4.2 cm. Right renal parenchymal thickness and echo texture otherwise appears within normal limits . There is no evidence of right sided hydronephrosis or renal calculi. Last Nov, the cyst measured 3.1 cm looks like and increase Please advise on this condition. This is a follow up from the Dr s orders. Please advise as to what questions we should ask regarding the findings. ### REPLY: HelloThanks for query. Based on the facts that you have posted you have been detected to have solitary cyst in upper pole of your right kidney. These cysts are benign in nature and present since birth. Normally no treatment is required.  Treatment is required in special situation when there is sudden increase in size of the cyst giving rise to severe pain in loin, or it gets infected. The size of the cyst that you have need to be monitored every year and active intervention (if needed) can be considered if there is persistent increase in size of the cyst. There are no specific questions to be asked for apart from size of the cyst and need for its removal .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: WI had heart attack 10 years ago am currently taking medication for blood pressure control also blood thinners and cholesterol meds 2 days ago I started having severe pain in lower legs associated with sever cramping more so in the right leg when I try to walk my calls completely lock up on the right leg pain on side of lower leg feels like nerve damage, l also have back issues that cause Pain in lower legs but never this severe this problem just popped up all of a sudden but will not stop hurting, before this started I was walking more than three miles every day now I cannot walk half a block. Any idea what is happening to me? I am healthy other than the heart attack over ten years ago and have not had any issues with heart since. ### REPLY: Hi, I understand your concern. The pain on your right leg on side of lower leg could be due to compression of nearby nerves as you are having back issues (probably sciatica). Please have an X-ray of the back done and consult further with neurologist. Electrolyte balance should be evaluated and properly treated as you are taking high blood pressure meds. Magnesium supplement can help. Muscle pain and weakness as side effect of lowering cholesterol meds should be ruled out. Ubiquitous Qu10 can help to reduce such side effects. Discuss this further with your doctor. Wish fast recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor, I am 42 old woman got married one year back.my cycle is not regular. I want to get pregnant as soon as .for this, I concealed to a OBGYN doctor and she suggested me DUFASTIN 1 tab three time for ten day and Ovofar tow tab a day for five day. I follow her guide line and did TSH and Folicular Monetaring test but after five days of FM test the age was ruptured. Again Doctor suggested to take same medicine. What shall i do for my betterment. ### REPLY: Hi Welcome to  As you are 42 yrs old, chances of conceiving naturally is low because as age advances quality of egg becomes poor and fertility decreases. Your periods are irregular which suggests there is hormonal disturbance. As age advances store of eggs in ovaries also decrease. You need aggressive treatment rather than waiting for things to happen. I would suggest you to undergo 1-2 cycles of GUI combined with ovulation induction(Ovular treatment) and if it is unsuccessful IVF treatment will be best option. Even with IVF, success rate is low at your age. Other option is IVF with donor eggs which has good success rate. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor I am mohd shuja from lucknow of uttar pradesh(INDIA). I am a patient of bronchitis( Asthma ) at the age of 13 and right now my age is 27 .I have taken lots of medicine and consulted the best doctors but doctors have said that it is incurable disease only I can maintain by taking medicine . right now I am taking foracast400 two time a day and levoline 2 times a day. In my throat something Crystal type is stick and then start problem in taking breath. please help me. ### REPLY: Hi, Thanks for using the . You are on steroid which may cause oral thrush (oral fungal infection). Shula you can stop Levine as it should not be taken continuously for long time and can start on plain montelukast 5 mg tab (since you are 13 year) once daily in evening and can reduce dose of forecourt gradually. This will help you to reduce side effects and also improvement in your health status. Hope I have answered your query. If you have any further questions I will be happy to help. Thanks get well soon.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My two year old has had a light spotty rash on his chest and face some on back and now had canker sores on his tongue. Benadryl has not worked. He was dignosed Thursday with a viral infection..Fever up to 104 and down to normal till this morning. if that helps ### REPLY: Hi... Thank you for consulting in . It could be any viral erythematous illness. But as you quote them as itchy blisters - the possibilities are Hand Foot Mouth disease/ Chicken pox/ any other trivial viral exanthem. I suggest you use calamine lotion as its giving results along with oral antiallergic like HY .  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi sir am santosh.i have masturbated my pennis in my hands with 24 times wit semen coming outside.buuut yesterday ialso i did d same process but my pennis colour hav been changed to brown in the region of glan and i have pain now.please tell me the effects of this and also tell me if i had a sexual matter with my wife will leads to pregnancy with my masturbated pennis r not ### REPLY: Hello, Masturbation is usually safe and never unhealthy. The pain and discoloration you are experiencing could be due to the pressure you have applied during the masturbation process. Do not masturbate for a week. Masturbation will not hamper your sexual health. Therefore, I suggest consulting a skin specialist for physical examination, diagnosis and treatment. 