Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sister is on Xanax, feyntnol patch and a pain medicine for cancer.  She has been on 25 of fentynol and within 6 days she has been bumped up to 100 now she is almost lethargic and breathing is really labored and right arm is twitching.. She was carrying on conversation Sunday and Monday patch was put on Tuesday and now cant even sit up..no one seems worried but me.. Just wondering what I could do ### REPLY: Welcome to , Though you have not given details about the cause of pain, and type of cancer, generally speaking it is not advisable to take XNA and fentanyl patch together. Also, to increase the dose of Fentanyl abruptly is not a wise option. Make sure also that she is not taking grapefruits or Grape fruit juice along with these medicines. It is advisable to consult her Doctor who can review her cause of pain, may revise the timings and doses or choose an alternative option for the pain. Wish her good recovery. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a root canal in early may.  Prior to the root canal, my symptoms were a hollow feeling in my left ear and tingling down my jaw.  The endodontist determined that my back lower tooth was not healthy (no infection) and performed a root canal.  The feeling mostly disappeared after the initial root canal, but obviously the endodontist and dentist have been in my mouth several times over the last month and a half, used novacaine, etc. for the crown.  During the entire time, I have had swelling in my upper left cheek (inside), like little pockets of inflammation.  Along with this, my allergies have been bad and I have had sinus pain, only on that left side in my cheek.  After the dentist put my crown on recently, my left gland in my neck became swollen and has not gone down.  The sinus pain comes and goes, the hollow feeling in the ear comes and goes and my jaw below my ear feels stiff and sort of hurts.  I went to the urgent care to rule out an ear infection or strep.  She said my tonsils and salivary gland are swollen and I had a lot of post nasal drip.  She recommeded Claritin D.  I have been taking it, but the swelling has not gone down with that or ibuprofen.  The dentist also looked at my mouth and says my teeth seem fine. ### REPLY: Hello, Thanks for writing in. The root canal treated has re-infected causing all these side effects associated. I would suggest you to get a thorough clinical as well as radiological evaluation done. If tooth can be saved, it has to be extracted. Or-else, tooth has to be root canal treated. Please get scaling done. Use soft-interdental toothbrush and dental floss to clean your teeth. Maintain good oral hygiene. Use chlorhexidine mouth rinse to gargle. Take complete course of antibiotics too. 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 kira. I m 23, 5f 2in I weight 68kg. I m 36 weeks preganat and have blood and protein in my wee. I ve had growth problems I don t measure what I should be so just worried about blood in wee. I had a blood test and urine test r weeks ago and came back normal. Hope u can answer my wuestions. ### REPLY: Hi, Blood in urine is not normal at any stage in pregnancy and should be evaluated further. Moreover, you have protein as well and the baby is smaller than expected. All these point towards pre-eclampsia. You should get your blood pressure checked and get a detailed blood tests for liver function and renal function and ultrasound for size of baby and amniotic fluid level. You should also get Doppler ultrasound to see the well-being of the baby. A Fetal heart trace will also be required.Also, a scan of your kidney is required to rule out anything abnormal. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I suffer from stenosis of the lumber region. Neurosurgeon says nothing sinister there and prescribed Dicloflex 75 mg. I find them good. Is it ok to take these tablets continuously. Since last Feb. 2014 have just used 2 months of prescription. Mary ### REPLY: Dear patient Lumbar canal stenosis has good results with conservative management. It depends on severity of stenosis. If lumbar canal is stenosis is more than 50 % surgery is must. If stenosis is less than 60% conservative management has good results. Dicloflex can be taken but has side effects on long duration that includes 1.  Gastritis with ulcer and if not treated may lead to perforation 2. Kidney damage with fibrosis 3. Mouth ulcers. So long term use is not advised. Ask for better alternative and go for physiotherapy.  Epidural steroid injection has also better effects on symptoms and is old procedure without any significant side effects.  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: Hi, I am in my 3rd trimester. Coughing since 2nd month of pregnancy. In last month, two instances where I ran out of breath and had to rush to ER, First time they gave me ventolin and it helped and they concluded it s asthma second time, ventolin was not helping. docs did all kinds of tests and every organ came out clean, now they want to do lung imaging. ### REPLY: Thanks for your question on . I Can understand your situation and problem. In my opinion you should consult pulmonologist and get done1. PUT (pulmonary function test).2. Ultrasound examination of chest.PFT is needed for the diagnosis of asthma. It will also tell you about severity of the asthma. And treatment is based on severity only. So PFT is must for you. Chest x-ray is contraindicated in pregnancy. So better to get done ultrasound examination as it is safe in pregnancy and can diagnose pneumonia and pleural effusion. Ventorlin is having levosalbutamol. It is short-acting beta 2 agonists (SAGA) and action lasts for only 2-3 hours. So better to start long acting beta 2 agonists (LAB) as its effect lasts for 10-12 hours. 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: Good morning, doctor. I have a couple questions that concern me right now that I hope I can get a positive answer for from you. First of all, I have this lump on my chest that looks like a mosquito bite except there are a couple small holes in it and it stings when I touch or itch at it. What is this thing? Second, I currently have a broken left collarbone from a car accident that happened 2-3 weeks ago and I might be having sex with my girlfriend who is leaving in a couple days and I was wondering is it possible for me to do that without any major consequences? ### REPLY: Hi. Thanks for your query. Lump on the chest like a mosquito bit but have the couple of small holes in it may be due to an insect bite, and you might have scratched and caused it to appear like this. Or can be due to would be caused during accident. Also noted that you had broken left collar bone 2-3 weeks ago; if you are young this might have healed to an extent, and you can have sex with precaution to be taken by you and your boyfriend not to be harsh and pressing, there might not have any problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 vertigo in December. It seemed to getting better with time, but still bothers me when I tilt my head from sided to side or try to look up. However, tonight, I have been getting dizzy again, it s coming and going. Just sitting at table and all of a sudden feel a quick spinning that thankfully isn t lasting long, but still scary. Also, my hands and feet seem to be cold and a bit tingly. Any ideas? ### REPLY: Hi, Your symptoms of dizziness and quick spinning with turning of head is consistent with peripheral vertigo(vertigo related to ear). I treat my patients with vestibular rehabilitation exercises and short course of betahistine (antivertigo . Consult neurologist for clinical confirmation of stagehand and feet symptoms are consistent with small fiber neuropathy need to be confirmed by examination and further evaluation ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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... My duaghter, 3 years old, has had a foul smell from her bottom. She is potty trained but still wears pull ups at night and they are wet every night. So I would expect odor from that. But even after I wash her in the tub she still has a terrible smell. I am afraid she will be embarrassed because of it. I even put baking soda in the tub and that doesn t help. Could she have some type of infection? She is very modest and I don t want to be too forward because it is a private issue, but I feel responsible as her mother to make sure nothing is wrong that needs medical treatment. Thanks for your help. ### REPLY: Hi, What you are quoting is exactly called encopresis. This occurs when the kid has hard stools, almost similar to constipation.  