Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dad was suffering from eosinophilia which is cured now but that is cured now. he recently had a tlc and dlc test and the results were:- tlc(11200),polymorph(79%),lymphocytes(19%),eosinophils(1%),monocytes(1%),basophils(0%).he is suffering with lot of chest congestion and faces problem while breathing.could you please suggest something ### REPLY: Cellophane you for contacting . According to report mentioned, TLC count is at the higher level. Normal levels are less than 11,000. It shows that some infection element is going on in the body. It can be due to chest infection as well. I need to know some more questions before treating more efficiently. They are:1. Had your father suffer such problem in past? If yes, then how did they settle?2. Is your father asthmatic? If yes, then is he taking any medication for it?3. Is your father suffering from any other chronic illness like diabetes or hypertension?4. Does your father have cough or fever? Apart from this I would recommend following basic management for the time being so that his symptoms could settle:a. Defense . .for cough. Acetaminophen 1 tablet after every 6 hrs if he has fever. Take hot water in a pot, add 1 tablespoon salt/glass into that pot, place a sheet over it and ask your father to take deep breaths in it. It will give soothing effect and improve the condition.d. If chest congestion continues then he would be needing "nebulization with Atrovent (ipratropium bromide) & clinical (Beclometasone propionate) which will improve it. Hope he will be well soon. Thank You ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mom is having "spells" she is 65. in feb 2011 she was great and suddenly she got clamy and vomited several times and was dizzy laid down and later was better but weak. yesterday she was watching tv and suddenly got a burning/numbing pain between shoulder blades that went down both arms and her legs felt weak she laid down and her heart raced after 10 mins it quit but today her arms still ach. i lost my dad to a massive heart attack he was 64. they are both stuborn and im only 26. do you think it could be heart attack? ### REPLY: HIIT can be a pain attack, a stable angina attack or a minor stroke as all have almost overlapping symptoms complete baseline cardio profile of mother should be donated echo treadmill test to rule out the functions of the heart and ischemia cardiac marker like top I should be done brain should be done to rule out stroke fasting and pp blood sugar to be done blood pressure to be monitored.a diagnosis can be made only after full investigation ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Gum Abscess, how can i treat this? It is quite soft to the touch and has swollen profusely but retains normal gum color. My side of my mouth has swollen because of this as well. I do have a very rotten tooth right above it and Im guessing its the cause since its roots were sore to the touch. ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have mentioned that you have swollen gums it is due to Sublingual calculus, due to Periodontal problem, you have Periodontal Access, For this swollen gum you should consult dentist and go for Scaling and Curettage done As you said that you have decayed teeth Also in upper arch also which is painful to touch you have Periapical Access in that better you go for extraction of that tooth, For swollen gums you Do warm saline gargle two - three times a day Consult dentist for Oral Prophylaxis Hope it will help on you Wishing you good health Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend is in intensive care at the moment.  She had a knee replacement op 3 weeks ago, and 1 week ago she became delirious and was sent to the hospital where they diagnosed septicaemia.  Now they are saying she has E coli on her wound.  How could this have happened? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. This septicemia is post-operative infection. I suggest you to do blood culture and sensitivity. Septicemia will show organisms in the blood, antibiotics sensitive to the bacteria should be taken. This will cure the infection at earliest. E. coli is the bacteria which is present in the gastrointestinal tract and infection may occur following postoperative infection. Your current approach is to take the antibiotics appropriately. Maintain good hygiene locally that consist of good cleaning and .   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 11 yrs old and has been having liver disorder problem since birth.  As per advice, he has been taking Udiliv 150 one tablet every day for the last 10 yrs.   However, his liver test still shows :SGPT 120SGOT 105GAMMA GT 780Please let me know whether I am on the right track of treatment.... ### REPLY: AFTER GOING THROUGH YOUR BRIEF CASE HISTORY, IT IS NOT CLEAR WHAT IS THE CAUSE OF LIVER PROBLEM IN YOUR SON.IT BECOMES EASY TO TREAT THE DISEASE ONCE YOU KNOW THE CAUSE.SO I WILL SUGGEST YOU TO DO VIRAL MARKERS FOR HEPATITIS B AND C.ALSO I FEEL EXACT DIAGNOSIS CAN BE MADE BY LIVER BIOPSY.SO IT IS ADVISABLE TO CONSULT HEPATOLOGIST AND GET IT DONE. I HOPE MY OPINION WILL HELP YOU TO DECIDE FUTURE COURSETHANKS .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 34 yrs and just 2 yrs back got married. i am not able to enjoy my sexual life.... bcoz penile foreskin gets very tight and the tip of the penis is exposed only 20%. i have checked online about this and need to get circumcision done in chandigarh..... any suggestions? ### REPLY: HelloThanks for query. Based on the fact that you have posted you are unable to retract your foreskin completely over glans penis hence unable to perform sexual intercourse with your wife. This is what is called as Mitosis. During sex the foreskin gets retracted over glans penis and acts like a sleeve during forward and backward movements resulting into stimulation of glans penis which is the key factor in getting sexual satisfaction. The only best treatment option is to get circumcised. This is a simple surgery done under local anesthesia as an out patient procedure and offers permanent cure and helps to have enjoyable sex for rest of the life. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I dont know if its just because Im sick and coughing a lot, but this is the second time this has happened... I feel like its hard for me to control my breathing and then my heart starts beating really fast, its never happens before. Just a little concerned. Could you give me an idea of what it may be? ### REPLY: Thanks for your question on . I can understand your concern. Breathlessness and tachycardia (rapid heart rate) are commonly seen in bronchitis and lung infection. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray to rule out lung infection. 3. PUT (Pulmonary Function Test) to rule out bronchitis. If all these investigations are normal than probably anxiety is the cause. Stress, tension and anxiety can also cause similar symptoms. So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. First rule out Pulmonary causes. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother is suffering from hcv. her current sgot and sgpt is 95 and 97 respectively. her viral load is 243498IU. doctors said she cannot tolerate interferon therapy as she is also a depression patient. What should I do? Her sgot and sgpt levels are contantly increasing. ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can.GOT and SGPT are sensitive indicators of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests. So the next step is to look for certain liver damage and most common case is fatty liver disease. It should be confirmed by ultrasound. Other causes are viral hepatitis, cirrhosis, medications, alcohol intake or autoimmune diseases. To verify exact cause, US, bilirubin levels and tumor markers should be additional done Then appropriate treatment can be started. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a 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: hello, I ve been coughing up clear phlegm. I have a semi dry to wet cough. I am now on a zpak, montelukast and loratatine. Yet, it s my 4th day and nothing seems to be working. What s your opinion. what does it mean to constantly cough up clear phlegm? ### REPLY: Thanks for your question on . In my opinion you should consult pulmonologist and get done clinical examination of respiratory system and PFT (pulmonary function test) to rule out bronchitis. Your symptoms like constant cough with clear phlegm and not relieving by treatment suggest possibility of bronchitis is more. So PFT is must. It will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilators for better control of cough. So consult pulmonologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! my son was outside yesterday and he came in and told me to look at his toe. Hes only 4 so hes not able to tell me what happened or what bit him but Its a lump with puss and I squeeze to let out the puss and its been three days now and it hasnt gone away yet. I have been putting antibiotic on it too. Is there anything else I can do to get rid of it? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your son may have some injury on his toe. Injury with secondary infection can lead to lump with pus formation. He may have some abscess formation. So he should go for incision and .  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter who is 5 years old goes to pee every 5 mints at regular intervals during the day. Her water intake is also not so much that she has to pee every 5 mints. She has been this since last few days. I don t know what to do except take her for routine urine examination. ### REPLY: Hi, Thanks and welcome to . Increased frequency of urine suggests urinary tract infection. It may be some local infection around urethra. Local spectrum examination to detect any local condition.urine microscopic examination and culture and sensitivity . Better consult pediatrician for prompt diagnosis and treatment. Hope this answer serves your purpose. Please feel free to ask further queer if any. . V. Subrahmanyam. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Since giving birth to my twins 3 years ago I started suffering from hayfever during the month of May . I get very itchy ears, mouth/ throat , itchy and watery eyes and watery nose . Suddenly I got a feeling of tightness in my chest and started coughing and wheezing . Sometimes when I sneeze or cough I get a taste of blood in my mouth. I am 32 years old, 59kgs and 163cm tall. ### REPLY: Hi Ruth, Thanks for writing in. I understand your concern. In case of allergies, the management comprises several parts. First is control of symptoms. The symptoms can be controlled in your case with Tablet Cetirizine 10 mg once a day. If you have significant amount of breathlessness, speak with your physician about taking inhaled corticosteroids. We should also be looking at .  This may have to be started just before May and continued till the season gets over. If you are getting the taste of blood in your mouth, I would suggest you get a CT scan and see a pulmonologist. I would like to rule out a lung disease definitely. Also, steam inhalation and warm saline gargles would help. Please see your physician. I am sure you can start feeling better very soon. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband ran his calf into something and has a huge bruise and his leg, it is swollen down to his ankle. It is going on 2 weeks now and not any better. Hurts to touch and when he has it elevated and lowers it he has trouble walking for the first few steps. He is on warfain so I want to make sure all is well. If he needs to see a doctor what kind of doctor? ### REPLY: Hello, The bruising and pain are not subsiding due to the effects of warfarin which increase bleeding tendency. However, it is not safe to stop Warfarin on your own. You need to follow up with a primary provider who can assess the extent of hematoma and his other medical conditions, and decide on whether temporarily stopping Warfarin is required. Meanwhile, apply ice to the area of pain. Take rest and Tylenol if the pain is too bothersome. Hope I was able to help please let me know if I can assist you furtherRegards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Have shooting pains in upper arm, inside, about one or two inches below the armpit. Just had annual mammogram at 1:00 pm today. Pain started late afternoon, isn t constant, but maybe 3-4 times an hour. Haven t lifted anything or done anything out of the ordinary this afternoon. Could the mammograms be the reason for the pain? Thank you. ### REPLY: Hi, sometimes people do feel this kind of pain even when they have had crutches under their arm. It typically also goes away. I doubt mammogram must have done that, but even in that case it should go away in a day or two. If it persists for more than 7 days and is disturbing or annoying your routine life, we should get it assessed by a neurologist since shooting pain can be due to irritation of nerve roots. I hope this helps do let me know if you have any more questions for me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 25 years old. Remain very tired and feel sensations in my body. Get tired soon after taking stairs and the Heart throbs for a day if I run at full pace. I dont smoke and drink. there is some pressure on heart but I have got all that tested. Everything seems fine (including echocardiogram). Could this be a problem with lungs, cancer? ### REPLY: Hi and welcome to . No, but it can be anxiety because you think you might have cancer. How can you even think of lung cancer if not smoking and are 25 years old.:) Good that you've checked your heart, but did you check your thyroid, lungs and estrogen and iron levels? These are the most common causes of symptoms you're mentioning. So do ventilation tests and other 3 i ve said, and I am sure you'll find exact cause and be able to treat it successfully. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 15 year old girl and have a small, inch long, about 1 cm. high bump on the left side of my neck, near my ear. I went to my doctor and they said it was a swollen lymph node due to some earlier infection. The doctor visit was about 2 months ago. My neck started to get sore when I moved it abruptly, so I went back about a month later, and she said the same thing, and that it would go away in a couple of months. The thing is, the bump keeps getting bigger by the day, and my whole neck feels stressed. Could you give me some guidance and information on this bump? Also, could you let me know if I should go back to the doctor. I know this may seem strange, but I wish I could just get an MRI to know for sure if it s cancer or not. Thank you. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You have enlarged lymph node. It can be due to some early infection or tuberculosis or may be due to lymphoma.  No need of MRI. You should go for fine needle aspiration cytology to diagnose.  Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My gum is swollen around my lower wisdom tooth. It is extremely painful and hard to eat or drink. My dentist gave me antibiotics which I have used for two days with no improvement. I keep having really thick saliva as well and generally do not feel well ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have swollen gums around wisdom tooth, don't worry it happens during eruption of wisdom tooth that is Peritonitis.  It happens when tooth is erupting that is Partially erupted or Impacted.  You do is warm saline gargle two - three times a day.  Consult dentist and go for Scaling and curettage of tooth.  Take one Tablet Painkiller Diclofenac sodium twice daily for symptomatic relief.  Hope this will help you.  Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am frozen by my fears..i feel that I cannot do anything at all. I have been suppressed all my life and controlled. Now I am incapable of doing more than a bit of cleaning. I don t want to go where anyone can see me, and I feel like I don t know anything at all...the world is a scary place for me. I know I have PTSD...what else could this be though? I am looking for ways to cure my brains inability to function but need to know what I m dealing with. Thanx ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. How do you know that you have PTSD? The symptoms are pointing more towards social anxiety. But this could also be an outcome of PTSD. In any case, self diagnosis is wrong. Consult a psychologist who shall use psychometric tests to diagnose your mental problems. Please do not hesitate. Do what is necessary. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When you are diagnosed with calcification of the arterial vessels around the heart, is there anything you can do? 5 Bypass surgery done 30 years ago is completely closed. Other vessels on right side of the heart are 90% closed. Blood flow is being carried mainly by collateral vessels. ### REPLY: Hi, Bypass surgery grafts can get blocked by a thrombus or can accumulate calcium over a long period of time.  As you are saying that all grafts are blocked and the right artery is also significantly blocked you will need further treatment for the same.  I can only tell you better if you send me a detailed Angiography report.  Angioplasty could be tried in a native blocked vessel or calcified vessel by a technique called as Rot ablation. So please send me the detailed report of Angiography if possible. 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: Hi,  my husband had a 4 way bypass surgery 8 years ago and last march he had a heart attack.  he has been feeling numbness on the left side of his chest, and last night he had a sharp pain on his chest which stopped after doing some breathing techniques.  Is that numbness related or sign of another heart attack? ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would like to explain that it is very important perform as soon as possible a comprehensive evaluation of that chest numbness, as it may be related to a new ischemic heart event. So, I would recommend consulting immediately the nearest RE service for a physical exam, resting ECG and some blood tests (including cardiac enzymes CK-MB, Troponin). Remember that after 5 years venous bypass grafts are more susceptible to possible occlusion. Hope to have been helpful! Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 since last 11/2 months i am having a very mild fever, checked by my doctor tested urine and found UTI which was treated by doctor and Urine Culture shows no bactarial infection now. However low grade fever still continue and I also have pain in right lower abdomen.  Dr asked me to take few medicines to cure pain as well as low grade fever but the sympom persists. Doctor recently suggested TB test (mountox) was found positive(?), got my urince PCR and Blood PCR done but only blood PCR shows doubtful TB infection? Now my doctor want me to go through AFB direct smear through URINE.  I may go through this test but question which remain unanserable is why should I have pain in my right lower abdomen for such a long time.  Is this may also be due to TB? ### REPLY: HI. Thanks for an elucidated history. One and half months of fever needs investigations. Along with the positive findings suggestive of tuberculosis and pain in the right Iliad fossa-which can be due to Tuberculosis. I would suggest you the following:CT scan of the abdomen. This will help in diagnosis for the UTI and the right Iliad fossa pain. This can be due to TB. Quantiferone Gold test for TB Diagnostic Laparoscopy and biopsy or FNAC to see for TB. A therapeutic trial with anti-tubercular treatment on an empirical basis with regular follow-up for weight gain, improved appetite, clinical improvement in overall health and particularly symptomatic improvement helps diagnosis and treatment of TB. Take second opinion if required. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 27+  and my husband is 34+.Since last six months we are trying for baby but i m not able to get pregnant.My doctor advised for serum insulin test and i did the same.The test result is 31.72.Doctor prescribed a medicine called glycomat for six months BD.Please explain the connection of this test with my problem. Is there anything serious. ### REPLY: Hi, I think you have polycystic ovaries.  So, your doctor advised for insulin test. You can take glycogen. It will help in increasing insulin sensitivity. Insulin resistance is a basic pathology in PRO.  I think you can try naturally for 6 months if your periods are regular. Be in contact with your husband every 2 to 3 days after your periods stop. It will increase chances of your pregnancy.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having severe pain in lower right abdomen 5 months after hernia surgery. Hernia was allowing colon to push through.  Surgeon said I had no scare tissue before but I had torn muscle.  He used mesh to repair.  I have continued to complain, had a catscan, nothing showed.  I am going to pain clinic tomorrow.  I do not want to take pain meds!  I am 55 years old, teacher, and have a autistic son that lives with me.  I am depressed because this is not the way I was before surgery.  I should have kept the damn hernia. ### REPLY: Hi welcome to  forum.  Thanks for choosing . Forum.  As you have described you have got severe pain abdomen 5 months after surgery for hernia. As you said you got hernia repaired but you didn't mention which side was the hernia. If the hernia is on left side, we can be sure that the pain is not due to hernia operation.  If the pain is on the right side it could be due to some adhesion or reoccurrence of hernia. It may also be due to some other disease of cecum, or ascending colon.  I advise you to consult a gastroenterologist for diagnosis and treatment.  Wishing you 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: My dad sixty seven years old smoker he had a bad cough for two months cough up with yellow mucus and it tastes really bad and he always feel very tired and weak and lost weight he did a lot of testing cta scan and it didn t show any sign of cancer he coughs a lot and especially at night ### REPLY: Thanks for your question on . I can understand your fathers situation and problem. Possibility of COPD (chronic obstructive Pulmonary disease) is more in his case. His CT scan is not suggestive of any infection, so no need to worry about tuberculosis or other lung infection. He was a smoker, having cough with expectoration and tiredness. All these are favoring COPD more. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PUT (Pulmonary Function Test). PFT is must for the diagnosis of COPD. It will also tell you about severity of the disease. And treatment of COPD is based on severity only. He will improve with inhaled bronchodilators and inhaled corticosteroid (ICS). Bucolic, expectorant and antioxidants .  So consult pulmonologist and discuss all these. Hope I have solved your query. 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: Hello, Ive been diagnosed with pericoronitis which is a wisdom tooth infection, and I wanted to know of it could smoke weed while dealing with the infection. It is not a mayor infection and I was only recommended to increase the frequency of my dental cleaning. Since its a dental hygiene issue I dont think itshould a mayor problem but I wanted to ask first and also I have a small wound on my foot and Im having to take  keral, tempra and posipen. ### REPLY: Hi. Welcome to . As you mentioned you have problem of peritonitis related to that impacted tooth. Maitain a hygiene around tooth. Apply a chlorhexidine gel our inflamed tissue surrounding a tooth... Antibiotics courses can start under doctors suggestion... Avoid smoking because it also affects... Surgical can remove that impacted tooth if needed. Consult an oral surgery for further treatment. Get well soon. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a rash on my neck. It itches and then it gets puffy and it looks like I ve been scratched all over the area. It is starting to come up above my eyes as well. It is not bumps, no puss is involved. It tends to look better when I don t scratch it but the itching won t stop. ### REPLY: Hi, It may be localized pruritic due to irritation by some irritants. Try to find out the culprit. It may be hair dye, oil, shampoo, soap, cream, balm, spray or something other. Apply mild steroid cream like mometasone cream on the affected areas. Tab cetirizine and oral steroid in tapering dose may be considered after consulting the dermatologist. 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: Hi, My 8 and half month old daughter has been suffering from a cold on and off for over a month. occasionally she has a high temp. The past week somedays she doesnt eat and today is passing very runny stools. she is also extremely tired all the time. whats wrong with her please? ### REPLY: Hi....by what you say this looks like a recurring viral illness. I will explain to you how a viral illness behaves so that you can be more comfortable. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im currently experiencing pains (5days now), around my upper left chest and left shoulder blade.  I dont feel pain while just walking or sitting.  I can even run 2 miles with no issues.  However, when I move a particular way, I feel a slight pain within my chest.  If I press down on one area, it feels bruised.  When I cough or breath in very deep, I also feel pain in my chest.  Please give advice.  Thank you! ### REPLY: Welcome and thank you for asking on ! I have gone through you question carefully. Since your pain does not increase with exertion . It is unlikely to be cardiac. Pain increasing with inspiration and having tenderness on pressing ... points out to muscle pains . Rarely it could be related to lung problem. Your pain should decrease with a weeks course of analgesics. Hope you will find this answer helpful! Wishing all the best,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, my age is 53 Years/Female. I am suffering from back pain since last two years. MRI scan report is as under: 1. Hypertrophied Ligamentum Flavum At Multiple Lumbar Level Compressing The Posterior Thecal Sac 2. Disc desiccation at L2-L3, L3-L4, L4-L5 & L5-S1 3. Posterior annular bulge of disc at L4-L5 & L5-S1 level compressing the ventral thecal sac and along with hypertrophied ligamentum flavum are narrowing bilateral neural foramina compressing the L4 & L5 exiting nerve roots significantly Please suggest me appropriate medicine for proper treatment. I have been consulted doctor but did not get relief. ### REPLY: Hi, Welcome to . After going through your query I think you may be suffering from degenerative spine with multiple level disc prolapse in lumbar spine. Many of my such patient got relief by analgesics such as diclofenac slow release tablets(if pain is more than strong analgesic such as tramadol is useful), Diapering, Glucosamine and neurotrophic agents such as mecobalamine. You can discuss with your treating Doctor. Hope I have answered your query. If you have any further questions I will be happy to help. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i just discovered a hard moveable nodule on left collar bone area. I had been having some swelling in area for awhile, and pain near collar bone. But neverva lump. I have been told had calcium on thyroid yland but when Endocrinologist did ultrasound two weeks ago , said gland fine, i told him had had puffyness at bass of neck left side. He said nothing of it. Niw, i have this painful hard mass size of large marble. And very fatigued ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have swollen and painful collar bone. Well there can be many reasons for symptoms you mention in query like fracture or injury, acromioclavicular ligament tear or wrong movement of arm or shoulder. The lump could be a lipoma, cyst or Osceola. I would suggest you to take proper rest and do not move arm or shoulder much, apply warm compresses and take ibuprofen or acetaminophen for pain. If condition doesn't get well then consult orthopedic surgeon for proper examination. Doctor may order CT scan or physical examination. Doctor may prescribe antibiotics, anti-inflammatory or recommend physical therapy or surgical removal of lump. Physical therapy will help a lot. Doctor may also immobilize your joint for some days. Doctor may also refer you to dermatologist for lump. 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 am a 45 year old man, 62 210 pounds. over the past couple months i have been having back pain in the middle of my back. i have been to a chiropracter 3 times but dont get any relief. for the past few days I have been having some tightness in my chest, a little to the right side, minor shortness of breath. I consider myself pretty fit and active. 4 years ago I got to feeling bad and I thought I may be having heart problems ( have GERD) and went to the ER but they said no, just GERD flaring up. I had a treadmill stress test to verify that diagnosis. I dont have any family history available. Am I worrying to much? ### REPLY: Hi, Welcome to . After going through your query I think your You are suffering from chronic backache. Treatment of back pain is exercises and analgesics (diclofenac SR). Sometimes strong analgesic(such as attract three times a day after meals) is required. Consulting with treating doctor is advised. Avoid long continuous standing. Sit in a straight posture. Eat milk, fruits and green leafy vegetables daily. You need to do MRI TO RULE OUT other causes. For chest pain you should consult physician to rule out heart related and lung related causes.  I think your query answered. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is samuel and i have a child 3years which have been using exebute cream applying on the affected part of the head and there was 70% success but now the problem is still reoccurring in near all part of the head. it look like ringworms. The child weight 11KG. I have been looking for the drug in the market with difficult is there any alternative. ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  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: i am 26 yr.old. before 2 month suddenly i feel like a whistling in my ear and quickly i was not in my sense for half hour and after 1 month it repeated again and after passing 2 days it repeated again 4 times in a day but not fully. my hand and face was looking as its going round after this i was feeling sickness and pain in my full body. my CT scan and MRI are normal and no genetic problem.i dot know i suffered from epilepsy or not. please suggest me this time i have not my report here my emeil is YYYY@YYYY ### REPLY: Hi, Thank you for posting your query. I agree with you that your symptoms could be suggestive of epilepsy. It can be diagnosed on the basis of history, and EEG (electroencephalography). There are several good medications such as oxcarbamazepine, sodium valproate, etc. for relief of epilepsy. Please consult a neurologist for detailed evaluation. Please get back if you require any additional information. Best wishes, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband was diagnosed with cancer in October 2013. He had chemo and radiation for 7 weeks. He was recently hospitalized for severe malnutrition for 3 weeks. He will try to eat but does not swallow his food. All he is getting is tube feedings through the night. I am worried that the same thing is going to happen again from not eating. What can be done. ### REPLY: Thanks for your question on . If your husband is not able to swallow than Total Parenteral Nutrition (TPN) is the only treatment we can give him. In TPN all the nutrients are given through larger veins of the body. Mostly through external jugular vein. So hospitalization and central venous catheter is must. In TPN infusion contains1. Protiens2. Carboy .  