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 doctor! I am from Sri Lanka . I am from a rich family . I am Enginner .I having every thing in life . but every time I feel lonely . Hate every thing in life . Dont like to go forward in socity . Dont know why . Some time feel to go suiside .Dont know why plz help me ### REPLY: Hello, I suggest you not to worry much. I assure you that you are not depressed or having any mental disorder. You may be lacking your self-confidence or self-esteem. It could happen due to many disappointing situations happen in everyday life. I suppose that you are just disappointed. Please consult a psychologist for counseling, and you should overcome your present problem. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an episode tonight : I began to choke on aspirated liquid. My partner began pounding my back. Then my hands began to move as if to clap. My face turned purple. I lost consciousness for a bit. When I began to regain it I noticed my hands still moving as though to clap. I was still having trouble getting any air. Eventually I did. Now my partner and sister are freaked out: You were in seizure!!!, You were GONE!!! etc. Did I have a seizure? Is it brain related or due to lack of oxygen to the brain? If I need to see a doctor, what specialty? I don t have a primary care physician that has any decent history on me... Any thoughts??? ### REPLY: Hello! Welcome on  ! Its seems that you have had a seizure. For this reason, I would recommend consulting with a neurologist and performing a careful neurological exam and some tests: - an EEG-complete blood count-blood electrolytes -a brain CT scan or MRI study. Other tests to consider would be a cardiac check up, including a cardiac ultrasound and an ambulatory Holder rhythm monitoring for cardiac arrhythmia. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had open heart surgery almost 10 months ago. Everything was okay until about 6 months after surgery. As for my heart, my cardiologist assured me that everything was okay. The symptoms that I shared with him were, very very tired. I could sleep all the time. I had a cough, that seemed to be worst in the morning but it could start anytime without any warning, occasionally night sweats, lost weight, from 190 to 160 and no appetite. He told me these symptoms had nothing to do with my medication or my heart. I had blood work and I am anemic. I was put on iron and vitamin D. What could be wrong with me? Thank you ### REPLY: Hi, It depends on the type of surgery you have undergone. In case you had a surgery of valve replacement, it can have complications of anemia. Your complaints most probably are caused by anemia. If your surgery wasn't valve replacement surgery, then you should look another cause for your anemia and symptoms. Anyway iron will help to recover from anemia. Hope I could help nourishing you good health In case of further questions don't hesitate to ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 bad teeth problem all my life and basically have got em fix , i still was having plague problem on my teeth but that problem has been bascially resovled after 8 cleanings in 1 year , but now the plague is being built on my lips , what should i do to prevent this ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have mentioned that you have bad teeth, plaque on teeth, for this you should Do proper Brushing twice daily Do Chlorhexidine mouthwash twice daily to prevent bad breath And go to dentist for Oral Prophylaxis As you have mentioned that you have plaque on your lips for this you should go for Local examination to dentist for proper diagnosis, maybe it can be Traumatic keratitis, or and white lesion that you are thinking of plaque Or if it is plaque go for Scaling and root planning Hope this will help you.  Wish you good healthRegards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 blisters on my glans penis ...... I have no prob in passing urine or pain . some times i get tingling sensation ..i have been to 5 doctors out of which 2 said it is herpes and 3 others said it is simple infection.. This blisters r continously coming and going for past 2 years. Had de first episode of blisters around 5 years ago.. ### REPLY: HelloThanks for query. Based on your statement I would sate that you have Herpes 2 genital Herpes infection . Herpes infection can remain dormant for many years and relapse again some time. Get following basic tests done to confirm the diagnosis,1)The swab test and culture of a fluid from blister 2)PCR blood test 3)Blood test to detect HSV antibodies.In the meanwhile tale Acyclovir twice daily for 10 days. Get the prescription from your family Physician. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! I got my ultrasound at 12 wks. It shows both uterine arteries have high resistance flow ( mean is. 85) .the baby s growth is perfect. my gynae has given me ecosprin75. Is it safe for the baby? Will it lead to excessive blood loss during delivery? This is my second child and I have 5 yr old who was delivered normal. Thanks! ### REPLY: HELLO THERE. YES CONSPIRING IS SAFE. BUT ITS USE IS INDICATED ONLY WHEN YOU HAVE PREVIOUS HISTORY OF RAISED BLOOD PRESSURE OR GROWTH RESTRICTION IN PREVIOUS PREGNANCY.HOWEVER HIGH RESISTANCE IN THE UTERINE ARTERIES ARE ALSO INDICATIONS THAT YOU MIGHT DEVELOP THESE COMPLICATIONS LATER IN PREGNANCY.CONSPIRING HELPS To avoid THESE. DO NOT WORRY ABOUT HAVING BLEEDING DURING DELIVERY. THIS IS BECAUSE CONSPIRING IS STOPPED AFTER 34 WEEKS SO THERE IS NO RISK OF EXCESS BLEEDING AT DELIVERY. 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 am 48 years old and I have a little pimple like bump inside my nose. I also have a hard lump under my nose that is causing my lips to swell up.  In the past I have been told similar things are infected hair follicles.  I cant go to work because I look like a freak.  what can i do to make swelling go away? ### REPLY: Hi Dear, welcome to . Understanding your concern. Thanks for your query. The pimple in the nose is usually painful ANF hard to treat because of location. There can be many reasons for pimple inside nose like nose picking, hair picking, environmental factors and use of excess antibiotic. The pimple under your nose is most probably a cold sore. I would suggest you to clean your nostrils with warm water twice a day to remove dust and bacteria, apply antiseptic cream or tea tree oil as an antiseptic, apply ice on nose to reduce swelling and take ibuprofen (if not allergic) or paracetamol for pain and swelling. Apply same method to lump on lip. I condition doesn't resolve in 2-3 days then consult dermatologist for proper examination and treatment. Doctor may prescribe antibiotics for at least a week if there is foliculitis. 