Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Can a Dr. tell if I m one month pregnant or two when i go for my first visit? On April 5th I had a slip up and i ended up taking the Plan B pill within 3 days. I got my period on April 17th, it was a little early, but it was a normal period, normal cramps. Then on April 30th it happened again, only this time i did not take the Plan B pill. Yesterday, May 21st I took a pregnancy test because i did not get my period and it came back positive.Is this pregnancy definitely from the most recent incident? Or is it possible that it was from the fist incident even though i took the plan B Pill and got my period? Will my Dr. be able to tell if I m one month or two by testing my Hormone levels? Please help! ### REPLY: Hi there, It is definitely from the recent incident that you are pregnant, that would mean that you are one month pregnant. If you want to be sure, do a urine pregnancy test as this will tell you how many weeks pregnant you are accurately. Ultrasound in early pregnancy is very accurate and can say for sure with a margin of just one week. And it is more reliable than the last menstrual period to tell about the expected date of delivery. So get an ultrasound done as soon as possible. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last Coitus :03days                     Appearance : Dirty whitisMethod of production :masturbation            Volume: 03 mltime of production:12:40 pm                 consistency:  Thick Liquefaction time:15minutes  pH: 8.0Microscopic Analysiscount / concentration: 75 million / mlpus cell: 0-1 / HPFdead 65, semi sluggish 10, sluggish 10, fully motile 15, red cells: nil, epith cells: A fewStained Film ExaminationAcrsomal Cap: present 70%Abnormal Heads : Seen 10%Mid Pieces: Present 80%Tails: present 85%< >Dear Doctors please reply of my question i m waiting for your reply. ### REPLY: Hi thanks for contacting ... According to the latest WHO guidelines sperm count should > 15 million per ml ... Motility >40%,Morphology at least 4% normal... In your report all normal except motility somewhat defective as it is 35% here.... Fully motile sperm should be usually greater than 25% .... Here it is slight less..... But I don't think it will create much problem in conception... If no conception occurs cause searched for like..... Stress/excess heat exposure / tight unaware /vitamin and mineral deficiency /smoking / alcohol etc.... For that you can consult psychiatrist or an . . 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 8 week old baby has been inconsolable all day, and has been unable to finish a bottle, she stops half way as it seems to cause her discomfort. there is a small number of white sores in her mouth (inside cheek and bottom gum) which resemble ulcers more than oral thrush. could newborns get mouth ulcers and if so, how do i treat it? ### REPLY: Hello, I can understand your concern. It seems that the child has been infected with some virus, and it is presenting as white ulcers in the mouth. For relief in the pain, you can apply local Endocrine gel (McCoppin) over the sores. They will improve healing, too. However, I advise you to visit a pediatrician once for the consultation and ruling out presence of viral disease and if it presents, its treatment. I hope this information helps you. Thank you for choosing . I wish the baby feels better soon. 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: Daughter has akathesia caused by reglan and compozine.  This has been on going for one month.  it has caused disassociation, anxiety, memory loss, tremors, out bursts of anger.  looking for help on how to treat her.  quality of life poor, never had issues until those meds were given. ### REPLY: Hi, Thanks for choosing . I have read your query carefully and understood that your daughter had taken Raglan (Metoclopramide) and Comparing (Prochlorperazine) (?? Dose and duration) and now she is having symptoms suggestive of akathisia since last one month. I would like to let you know that both the .  And akathisia is a rare side effect of both of them. It can be treated with B-blockers (like propranolol 20-40 mg/day) and a benzodiazepine (like clonazepam 0.5-1 mg/day). But the patient needs to be evaluated by a psychiatrist before starting those medications to identify the cause for its onset in the patient and the cause for its prolonged duration of side effect. Hope I answered your query, let me know if you need any further information. 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 girlfriend is running a 111 heart rate. She is a diabetic and has a doctor appointment for the 17th and an appointment with cardio on the 19th. Should we be concerned about her waiting for the appointments with her heart rate running so high? Also has had a few chest pains on occasion but they go away. ### REPLY: Hello, I have gone through your question. Thanks for using . As such I need more information on symptoms of your girlfriend. But if she has chest pain and heart rate of 111,you should get her ECG as early as possible, because in diabetics, heart disease may be deceptive and may have milder symptoms with high heart rate. So I suggest you to go for early check up, however it may turn out to be minor condition, but first we must rule out heart disease. My best wishes. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am a 26 year old male 63 230 lbs and I have had some itching problem mainly around my jock. I have had itching and when I am normally up and doing something I dont seem to have much itching at all but when I want to lay down and take an easy I seem to itch more. On my sack I have red bumps or lumps dont know what to call them but they keep popping up and have a tingle to them and can itch and I have to rub them to get relief. I dont know what they are but I was wandering if you had any clue to what they could be. The isnt any discomfort but just have some irritation in my sack and a itch that wont go away. ### REPLY: Hi, It may be scrotal dermatitis most probably. Consult the dermatologist for the perfect diagnosis and proper diagnosis. The disease may be due to some irritants like perspiration, soap, detergents, clothes, deodorant etc. I would recommend you to take antihistamines like cetirizine. Apply mild steroid cream. If needed, a short course of antibiotic may be taken. Do not apply soap while bathing. Keep the area .  Wear cotton clothes. Avoid worries and stress. Mental upsets might exacerbate the disease. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im 18 and sexually acive and live with my boyfriend. last night i noticed that my uhum nipples where suddenly a lot harder than usual and very sensitive, it felt uncomfortable when i touched them. although i know that on some girls it gets like that before they are about to get their period. although i have had my period since i was 14 and never had such symptoms. ive been on the pill for a while and i know the rules although recently about 2 weeks ago i had my period but stopped my pill because i forgot to buy a new box, we stayed responsible and for the while that i wasnt on the pill we had seks but with condoms only.. eventually i went to get a new box but i think i have to wait until i get my next period and then start again. im not sure if im pregnant. but before freaking me and my boyfriend out i want to know what it might be. im planning on taking a pregnancy test when i am supossed to get my period again so iknow for sure. although i have a nother question, if im not pregnant and take my pill again, how long do we have to have seks with a condom untill i am safe to have seks without condoms? so there are my 2 questions. please help. Thanks in advance :) ### REPLY: Hi, Thank you for posting your question here, I will try to answer it to the best of my abilities. If the condom didn't break then the chances of you getting pregnant are close to nil. Yes, you can start taking the pills right after your next period. So naturally during that time, it is better to use a condom. I recommend that you don't have sex without a condom till you have at least taken the contraceptive