But what happens here is the liquid stools will seep out on the sides of the hard stools and leak out. But, the main treatment of this is relieving of constipation. Suggestions: 1. Natural methods are the best to relieve constipation.2. Constipation is a risk factor for UTI3. Maximum milk consumption per day should not exceed 300-400ml4. Minimum 3-4 cups of fruits and vegetables to be consumed per day5. Toilet training - that is - sitting in an Indian type of lavatory daily at the same time will help a lot. 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: straightening of normal cercic lordosis sir i have numbness in my hands & legs often & shortness of breath racy heart beats & fiziness from last 3 months finally i got my xray for neck resulting for straightening of normal cercical lordosis due to paraspinal spasm are these symptoms are because of spasm pls reply ### REPLY: Hello, To comment anything else, I need to examine clinically and need additional information like presence of morning stiffness, other joint involvement, Fever. Back stiffness/pain. In presence of inflammatory arthritis, breathing problems are possible. Giddiness would be considered in patients with neck pain. Palpitations needs further evaluation with cardiologist/Internist. 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: Hello! I have what seems to be an enlarged lymph node in the back of my neck, where back, shoulder and neck meet. Not really big, I dont think its bigger than 1 cm, 1.5 cm at most, but pretty hard. It pops out more when my back is tender. Its been there for almost a year, I went to my doctor when I found it and he said it was nothing, blood work was ok. But its still there. Should I concern? ### REPLY: Dear Friend. Welcome to . I am . I have read your query in detail. Furthermore, I understand your concern. The lymph node can be due to bacterial infection if it is single. In such conditions, I advise following:To take antibiotic like Augmenting for a week. If the lymph nodes settle, it's good. If it doesn't then a FNAC would be required. So, you may observe this and after 1 week, if it doesn't settle, get following:1. FNAC of the Lymph Node2. ESR3. X-ray Chest4. Sputum For This is my best advise for you based on available details. If you have any further query please ask me. Stay Healthy. ChatDoctor, MD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Evi, I am 40, and I had a Hysterectomy a few years ago because of cancer, and I am on hormone pills.Last  month while working at my job, I was not looking where I was going and ran into the corner of a cardboard box , and bruised my left breast, it did not leave a mark. My left breast is still sore, and there is a kinda  hard place in my breast. I went this long with out having my breast looked at because I thought I would go away like all bruises.   I have told my husband about this and he looked up my symptoms online, and told me it might be what is called a deep tissue bruise or a breast contusion, that takes a long time to heal. This worries me alot, because it has not healed, and plus having cancer once. Could this type of bruise become cancer?This has me so worried.Hope you can help me . thanks ### REPLY: Hi ! Yes, it could be a deep tissue bruise which takes a longer time to heal. However, because you have a past history of cancer for which you had a Hysterectomy done, your concern is also justified. To have a proper piece of mind, I would suggest you to get yourself reviewed by a general surgeon, who may advise you for a mammogram. As such a screening mammogram in your case would be appropriate. Wishing you an early recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have asthma.... one month ago i was treated in the er for "bronchitis". i received anti-biotics which ,along wth drinking water...the congestion did clear up. but the pain in my chest remains.... at first i thought it was from the soreness of coughing & breathing, yet i have had no congestion or breathing asthma problems since it clear up over two and half weeks ago. iam 48 and recently diagnose this summer as diabietic.....i hate going to hospitals and would love to get a answer to ease my stess before i see my gp next week.....regards ### REPLY: Thanks for your question on . I can understand your concern. Possibility of musculoskeletal pain is more likely. No need to worry about lung related pain as your congestion and breathing has improved. Avoid movements causing pain. Take simple painkiller like paracetamol or ibuprofen. Apply warm water pad on affected areas. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a really bad middle back pain that hurts when I move. And very sharp pains when I take deep breaths. I m able to walk but very slowly as the pain is sharp and hurts a lot. I ve also had a head ache since thurs and since then too I ve also not been able to hold food down. If I eat a meal it feels stuck on my chest and I cough and vomit it up. I was told last year that I had copd and just wondering of any of this is related. I ve been in bed since thurs. Attempted to work today but couldn t stand it. I m also freezing and shivering but my partner says my skin is burning Should I go to hospital ### REPLY: you must visit hospital as pain in the middle, vomit and other problems need attention of doctors with few X-rays of chest and back. An upper gastro-endoscopy for food pipe and stomach and upper bowels may be required, chest x-ray for COPD issues, and spine X-ray?MRI for disc related lesions. You will be given anti-emetic to control omitting, antacids/PPI inhibitors or acidity controllers and some pain medicines. Complete assessment is the necessity as of now. Endoscopy rules out food pipe lesions, stomach lining issues, ulcers etc 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: After almost everytime I have a runny nose, I will get a sore either on the bottom of my nose or inside. If I were to wipe the scab off (which is yellow in color) it would be sort of "weepy" or "runny" and then reforms the yellow scab. It last about a week. It also does not seem to respond to Abreeva (I thought perhaps it was Herpes 1) ### REPLY: It's not herpes but a kind of friction reaction caused because of extra and frequent wiping of nose post rhinorroea or running nose. You should concentrate on treating running nose. Wipes will reduce. Friction will reduce. The rule is avoided the cause of ailment. In the context if you use herbal approach, it will be far better and cure permanently. Chiara Habitat and Shading oil for running nose and for scabs Atari oil is unprecedented cure formulas in classical Ayurveda which we try on our own patients. Yes, get your sugar level checked too. We can help you more through  if need be or any Ayurveda doctor can. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi just recently my bell end has been itchy and red its cracked and bleeding aswell but today I have noticed my foreskin has gone really tight when flacid and I cant pull it bback im 25 and have recently been using ciprofloxacin for a urinary tract infection ### REPLY: Hello, You are having Atlantis as per mentioned history. It is inflammation of glans penis foreskin.  You can be prescribed a topical steroid for your fibrosis problem. Mitosis means you cannot be able to retract foreskin back over glans.  If no improvement than minor surgery can be done to remove foreskin called circumcision. I suggest you consult Urologist for examination and discuss all these.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have suffered 9 kidney infections in the past 5 years without the precursor of a uti . When these happen my urine is extremely dark and I have high blood pressure- I fear I may have brights disease. Also during these infections there is a lot of protuen being spilt over the kidneys and I repeatedly have pitted edema . Please help with any information. Concerned extremely, Michele ### REPLY: Hi Michele, some females can be prone to repeated UTI episodes even without any obvious underlying cause. However, if episodes are frequent or the infection involves kidneys, a thorough evaluation for a cause is needed. Your BP and kidney function (creatinine) also needs to be checked.  