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: I just had my CBC done to check my Hb level which is normal 12.9 g/dl and other values are also in a normal range but i had a raised MPV thats 12.7, can it be due to mentrual cycle because its my due date.I actually dont have periods now but its my due date cause my ESR is also raised 23mm/1st hour???If MPV is not raised due to menstruation then what are the possible causes??is it serious? ### REPLY: Hello, Thanks for your query. A high mean platelet volume is an indication that something is causing the destruction of the platelets or that the production of the platelets is increased. Platelets play an important role in our blood clotting. A high mean platelet volume also means that the blood will clot faster, which can lead to thrombosis and stroke. Leukemia and idiopathic thrombocytopenic purpura can both cause an increase in the mean platelet volume. 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: I have the gum infection and i have tried with several doctors to treatment but so far no results.....they also removed several of my teeth and have few cracked teeth left and am unable to eat well.  I am also feeling weak with reduced palpitations.  and other complications coming up.....i am travelling to bombay tomorrow.  what should i do ### REPLY: Thanks for your query, I have gone through your query. The gum infection can be treated with scaling and root planing, if needed bone grafting. The cracked teeth can be treated with either RCT or extraction. Before that we need to find out the cause for the gum infection and cracked teeth. If the gum infection and loose teeth is because of the deposits then the scaling and root planing will work. If the cracked teeth are secondary to grinding your teeth during nighttime(bruise), then you need to get a soft splint to prevent damage to the bone and teeth. For this you need to consult an oral physician and get it evaluated. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, I am Male patient . My doctor give me two test (Testosterone its 3.98 ng/ml) and (Prolactin 10.9 ng/ml) then he prescribed me 12 injections (Koragan 5000 I.U) and said 1 injection per week. also prescribed tablet Bromocriptin for 2 months. Now am worried about this hormone injection (Koragan), is this right for me or i shouldnt use it? please suggest me what should i do. ### REPLY: Hello, From the history given I understand that you are undergoing treatment of infertility associated with hyperprolactinemia (elevated blood prolactin) and hypogonadism (decreased male sex hormone testosterone) Foreign hormone (human chorionic gonadotropin) injection is used in the treatment of male hypogonadism to increase the testosterone level. Generally, it is well tolerated by most of the men however its common side effects include injection site pain, headache, fatigue, acne, sweating, deepening of the voice and depression.  If these bother you or appear serious, let your doctor know.  It is the correct treatment and continues to take injection foreign as prescribed by your doctor to overcome the issue of infertility. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have very bad allergies due to high pollen count. In the back of my tongue and side my taste buds are swoolen and also the bell in the back of the throat is also and i have a bad post nasel drip. i have been gargling with water water and salt but my throat seem to get more worse what can i take or do. ### REPLY: HelloWallet causes inflammation of nasal lining membrane hence there develop. Nasal itching, watery gonorrhea, nasal obstruction, sneezing, post nasal discharge (as most of these symptoms, you are having). Do following measure. If possible change the site or place and migrate to pollen free area. As pollen is a predisposing factors for asthma. When such patients visit my clinic I advise them to take MONTELUKAST+ FEXOFENDINE tablet once or twice in day according to severity of symptoms. Steam inhalation also provide relief. For throat take some longer of dextromethorphan, available over chemist shop. Still no relief then take levofloxacin 750 mg tablet once in a day for 5-7 days. Hope this will be helpful for 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, 3 months ago my friend had a showdown at work and as a result of a lot of stress. I took him to a psychologist who recommended him Ativan and Oleanz Plus. He is 35, male and works in a industry requiring long hours.since that episode it has been 3 months and he has these flare ups. He stopped the meds within a week, and is trying to engage himself socially more. but negative thoughts seems to be hounding him again and he refuses to see a counsellor. His thoughts are random, like he is being spied on, or people are out there to get him, or he doesnt "know what is gioing on" and thinks others know more about him and not telling him that. How can i get him to confront this. ### REPLY: Hi, Thanks for using . I have gone through your available history. Your friend seems to have developed schizophreniform disorder or adjustment disorder with psychotic features. He requires medication as well as counselling. If he does not agree to consult psychiatrist, you can give some medications like olanzapine or risperidone out of knowledge of the patient. You may have prescription from your local doctor for the same. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 41 and have been diagnosed with hypertension.  My blood pressure was 198/116 on Friday and today it was 169/98, which is obviously still too high.  When I was first diagnosed about a year ago my blood pressure was 215/110, they conducted all the tests then, due to the fact I am also a type 2 diabetic.  