Lipids4. Multivitamins5. Minerals and trace elements. You can also give fruit juices, water, mashed food through NASA gastric tube. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 experiencing toothache in my lower right side molar and at the same time a headache, sometimes twice a day. The dentist told me there is nothing wrong in the area after taking X Rays and has provided me with a tooth guard at the same time, But the pain continues. I wonder if this have to do with a brain nerve or heart disease?? ### REPLY: Thanks for your query, I have gone through your query. You have to consult an oral physician and get yourself examined thoroughly to rule out the cause of pain. The pain in the tooth could be because of the decay or the surrounding gum infection or impacted tooth. The headache could be radiating pain from temporomandibular joint disorder or from impacted tooth. Please take a second opinion from oral physician and take radiograph like OPG. 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: Hi. I have schizoaffective disorder . About 4 years ago I got in a fight and a guy hit me over the back of the head. Since then I heard clicking noises in the back of my head. The noises changed and now I hear a squeching tricking sound all day, right at the back of my head. I haven t been to the doctor about it. What do you think it is? ### REPLY: Hi, This sound may be symptom of your schizo-affective illness. In such illness people may hear different kind of sounds which is known as auditory hallucination. Nature of sound depend on the left history and development of that person. First, do not worry about that. Second, It is better if you report these sounds to your psychiatrist so that he can take appropriate steps to reduce or stop them. I hope this information has been both informative and helpful for you. Wish you Good Health.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good afternoon sir, I am sunil,having discomfort with my sex life,I am 50 years old,Last 5 years I used to live single,due to separation, last one month I married again, and having problem when ever I try to have an intercourse , I used to have erection several time when I think and try myself,but with erected condition Try with my wife in vain !!!!!! please note that my previous sex life was excellent.Please advice me what to do. ### REPLY: Hi and welcome to . Thank you for your query. I understand your concerns and I will try to help you as much as I can. Erection problems can have many causes. These include:Physical problems, such as injury to nerves or loss oxblood supply to the penis. Other health problems, such as diabetes, high blood pressure, anxiety, and depression. Side effects of certain medicines. Stress.  .  The exam, lab tests, and sometimes mental health tests can help find out the cause of the problem. Treatment is based on cause and include avoiding tobacco and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went for a run about 7ks felt good. Then drove to chemist to get script while I was there I tested my blood pressure it read 140/91. I little concern when I got home I checked it again on the same arm same reading, than checked on other arm 127/75, than other arm 127/75 is first reading ok.? Normally my BP is normal ### REPLY: Hi, Whatever the blood pressure readings given by you, all are absolutely in normal range. Blood pressure and heart rate rises in response to any type of physical exertion as in your case. It takes variable time to stabilize heart rate & blood pressure after exercise. Why are so concern about your blood pressure? I want to know-1) Do you have high BP problem, if yes then on which medications.2) Any other associated illness like diabetes or cholesterol problems.3) Family history of high BP, diabetes, cholesterol problem. If you are a healthy adult then check your BP at least once in 3 months, do OG TT, Lipid profile once in a year. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 frequent fluttering center-to-left ribcage, happening dozens of times a day over past 2 weeks. No pain, actually tickles. Seems as though a heart palpitation would feel different, this is low in the ribcage and when pressing hand to ribcage is more evident just below the left rib. ### REPLY: Hello Thanks for writing to us, I have studied your case with diligence. As per your history there is possibility of rib contusion or Costco . Rib contusion is visible on X-ray. I will advise consulting to orthopedic surgeon. Medication like muscle relaxant and analgesic will reduce pain along with it use rib support belt. You may consult physiotherapist for pain management. He may start TENS, or ultrasound which is helpful in your case. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not forget to give rating at end of discussion. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I WAS GOT DEPORTATION  FORM 2 YEARS AGO WHEN I WAS ON CANADA AND I DIDENT GOT ENY QUIRE NOW I FEEL LIKE I LOSE MY MIND AND I WAS BE SO ABSENT  I LOSE MY WIFE AND MY WORK EVRY THINK AND EVERY DAY I WEAKD UPLIKE NEW MAN WHAT SHOULD I DO I WAS GO 2 Psychiatrist FORGET UR WIFE AND UR LIFE AND FORGET CANADA I LOVE CANADA SO MUCH IT WAS THE FIRST TIME ON MY LVE I FEEL AIM HUMAN HERE IN CAIRO EGYPT AIM NOTHING SO I TACE SOME MIDETION AND AFTER THAT I FEEL EVRE DAY IAM NEW MAN LIKE NEW LIVE I HATE MY FAMILE MY DR EVREY THINK HERE EVEN TALK ARABIC I HAT THAT WHAT SHULD I DO AND MY FAMILY THEY ARE RESESS THEY DOESNT LKE AMRCAN OR CANDIAN PEAOPLE AND I HATE THAT I FEEL LIKE AIM BABY HERE I 31 YEARS OLD ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  From the given description it is very difficult to diagnose your problem. It does not seem like amnesia or memory related disorder. This could more be like some sort of anxiety disorder or depression. You need to work with your psychiatrist to have a proper diagnosis and treatment. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell down in livingroom after sliding on a toy truck, did the splits, right leg went back landed on knee while left leg out straigt, had a child on my left hip. I have went to chiropractor twice but I am sore from my neck to my toes, any suggestions or how long can I expect this? the fall was 10-02-11 ### REPLY: Hello, Your complaints are not specific, if you are able to walk or not or able to bear weight on your affected limb, what about swelling or tenderness. As of now if there is no such significant complaints my advice is to do icing at sore points, and to give rest to the affected part in case of the significant complaints get s X-ray done of that part. 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: Hi , I m 17 years old. Me and my bf had sex on Saturday we used protection. Afterward I gave him oral till he came then about 20 mins after he came , he inserted his penis in me for about 8 second then took it out . What are my chance of getting pregnant ? ### REPLY: It is unlikely that you got pregnant if he did not ejaculate inside you.  However, it is possible that some semen was left on his penis.  Although I think it is very unlikely that you got pregnant, you might consider taking a morning after pill just to make sure.  These are available without a prescription from a pharmacy, and they are very effective in preventing pregnancy as long as you take the medicine within 3 days after having sex.  It is great that you used a condom, and you always should to protect yourself from unwanted pregnancy and STDs.  However, you should also talk to your doctor about starting a reliable form of birth control so you don't have to worry about pregnancy at this time in your life. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am feeling something stuck in my mouth while swallowing saliva for the past 2 weeks. I am able to eat well but I fear of cancer.. When I consulted the doctor, I had been told that it might be due to acid reflux and provided me ulgel-A, Pantocid (before food in the morning) an Phlogam/disperzyme/bidangen forte in the morning and night. Now I am feeling more saliva at mouth after starting to take ulgel from today morning.. Will this be a symptom of any cancer? Please reply. I am working in IT company and so always at desk for almost 8hrs a day.. female - non-smoker but a bit over weight ### REPLY: Helllo there, thanks for the query. Im an oral diagnostician, I reviewed your symptoms, I could think of 1) elongated uvula?--did u have in past week, any cough and cold 2) enlarged tonsils? 3)any lymph node enlarged in your neck?? If your symptoms don't cm own with the medicines your taking.try some Luke warm or salt water gargling... too much saliva is nothing to worry. If your fear doesn't subside, please consult a local dentist or ENT surgeon ... to check your throat. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 15 years old, weight approx 52kg and found a small pea sized lump in my armpit a few months ago. I didnt think much of it at the time however I am now beginning to worry as it has not gone away. It does not hurt or puss or anything, however It will not pop or go away. ### REPLY: Hi. Thanks for your query. Read and understood that you have a small pea-sized lump in the armpit, which is there for months, and you can not pop it. It is not painful, no pus nor anything. The most probable reasons for such a lump are:Sebaceous cyst Lymph node. In a young boy of your age it is most likely to be a cyst. You may please get this confirmed by actual examination by a General Surgeon and get treated if needed. I hope this answer 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, may I answer your health queries right now ?  Please type your query here... I have asthma, I use albuteral, symbicort and theophylline, still feel short of breath all the time, peak flow is good, can breathe in deep, just feel pressure ...Dr thinks its just an allergy.. ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. I would almost agree with your current treatment. Were I treating you, I would add montelukast in your treatment.2. I would suggest you allergy testing which will help you identify the substances you may be allergic to and also to know the measures to avoid them. Based on the results, an Allegist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms over long term basis.3. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution.4. Regular breathing exercises and a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc.) will also help you in a long run by improving lung capacity and immunity respectively. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For the past 6 weeks I have been having migraines but the last couple of weeks they have been accompanied with a fever, nothing above 101. I have never had migraines before this pregnancy and this is not my first pregnancy. My OB advised me to just take Tylenol and stay in a dark quiet room but I have to work so that is impossible. I m starting to worry because not only am I having the migraines and fevers but I m starting to see flashes of light off and on. I m now alomst 13 weeks and my OB said that the hammering of hormones that are causing these migraines should slow down and the migraines should subside but every week they have been getting worse. They have gotten so bad that I have had spells where it s too much for me to even speak. Could it be more than just hormones and is it normal to have a fever with a migraine? I just turned 35 today and I do not have any other health problems. ### REPLY: Hi. The rise in temperature can be associated with your pregnancy and the hormones, and if the fever is low-grade then the hormones are most likely the cause. As for the migraines, they are very commonly associated with pregnancy and also with hormonal fluctuations that take place during a women menstrual cycle. The migraine headaches should subside as your doctor said, but it is all depends on your hormone levels ma'am. I understand how frustrating they can be, but unfortunately any other strong pain management medications can complicate your otherwise normal pregnancy ma'am. Please be strong, and try and take some time off from work, because that's what every pregnant woman should be doing. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi  Im a 51 year old women with no real heal issueslately Ive been having itchy red streaks that just appear one or two at a time. there on my arm or shoulder or anywhere. I spray with a anti-itch spay and it goes away only to return on another area. I have not changed any of my skin products and have not been in contact with anything odd. What might be causes this to happen? ### REPLY: Hello, Thank you for posting on . The condition you have referred to is called Urticaria or hives. It's an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up. You may have to go for specific tests like patch test, food prick test, IGE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various antihistamines for long duration(at least 3 months) with or without oral corticosteroids. For non-responding cases there are many other .  Hope this will help you in resolving your query. 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: for about the last 2 to 3 weeks i have been having very sharp painful pains shooting thru between my shoulder blades.I had thought i twisted or turned wrong and it would heal itself.. but it is still with me and hasnt got better, it isnt constant but very frequent ### REPLY: Hi, It looks like a nerve root entrapment in the cervical spine and an MRI is suggested. Using cervical collar, doing hot water fermentation, strengthening exercises for neck and inter-scapular muscles along with shoulder stabilization exercises should help reduce the symptoms or pain in the shoulder blades and also the radiating symptoms. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been dealing with chronic upper abdomen pain and nausea for about the last 6 months. The pain is in the middle and each side right below my rib cage. It seemed to have started after having my gallbladder removed. The pain started as just random episodes but has progressed to something I am having to deal with on a daily basis. It is almost a colic pain that will intensify and when the pain is at it s worse it is comparable to labor pains. I have been to 3 different doctors and have had almost every gastro test done: endoscope, colonoscopy, ct scan and a gastro emptying which they all came back clear as did all my blood work. I still have to do a test to check for over growth in my small intestines. This has turned my life upside down. Somedays I can not even get out of bed because the pain is so bad. I feel depression has started to set in because of this. I have had to deal with doctors that seem to not believe I am actually in as much pain as I am which makes dealing with this that much more difficult. If anyone has any idea of what this could be or suggestions for me please share. This is truly taking a toll on me. ### REPLY: Hi. Gone through the history carefully and repeatedly. I was just wondering about any other associated symptoms other than you have noted. One good thing is most of the tests are normal, at least it rules out the problem related to colon and stomach. Pain is in the middle and each side right below my rib cage ::: This suggests me that the pain may be due to overstretched nerves bellow the ribs. (You have not mentioned means there is no distension, vomiting constipation). I would advise you to try tablet