You will also need long term antibiotic prophylaxis (course of low dose antibiotic tabs for 6 months or more) to prevent repeated infections. Cranberry extracts are now available in tablet form, these decrease chances of repeated infection. Consult a urologist or nephrologist. 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: Impressions on endoscopy ultrasound found pancreatic parenchymal abnormalities consisting of hyperechoic strands and hyperechoic foci were noted in the entire pancrease.. having pain in middle abdoman which can include back pain.  have had problems off and on with pancrease flareups. 2 years ago gallbladder removed.  My stomach swells outrageously large and very tight.  The Doctor  will continue with more testing.  what is hyperechoic strands and hyperechoic foci?  Thank you. ### REPLY: Hello. Hyperechoic strands and hyperechoic loci are nonspecific signs of abdomen ultrasound. Abdomen ultrasound is not the most sensitive test to diagnosis pancreatic diseases. If your doctor suspects pancreatic disease the best test is computerized axial tomography(CAT)I suppose your doctor will request that test soon to establish right diagnosis and treatment. I wish you good health.(In case the answer would have been useful please indicate this) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About a week ago I had a horse fall on me and smashed me on my right side of my body. I have not rested or allowed by ribs to heal at all. They hurt me 24/7 and it is hard for me to sleep. There is a pretty big bump where it seems my ribs have moved. I understand ribs must heal on their own, so do I need to still go to the er?? ### REPLY: Welcome to  I have gone through your query and understand your concern. You have got injury to your ribs. Treatment of it is rest and analgesic such as ibuprofen. It generally takes nearly one month to heal To confirm about fracture you need to get its x-ray done and treatment of it. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 3 yrs ago. Got hit very hard on my right side off motor bike by 4x4 .. I pull out on green. My speed 20 other hit me 50 km. I change direction from south to east quickly. Flew 20mtre down road landing hard on my backpack. The bull bar took a chunk out my thigh muscle. Open to bone. I still get pain running threw up leg to butt. Then now I live with tinggles numbness. I Broke 6 back ribs. But now and all this time I hv back neck hurting. Tip Side and back. Sprain down arm.akes back skull. Hurting stuff back front neck color bone aera. On and off muscles feeling hit sharp jabs . And muscle hurt ake.Then when stop sore to touch. Plus lost strenth in arms couldn t cut cheese.and lots other things hard .But I m getting there.So do iI hv whiplash. From changingddirection fast and landing hard on my back pack. Head bending back as well quick side ways movement. I hv been told got muscolarskullartor pain... that be from landing and broken bones. But my shoulder and shoulder blades and all muscles hurt tight sore ake too. I just live feeling hit hard sore still hard to shake it. ### REPLY: Hi, The only worrisome thing to be ruled out is an injury to your nerves in the neck after trauma...get physical examination with a neurosurgeon and if there is a real weakness of arms then probably you'll need an MRI of cervical spine along with brachial plexus. If it comes out normal then massage your muscles and probably get some muscle relaxants that ll help. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Have been complaining of shortness of breath and chest pain. Cardiac work up negative. Pulmonary findings sleep apnea. Chronic obstructive lung disease. Had chest xray which states coarsening of the interstitial markings. Trying to understand. What does this mean. ### REPLY: Hi welcome to the  Interstitial marking coarsening can be seen in interstitial lung disease rather than COPD.... For COPD confirmation better to investigate with pulmonary function test esp. Spirometry... In pulmonary function test FEV1, FEV1/FCC, FCC, DCO etc. like investigations will be done... And this pulmonary function test able to differentiate between COPD like obstructive problem and restrictive lung disease like pneumonia or interstitial lung disease Smoking is the most common cause related to such problems Hope your concern solved Consult pulmonologist for examination and pulmonary function test (if needed after examination) 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 an almost grown wisdom tooth and now my gums are swelled and painful. I am using water and salt to ease the pain, but it comes back. I cant open my mouth fully, it hurts. Its the second day and I am having problems to swallow. Also, its hard to clean the tooth since its way back in my mouth. 6 years ago I had a wisdom tooth who grew under my last tooth which was taken out. ### REPLY: Hi there, Thanks for writing your query, Wisdom tooth is the last tooth to erupt in the oral cavity and often its eruption is associated with symptoms like pain and discomfort in eating, difficulty in opening mouth, swelling in the jaws and cheek bite.  Wisdom teeth are often tilted in position and impacted in the bone, gums overlying the tooth usually undergoes inflammation, shows pain and swelling known as peritonitis.  I would suggest you to go for symptomatic treatment at home like gargling with lukewarm saline water or antiseptic mouthwash like chlorhexidine or Betadine.  You may need to get an OPG radiograph done for you which will show the exact position of the tooth, consult a dentist and get the tooth extracted surgically.  Continue with the course of antibiotic Augmenting 625 mg along with analgesics like diclofenac two times daily for 3 to 5 days.  I hope this helps, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir/madam My mother is an old patient of CA ovary GR I in 2006 after that she has been given 6 cycles taxol chemo . she was fine enough now recently i had done a USg for my mother and in that it is written Liver is enlarged and Hyperechoic , other than that it is hepatomegally with Grade II fatty change please tell me as fast as possible I am very much worried Sir, ### REPLY: Hi, I had gone through your question and understand your concerns. Well, first I don't think that ovarian cancer that she has and fatty or enlarged liver are related since this is not sign of liver metastasis. Only focal liver lesions may be metastases, but it would be described. So this is good news for her, and we hope that cancer is cured. Second, enlarged liver is mostly caused by fatty liver which can be treated with lifestyle habits.it means that quitting alcohol is the most important thing. Father, if she is overweight or obese it should be managed by diet and exercise. Eating a balanced and healthy diet is important. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI doctor , I have been suffering from Dust allergy , running nose and sneezing for quite some time and one of my doct suggested me to have levosetride 5 mg tablet as a remedy . as of now i am really happy with the results and all of a sudden one of my friends pressed the panic key in me by saying that its a steroid and will cause side effects . I am equally worried with the fact that i am also undergoing my infertility treatment cos of the low sperm count . pls advice ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. First, please re-check the content of Levosetride 5 mg yourself. It is Levocetrizine 5 mg. It is not a steroid. Furthermore, it is an antihistamine which is used in allergies and itching. Common side effects are sedation, .  If you are not experiencing any of these, I would think you can continue using it for long period. I have not heard it to have any effect on infertility/infertility treatment.2. Personally I would suggest you allergy testing which will help you to identify the substances causing troubles to you and also to know how to avoid exposure to them.3. Please avoid exposure to dusts, smokes and air pollution as much as possible.4. Regular breathing exercises and diet rich in vitamins and minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc.) will help you in a long run. 