Can you assist me with what may be causing the problem? ### REPLY: Brief Answer:You should see an internist. Detailed Answer:Hello, Thank you for using . I understand your concern. Your age is too young, and your blood pressure levels are too high, to have an essential (primary) hypertension. You should be screened for all the secondary possible causes of hypertension such as renal stenosis, renal parenchymal disease, Cushing syn . For excluding each of them, you need to do a series of laboratory and imaging exams. The internist is the adequate doctor which may lead you in detecting the causing factor of your hypertension. I seem a little long way to do, but I encourage you to go under it, cause treating the causing factor once is better than treating hypertension for all of your life. There are even cases in which even though you do all tests for secondary causes, it doesn't get out nothing. At this case we are in front of an idiopathic hypertension, which we have to deal with. Hope this is helpful. Let me know if you need more clarifications. Otherwise, please close and rate the answer. Kind  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 34 wks pregnant and have 2 vaginal lumps 1 in the crease where my thigh and virgina meet and a smaller one just inside the lip of my virgina the outside one did pop and bleed a little but feels hard still :( is this serious is my 14 year partner a cheat ? ### REPLY: Hi. Thanks for your query. Noted your history of 34 weeks pregnancy and having 2 lumps, the bigger one at the crease of vagina and the thigh and the smaller one at the lip of vagina. One of them pop up and bled but still feel hard. I do not think that your partner of 14 years cheated you as these lumps appear to be infected cysts or so and not an STD. Please get checked by a Gynecologist to be ascertained about the diagnosis and have proper treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor ,My husband 30+ is suffering from chronic sinusitis . its been 7 months now we have tried homeopathy and he took lots of antibiotics also . He feels very tired all the time mentally and physically there is so much weakness . Discharge from the nose is brownish thick and when it gets worse he sneezzed a lot . He is an IT professional . it seems his immunity and strenght is decreasing day by day . My questions are  What kind of Food i should give him to regain the energy ? Should we go for Surgery ??What is the solution or mendatory precautions ?? Please advice ASAP. Thanks a lot Megha Pune ### REPLY: Hello. Welcome to . I am .  Chronic sinusitis is a really disturbing condition. Due to nasal congestion and blockade breathing becomes laborious and incomplete which lead to these king of symptoms. If I was your treating doctor then I would have done following things.1- Detailed history of patient to have insight into causative or precipitating factors.2- Radiological investigation preferably contrast CT of sinuses.3- Endoscopic evaluation and biopsy for observing lesion and specimen for bacterial and fungal culture. Immunological tests for allergen must be done to prevent exposure to various allergens.4- Treatment initially will be directed to suspected pathogen in form of antibiotics and symptomatic relief.5- if after medical measures it is not relieved then ENT surgeon must be consulted and evaluation should be done for surgery.6- Regarding diet food allergen must be avoided. Only garlic has proven to be beneficial in chronic sinusitis by various studied. So it should be included in diet. I hope I have answered your concern in the best possible way. I will be glad to help you further. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir my wife is predancy 8 month raning now. Before 7 month blood sugar is ok,but just start 8 month blood sugar is fasting 77mg/dl and after lunch 171 mg/dl.So I am and my wife very apsad.Tale me fasting 77mg/dl-----after food 171mg/dl is ok or bad my wife and my baby is ok.... ### REPLY: Hello, Thanks for the query. The blood glucose levels fasting 77 mg is normal. However, 171 mg after lunch if that is after 2 hours, then does signify presence of gestational diabetes. My suggestion is got an Oral Glucose Tolerance Test done immediately. If the test values are above 180 mg after 1 hour, & >153 mg after 2 hours, then it is confirmed as gestational diabetes. This has to be immediately controlled first with dietary control. If that does not work, then Insulin injections. It is absolutely essential to maintain blood glucose between 90 and 120 mg all throughout the day. For expected normal outcome of pregnancy and for the health of the fetus this is necessary. Increased glucose level can lead to a bigger fetus (macroscopic) and difficulty in delivery. So please get the necessary test immediately. Then follow doctors instructions meticulously. 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: hello I have a hard lump under the skin on MY buttocks with cellulitis redness and some pain. when taking doxycycline, the lump goes down pain goes  away. I did get a rocephin injection over a Year ago in that spot. thats when all this began. pls help im starting to worry ### REPLY: Hi, I had gone through your question and understand your concerns. At this area it may indicate several issues and most common are colonial cyst or perianal abscesses. These are inflammatory processes in sacral and perianal area usually manifested with pain, redness, swelling, fever and pus discharge. Cellulitis is less common and may be present in sacral area as well. This is mostly caused by beta hemolytic streptococcus, and it necessitates antibiotic treatment with augmenting, or combination of Capitol+ metronidazole. You should also, apply cold compresses, take nonsteroid painkillers such as ibuprofen 400 mg and rest. If there is no improvement within 2 days, you should see doctor and have intravenous antibiotics. 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: Please help me. I got cut on my foot im not sure what had cut me but its very different its not red but is kinda swollen a little but then there is a point wher it goes up kinda like a flat valcano then going in where the cut is and there is a little circle around the cut that is white IS IT INFECTED?! ### REPLY: Hello, Welcome to , The history and symptoms are suggesting me that you may be suffering from a cellulitis following a cut of unknown cause. The symptoms of swelling and discharge from the wound is suggesting that you may be having infection of the wound. For your symptoms I would suggest you to follow1. Keep the area clean and . Take oral antibiotics like Tab Autoclave, 625 mg, twice daily for five days.3. Tab Later D to reduce the swelling and the pain. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have one week noticing a bump or lump growing near to my hairline and my right ear. Is painful and is infected cuz I pop it this morning and pus and fluid reddisChatDoctore out ( nasty ) anyways, I put neosporin after that and a bandaid. Please help. Thanks. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have enlarged cervical lymph node. It can be due to reactive hyperplasia or tuberculosis with abscess formation.  You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Reactive hyperplasia needs a course of antibiotics.  Tuberculosis needs complete course of anti-tuberculous treatment.  Consult your doctor, find the exact cause 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: my wife underwent a CT scan during early pregnancy(1-2 weeks).My doctor has recommended for tripple test with NFT and 2nd level ultrasound. is it necessairy to do chronic villius sampling and amniocentesis to check the health of fetus. i am confused what to do for amniocentesis test result and abortion timings if it is negative and also chance of miscarriage. kindly help me. ### REPLY: Hello, and I hope I can help you today. It takes a very high dose of radiation in order to cause any harm to pregnancy. In the early first trimester, high doses of radiation will produce miscarriage, rather than a genetically abnormal fetus. Furthermore, a cumulative radiation dose of under 5 rd (which is the radiation in about three CAT scans) has not been shown to be a risk for malformations in developing human fetuses. Amniocentesis, or chorionic villus sampling, can only detect diseases of the chromosomes of the fetus. The fetuses chromosomes are formed at conception, and would not be affected by radiation exposure. Therefore, these tests are not necessary unless a high risk is detected on the routine screening tests such as the triple test use in all pregnancies to calculate risk for chromosomal abnormalities. So in summary, I would not recommend aborting this pregnancy based on a radiation exposure under 5 rd before fetus even develops. I agree with your doctor to do the routine genetic screening-which consists of a triple test with nuclei translucency (NT) beginning at 11 weeks gestation and only consider amniocentesis or CVS if that testing appears normal. A level II ultrasound also is essential in every pregnancy to rule out birth defects. However, I want to reemphasize that if the fetus survives the first trimester, It is unlikely that the radiation exposure caused any effect on the pregnancy at all. I hope that I was adequately able to answer your question today, and that my advice is reassuring. Best wishes for the rest of the pregnancy, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hey .... my 6 year old little brother was in the bath and i came to wash him a he has these raised , dry , rough spots on is skin hips up he said they didn t itch they don t look like chicken pocks we did the cup test no results im a bit worried please help xxx ### REPLY: Hi...by what you say I feel that they could be warts which spread by contact. I suggest you consult his dermatologist. But... Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had a severe headache and had someone rub my neck especially in a particular spot right under my skull right of the middle. it feels extremely bruised, limited range of motion for days now. right side of my face and ear also now hurts. what muscle did i bruise and did i do nerve damage as well for it to be affecting my face? ### REPLY: Hello, It looks that a very hard massage was given. Probably it had traumatized your soft tissues at your neck. I shall advise you following to have relief in this:- Wear a soft cervical collar to give rest to soft tissues-Take a good analgesic like Tylenol for relief of pain-Avoid hardworking and continuous sitting in front of computer-Consult to your doctor if numbness at your face or ear area increases or problem does not resolve. In such cases in my OLD I used to give mild steroid preparation to relieve from edema on soft tissue. 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: My daughter is 21 months old.When she gets upset and starts crying she looses her breath.She crys so hard her lips turn blue and her face turns real red.I blow in her face but sometimes it takes 3 or times before it helps.I was wondering if there is something else i can do? ### REPLY: Hi.by what you quote I feel that your kid is having a breath holding spell. The best way is to break the spell. You can achieve this by pinching the kid so that it, the pinching will cause the baby to cry and to cry the baby has to take a breath first and so the breath holding spell will be broken. But to prevent the spell, you need to be clear in not bending to all the whims and fancies of the kid because, kids usually develop this sort of tendency when they are adamant and the adults start accepting their requests when they cry inconsolably. This sort of behavior might in future lead on to adamant. So please curtail it now itself. 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: after implant placing surgeries, i had developed chronic painful irritation in my mouth and gums (cant have spice foods, gums are always red, and even tooth paste causes discomfort) ; also, my left salivary gland gets enlarged occasionally. my dentist (and his colleagues) cant diagnose this condition. please help ### REPLY: Thanks for your query, I have gone through your query. The painful irritation could be secondary to the infection of the implant site or some allergic reaction like allergic dermatitis or licensed reaction to the toothpaste or any restorations or any food items. Consult your oral physician to rule out the above said causes. And treatment can be initiated based on the cause. If is because of the infection of the gum or implant site cleaning of teeth, if it is allergic dermatitis or licensed reaction then topical steroids with discontinuation of the food or things causing allergic reactions. I hope my answer will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I wipd my hand on the tiles of a pool and cut my finger. I removed a slice of the tile from my finger, cleaned it, put on an antiseptic and covered it, Since it happened in the joint of the ring finger, it is tender, swollen, black and blue, and it feels slightly numb at the tip of the finger. What should be done next? ### REPLY: Hi, If I were your treating Doctor for this case, I would straight away put you on a course of antibiotics because yours symptoms indicate that it is a typical case of infected finger. So don't delay and immediately start on definite 500 mg twice a day for five days and antacids with them. So that infection and swell, pain everything gets controlled.  