pill for two days in a row without being late. I hope this answered your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a small read rash on my neck before my uncle s wedding where I wore a heavy artificial necklace. The rash has worsened. It has become red, extremely itchy, stinging and clear pus comes out too. It has spread all around my neck and chin . I tried using betnovate , mederma , soframycin, boroline and cutisoft but these creams either worsened it ir had no effect. It has been 1.5 weeks now. I am on a vacation and there is no dermatologist around. What do I do? ### REPLY: Gud morn.the symptoms u have mentioned points towards contact allergic dermatitis occurring due to allergy .hence u should even take oral anti histamine tablets to control your allergy .tablet levocetrine twice daily for 3 days can be taken .as your having pus too, it's a sign of secondary bacterial infection and so taking antibiotic like retro twice for three days also will help u. Continue renovate -g ointment and better take good diet full of iron rather avoiding some foods.cause strengthening your immunity will reduce the condition earlier .or u can even take iron tablet daily one for at least ten days.don't do itching over the rash and avoid further ornaments in future too .as your allergic to it.usually such rash takes nearly 2wks to get relieved completely so have patience and take the treatment . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother is 80 years old and was diagnosed in November 2013 with emphazema and COPD. They now say the diagnosis is advanced. At this point they are not saying cancer. But she complains of constant pain in what she calls her back but upon my investigating I find that the pain is in her right wing area. Her breathing is very labored at simple things like eating or just getting to a stand up position. She quit smoking approximately 25 years ago (she was a 3 pack a day smoker). ### REPLY: Hi, Thanks for your query. After going through your query I came to know that your mother is suffering from COPD. Doctor has said that her disease has advanced. It means that her COPD has become more severe, it doesn't mean she developed cancer. Please follow your treating doctors advise as she will get likely to relief and unlikely to be completely cured. You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 4 years old and shes been ill up and down for the past 12 weeks finally getting her self back to normal. I noticed the day of finished her medication that her stomach was quite big and in my words looked swollen. when she was ill she would complain of head aches and stomach aches but thought nothing of it. shes pooing at least 2-3 times daily but shes got rotten burps that make me gag. ### REPLY: Hi... Thank you for consulting in . It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lower sharp left back pain. Possible kidney stone? I had this pain one other time & was given a medication that took the pain completely away. That was 5+ years ago. I don t know what the medication was. I was only given one tablet at a surgery center. ### REPLY: Hello, I have studied your case. When such patient comes to my hospital we usually take x-ray spine or if required MRI to see for any nerve compression and USG abdomen and pelvis to see for kidney stone. Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor. You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am crying every day and even feel I dont want to live anymore.  I have a lot of situational upheaval.  I am on 60mg of cymbalta which I have been on for about 10 years.  Ive tried a higher dose but it doesnt agree with me.  I hurt emotionally and physically. Im 75 years old.  I also take alprazalam.  Please help me stop the pain in my mind and body.  Im at the end of my rope.  I see a nurse practitioner regularly.  Ive been hospitalized for depression at least a dozen times.  That doesnt help.  Please answer as soon as you can.  I am desperate. ### REPLY: Hello, If a patient is taking an antidepressant medication in adequate dosage for sufficient amount of time without significant improvement, a switch to another antidepressant medicine is recommended. Since you are on 60 mg cymbal ta for the last 10 years with minimal improvement, and you have severe depressive symptoms at present, I would advise you to consult a psychiatrist and consider shifting on some other antidepressant .  All the best. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir,my name is prasanna.i was married in 2006.it became 5yrs.till now we have not blessed with baby.i am 24 yrs old.female.i have been tested for thyroid and other harmonal imbalances.please suggest me right medicine. ### REPLY: Hi Rosanna, Welcome to  Forum. There is no right medicine it's all about the right timing. Since you have mentioned that you have underwent series of test for finding the cause of infertility and I presume nothing came positive in your test and consider doing test to your husband, do semen analysis find out the sperm count, motility. If everything comes negative there are .  Don't loose faith, you will surely succeed this. All the Best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister just had her wisdom teeth pulled, and she has been sleeping most of the day, only eating a small cup of pudding. Just now she said she felt like fainting, and was getting very shaky. Is that from lack of food or something more serious? She was having a hard time opening and closing her mouth, so she hadnt felt like eating much. ### REPLY: Hello thanks for consulting at . It is due to post extraction complication due to multiple injection sites resulting in damage to muscle fibres--inturn muscle go in for contraction. Hence repeated mouth opening and closing is required. Even though painful to open and close, you have to --u can chew a gum it will result in small movements of opening and closing. The sleeping whole day could be due to local anesthetic effects. The fainting and shaking could be due to lack of food, imbalance of electrolyte sand also hypoglycemia.... Try keep HY . .you may also need antibiotics and analgesics. Kindly consult an oral surgeon for a check-up and treatment. Hope it 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: hello, im 38 and 12 days late for my period. i am so bloated soar breast but negetive pregnancy tests!.i see gyno on friday. could i be pregnant and get negetive results.i have 28 day cycle like clockwork so why am i 12 days late and neg response.thank you ### REPLY: Hello, I suggest you to undergo one blood test for beta-ChatDoctor to confirm pregnancy. It is more reliable in early weeks. Besides pregnancy, late period could be due to hormonal imbalance, mental stress, over weight/ extreme loss, emotional upset, irregular diet habit, high prolactin level etc. You must undergo one pelvic ultrasound scan and hormone test to pinpoint the diagnosis on negative blood test. You may require hormonal pill to induce period. Kindly, consult with your gynecologist and take complete prescription. You should control body wt, avoid stress, take healthy low carboy . Be well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 11 year old son mentioned during dinner tonight that he still gets a fainting feeling when he pees - and that it is now happening throughout his pee ( not just at the end or at the beginning). Could this be caused by dehydration.....he doesn t drink much ....or is this something he should go to his doctor to have test done...? ### REPLY: Hi, your explanation of the problem is suggestive of Vasovagal syncope in the form of Micturition syncope. It is not so uncommon problem seen in some adolescent and more commonly in adults. This could be due to neuronal excitation which is triggered by urination. Or it could be due to any underlying cardiac disease like a structural heart disease or any arterial block. So, get an ECG and Echocardiography with Doppler of large vessels done to rule out any abnormality. Usually, a CT scan head is also prescribed to rule out brain disorder. These syncope are sometimes are preceded by some auras in form of lightheadedness, nausea, black out or headache. When these appear, the child can abort this attack by clenching of fist, grinding of teeth, tightening of thigh muscles. And after every episode, some amount of sleep should be given. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am a little uneasy as I dont know what it is that I am touching on my bicep. I feels as if I have a little bb sized bump/lump on my vein on my bicep. I noticed it yesterday and it did not hurt when i touched it and I initially thought it was a knot so i tried to massage it out and know (today) it hurts when I touch it and i think I may have made it sore by doing so. Im a bit uneasy about what this is can you help? ### REPLY: Hi, Good Evening. Thanks for the query to . I studied it in depth and I understood your health concerns.-Treatment-for-sore lump-1- Mostly it appears to be -insect bite/mosquito ? Spider or a boil -as its pain has grown today after rubbing yesterday.2-As you are worried I would advise you to check with your ER-Surgeon-who would fix its diagnosis from either of the two and would treat accordingly.Don't get scared and uneasy Hope this would help you a lot to relieve from painful biceps lump on the vein. Wish you fast recovery-and healthy life. Wellcome to  with more queries till you are satisfied. Have a Good Day...!! . N.M.S.GENL-CVTS, Super specialist and Senior Consultant-and Expert in Non-Curable-Disease therapy for Cancer, Asthma,etc., Rejuvenation therapy and Tissue failure -reversal therapies. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: can a person use seroflo 250 instead of formonide 200 ### REPLY: Aeroflot is Albuterol + Fluticasone while Hormone is Formoterol + Budesonide. So on the face of it, they appear totally different, but they contain combination of same groups of .  Hence, they have same mode of action with subtle differences regarding potency, efficacy. So your doctor might have changed your prescription from Hormone to Aeroflot if you have not been responding well enough to the former. But the pharmacist cannot substitute it. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have taken lots of pregnancy tests and just last thurs it showed negative then i looked at it again a couple hours later and it showed positive took another one right after and it came out negative then changed to positive took one this morning and it showed negative I am 9 days late with some symptoms of being pregnant. I was just wondering idf I could be? ### REPLY: HI, I understand your concern.  Actually, Pregnancy test of urine is said to be reliable after 8 days delay in pregnancy.  False + ve test is more likely than false -ve test. False + ve can be due to polluted urine simple/ polluted collection container.  * I would suggest repeating urine test after 3-4 days with a boiled urine container / careful collection of urine avoiding its contamination or burning / urination or white discharge.  * In case of doubt blood  test will confirm./USG scan after 5 weeks pregnancy.  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: So my name is Kat and I m 18 and about a year ago I noticed a lump of some kind under my chin near my neck. It doesn t hurt but I can pop it in and out and sometimes it feels funny if I leave it alone. I m concerned because I m having it again. It never went away, it just stopped popping out as much. I asked my doctor but she didn t really pay attention to it and said it was nothing. I don t feel like it s nothing. Any advice? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint a lump under the chin can be due to 2 causes:1. It can be a swollen lymph node caused due to infection in the head and neck region.2. It can be swollen submental salivary gland and can be caused due to either clogged duct of the salivary gland or due to infection in the gland. Confirmation can be done by consulting an Oral Physician and an Ultrasound or MRI can help in confirming the diagnosis and proper treatment can be planned accordingly. In case if it is swollen lymph node a biopsy can be taken to rule out TH exact cause of swelling and in case of infections antibiotics can help. Clogging of the salivary gland duct can be relieved by removing the obstruction that are the crystalline stones formed in the ducts of the salivary gland from minerals present in saliva and removal of the stones either manually if located superficially or surgically if present deep can be done. In case of infection antibiotics can relieve. 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: in the last 2 weeks i a have been feeling dizzy and unwell, and then yesterday i experienced a burning sensation in the left side of my brain for 30 seconds. I have been quite stressed lately. I went to a doctor but he sent me away saying it was my stress and depression. Is this common? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Such things do happen, and the experience may sound weird. Stress do wonders with human. Coupled with apprehension / anxiety they play havoc. Weird body symptoms due to stress or apprehension are called somatoform symptoms. If the symptoms prolong due to the anxiety and negative thinking of the patient, the patient feels as if the symptoms are actually there. No amount of medical intervention or tests or clinical advices fail to convince him. Then they become mental disorders and called somatoform disorder / Hyperion .  You should forget the episode and never bring it back in your brain. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed a few years ago with borderline personality disorder, anxiety and depression, I have taken antidepressants forever since I was in my 20s I am now 39. I have had a lot of traumatic things happen in my life, My dad committed suicide today would have been his birthday. I have been abused in every way and I am trying to get my life back. For many years Ive had no libido, no joy in my life.  Ive missed bdays anniversaries weddings etc. All because I felt depressed and didnt want to leave my house. Ive missed so may things, I have this. I have just been weaned of celexa 4omg which I took for years with the Seroquel. My meds now are wellbutron xl 150mg, I started this pill less than two weeks ago, I have increased the dose to 150mg twice a day, I also take Seroquel at night. I have read so many testimonies on these meds and I am concerned. I have been getting severe stomach aches as well as feeling a slightly spaced out. Im wondering if I should stop taking wellbutron and Seroquel and asking my dr to put me back on celexa. Do I have to take meds for life??? How does a dr really know if you have mental illness couldnt it just be due to life experiences and the need to get past them? I feel like I am stupid or labeled and its embarrassing, I just want my life back. I have no joy at all. ### REPLY: Hi, Firstly borderline personality disorder (BPD), makes a person vulnerable for mental illnesses. The thought processes that a person with BPD has is quite different from that of a person without the disorder, and it makes it difficult for the person to cope with day to day stresses that every human being faces in their life. Patients with BPD tend to suffer from complications involving mental health with the slightest of stress. And as you mention, what you have gone through is much more than usual. Coming to your query, why can't this be a normal reaction? Now, if a person without BPD or with no vulnerability happens to go through these experiences then the outcome would depend on his coping skills. Excellent coping skills → Brief period to recover and no illness. Poor coping skills → mental illness. The symptoms of loss of interest inability to feel joy and low mood for many years is a sign of a mental illness. But it is great that you want to come out of it. There are many ways. Medications being one of them. Adequate medications usually help control these symptoms. There are additional treatments that can benefit you which is psychotherapy that involves, building a positive outlook and personality transformation etc. This helps in building coping skills as well. Trained psychologists administer them. They are known to be useful in cases of BPD apart from medication. It takes a minimum of 2 weeks to determine whether a .  