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: I have a hard very painful to the touch, and painful when not touching knot on the right lower side of head.. And pea size painless lumps on back of neck.. A lot when I stand up vision blurrs completely out for a second and returns making me feel a little dizzy and nausious.. Please tell me what It could be! ### REPLY: Hi, I understand your concern and would explain that your symptoms could be related to inflammation. The painful knot may be an infection or a cyst. I recommend consulting with your family doctor for a physical exam and some tests: - complete blood count- PCR- sedimentation rate for inflammation brain CT scan would help give more information on the knot and exclude possible intracranial lesions. Hope you will find this answer helpful. Let me know if I can assist you further. 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: HOCKEY MISHAP..FEET WENT FORWARD..LANDED FLAT ON MY BACK BUT PREVENTED MY HEAD FROM HITTING ICE. IMMEDIATELY FELT NECK PAIN. 4 YEARS LATER STILL PAIN IN NECK, MRI REVEALS 6TH VERTABRA PINCHING. TRIED CHIROPRACTOR (LASER THERAPY), MASSAGE THERAPY, ACUPUNCTURE,  AND STILL NO RELIEF. SHOULD I CONSIDER INJECTIONS TO MANAGE PAIN? CHRIS ### REPLY: Hithanks for using ChatDoctorpinching or compression of the cervical vertebral region, these are all recurrent chronic problems change of lifestyle is very important please use a soft cervical collar, to immobilize or avoid excessive movement of the joint, which progresses the injury. Relaxation physiotherapy exercises will help you can try with preparations pregabalin or gabapentin added with metylcobal amine on daily basis. These are safe on the kidneys for long term therapy also 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 constant pain in my left foot, on the outer left side between my toes and my ankle. Compared to my right foot, looking at it, it looks a little swollen, although there is no redness. Even when I go to bed to sleep for the night, the pain is always there, even laying down. What could it be? ### REPLY: Dear Patient, Single join tie ankle of one side getting involved, swelling but no redness, indicate towards an arthritic joint, you need to screen this and help your doctor find out the cause of this arthritis, You fail to provide some information like your age, since when are your symptoms, also do you feel any stiffness in the ankle or other joints on getting up in the morning. Just see your doctor and discuss your concern. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have intermitted pain in my hand and foot left fingers and half of the hand and foot. Sometimes it is accompanied by an electric shock. I am 65 male.my uric acid is 3.0,vitamin D is 39.3,vitamin B12 is 624,hgb.AiC 6.5,sodium 138,potassium 4.5rheuatoid factor 10.2,WBC 3.0,RBC 4.86, Hemoglobin 13.3 ### REPLY: Hello, I have studied your case. Due to compression of nerve root there is tingling numbness in your feet and fingers pain associated with it. I will advise you to MRI spine for better diagnosis. It can be due to various causes like sudden jerk to spine, due to facet arthritis, degenerative, due to chronic systemic disease like diabetes or hypothyroidism. For these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Another possibility of peripheral neuropathy. 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 are satisfied with answer do not hesitate to rate this answer 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: My doctor prescription me confido 2 tab morning and 2 tab evening is there any risk. I am 43l age had been suffering from premiere ejaculation 3 years before but my wife passed only after 1 month of marriage. Now I am going to marry after month As I am not masturbating since a year and doesn t have night fall till today so I consult a doctor who prescription above Please answer ### REPLY: HelloThanks for writing to us. I believe that some changes in diet and lifestyle can bring about a significant change in the symptoms. You have to be confidant that you are not the only one who are facing this problem. I suggest you to use Neo tablet (Charge Pharmacy) for 3 months. It is one of the best remedies available for erectile dysfunction. It is safe for long-term used hope it is helpful to 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: Hi Doctor. Im 29+2 weeks pregnant and since yesterday Ive experieced frequent loose stools, flatulence, acid in the stomac, colics with cramps in legs and arms. This morning I went for a stool test and they told me its amoeba. Because I live in the subsaharian Africa and here in the village we dont have any good doctor, Id like advice on which medicine to take, and how often. Thanks. ### REPLY: Hi madam, came to know about your problem of loose motion comics and cramps, as you are residing in rural remote area and pregnant 29+2 weeks, I want to suggest you to take plenty of fluids with electrolytes if available to you, if not than you can take sugar+salt+ lemon water 2-3 liters in a day, also take Metronidazole 400 if you have, for your cramps you may have your medicines as advised regularly in pregnancy i.e. folic acid, iron & calcium as given to all pregnant women along with these you must take a glass of milk regularly during this period. You can also take curd & rice to control your loose motions and flatulence too. Good Luck take care, recover soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi , i have a small bump in the top of my mouth , i had it for maybe a year , was a small poiny thing , and i was thinking id maybe from my dentures , so i ignore it for a while .. now i feel that is a little bigger , its not under the skin , its above , and im concern , wonder what kind of doctor must see ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have bump in mouth since one year which could be due to dental infection from acrylic surface of denture, due to embedded root stump, sinusitis and dental caries. It could be due to palatine torus as well. I would suggest you to visit oral surgeon once and get it examined. You should go for Occulucal radiograph and orthopantomograoh(OPG). From radiographic findings exact diagnosis can be made out and treatment can be done. Till then take proper antibiotic course such as Amoxicillin to subside infection. Do warm saline gargles as well. Avoid extreme sharp and spicy food substances. It can be excised surgically. Denture could be remade if it is hurting oral mucosa. 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 39 weeks and 2 days pregnant many times i get menstrual cramps and suffer from lower back pain so is it that i am in labour and if it is so then y i am not getting it properly and is it that i need to have artifical pain or what other things should be done in order to induce labour pain ### REPLY: Hi there, The last few weeks of pregnancy are the most uncomfortable and also filled with anxiety and stress. And as the baby grows larger compared to the womb you can feel tightening and pain which can be mistaken for labor pains. You need not worry, as some women may get into labor by 42 weeks, that is 2 weeks after their due date and this is absolutely normal. You are still at 39 weeks and should not be worrying. A true labor pain will be increasing in intensity and length of time and will be from loin to groin and is usually accompanied by bleeding or breaking of waters. Do not worry, if you don't get labor pains by 42 weeks then induction of labor will have to be considered. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with hsv type 1 Sept 6th had my first outbreak and it cleared up. Today I have a rash all over outside of my vaginal lip only in the hair area but its all over and itchy like crazy. This is nothing like my outbreak a few weeks ago. I dont have insurance but is this worth an er visit? ### REPLY: Hello, Welcome to , As you had an outbreak of HSV 1 infection previously which is known to affect the area around the mouth. As you are having itching around the genital region, there are many conditions which can lead to this problem and one of the cause may be HSV 2, but it should be confirmed by physical examination by your doctor. I would suggest you to undergo physical examinations before you take any medications. 