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 ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pain in back near to spinal card ,i check to doctor he told me that u have sand in kidney seen in ultasound and urine test result RBC 03-04 and pus cells 10-12.and i have vomiting .i used medicine ciprofloxacin 500mg twice a day.i used 5 day but i have same pain and pain is deadly.i drink to much water and using wash roam for urine every 5min.for pain i used voren tablits.please give me advice what i do. ### REPLY: HelloThanks for query. Severe plan in back with frequent urination and vomiting with positive findings of stones in kidney and pus cells in urinalysis strongly suggests kidney stones with secondary UTI. You need to get hospitalized for a couple of days and take following treatment .1) Intravenous Fluids .2) I. V antibiotics 3) Pain management if required .4) Assessment of kidney function by blood test for renal functionFurther treatment as regards any endoscopic intervention for treating stones will depend upon the size of the stones and degree of back pressure changes in kidneys reported in ultrasound Scanning report. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 currently taking Harvoni along with my other numerous prescriptions medications and my immune system is real low. I have a recurring herpes sore that has returned on my buttocks and I would like to know what is my best way to treat this at home. I am about out of money from going to doctors as it is. Any suggestions? ### REPLY: Hello, my name is . I understand your concern. Some advices that I can give to you are:-Antiviral herbs: These include elderberry, calendula, echinacea, garlic, straggles and licorice root.-L-lysine (1,000 milligrams three times daily): Can help treat and prevent outbreaks.-Lemon balm extract: Apply as a topical cream for healing-Vitamin C (1,000 milligrams daily)-Zinc (30 milligrams twice daily)-B-complex (50 milligrams daily)-consume orange and red vegetables consume fish Hope my answer was helpful, if you have any other question I will be glad to answer, 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 washaving pain on my left side of my chest weeks ago...and now i am having pain...left side  below ribs..i even have problem in breathing ...i have to take half breath and leave it...i am scared.....my friends say my lung has collapsed....i cant belive them....what can it be ### REPLY: Hi welcome to . Here according to history conclusive diagnosis cant made . Your physical examination including auscultation needed .... It could be emphysema, bronchitis like cause if having habit of smoking .... Sometime if having hypertension history than heart failure could because ... Investigate with .....1. Chest x-ray 2. Spirometry 3.EKG According to cause treatment given Like that if bronchoconstriction present than bronchodilator given in form of inhaler ... If no cause found than HE estimation done for rule out anemia Take care Avoid stress and smoking ... Advise : consult pulmonologist and discuss all this ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: First off I do have hpv.... I had sex with someone new and a few days later noticed my lymph nodes in my groin were sore. No discharge nothing else just swollen nodes for a week now. Today I noticed the fluid filled blisters under the head. Is this my hpv acting up? ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion it is not an HPV.HPV never causes fluid filled blister and lymph nodes. It is other STD. Definitive diagnosis can be possible only after Grams staining from blister fluid followed by microscopic examination. You can wear condom during sex. This will prevent further transmission of infection. You can take the simultaneous treatment of HPV and other STD. Treatment for both the partner is necessary to prevent cross infection. I will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, We are trying to have a baby and gave it a big try this time but as we are planning to go for an Invitro (ICSI) for the next period, my doctor gave me Primolut Not from day 16 to day 25. I am wondering if this will have a negative impact on my pregnancy if I am pregnant because as explained we gave it a big try this time. Thank you in advance for your response. With my Best Regards; Mme Sue ### REPLY: Hellos you are going in for CSI next month, your doctor has given you Primal N for regulating the cycles. However, in case you have conceived this month, it is not advisable to take Primal N, as it causes virilization of female fetus and other abnormalities in the baby. There are other formulations of progesterone like Me . These can be substituted for Primal - N. Please brief your IVF practitioner about the state of affairs and switch over to a safer  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pain from my shoulder to my foot all down the right side Back aches Tearing feeling at top of buttock Outside of leg always feels tight Foot aches along the last two toes under sole Knee sometime aches Outside muscle on knee is growing People have noticed me limping Has been ongoing for a while but getting worse any help would be good thanks Donald ### REPLY: U have a query that is bizarre in its nature although thank you for your question. U have pain in multiple sites of your body on the right side as u mentioned. But even if these painful sites have occurred at the same time, it is not necessary that these are related. I would advise u a .  