gabapentin 300 mg start from once a day to twice and then thrice if helping for a week or so. This will be diagnostic and prognostic also. Please discuss this with your Doctor. MRI of the thoracic spine may also 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: hello doc,Recently im going through alot of stress and have been crying my heart out due to some unexpected incidents. Since then im having a pain in my heart every now and then and specially when im thinking too much. Is it normal or should i get myself checked? ### REPLY: Hello! Welcome and thank you for asking on ! Your symptoms are not typical of coronary artery disease, but this disorder can not be excluded. Other possible causes to consider would be: anxiety, gastritis or gastroesophageal reflux. For this reason, I would recommend consulting with your attending physician and performing some tests: -a chest X-ray study- a resting ECG and cardiac ultrasound-cardiac enzymes-complete blood count for anemia- PCR and ESR for inflammation. A cardiac stress test would be needed in order to investigate for coronary artery disease. I would also recommend trying an antacid or omeprazole. If it helps improve your situation, it would be indicative of gastritis or gastroesophageal reflux. In such case a fibrogastroscopy would be needed. Hope to have been helpful! Wishing good health,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an intercourse with my fiance last night. it was my first time intercourse and my foreskin tore. when i checked it, it was bleeding, not very heavily. but yes. i examined it myself and i saw that my foreskin had torn. the next morning i had a small swelling and my foreskin ahd come back up but looked weird. And when i try to pull it back now, it pains and i am not able to pull it back. I am really concerned. Please help. ### REPLY: Good morning, and thank you for being with  !!! You might have a condition called fibrosis where in the preputial skin is tight and doesn't allow the head to be exposed. Because of the cut and trauma to the skin it is tender now and very inflamed that's why it looks different. Let it subside and let it heal for one week. If the problem persists I recommend seeing a urologist, he may prescribe a steroid to help soften and open up the opening or in severe cases may need to do circumcision. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was diagnosed with mono 4 weeks ago. After being diagnosed I had several blood tests showing extremely high levels of enzymes( the doctor said over 400 in the count and average is around 100). So my liver was swollen and Im now wondering when can I drink alcohol again ### REPLY: Hi thanks for asking question... Just now rest your liver by taking very low fat diet ... Alcohol and its metabolite aldehyde us toxic to hepatocytes.... So avoid use of alcohol until liver enzymes comes to normal.... After resolution alcohol can be taken but in less amount. Maximum safe limit 20 gm per day. ... According to my opinion alcohol should never have taken as it has many side effects on body.... Take care. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having chest pain (pressure, not sharp pains), am frequently tired, and have been diagnosed with PFO. The chest pain occurs more often during exercise or when under stress. Should I worry about the pain and is there a long-term solution? Thank you. ### REPLY: Thanks for your question on . Since your chest discomfort (pressure) is mostly related to exercise, it is muscular pain mostly. But cardiac pain can occur with stress and exercise.  So we need to rule out cardiac cause first. So get done ECG.  If this is normal than no need to worry about cardiac cause.  It is muscular pain mostly. Try to follow these steps for better symptomatic relief for long time.1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 stopped taking 150mg zoloft 5 days ago and up until last night was doing fine. Last night I became very teary, crying over silly things. Today is more of that but also nausea and feeling very agitated. I have taken 10mg temazepam to try and calm down. I dont want to go back on the zoloft but these withdrawal symptoms are stressing me out! Any advice? ### REPLY: Degree understand your concerns Zoloft is anti-depressant (SSRI). You did not mention your other symptoms. Are you under treatment for depression and anxiety? Self-medication can kill. Anti depressant taken for one week is not enough at all. Doctor prescribed these .  Don't take your own decisions. Consult psychiatrist again and get his advice. You must also follow meditation, yoga the psychotherapy for streamlining your lifestyle and thinking. I can help you if you desire so. 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: Sir(s), I am working in Andaman. Male, aged 52. Consumed Gutkha for the past 4 years. Left the habit for the last 01 month. Having irritation in the left side of throat. Itching sensation around throat (neck). My left side head & jaw pain a bit.  I suspect it to be Cancer. Am I right. What I need to do? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some granular pharyngitis.  It causes itching sensation in throat.  If you have any ulcer or lump in your mouth then you should go for biopsy to rule out cancer. Otherwise, no need to worry. 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: Hello Doctor,My age is : 22My weight is : 62I have a problem that semen is getting leak during motion esspecially when i give some pressure, pls tel me the reason behind this and also an solution for this, i mean it is a common problem or i have to check with a physician?kindly help me for the free motion alsoFYI, my body is normally a heat body and i ll consume more non-veg. ### REPLY: Hi. A little leakage is normal, but this could also be due to mild sphincter weakness of your pelvic ring. Do you also get frequent night falls? This could mean that too much sperm production is occurring which is not getting let out. What is sexual history and do you masturbate? If yes them how frequently? Do let me know so that I can advise you better. Do not worry It's anything serious and can be managed. Please answer the above questions and I will get back to 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: Hi. I have a bruise on my arm that I received when getting blood work done. The bruise quickly spread from the injection spot and is a purple/red colour even though it s a week later. The red seems to be spreading across the bruise, but the outline of the bruise is yellow. Should I see a doctor? ### REPLY: HelloThankyou for contacting . Bruises usually take around 2 weeks to heal. They change their color from red to dark blue and then to golden yellow after they which they fade away. Your bruise seems to be following the same cycle and in my opinion it is fine. Please contact your local physician if the bruise starts spreading rapidly, starts hurting more or u feel a swelling at that area. Hope this answer your query. Please feel free to ask again if you have any query. 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: hi, i came off my moped on the 23rd of last month, i have badly bruised my top arm i have been given some exercises to do but i cant do anything with my top arm as it hurts on the inside when trying to lift it. but i have also now got a very sore throat that has came on today, could this be related? ### REPLY: Dear patient sore throat and shoulder pain are not related. Shoulder pain should be investigated with X-ray of shoulder with clavicle anteroposterior and axillary views to rule out bony injury if not done before. If X-ray was done and found normal MRI of shoulder should be done to rule out soft tissue injury. Meanwhile, start tab diclofenac sodium 50 mg twice a day for pain relief. Exercises can be continued if there is no pain. Please visit expert orthopedic surgeon nearby you with 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: My arms throb when I bend at the elbows. One side turns blueish. I also cannot bend my knees for too long. This also affects my sleeping, as I have to make myself try to keep arms and legs straight. It s impossible to sleep in the only comfortable way - on my side. ### REPLY: Hello, I would explain that your symptoms could be related to peripheral arthropathy or peripheral neuropathy with liability to pressure palsies.  