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: do you have any idea what might cause me to have abdominal pain, then really bad diarrhea and then feel like I am going to faint and would if I didnt get to the bed where I can lay down. After it passes then I am week for a while.It is scary because I never know when its going to happen and I might be in a store or on the highway. Thanks ### REPLY: Namaste Welcome to  Greetings of the day Intermittent episode of diarrhea with cramps abdominal pain could be due to parasite infection like Guardians or amoebas. I suggest you to get a stool routine examination done to look for parasite and their ova or cyst.  Also, 7 gay empirical treatment with Metronidazole will provide you the much-needed relief from these annoying symptoms. Wishing you a healthy life Take care Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 13 yo daughter s MRI reads: mottled pattern of abnormal bone marrow signal intensity throughout the hindfoot may represent complex regional pain syndrome ( reflex sympathetic dystrophy) although is nonspecific and could not exclude other entities as described above. Described above was Charcot arthropathy, but there is no evidence of this. What does all of this mean? ### REPLY: Hello, The exact cause of complex regional pain syn .  Symptomatic treatment with supportive care must be given. So don't worry in case of chariots joint may be due to nerve damage lead to arthropathy. Medication with regular exercise and physical therapy may useful in some cases. Please consult with your orthopedic he will examine and treat you accordingly. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother has just been diagnosed with a tumour in her lung she is waiting for an appointment to see what kind of tumour whether its cancer or not and which form.....a couple of years ago she had bowel cancer and had half her bowel removed and was doing really well, we are concerned obviously and wonder whether there will realistically be a treatment available ? She is in her early 80 s too so difficult age to be coping with this. ### REPLY: Thanks for your question on . In my opinion the present lung tumor might be malignant only. Since your mother had bowel cancer chances of lung metastases are very high. So better to get done PET (Positron Emission Tomography) scan and if there is hot spot than probability of malignant tumor is high. You may biopsy to confirm this. Treatment will remain palliative chemotherapy only, as it is stage 4 cancer, so surgery is not indicated. So better to consult oncologist 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,A relative was admitted to hospital with kidney stone.  Now has sepsis and UTI.  Lab has had blood and urine samples for ~24 hours to see if UTI and sepsis are same.  They want to wait to see if infections are the same before treating.  He had a colonoscopy last Monday.  My concern is possible peritonitis.  They did a CT scan said no evidence of peritonitis.Not sure how long labs should take to come back.  If tomorrow will have been close to 36 hours.  My concern is sepsis should be treated aggressively now, not wait to see if sepsis signature is same as UTI.Your thoughts would be appreciated. ### REPLY: Hello, Thanks for the query to . Forum. Usually when we have no facility for culture & .  Just urine examination will find out the depth of infection. If pus cells fulfilled may be severe infection. If few pus cells 10-12 nothing to worry. In peritonitis usually there develops swelling over abdomen with fever (high grade) and breathlessness. If all these symptoms did not present then need not worry. In my opinion as your patient has renal stone, so stone in itself may cause infection and fever so consider this point. Ultrasound abdomen will find out the real position of stone in kidney. Good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have problem moving my stool and ican feel a small lump there if i exert too much during vowel movement. But after doing exercise i donot have this problem the stool moves easily. Do i need surgery to remove that small lump that appears whenever i forced vowel movement or should i contiunue the exercise. Will my vowel movement became normal again even if i do not exercise. ### REPLY: Hi. Thanks for your query and an elucidated history. The relations between the things you mentioned are rare. But surely is helping you. As you have not mentioned where exactly is the lump it is difficult to tell about it. One thing is sure. If there is a lump, which is not a normal body part, it should be removed. Please continue exercises, Yes, your bowel movements may become normal with proper bowel training, and then you may not have problems in passing motion whether you exercise or not. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 red lump on my labia, its like in the middle of my lip. it is very smooth and soft but hard on the outer part. The skin around it is a bit itchy and painful when walking. im not sexually active. so it can t be an std but I do have a low immune system and get cold sores but I haven t had one for a good year or so now thanks ### REPLY: Hi, If I were your treating Doctor for this case of an itchy labial lump, I would come up with only one and one possibility that is a sebaceous cyst with super added fungal infection! Nothing to worry about this and try not to get infected there repeatedly! I suggest you to go for an FNAC test of the lump for confirmation if necessary otherwise take cold compress, local antibiotic/antifungal creams and also oral antibiotics and revert to us to relieve your concerns! Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father is a liver cherosis patient recently he had an internal bleeding and he had to get a couple of viens stitched by endoscopy.i want to know what stage he is at .he also get fever every couple of days 102.the dr gave him some antibiotic injections for 6 days now .pls inform mehis stage .is it true that there is more chances that it has gone in portal vien ### REPLY: Hi thanks for contacting .... Noted your father having cirrhosis and history of varietal bleed.... So he has chronic liver disease with portal vein hypertension... For exact grading biopsy needed.... But let me know you care has to be taken to avoid further complication... If needed here beta blocker might prescribe for portal hypertension. Low salt diet taken.... High protein diet useful.TIPS like invasive shunt procedure helpful in reducing portal hypertension.... If condition worsen ultimate treatment is liver transplantation... Early in morning take grinned spinach and carrot juice.... One tsp crushed papaya seed with lemon juice helpful... If behavioral abnormality, tremor, sleep disturbance and varietal bleed occur immediately directly consult gastroenterologist.... Take care. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Female 57. My SGPT (ALT) was at 17 one month ago. Recently, 30 days later, my level increased to 24. I took benadryl (2x 25mg) at that exact day I had the blood panel. Before that never took benadryl before. Could the benadryl cause the increase from 17 - 24? Thank you. ### REPLY: Hello, 17 and 24 are generally within the normal range and that is a small change that often occurs without there being an actual abnormality. If the result is far outside the normal range for that lab, then it would have to b evaluated.  The ALT alone being elevated generally is from alcohol acute effect or another direct liver toxin. And generally this is a rapidly reversible issue when the .  Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a huge hard lump under my ear. It has been there for almost 5 years. Im not sure if it is a lymph node or a lump. It has grown over the years and has never gone away, not for a single day. It has though, increased and decreased in size, and seems to get bigger when I am stressed. It also seems smaller when I first wake up in the morning but immediately gets bigger. I had a doctor tell me years ago that it was a swollen lymph node due to the hole I have in my eardrum so that it could fight infection. He told me later on another visit that it was a cyst, which I should not worry about(because I have a couple of cysts....supposedly, in my hand). I am concerned that this could be lymphoma or some other serious problem. ### REPLY: Welcome to . 