I do not know the reason for switching your antidepressant but if the recent  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently had several weeks of being dizzy,off balance, ears felt like they were stuffed with cotton I thought I was going deaf. Made an appointment with an   ENT was tested for Vertigo and Meiners disease,but did not have.ENT Dr. sent me for a MRI  The MRI shows spot/something on the brain stem. Cant see the neuro until Sept. any suggestions. ### REPLY: Hi, thanks for using  Vertigo can be due to central or peripheral causes. Central causes mean that the problem originates from the brain or spinal cord. The structures in the brain that are mainly involved in balance are the brain stem and the cerebellum. The lesion or spot that was seen on the MRI can be due to different possible conditions such as : (1) artifact- this is something that is not actually present within a person but due for example to the machine used or tool(2)a mass within the brain stem- it is possible that it is related to a tumor(3) stroke-this is due to disrupted blood supply to an area of the brain, it would also cause a change in the image(4)infection(5)trauma(6) multiple sclerosisYOur neurologist would be able to determine, based on physical findings and reviewing the image, what the area represents. I wish you the best and hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Severe food poisoning, 6th day now am able to take in small amounts of blan foods. But now after eating within couple hour i feel a lump in my throat ...i have to drink plent of water because it feels like there still something stuck in my throat, i belive i have an infection in my throat. Am i able to take antibiotics now? ### REPLY: Thanks for asking in  forum In short: You need prescription from doctor and also assessment before taking antibiotics. Explanation: After severe vomiting sometimes it may feel like you have something in your throat. It may not be an infection always. So, don't diagnose on your own.  Instead, go to your doctor and get yourself examined for any throat infection if any present. Meanwhile you can gargle with salt water every 2hrs and can take plenty of fluids which will help to get rid of your infection if present.  Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 20 5ft 3 about 7stone. I had a filling put in my front tooth as I had a small cavity about 5 days ago. Ever since the tooth that had work done has been extremely sensitive and painful. Where the anaesthetic was injected, those teeth are also hurting a lot, and my whole mouth just generally aches to the point where it is difficult to eat. Its as if i have toothache in all my teeth! Is this normal? What should I do? ### REPLY: Thanks for your query, I have gone through your query. The sensitivity in the teeth could be because of the deep decay or because of the improper base given below the filling. Consult an endodontist and get it refilled. You can get a radiograph done to rule out whether the decay is involving pulp or not, if the pulp is involved then it has to go for root canal treatment. The pain at the site of injection can be treated with topical anesthetic and analgesics like Anabel gel. Apply 3-4 times daily hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have MS and am taking meds for it.  But for the past several months I have been in exterme pian when I  wake up each morning. I fell like a have a very HEAVY weight on my chest and arms.  I can barely get out of bed  i am very very weak all day long?? ### REPLY: Thanks for your question on . I can understand your concern. You are already suffering from Mitral stenosis (MS). This can cause congestive heart failure (CHF) and this can cause heaviness in chest, weakness etc. So better to consult cardiologist and get done 1. ECG 2. 2d echo 3. Stress test (trade mill test). You may need diuretics and other cardiac supportive .  In severe cases of MS, surgical correction into the form of valve replacement is needed. So consult cardiologist and discuss 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 red lump on the roof of my mouth, it kind of looks like a spot that you would get on your face, this is on my right hand side on the roof of my mouth towards the back. i keep on accedently rubbing my tongue along it, and it is becoming very irritable, i does not hurt its just when i rub my tongue along it is when i can feel it. ### REPLY: Hi, Dear,Thanks for the query to . I went through your query and understood your health concerns. In My opinion-that lump on roof of mouth could be due to -cyst of the tiny salivary / mucous gland on the roof, may be caused from eating food trauma/ viral infection.-Please show it to Dental surgeon, and he would treat it accordingly. Your main worry is for the cancerous lump in the roof of mouth.-No need to worry as its retention cyst of the salivary glands mostly.-Hope this would help to resolve your worrisome query on your next visit with your family GP doctor. Wellcome for further query to  in this regard. Wishing you fast recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter has had a swollen lymphnode at the back of her neck near the hairline for six months now. She just had labs at a check up and they say it showed low thyroid function. Could these two things be related? Is it possible for it to be cancer? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. First your low thyroid and swollen lymph node doesn't have any relation. There ate many causes of swollen lymph node.  Most common causes are reactive lymph node and tuberculosis.  Others are rare like lymphoma. If you don't have other features like liver and spleen enlargement then chances of cancer is very, very low. You should go for fine needle aspiration cytology to search for the cause.  Then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir,My nephew is suffering from sudden fever and low cold for last 7 days. Along with this he is having loose motion as well. Doctor advised to go for blood test and found that WBC had count 11000 and on next day it had count 14000. He is just 7 months old. Doctor is suspecting it as a case of septicemia. Please advise as we are very much worried about it. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes, it looks like septicemia. I advise you to do blood for culture and sensitivity. When there is septicemia bacteria can be isolated from the blood culture. With the help of sensitivity, we can give antibiotics to the patient. Patient can be treated effectively with it. For fever, you can give paracetamol under your doctors' guidance. This will bring the temperature down. Do not do overdose. Maintian good hygiene around baby. This will effectively play good role in treating the infection. Give good breastfeeding and ORS to baby. This will maintain good HY . I will be happy to answer your further concern on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is on medication for Hep C we were just told his hemoglobin is 8.6 and he needed to stop the medication over the weekend and go in for more blood work on Monday. What I would like to know what does it mean to be so low and if there is anything we can do to help increase it ### REPLY: Hi, Anemia is decrease in hemoglobin levels below normal. In males, it is 13-15.5g%. From your history, your husband has 8.5g%. It is moderate grade. Severe is less than 6g%. Workup is necessary to identify the cause of anemia. As he is suffering from hepatitis, anemia of chronic disease could be present. Low hemoglobin can lead to reduced immunity and cause needs to be identified. After a workup, a cause may be identified and based on it, treatment started. You need to improve his nutrition, particularly on diet rich in vitamin B12, folic acid and iron. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: liver is normal in size and shows hyperechoic echotexture . No focal SOL or IHBD dilatation, but gall bladder is distended with few calculi seen within the lumen. No pericholecytic fluid collection. IMPRESSION: USG study reveals fatty liver changes. CHOLELITHIASIS ### REPLY: Hi welcome to the  You are having fatty liver with gall stone For these conditions ursodeoxycholic acid 300 mg dose tablet can be prescribed (it will help in cholesterol dissolution in bile and reduce cholesterol absorption) Take low fat diet. Use less oil in cooking Regular exercise done like jogging, swimming etc. Lose weight if obese. Green leafy vegetables, fruits consumed more Refined food avoided Alcohol intake limited Some doctor also prescribes vitamin E for fatty liver as having antioxidants property Hope your concern solved Take care Regularly check liver profile... If having further query feel free to ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, For about 3 continuous days now, I have been feeling this very odd sensation in my lower leg. The exact location would be where my Peroneus longus muscle is located. This sensation is only felt on my left leg. I can describe this strange sensation by comparing it to a pinch of electric shock at the same exact spot whenever I stretch my leg. It usually occurs when I bend my upper body towards my knees without bending them. There are two major changes in my life, I must say. 1- I stopped smoking cold turkey, it s been 10 days all together. 2- I ve started working out very intensely. Sometimes I stay for 3 hours long at the gym. The is first time I get such a strange feeling. Your help is appreciated :) Mimi ### REPLY: Hello, On back of our leg starting from middle of our hip, we have a thick nerve, which passes from the middle of the thigh to the back of the knee. This then divides in two parts, one part goes anterior in leg by encircling our outer bone at leg and other at back of leg. As you stretch your knee without bending it, the these nerves stretch out. Due to friction at some hard area in there, you feel such electric sensation. It is normal in nature but excessive stretching should be avoided. You should gradually do exercises and with time your body will adapt. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a small lump on my shoulder for ages and the other day it seemed to get a head. I squeezed it and loads of fatty white smelly stuff came out, this has gone on for about a week and now it seems to have gone down. I cant feel it moving under the skin as it used to, it is just a bit sore. Is it ok? ### REPLY: Welcome to  I am  and I will help you with problem I have gone through your question. To me, it appears to be sebaceous cyst, which was present there for long time, and now it got infected. If a patient with similar complaints walk into my clinic, I perform excision of the sebaceous cyst, leaving the wound open for repeated antiseptic .  Tab Co-amoxiclav 625 mg 8hourly, tab paracetamol 500 mg 8hourly are prescribed postoperatively for 5 days. Patient usually respond to this treatment in 3-5days, while the wound is then closed with delayed sutures. I hope my answer will help you. Do rate it, if you like it. 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: Actually my daughter is suffering from fever for about 6 days. she is taking Crocin 6 days / Oflomac 6 days / Advent 3 days / and if req d Domstal. for the past 3 days the average fever was 100.4 But from this morning she felt better. But now in the evening again she is not feeling well. For these 6 days she did not take food regularly She took food only last night, But now from the morning she took about 30 Gm of Choco Kellogs. pl. let me know what is the reason. She is 3 Yr 6 Months ### REPLY: Hello. As per your complaints, probably your daughter is suffering from enteric fever, and it is associated with decreased appetite. Whatever the cause is, chil . Secondly the medicines which she has been taking also causes a bad taste especially after-taste, so the appetite is decreased. Dnt worry, she will eat normally once the infection is settled and medicines are discontinued. Hope it will help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had low back pain for a couple of years now. I have had injections , physical therapy and a tens unit at home. Nothing has worked. Sometimes the pain will go into my hips and legs. It has gotten to the point that I can stand at my sink for more than five minutes to wash dishes. I am only 39. My MRI reads: The alignment is normal. Vertebral body marrow signal is benign throughout. There is a small Schmorl node type superior endplate defect at L2 centrally and a similar slightly smaller lesion at L3. The lesion at L2 has signal which suggests it may be relatively recent. T12-L1: tiny left paracentral disc protrusion minimally indenting the thecal sac without significant canal or foraminal stenosis . L5-S1: small central disc protrusion just abutting the ventral thecal sac without significant associated canal or foraminal stenosis. Can someone please explain some of this and what other options are there? ### REPLY: HAI, Thanks for writing in. Schools node are nothing but disc protrusions inside your vertebral bodies. They are benign and usually don't cause any problems. After reading your MRI it seems there doesn't seems to be any significant findings. Small / tiny disc protrusions might be present for all individuals. Since there is no canal or foraminal stenosis, the pain is not a neurogenic / isogenic pain. Your MRI also didn't comment anything abnormal in your sacroiliac joints. Sometimes spondylosis at L5/S1 or any other levels can be missed by MRI. After a thorough clinical examination, you might need to undergo stress views of your spine +/- CT at the levels to rule-out any instability of segment or spondylosis. Till that time you can wear lumbosacral belt, back strengthening exercises, lying on hard bed etc. Avoid leaning forward, sitting /standing in same posture for longer periods, lifting heavy weights.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi...My husband is 87 with MF diagnosed 11/1/12. He curently weighs 130 RBC 2.92..WBC 11.5 HGB 8.8HCT 26 LDH 966.....bun 45...creatine 1.54 ..cr cl..30.03......sleeps most of the day...has congested heart failure, seizure and gout all the time..We can never get any feed back from his 3 doctors...all have different opinions..he s on numerous heart and blood pressure drugs but nothing for MF...He wants to know what then end stages are? Will the heart give out or the kidneys? He won t take anything for pain....Entire body is in pain..Any idea? Suggestions? Words of advice? ### REPLY: Hi, Thank you for posting your query. By MF, do you mean myelofibrosis or any other disease? Has the diagnosis been confirmed by doing a bone marrow examination? I agree, there are no definite treatments for end stage MF, however, you need to discuss this with his doctor. For seizure control, there are good medications such as levetiracetam tablets. For gout due to high uric acid levels, good medications include allopurinol and Eurostat. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Daughter was given a 2 step Mantoux test on Wednesday, August 18. On her way home from getting this she blacked out while driving and came very close to losing her life. She wrapped her vehicle around a tree. She remembers getting sick and feeling dizzy. But, cant remember anything after until she woke up. Did this test effect her in a negative way? If so, how? She is 16, 5 ft 4 in., 190 lbs. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Mantoux test is designed for diagnosis of TB. In this test antigen is injected intradermally in the skin and reaction is measured. As it is an antigen type test some allergic reaction can be possible. But fainting and unconscious less is very unusually seen. So in my judgement this reaction is not related to the TB and has different etiology. You should examine yourself to nearby physician. They examine your CNS and CVS system. Reason for unconscious less must be in the two system. Till you examine yourself I suggest you not to . I will be happy to answer your further concern on 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: I have a lump in my neck I noticed three months ago but it went away .ive lost a lot of weight about a stone and a half but I feel well. This lump has come back three times and now I ve made an appointment but before I go in I d rather be per warned what could it be ? It s always the exact same place it s in ### REPLY: Hi ! Good evening. I am  answering your query. Considering the history of weight loss, I would investigate you to rule out tuberculosis of the cervical lymph nodes depending on where you leave. Investigations might include some blood tests, and a FNAC of the swelling. Till then, I would advise you for proper diet, and a routine exercise program. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish 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 m 4 Month pregnant , I have been having problem of dizziness , weakness , headache.my problem of dizziness occurs mostly whenever I lied down on bed and turn left to r or r to l and sleep straight.i went to physician , he prescribed me vertin 8mg 3 times a day for 5 days.i just want to know is it safe to take vertin 8mg in pregnancy. ### REPLY: Hello dear, welcome to Ask a doctor service. I reviewed your query and here is advised. There are no adequate data from the use of betahistine in pregnant women. It means that there are no sufficient human studies for use in pregnancy of vermin. Remember to mention to your doctor that you are pregnant, and he will balance profits vs contraindications. Hope I have answered the 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: What is the cause and its effect if found two small nodular foci of subcortical hyperintensity in Flair images in right high frontal region - Deviated nasal septum towards left side with hypertrophied left middle and inferior turbinates - Sella is empty with flattened pituitary gland along the floor ### REPLY: Hello Thank you for trusting  Dear thank you for asking this question. Dear empty sell may be accidental finding on MRI brain. In MRI scans pituitary gland not visible, so it appears like empty, so it is called empty sell. In primary empty sell arachnoid layer extends below the pituitary cause compress pituitary cause empty sell. Secondary empty sell due to tumor or trauma or infection or in pregnancy induced hypertension may cause pituitary apoplexy ahead to empty sell. Usually turbinates hypertrophy seen apposite side of deviation of deviated nasal septum. For DNS can consult ENT surgeon he will examine and treat you accordingly. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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. My son is 11 months old now. When he was having cold last month, he was doing mouth breathing. We did a Xray and he was diagnosed with adenoids. ENT specialist checked him and said that he is breathing through nose and told that if he is sleeping with no issues, then no need to remove these. If any issues again come for checkup. Two days before he is again having stuffed nose. we applied some menthol ointment and now he is ok and no sleep disturbances. I want to know when is the safe age to do surgery if needed. Is my son OK now? Please reply doctor. ### REPLY: Hello, Right now, there is no indication for a surgery. It can be performed after the baby is 3 years old. Though the surgery is safe even before 3 years, there are chances of recurrence if done now is the baby has recurrent pus in the ear, recurrent nasal blockage and sleep disturbances. Adenoids tend to grow during the initial 3 to 4 year of age and start to shrink during the ages when the child attends school. They become asymptomatic by 8 to 10 years of age. Therefore, there is nothing to worry at this age and don't think about an adenoidectomy so early. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My name is Denise Gold. I was wondering what could be wrong with me. I am 16 years old, I m 123 pounds, breast cancer and diabetes run in my family, I m mildly active ( I walk about 2-3 miles about 3-4 times a week, medium pace). About 4-5 weeks ago I was 134 pounds, but now I m only 123.. I m not an expert, but I m sure 11 pounds lost in 4-5 weeks isn t okay. I eat the same as I ever did, so it couldn t be change in diet . Also, my gums have been really weak lately. They never would bleed for me when I would brush my teeth , but now when I brush my teeth i can spit out dark blood, and at random times they would just start bleeding . I brush my teeth on a regular bases, my Mom s a health freak. Another thing is I ve been extremely hungry lately, more than I usually ever am, but when I eat I feel sick. I don t think it would be pregnancy because I just got a really heavy period, mind you it was a whole week early and only lasted 2 days (my normal periods are usually ALWAYS the same time or very close to the same time every month, never a week off, and they would always last a minimum of 4 days. Also, my breasts have been getting really sharp pains at least a few times a day, especially in my left one near the midline of my body. Another thing is, I swear I ve been so mean lately, naturally I can be mean sometimes, but never like this. I just feel like it s something I can t control. Another thing, I m in a career tech. school and I m going for allied health. Well, my class was practicing vital signs and my teacher was demonstrating on me with the radial pulse . She pointed out that my pulse was extremely slow for my age. Also, I ve been having a lot of bowel movements for the past couple weeks, more than I usually do. ### REPLY: Hi. From your history I understand that you are quite obese and have been having weight loss, with recent onset of bleeding gums and a low pulse rate. I'm not sure on how low did you mean your pulse rate is, though I guess if you do not have any fainting attacks or chest discomfort due to this, you need not worry. Weight loss despite normal diet, may be an indication of the onset of diabetes, or may be due to thyroid dysfunction which may also have abnormal bowel movements. Bleeding gums can not be tied up with these two conditions, though bleeding gums is a very common problem. It could be that your gums are unhealthy with infection, or you have scurvy, or you have some other condition associated with weight loss which can be picked up after a detailed evaluation of you and your blood counts. So please consult a physician for the same. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi. I am a female aged 46 years old and recently have discovered that I have a problem with my teeth and gums. I tried changing my toothpaste, but seems like it is not helping. Could the sensitiveness of my teeth and the pain of the gums be due to iron defeciency? I have not yet had my iron test done. Thanks. Concerned patient. ### REPLY: Hello. Tooth sensitivity mostly at your age is due to teeth attrition. You can use thermostat or sensory toothpaste instead of regular ones. For gum problem chances are there of your having gingivitis or periodontitis .starting treatment for it is generally scaling and polishing of teeth. Yet you should consult nearby dentist once to see the condition clinically. You can recons ult for further queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello...im 39yrs old...last night i had severe abdominal pain and my gum hurts...since this morning my stomach is ok but my upper lip swollen first and shortly the lower as well and i feel numb in my hands and arms. Ive been taking ferrous sulphate 3 times a day for the last 2weeks...can you please help me. Many thanks! ### REPLY: Hi welcome to  forum.  Thanks for choosing . Forum.  You are using Fergus sulfate for 15 days. Night you had stomach pain, in the morning you had pain and swelling of the upper and lower lips.  Most probably the stomach pain is due to overdose of Fergus sulfate, in large dose. (t.i.d.) The swelling also may be due to the same .  Anyhow it will be better to consult a physician for diagnosis and treatment.  