For this reason, I would recommend performing a Doppler ultrasound of the leg vessels and nerve conduction studies. You should discuss with your doctor on the above tests. 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: Hi, I am 38 years old male from India and consume alcohol at least 3-4 days a week, heavy during weekends; recently I had a bit of discomfort in my right lower quadrant, below the right rib cage and decided to take LFTs. The results came back as ALT of 60.85 and AST of 28.13. Does this mean a cause for concern, please advise on these results. I generally eat fried/fatty foods moderately to high. ### REPLY: HiT hanks for choosing  for your query. I have gone through the problem described in your question. In view of alcohol intake and raised level of ALT enzyme and the associated right upper qua .  This is a matter of concern. Get the LFT done to find out the extent of the problem.Meanwhile, stop taking alcohol in any form (in addition to causing liver disease, it can virtually affect almost all the organs of the body including the testicles), Start taking fresh fruits and vegetables which can prevent the liver injury, Avoid taking oily vegan or non-vegan dishes like fast foods, junk foods etc. You can have baked white meats like poultry, fish, and eggs ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lot of anxiety lately and depression from going off birth control . I ve experienced a lot of emotional stress that s come with it that includes but is not limited to thinking i have a serious health issue. Last time I went to the doctor they said I was fine and healthy. After I realized most of my symptoms were coming from my anxiety I had some relief and they started to go away. Then a few days later I noticed two dents in my skull that I am pretty sure were not there before, or were not as deep. I may not have noticed before but when I did I panicked and my anxiety came back. My head tingles a lot and feels numb when I sleep. This could be caused from a number of things but I was wondering If I should worry. I have no insurance so I have to get on a waiting list at a health clinic to get an appointment. ### REPLY: Hello....your symptoms match the profile of a Hyperion . .these people frequently fear that something is wrong, and some underlying disease process is going on in their bodies. All investigation comes normal but still they fear...sometime fear shift from one to others. These people want to get investigated for various illness. My question is, do have any problem in your scalp except feeling a dent which you found incidentally while you were exploring and later on became tense due to that. If answer is no...than you have to learn to let such things go and not to worry so much....because if this persists you may be progressing to a chronic illness, and you may face lots of problems due to that. 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 was in a car accident a week ago. i have a serious bruise with a lump on shin. My calf also burns and feels very tight. They xrayd it at the er after accident but it was severly swollen at the time and didnt see anyfractures. should i go back to dr? ### REPLY: Dear Sir/ Madam Does passive movements of your toes/ ankle cause pain in the calf. Are you on blood thinners like Warfarin?. Examination of peripheral pulses is to be done. Compartment syn .  It is recommended to elevate your leg under two pillows and to do active toe movements and visit your treating doctor. Other possibilities could be contusion of your calf muscles, Deep vein thrombosis.  Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor , i have put a straight wire brace on last july...went to tighten my brace till dec...after tat i came to saudi...i am putting tat module kind of rubber on my teeth without consulting a doctor here becoz there r no good doctors nearby...gap started filling but new gap is forming infront of the removed teeth on all four sides...wat shud i do now? ### REPLY: Dear friend. Thanks for sharing your concern. Generally it is good to take your dentist advise who is treating before moving. So that he/she can suggest you how you can continue your treatment there or whether it can be discontinued at this stage or not. Any ways since you have not done that, you can look for a new orthodontist in that area and can continue your treatment if he/she is willing to. Any adjustment done by self can harm your dentition and jaw therefore please do not try that. Thanks. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m 46 years old and I have had a regular monthly cycle every 4 weeks on the dot. The last 6 months my periods have been very painful with terrible mood swings and almost depression . The last period I had was on November 16th 2012 and I have had not had a period since. I would describe myself as healthy and I have no apparent health issues and I have not been in a relationship for a while so I know for a fact its not pregnancy. Should I be concerned its a relief not to have them..... ### REPLY: Hi, Welcome to  Forum As you are 46 years old, you are in per menopausal age. Menstrual cycle stop around 45-50 years of age. Before that women used to have irregular and prolong gap between the periods which is frequently associated with anxiety, depression, mood swings and hot flushes. You can meet gynecologist and psychiatrist to rule out other pathology. Anti depressants and hormone replacement therapy provide relief in symptoms. Wish you Good Health and all the best.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my  mother is patient of bone  cancer now  is  infected from heavy  cough in chest .she has probolem in  breathing  because of  this .she  has also  high pus  cell  in urine she  is  bed  ridden.now  i am  giving  her  mucine 3times  but  not  good  result  .pl  suggust ### REPLY: Hi, Thanks for writing in. As your mother is under treatment for bone cancer, her immunity might have come down. This has caused an increased tendency for her to acquire infection. The high pus cells in urine and cough might result from low immunity and higher susceptibility. Right now she requires immediate treatment with antibiotics to control her cough and pus cells in urine. Urine culture and sensitivity might have to be done to know which antibiotic is suitable to her. The cough also requires to be treated and giving a broad spectrum antibiotic should help. You can give her any cough syrup with expectorant to bring down the cough but treating the infection requires antibiotics. An X-ray chest should be done to know if there is fluid collection in the chest. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son 23 years old son has got a awelling on his right side chest wall with pain. On FNAC pus was detected. On CT Scan TB was suspected. But all other anciliary tests are negative for TB. there has been weight loss, evening fever and weakness. Please suggest. ### REPLY: Hi thanks for contacting .... Noted you have abscess like lesion over chest. CT scan suspecting TB.... So here tuberculosis confirmed by sputum examination by Zn stain or sputum culture in ACTED system... Which ancillary test you done???? Genetic testing helpful for tuberculosis like PCR or fluorescence... If tuberculosis not present treat abscess with antibiotic..... Weight loss, fever (prolonged) can be by HIV or any other chronic illness ... Rule out it.... Diabetis also should be ruled out by sugar estimation... Take care. .  ### END