1. The history and symptoms suggest most possible cause could be Sebaceous cyst - which does not need any specific treatment unless until causing discomfort or cosmetic issues.2. Next possible cause could be lymph nodal enlargement - but does not expect to see for so long with no change.3. In this case I would recommend getting an ultrasound scan done-that will characterize the lesion (cystic / solid / mixed) and its source and extensions. 4. In case of mass lesion an FNAC - fine needle aspiration cytology would help to evaluate the nature of cells.5. Suggest to get an appointment with your GP, get examined and needful investigations and treatment will help. Good luck. Hope I have answered your query.Anything to ask do not hesitatehttp://doctor. ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 19 year old daughter recently noticed bald spots on her head, 2 of them is dime sized and the other one is about the size of an egg. Also, she has a lump on her armpit. In the past, her lymph nodes were huge but eventually the swelling went down. She mentioned to me that sometimes, there s blood on her stool. I am so worried because cancer runs on her father side of the family. ### REPLY: Hi and welcome to . Thank you for your query. I am  and I will try to help you as much as I can. Spots on head are probably atheromas and these are small subcutaneous glands which may become clogged and grow. This should be surgically removed under local anesthesia. This is not serious. Her blood in stool is something else, however,cancer is the last thing to think of in her age. It is in most cases caused by hemorrhoids or anal fissure, so she should see proctologist for further evaluation. I hope I have answered you query. If you have any further questions you can contact us. 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: I have a 23 month old grandson.  From the day of his birth, he has periodically had the following symptoms: yellow skin, yellow corneas, hard white stools, abdominal pain, and fevers of an unknown cause (all occurring within the same timeframe).  When my daughter takes him to the local ER, a walk-in clinic or his physician, they tell her it is because he has had too much milk in his diet, or hes eaten too many carrots, or some other lame excuse.   I am beginning to believe that this is because he is a medicaid baby and no one wants to spend too much time on his problem.  There is obviously a hepatobiliary problem here, how do I get someones attention about it before he has permanent liver damage? ### REPLY: Thanks for follow up. It is clearly seen that your grandson has unknown interns. We have lots causes of ikterus-hereditary, carrot overeating, viral infection like as hepatitis A, B, diskynesia of bile ducts, obstruction of bile ducts. You should do deep examination, you should check blood test, liver function test, stool examination, stool for ova and cyst. You give to baby diet number 5, see in the Google, it means not fatty, not spicy, not sour. Start to give him hepatoprotector- LIV 52 1 tab 2 times after 15 min before meal 1 month. Consult at gastroenterologist in hospital 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: GOOD MORNING SIR ,IM SUFFERING FROM BREATHING PROBLEM N BLOCKED LOSE FOR LAST 2 YEARS .I DID DNS SURGERY (SEPTOPLASTY) BEFORE 1 YEAR AGO .BUT WITH NO BENEFITS .N WHEN I WENT TO DR HE SAID THT THERE IS STILL MODERATE DEVITION BUT THATS NOT A BIG PROBLEM, AFTER THAT I DID TURBINATE REDUCTION BEFORE 6 MONTHS AGO BUT STILL IM SUFFERING WITH THIS PROBLEM .RIGHT NOW I HAVE MORE PROBLEM IN MY LEFT NOSE N I CAN SEE THE TURBINATE IS OBSTRUCTING M BREATHING .MY RIGHT NOSE IS NOT BLOCKED BUT WHEN I TRY TO DO BRAETHING EXERCISE I FELL LIKE IM UNABLE TO BREATHE DEPPLY .I HAVE TAKEN MANY MEDICINES BUT OF NO USE .I TOOK HOMEOPATChatDoctorEDICINE FOR 4 MONTHS BUT NO EFFECT N I TOOK AAURVEDIC MEDICINE BUT STILL NO BENEFIT ..PLEASE TELL ME HAT CAN I DO TO CURE THIS PROBLEM ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you should consult senior, experienced ENT doctor because obstructive lesions in the nose need surgery only. So for obstructive turbinate, you need to get it surgically removed. Another thing is allergic rhinitis. You are not improving 100% after any previous surgery. So possibility of allergic rhinitis is more. And so you will need 1. Steam inhalation 5-6 times a day 2. Intranasal spray containing steroid (fluticasone)3. Oral combination of antihistamine and anti-allergic .  So first undergo surgery for turbinate and then start above-mentioned  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 diagnosisd with retroperitoneal fibrosis and it has begun to affect my kidneys I have had multiple stents placed and removed!  Now I am having issues with keeping any food or drink in my stomach. And now  developing pains in my stomach along with the horrible L flank pain! any suggestions?? ### REPLY: HelloThanks for query . Based on the facts that you have posted it seems you have been diagnosed to have Retro Peritoneal Fibrosis. This is disease caused by unknown etiology which causes inflammation and fibrosis in retro peritoneal tissue and gradually involves the organs like kidney and ureter giving rise to flank pain and obstruction to flow of urine from kidney in to bladder. The objective in managing this disease is to maintain kidney function by decompressing the kidney which was attempted by putting stents in ureter for many times. In view of unknown etiology many medications have been tried with uncertain results. The best alternate is to undergo surgery of Uroterolysis where ureter is freed from the fibrous tissue and to maintain flow of urine from kidney in to bladder. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 anxiety? can it be cured by acupuncture?I love traveling but now i always go with somebody from the family coz Im afraid it will occur again. Im 30 yrs. old and this illness started when I was 24. Sometimes I catch my breathe but I know its only in the  mind but I cant really help it sometimes ### REPLY: Hi Welcome to ChatDoctorI have gone through your query regarding cure of anxiety through acupuncture. Anxiety is one of the most common mental illnesses worldwide. Many people suffer some form of anxiety occasionally, but others cannot manage this natural response to a stressful situation. When a person experiences a highly stressful or threatening scenario, the mind can be overloaded and fail to develop ways of coping. Acupuncture is an ancient form of traditional Chinese medicine. It works on the principle of stimulating points in the body to correct imbalances in the flow of energy through channels known as meridians. This belief is based on the interaction of the five elements (wood, fire, earth, metal and water) and having profound effects on internal organs, which are either yin or yang. Traditional Chinese medicine also recognizes the mind and body interacting as one, meaning that emotions have a physiological effect on the body. Western medical practitioners traditionally have questioned the validity of traditional Chinese medicines such as acupuncture. More recently, acupuncture has been recognized as a legitimate treatment for some conditions and is growing in popularity.<>Traditional Chinese medicine relates anxiety to an imbalance of the heart and kidney. Fire represents the heart and joy according to the five elements. The diagnosis is that too much heat in the heart will imbalance the interaction with the kidney (represented as water and fear). This will result in the water organ failing to contain the fire organ rising up to the mind, leading to anxiety. Acupuncture on points around the heart, kidney, spleen and ear are used to treat anxiety. Pro and con of everything are there t least it has no side effects. So you should not worry about it. Can get cured through Acupuncture Hope this gives you reply to your query, All the best Take Cardona hesitate to get back if you have any further query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 35 year old male and have a fatty liver for the past 9 years now and apparently high uric acid levels also . drinking alcohol for the past about 18 years regularly. I feel fatigued and drained when wake up in the morning and have pain in the ankles and knees. I used to be fair in complexion but now look dark and pale , hair fallen and greyed and look much older than my age my height is 5 8 and weight is 82 kgs. what should i do ? ### REPLY: Alcohol causes mood changes forgetfulness (dementia), reduces it B 12 and folic acid levels. Causes deranged cholesterol all damaging your health. Leg pains could be due to neuropathy associated with alcohol secondary to faulty IT B 12 metabolism.  