What ever the reason is you will be fine soon. You may have to stop the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 m name is suresh iam 25 old,sir one of testis is some what swollen,but i do not feel any pain,i had habbit of hand pumping for past six years.recently i found that,my semen is thick only a small amont.i was so worried about thise, give me your kind suggestion. ### REPLY: Hi, There will always be some difference from one testis to another. If you feel it is very much frank - it can be due to orchids, HY .  Doing an ultrasound scrotum can help you diagnose it. Semen - usually it will be thick when you ejaculate, after few minutes, it will be liquefied. Do a semen complete test to know the cause. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 30 yrs old(Male). I am having pain in my in right side back of chest since March2011. I have been diagnosed with CT scan and MRI which says that I have lobulated margined expansile osteolytic lesions in relation to right sided poeterior elements of D9 vertebra with involvement of adjacent bone , extraosseous components and associated extradurtal compression of dorsal spinal canal around D9. The lesion measures about 44 mm X 39 mm in axial plane and about 36 mm X 43 mm in sagittal plane. Please advise suitable doctor in AIIMS to be consulted for the suitable treatment. ### REPLY: Thanks for your question on . I can understand your concern. I have gone through the MRI report you have attached. It is suggestive of osteophytic mass lesion in the vertebra which is also causing compression on spinal cord. Possibility of malignant looking mass is more likely by this description. You should consult orthopedic doctor for this. You will need Biopsy from the mass to confirm the diagnosis. Unblock resection with placement of implant today stabilize the spine are needed. So consult orthopedic doctor in AIMS discuss 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 been on the bc pill for the past 20 years. For the past three years I have been experienceing depression, anxiety. I am seeing a psychologist and mental health therapist. They have me on prozac and clonidine. I have tried several other meds as well. I feel as thou I am going through premenapausal symptoms. At my request my Ob has taken me off the bc pill. I am still experiencing hot flashes, moodiness, depression, anxiety, but now have terrible back and pelvic pain. Is this my body having withdrawals from the bc pill? ### REPLY: HI, thanks for using  Discontinuation of the birth control pill should not cause any pain including pelvic or back pain. This pain would have to be related to another cause. Back pain can be related to the vertebra or the surrounding muscles. If it is muscular, it would usually be on the sides and be related to movement to a particular side. Vertebral pain is normally central though it can extend outwards. Pelvic pain can be related to the hips bones or the other organs in the pelvis (uterus, ovary, bladder, fallopian tube). Since the discontinuation of the pill is not likely to cause these symptoms, you should consider visiting your doctor for an assessment. This would be physical examination and imaging. Perimenopause and menopause can be associated with emotional changes as well as physical. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 10 weeks pregnant. My boyfriend and I were decided on abortion, so I drank one night last week, when I was 9 weeks. Also, I continued to take Riddilin. Now I m not so sure about having an abortion, but am not sure if keeping the baby is even a possibility right now. What are the chances drinking one night and continuing to take Riddilin has harmed my baby? ### REPLY: Hello, I have gone through your query and understood the concern. Methylphenidate has been assigned to the category C by the FDA. This means there are no adequate controlled animal studies to detect fetal effects while this .  Thus, if you have taken the medication once, you can think of continuing the pregnancy. If however, you have also taken the medication to induce a medical abortion, abortion is the only alternative left since fetal anomalies are a possibility with the use of Bisoprolol and Mifepristone. Please contact a specialist for further help. Do not self-medicate. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was just diagnosed with the flu and bronchittis.  I am having trouble breathing because my nose is very congested and my abdomen is swollen.  I am taking Tamiflu and cough medicine and an antibiotic. It is harder to breathe when lying down.  Please help me. Thanks ### REPLY: Thanks for asking your question I completely understand your problem continue the above treatment add on can be-in flu and bronchitis if the sputum color is yellow u need to take some antibiotic course like levofloxacin after consulting a pulmonologist, as yellow sputum is present in infection. Steam inhalation will help a pulmonologist can request for a chest X-ray and can rule out other resp tract infections thanks/ regards feel free to ask more questions may god bless you with good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had sex with my girlfriend before 3 months...i didnt eject my cum...but i had precum around my pennis during that time..and i made only two strokes then i used condoms...for the past 2 month she had normal periods...this month her period is deleying by one week.not yet....could she be prenant..? ### REPLY: Hello dear, I understand your concern. Once the period occurs the pregnancy is ruled out. You had intercourse 3 months ago. After that she got the periods for 2 months. Within this month you did not do the intercourse to raise the suspicion of pregnancy. So the delay in period cannot be due to pregnancy. The cause for delayed pregnancy can be due to hormonal imbalance due to stress or any. Wait for spontaneous onset of periods. Or if you had intercourse within this month or after the last period then you might need to do a urine pregnancy test a week after missed period. Nothing to worry. Hope this helps. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 28 years old.Ten days ago I was suffering from Dengue fever.I was ok then again I became sick and temp raised up to 103 degree.I got my blood test today.It says Serum ALT SGPT is 236 U/L.From the internet I have learnt that this is not normal.Please suggest me what to do with it. ### REPLY: Hi welcome to  .... Noted you had dengue infection with elevated liver enzymes.... Here you need to maintain plasma volume as you have dengue with more and more water . ... Papaiya like fruits useful.... For few days take soft and bland diet. Avoid alcohol. Fatty and fried food taken very less. Non veg food avoided.... Even if after recovery from dengue and after that few days liver enzymes elevated then complete LFT profile done with viral marker study for further work up..... 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 nephew 3+, has cut himself with a rusted knife, just scratch and little bleeding, given savlon, he has been given DPT earlier and his next dpt dose is when he will be four year. He has not been given any tt now but doctor recommended antibiotic flucloxacillin, his mother is confused. Need your suggestion . ### REPLY: Hi, welcome to . Since your child immunization is complete for age and though the knife was rusted, the scratch and bleeding was little, there is no need of giving tetanus injection. Whenever a wound occurs, there are increased chances of staphylococcal infection, so child should be given cover of antibiotics like oxacillin. So, you should continue the antibiotic for at least 3 days. I hope this has helped you. 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: sir,my query regarding my mothers health problemActually she is suffering from mental problem.like she think some call her,like her son ,any person.ans she also believe this thing in reality.this problem starts from in the year 1997 and we also gone through treatment in orissa in year 2000.but this problem is continue.please reply . ### REPLY: Hi, I do understand your concern regarding your mothers' health. Your mother seems to be suffering from a psychotic illness. However, more details regarding her symptoms would help in arriving to a definitive diagnosis. Symptoms like auspiciousness, aggression etc. in addition to hearing voices might be suggestive of schizophrenia. You also haven't provided details regarding what medications have she been on (with dose and duration). She might need treatment with antipsychotics (olanzapine, risperidone, etc.). It might be possible that she doesn't respond to the 1st .  