For example pain in your sole and last two toes can be related to faulty/badly crafted footwear and so on. Take care. Some amount of rest, physio and pain relievers may help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: good evening !! i am radha n i am 20 years old..i had my period last month 6th n  i dint get the cycle in this month ..i had sex in between i.e on 17th ..i am doubting it pregnancy ...but i am not finding ny symptoms of pregnancy ..wat should i do further now ..can i get ny suggetion ### REPLY: Dear Rad ha, You had your last period on 6th and sex on 17th. There is a possibility of pregnancy. The egg is released 14 days prior to next period. The egg has life of 24 hours and the sperms are active for 72 hours. Hence, a period of about one week around the day of egg release is a fertile period; which in your case would be between 18 and 26. So your sex on borderline. Since you have missed period, you have the following options to detect the pregnancy:1. 8-10 days after missed period, get pregnancy test done on overnight morning first urine sample. Done earlier, these tests may give false negative results.2. You may opt for Beta  test which can give you reliable diagnosis of pregnancy even few days before missing a period. If you are pregnant and this is unwanted pregnancy, you may opt for medical termination of pregnancy. Tab. Mifepristone followed after 24-48 hours by Tab. Bisoprolol can terminate the pregnancy safely and successfully up to 9 weeks of gestation. These are not over the counter medicines. You have to buy them only with Obstetricians prescription and take them under observation. 7 days after consuming the last pill, please report to the Obstetrician for follow up. Completion of abortion can be ascertained by ultrasonography. Since these medicines cause developmental abnormalities in the baby, pregnancy should not be continued in case of failure of these medicines; pregnancy should be terminated by surgical evacuation of the uterus. 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: Hi, I am a 51 year old female. In june of this year, i had pleursy and then it turned into a pleural effussion... The ct scan showed that it was a small effussion and also a small nodele 7mm.. I had alot of pain with it being such a small effussion... From june to nov. i have had pain and inflamatiom on my right side, which is were the effussion was.. I had my gallbladder removed two weeks ago and some of gast. problem s are better but my right upper part of my back ribs now have large lumps on each one of the ribs... the surgeon said it is lypoma. i wake up eveery morning and the lumps have grown.. i also have med. to low grade fevers and fatigue .. I just had a follow up ct scan to see if the nodele has grown any... I should get the results tomorrow.. My question is: could this be more than just lypoma...? ### REPLY: Hi, I had gone through your question and understand your concerns. This looks to me like so called postcholecystectomy syn .  Symptoms include systemic symptoms such as sweating and heat sense but also dyspepsia, nausea, and vomiting, flatulence, bloating, and diarrhea, Persistent pain in the upper right abdomen. Some individuals may benefit from diet modification, such as a reduced fat diet, following cholecystectomy since it may be more difficult for digestion of fatty foods. Postcholecystectomy syn ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor i masturbate continously 4 years now my age is 17 i do it from 13 now i feel more depressed losing self confidence poor memory and many more please give me some advice i feel inferior to speek people and i did not able to see others people eye ### REPLY: Hello dear,First, remove all myths & misconceptions from your mind about masturbation. In fact, Masturbation is completely normal & doesn't have any bad effect to the body and mind. Since you are feeling that your masturbation is interfering with your normal functioning, you can try out the following measures:1. Improve your social life by spending more time with friends and relatives.2. Keep your mind active and busy at all times either through curricular or extracurricular activities.3. Regular physical exercises, yoga and meditation. This helps in improving concentration & builds up the confidence level. So, now stop thinking and feeling guilty about this all the time. Wishing a Good Health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I do not know whether or not to be concerned about a lump in my neck.  It has been there for several years now.  However, lately I have begun to experience some other disturbing symptoms.  I would like to know if the lump is a lymph node or my thyroid. 55-year-old female, 190 lbs. BMI 29, otherwise healthy as an ox. ### REPLY: Welcome to  .1. In this case first I would examine you, and locate the lesion.2. After that I would perform an ultrasound scan - cheap / non-invasive / no radiation.3. It will help to find out weather it's from your thyroid / lymph node / brachial cleft cyst / lymphocyte.4. Ultrasons will also help to evaluate weather It's operable or not - involvement of the neck vessels.5. So you better take an appointment with your doctor and accelerate the process.6. Hope it helps you. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: helloI just noticed a bump on penis. It looks like a pimple that you can get on your face. I have been sexually active. I squeezed it a bit (it was a bit painful) and white puss came out, just like when you squeeze a pimple on your face.Shall i be worried? ### REPLY: HelloThanks for query. Based on what you have stated I would state that you have Sebaceous Cyst over penis. The penile skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Take antibiotics like Doxycycline along with anti-inflammatory medicine like Diclofenac twice daily for a week. If persists even after taking antibiotics consult qualified General Surgeon for clinical evaluation and further treatment. If needed it may need to get excised in Toto (Completely along with the sac) under local anesthesia. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 6 yo girl was accidentally hit in the her mouth and the top two front teeth were knocked loose. ER doc removed one by just trying to push it back in. She is distraught because of loosing them, hasnt lost any teeth yet. We were told that the remaining tooth might be pushed back in and it may stay in place. What would be your recommendation on how to handle this with her and what type of dentist to seek for treatment. We are guardians and she hasnt had anything more than a cleaning or two before our care. I wanted more information and was just doing what I thought was general research. I didnt expect a payment component as I wanted to get a background of this type of situation. I think I need to start over and come back once I have basic knowledge. ### REPLY: Hi...thanks for the query...most probably your daughters tooth was primary... permanent erupt at the age of 7-8 years... so don't worry if re implantation failed...just clean the affected area or socket properly... tell her to go for warm saline rinses... and assure her that new tooth will come soon...you can also go for temporary removable plate also after the area get healed... it will also maintain your daughters arch form by acting as space maintainer...but please do CONSULT PERIODONTIST ONCE... and don't worry... she will be fine... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 20yrs old...I m taking ipill as a regular basis after each sex..I come to know the side effect of ipill.As I m studying so ryt now I don t want to become pregnant for 3yrs..so would u suggests me any long term contrAceptive device suitable for my age???? ### REPLY: Hi there thanks for posting your query at  First i would suggest that you are doing a very wrong thing by taking I pill. This pill should be reserved only in very exceptional cases in case there is a contraceptive failure. Because it is a accompanied by many side effects Dear there are ample number of birth control methods One of the most commonly used at your age is the oral contraceptives containing estrogen and progesterone that prevent the implantation of fertilized ovum use of condoms by the male partner or depoprovera injections every three months or insertion of IRENA or regard device in the uterus all are good, though they have their share of side effects and disadvantages as well. So choose one ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Kidney patient CRF since last two years. Presently undergoing dialysis twice a week. I am lady of age 47. My weight is 41 kg. BP remains below 140. It does not increase during interval of Dialysis.Urine output more than 1000ml per day and input is 1500ml. I feel hungry and take normal food. My question is whether I need to undergo dialysis twice a week or once a week. Because after dialysis I feel headache for next 12 hours. ### REPLY: Hello and welcome to . As a Urologist, i can understand your concern. In CRF, maintainence of kidney function is, twice or thrice weekly dialysis. As your body weight is low,twice-weekly dialysis is sufficient. Your blood routine, creatinine,electrolytes and B.P. should remain normal. After dialysis, headache is commonly due to anemia or electrolyte imbalance. Dehy . Maintain the intake-output chart. If you've any doubts, you may send the reports as a direct question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with Eosinpohillic Esophagits within the last 2 weeks, I started on flovent and I was told to swallow it. I am now having left side pain. I have only been on the medication less than a week. Could this be related to the medication, since I know it can cause Candidia? ### REPLY: Hello, thanks for your query, eosinophil esophagitis symptoms wise. Similar to esophagitis where one can see difficulty in swallowing, heart burn, belching and stricture formation. It will not lead to candidiasis, the medication (steroids) can cause when used in prolonged interval causes d candidiasis. U can start Monte+ LC(montelukast+ cetirizine) one tab at bedtime. Esophagoscopy screening procedure to rule out any stricture. All the best. 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: Ok so here s the deal my daughter has asthma and Everytime around the winter months she gets sick with cold viruses sometimes pneumonia, but not so far this year. Her pediatrician and allergy Dr has her on a couple of steroids and when she gets a cold I give her albuterol too. Well my questionvis she gets these white spots on her tongue whenever she gets these colds. First I thought they were coming from the steroids she s inhaling because I read somewhere that this is where the spots are coming from...her Dr gave me the name of the spots when a child gets them when they have a virus...but can you tell me what this may be or if the steroids are causing them to appear...sorry so ### REPLY: Hello, The most likely cause of the white spots, especially since she uses a steroid inhaler, is thrush. This is a yeast infection in the mouth. Steroids and antibiotics make parts of the body susceptible to yeast infections. These white spots cannot be removed with gauze or a washcloth. To decrease the chance of her getting these spots have your daughter use water to rinse and gargle her mouth right after using the inhaler. 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: On August 14th I went to the ER with a kidney stone , shown by a CT scan . There were the following things also noted from the scan: Nonspecific abdominal varicosities, indeterminate nodules in mesentery , recommend close F/U CT. I have had no more pain since the day following the ER visit, so apparently the stone passed. I saw my family doctor yesterday. He said it was my choice to do the follow up scan in 3 months or go to a general surgeon for his opinion now. Last night I had blood tinged urine twice, but have not had it since today. I do have a little lower abdominal discomfort, but no pain. I see my urologist Monday (9/09) for the results of the x-ray he did on 8/23. What could be the cause of the blood tinged urine and should I be alarmed? ### REPLY: HelloThanks for your query. Based on the facts that you have posted it appears that you had pain in abdomen due to kidney stone detected on CT scan Now you have passed blood stained urine (Hematuria) for two days. Most likely this could be due to small stone in urinary system. Or UTI Please get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to. Please take broad spectrum antibiotics like Cefuroxime along with urinary antiseptics like Nitrofurantoin twice daily. Get the prescription of medicines from your family Physician. Ensure to . To keep your urine dilute This will help to control dysuria. If hematuria continues you may need to consult qualified Urologist for clinical evaluation and further management. ### END