Keep uric acid controlled by medications and repeated levels checked. Exercise, reduce alcohol consumption, and vegetable diet will all help u.  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: just came from doctors, back really sore in lower area, been running alot and feel good physicaly, but pain scale of 6 on lower back.. he sending me in for ultrasound because i have cramping in my liver area, muscle spasm or liver mass..meantime no antibiotics because of possible pregnancy? last Period was the 21st of jan. urinating alot.....drinking cranberry juice and water. pain hurts may i take a tylenol 3? ### REPLY: Hello. Thanks for writing to us. The pain in the lower back that you are having is likely to be a muscular pain. Other causes of such pain like renal pain or calculus need to be ruled out after an ultrasound scan. You have been guided in the right direction. Wait for the investigations. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://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: why do i get chronic asthmatic bronchitis every time i get even the slightest little cold?  I always end up at urgent care and need a prescription of levaquin an inhaler and albuterol  for my nebulizer.  my cough will last sometimes for 5 or six weeks.  i cant be near my grandchildren at all if they have even the slightest cold i end up so sick.  this happens to me several times a year.  could i have something more serious than bronchitis? ### REPLY: I don't know your country of origin and / or some herbal preparation are available or not? You can take care of your cold and asthma by increasing your immunity. Cap. Gilroy and cap. Tulsa can be taken twice a day. Home remedies-black pepper-2, cardamom-2, long pepper 1. .  Boil it with a cup of water till 3/4 remains. Filter and add sweetener as per your taste. Sip it like tea two times a day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: iv just found an immobile boney lump behind my right ear. its appeared in the last 2 hrs there are no breaks to the skin and iv had no trauma. its sore to touch and iv had a few white head spots on my scalp over the past few days. the lup appears to be totally different and unrelated. ### REPLY: HI, Dear,Thanks for your query to  virtual Clinic. I studied your query in all the details put forth by you. I understood your health concerns painful sore hard bony post auricular lump on right side. Cause about painful sore lump, which is hard immobile behind ear-The facts of your query indicates that you have white acne or keratitis with white heads in the scalp / or could be psoriasis white scales. As the lump is noticed in last 2 hours with sore white head spots, White Anne / or Acne with blocked white sebum, due to hair folliculitis of subacute type, seems to be the possibility in your case. To rule out Lupus would need Er dermatologists opinion, as I don't think it to be lupus. Due to ambiguity in your complaints, to rule out if it could be normal mastoid bone also, Second opinion from ER Surgeon is advisable in your case.Hence, I would definitely advise you to get Second Opinion from Er Surgeon simultaneously, to avoid further complications of missed diagnosis. So don't forget to take Second opinion from ER Surgeon. Hope this reply would satisfy your query and would resolve the worry with it. If you feel satisfied with this reply, dont forget to hit thanks and write excellent review comments, which would improve my rating for new needy visitors to . Welcome for any further query in this regard to . Have a good day. With . N.M.S. Genl-CVTS, Senior Surgical Specialist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I m 16 years old and recently I been having these sharp pains in my lower left abdominal . I m not on my period or pregnant . It just started happening to days ago, I can barely sleep walk or move it hurts really bad. It s a stabbing pain worse than cramps , if I touch it nothing happens. It just hurts on the inside of my body . ### REPLY: Hi Simone, Thanks for writing your query. It would be helpful if you give some details about your diet and also about your stool. You can take antacid like Sanitizing 150 mg twice a day along with painkiller like Metonymic acid and antispasmodic like Dicyclomine after discussing with your doctor. You should also get yourself investigated for :-1. Complete Blood Count (CBC).2. Kidney Function Test.3. Ultrasound Abdomen.4. Urine examination.5. Stool examination. Further treatment can be planned according to the reports of the above investigations. Avoid spicy foods. You should .  If the problem persists, get yourself examined clinically. I hope this is helpful to you. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I need help with MRI results... I have severe neck pain left side and lower lumbar spasms on right side, also after a few hours sleeping hip is numb have to switch sides, feet will not flex at ankle or in bottom of foot have to shuffle and it hurts for a few minutes after I wake. Right side thumb has burning when bending it and sharp pain in it Findings C3-4 central disc osteophyte complex effacing the anterior thecal sac w/o spinal stenosis or foramina narrowing c4-5 There is a broad based dis osteophyte complex effacing the anterior thecal sac w/o stenosis or narrowing c5-6 broad based disc osteophyte c6-c7 large left paracentral disc osteophyte complex effacing the left lateral thecal sac with moderate left neural foramina ### REPLY: Hello, In my opinion, you should get to be seen by a good physiotherapist as you will need a long-term professional physiotherapy and rehabilitation plan to overcome these manifestations and avoid further damage to your neck and back. Please consider doing a full spine x-ray as you may be having scoliosis to the left side causing the narrowing of the foramina and disc spaces compression. Ultrasound, inferential, heating, massage, osteopathy, and exercises are helpful to you. Avoid traction as it will aggravate your problems. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: have B-cell defiance because serum levels of IgE and IgD were low compared to levels of IgG and IgM. There were low levels of IL-2,4,6 that leads to the cytotoxic CMI leading to low levels of B-cell.You need to comment on these result in a scientific fashion giving clear answer supported by facts. ### REPLY: Hi, Welcome to . B-cells are white blood cells present in the blood which are responsible for humoral response of the body to any infection. Humoral response is the production of antibodies which are specific to the pathogen causing infection and these antibodies attach themselves to the pathogen causing its death. Antibodies are usually immunoglobulins (IG). There are 5 types of Immunoglobulins in our body. Egg, IGA, IGM, IGE and ID. If there is a B-cell deficiency, there will be low levels of Immunoglobulins produced.IL-2, 4 and 6 are factors which are called cytokines which modulate the cell differentiation and hence affect the cell mediated immunity. Deficiency of these factors may cause depletion of both B cells and T cells. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am 38 male live a pretty healty lifestyle hardly drink alcohol, dont smoke , work out 5 times a week i own a fitness club so i take are of my self .I have been smoking weraed a little more often than usual lately my wige and i are planning on having a second baby i was told i have to go do a sperm test sometime this month will the sperm test show that i smoked weed , note i dont smoke alot when i do its very small amounts maybe a .2 of a gram but not eery day or just a quick toke of a pipe .What can i do to improve the quality of my sperm so it doesnt show up or affect the reaults in a negative way ? ### REPLY: HelloThanks for query. You have not posted your semen analysis report in your query. Assuming that your sperm count to be low I would suggest you follow regime,1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc3)Take anti oxidants like Almonds 5-6 every day.4) Avoid alcohol and smoking. Taking Camphene Citrate once daily will help to increase the sperm count .