Then another  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doc,i m in urgent need of your help....my sister in law is suffereing from SLE as confirmed by a doctor here in ahmedbad, india. Within 3 months her weight has been reduced to almost half..she is suffering from severe arthritis, bronchitis, cough and fever..kindly help me in this regard as one of the local doctor says there is no cure for SLE....it will be very kind of you if you can guide me what precautions to take and what are the medications.... ### REPLY: Dear Friend, Thank you for your question. Your patient seems to be very sick. Her bronchitis is most likely SHE induced lung disease, however we should differentiate it with lung infection with cultures and CT Thorax. She should also be worked up for other major organ involvement like kidneys and nervous system. She requires steroids and HCQ for management asap. Please consult Immunologist/ Rheumatologist urgently for same. If issues regarding appointment please try at Jaipur. 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 wearing an automatic event monitor.  It beeps ocassionally. However sometimes I feel a sharp pain and nothing happens.  I can record, but when I do the memory gets filled and I have to call it in.  Should I be concerned if I feel a sharp pain or a small flutter and no beep automatically goes off? Should I hit the record button then or not?Thank you! ### REPLY: Thanks for your question on . I can understand your concern. Yes, you should definitely press record button whenever you feel chest pain or fluttering sensations. This might be onset of arrhythmia (rhythm disturbances in heart). So don't take this lightly. Discuss this with your cardiologist. 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 ve a very dry dandruff type in my private part areas and even in penis glands, arms, head and behind the ears, it itches a lots and when scratched, the dry skin comes out, even break the penis glands joint after sex, it also breaks behind the ears and sometimes it bleeds. It also cause pain and even smell. I ve visited 2-3 doctors but not improving so please advice. ### REPLY: Hello, The condition that you are describing sounds like seborrhea dermatitis, which can be treated by washing the affected areas with an antifungal shampoo (can be used on all areas of the skin). The shampoo should be left on for 5 minutes and this should be done twice a day, that is Total shampoo. An antifungal cream and oral antifungal can also be used, that is of antifungal creams like Clotrimazole, Console and Ketoconazole. It can take 2 to 4 weeks to respond. 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: dear dr,        one of my uncle having kidney probelm,he admitted the hospital, dr said kidney creative 9.5, and we can put dialysis, and dr said cant recover kidney only transplanet,pls i need to help how will recover my uncle kidney and do the function of kidney, pls tell me sir,regards,shahul ### REPLY: Hi Shall and welcome to .  As a Urologist and kidney transplant surgeon, I can understand your anxiety. Your uncle has CKD(chronic kidney disease), and it needs treatment.There are only two options for his treatment ;1.dialysis or 2.kidney transplant. Dialysis is done two or three times weekly and is called maintained dialysis. A kidney transplant is a better option, if he's below 65 years age. You may send all your doubts as a direct question, in my name, with reports. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 55 years old - got my period after not having it for 7 months. The day I got my period I felt cramping and  shooting pains in pelvic area, but never went away. I went to several doctors and a small cyst was found on my  ovary, but nothing else. Cancer was also ruled out. Do you know what could be causing this pain? Stones were found in my gallbladder around the same time and was removed. All the pain came on simultaneously - gallbladder and cramps. Do you have any idea why they dont go away. Can get very severe it Im not on a pain reliever. ### REPLY: Hi and welcome to . I understand your concerns. If your gallbladder wasn't removed then it would be good to have laparoscopy cholecystectomy and this may because of your pain. Ovarian cysts may lead to cramps but also hormonal imbalance or endometriosis. It would be good to do do exploratory laparoscopy to see what is going on if all tests are negative. So you should consult your doctor about this, especially gynecologist. I hope I have answered you query. 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: Ive been feeling like Im running a fever, eyes feel like Ive been  swimming in a pool too long, Im having some mild pain in my lower right abdomin (between ribcage and natural waist)  I usually feel better in the morning but gets worse as day progresses.  Im constantly cold as well. ### REPLY: Hi ! Good evening. I am  answering your query. If I were your doctor, I would personally examine you clinically, followed by a complete blood count, a urine routine, microscopic, and culture/sensitivity test, followed by an ultrasound of abdomen, if need be. The feeling of constant cold is possibly due to fever. The treatment would depend on the results of clinical examination. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. 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: Hi, My daughter is 4.3 yars old. She got fever on and off from last 3 days but not more than 100 Deg. But today morning onward she has 100.5 degree, look like throat infection. yesterday night she has nasal congention too. but not cough and cold kind of.I have given her crocin DS 6.5ml as her weight is around 22-23 kg. She is complaining for throat pain and she is little bit coughing. Could you please suggest medicine for her as it is already 4th day. Thanks in advance. Regards, Surbhi ### REPLY: Hi...by what you quote I feel that your kid might be having a viral sore throat or a streptococcal infection. I suggest you see your pediatrician and get a rapid streptococcal antigen test done. If it is positive then she will require antibiotics. If it is negative then it might be viral illness and doesn't require antibiotics at all. Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15 mg/kg/dose (max ceiling dose 500 mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. 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 my stomach swells up and I also have a tired sort of gritty feeling behind my eyes for some period of time over possibly the course of the week I start to feel as if my body inside is shaking and I have mild anxiety attacks.over this period of time I have swollen stomach slightly painful sometimes not always and after my anxiety attack I am really tired.throughout I have very low energy.I have had numerous blood tests are which of showed nothing and also I have had blood tests for a thyroids problem botChatDoctore back as ok.my diet is ok but not great and found last year when this happened I ate extremely healthy and it went away.i understand that I have to keep a good diet of fish veg and fruit ect but wonder what is happening to make me feel like this.i occasionally take omeprazole for acid indigestion could indigestion be the problem? Or just a symptom of a problem? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I can understand your emotions. In psychology, we broadly call it obsession. You had that disturbing sensation once. You expected it to happen again and focused. Then you started experiencing it as you were expecting it. Then your body brought the familiar symptom because you are expecting it. Then you started worrying that the symptom is coming again and again and expect it. Body brings it again as you are expecting it. You become worried and so on. That is obsession in simple terms. Ignore it and the problem vanishes. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END