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 68 years young, 5 3 after Whipple surgery on Pancrease I lost 26 pounds (which I don t mind) After surgery one year ago in May I was 108 pounds....now after 6 months of chemo I m up to 112-114 which is fine. But I have IBS and continue to have sleep issues; and am having problems remember things. pancratic whipple surgery to remove cancer from opening of pancreas. Taking enzymes and photonics for the IBS. Having difficulty sleeping. Melitonan not working now. Sometimes Ambian takes quite a while before I get to sleep. How long will the chemo I was given for 6 months stay in my body? I m working with a trainer for Pilates but still feel tired and sleepless. Any recommendations? ### REPLY: Hello dear. I have gone through your case. The symptoms of IBS you are suffering from are due to pancreatic deficiency. You should take pancreatic enzymes' replacement therapy after consulting your doctor. The effect of chemotherapy vanishes quickly after 3 weeks of last chemo, so no need to worry. For sleep problem, there are many better .  You can meet a sleep physician who will help you in this matter. Hope I have made you understand. Thanks 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 daughter had her tonsils out 5 days ago and immediately started saying her tongue felt numb and swollen. We just thought it might be from a numbing medicine used during surgery. It is now 5 days later and her tongue is still swollen and numb. Is this normal? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint slightly numb and swollen tongue after tonsillectomy procedure seems to be most probably due to side effect of anesthesia or the post surgery medications given to you that might be causing allergy. As it is 5 days already, I would suggest you to take her to the treating Physician/ Surgeon and get her evaluated as by now the side effect of anesthesia should have ceased, and it can be probably due to medications. In case if it is due to allergic reaction to any medication then the medication can be changed to other competent . . As of now do alternate warm and cool compresses over her tongue. Hope this information helps. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Am suffering since two year from prostate first size was 49mm and then 34mm and now again return to 46mm wall i taken 5-10 mmg xatral tablet and now my phscian give me for my last analysis of 46mm size 10mm Xatral tab plus proscar tablet (xatral tab one in night and proscar one tab. in morning),please i need yr help what you advise me ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have Benign Enlargement of Prostate (46 GMS)and have been taking Central (Alfuzocin) and Pros car (Finasteride.) Both these . However, the size of prostate and severity of the symptoms is predominant factor to decide regarding endoscopic resection of prostate (TURN). It is always advisable to get TURN done rather than taking  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: generalised pain in head but sever in base of skull and neck. cannot support the head in a manner that eases the pain. moving the head even gently causing more intense pain. applying pressure to back of neck where i believe muscles are not affecting the pain, pain feels deeper and more central, as in not on the surface ### REPLY: Thank you for your question on . Sir/Madam, From the information that you have provided is a little difficult to come to a diagnosis, because I would like to know if the pain you are experiencing is associated with any nausea, if this pain increases on exposure to sound or light. This would suggest a possibility of migraine. But right now I would suggest that you get your eyes checked and also get a radiograph of your neck so that we can rule out the possibility of any spondylitis. You can try sleeping without a pillow at night in order to ease your pain, and also do some hot compression. I hope this information was helpful. Do get back to me for further queries. Regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: is there any hospital that will perform a liver transplant if the patinet does not meet the Milan Criteria?  Hep c and HCC..resection of 3 cm tumor on Aug. 2, 2010. Cancer returned as 7 lesions..I round od chemoembolization.  Scheduled for 2nd treatment Jan. 20 & Oral Nexavar. ### REPLY: Hi, I had gone through your question and understand your concerns. Generally yes. There are some other criteria such as San Francisco which is extended and involves more patients than Milan criteria since even patients with 8 cm large tumors may be capable for transplantations. However, if there are 7 lesions then the benefit of transplantations is questionable and I would say this would be useless, unfortunately. Wish you good health. Kindly regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i think I have a yeast infection it Burns and itches and I have white discharge I just put triple antibiotic on it and used a douche about three days ago I also just started my period my questions are do I have a yeast infection and will. Medicated douches help thanks also I am sexually active ### REPLY: Hi Thanks for your query at !In my opinion you are possibly suffering from yeast infection like vaginal candidiasis/ thrush caused by candida Africans. Get investigated for vaginal wet mount microscopy, microbial culture, and antigen tests for fungus. Get your pregnancy test done if needed. Get your blood sugar fasting and post radial checked. HIV may also get tested by ELISA. You are advised to take Oral Agent fluconazole as a single dose along with your current treatment. I would like to know have you been taking antibiotics ? As this could be risk factor. I hope I was of help. Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had a small squishy lump in my armpit for about 5 months. I noticed it after a trip to Thailand in which I got very sick there. It is about the size of a marble. It moves and is somewhat squishy. But it does not hurt. It sometimes seems to grow or shrink randomly. I have gotten mixed signals as to wether it s serious or not because all symptoms show an infection of some kind except the fact it is painless. Any help appreciated. ### REPLY: Dear user,This kind of new appearing lumps in armpits can come after infection in the arms, hands, chest, or breast, and they can be indicative of any systemic (generalized body) illness. And these usually resolve with the resolution of disease. As we don't know what did you actually suffer from during your stay in Thailand, but if it's persisting, it needs to be checked. Usually that involves doing and ultrasound of your maxilla (armpit), and taking a biopsy out of this lump to know the exact nature. You might need a few blood tests and x-rays / scans to locate the source of the disease. I would recommend get an appointment with your doctor and get the required tests done. Hope you got your query answered. Please write back if you need to ask something else. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am now experiencing severe cramping (lower abdomen the spreads through my entire stomach up to my diaphragm. stomach pain. Started last night. The pain comes and goes but when I feel it, it is the most painful feeling I felt. Lasts for a few seconds. Pain also radiates on my left shoulder. Feels like. I need to pass air but I can t. Please help. Thanks ### REPLY: Hi. With the history you have provided the spasmodic pain in the abdomen with a referred pain to shoulder is suggestive of the peritonitis part also. I would advise you to go to ER/ Hospital immediately. Be nil orally, do not take anything orally. You need the investigations of :: X-ray of the abdomen in the standing position to see for the gas under the diaphragm. X-ray of the chest. Ultrasonography for fluid in the peritoneal cavity. If you have a perforation you may need urgent surgery. If there is obstruction and causing secondary peritonitis, conservative treatment can be tried. ### END