Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 cystic ovaries- which cause pain at one point in each month as my cycle starts to move. I seem to have cystitis/thrush/yeast infections often if its not one its the other. Its ruining my sex life and my relationship with my partner, please help? Thanks you- Olivia ### REPLY: Oct 2015Hi, Thanks for posting in . I understand your concern. Symptoms of experiencing recurrence of bacterial vaginosis may be due to poor hygiene or due to transmission by asymptomatic partner during sex. If the infection recurs again and again, the following things need to be done: 1. Maintenance therapy like a regimen of oral fluconazole tablets once a week for six months or clotrimazole as a vaginal suppository used once a week for six months can be used, along with a course of metronidazole.2. Treating partner too if the partner has symptoms needs to be treated. Other measures which needs to be taken care are the following: 1. Wash the area with warm water and mild antiseptic twice daily until the symptoms subsides. 2. Abstain from sexual activity till your symptoms subside completely. 3. After using the toilet, wipe from front to back to avoid spreading yeast or bacteria from anus to the vagina or urinary tract. 4. Wear loose fitting cotton undergarments that helps keep your genital area .  5. Change pads or tampons often during periods. 6. Use vaginal antifungal medicines which are available for 1-day, 3-day, and longer courses, depending on the strength of the medicine. 7. Along with it, she can use vaginal boric acid capsules, which are available over-the-counter. Do not use this medication if you are pregnant. For cystic ovaries, you need to be treated with regularizing cycles by means of birth control pills and ovulation inducing  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 DR., my niece 10yrs old girl have low platelet issue since last 18 months, as DR s chronic ITP case, we gone thru lot of treatment in Sir GangaRam, AIMS & in Homoepathy... last 8-10 months were ok like platelet count was btw 10k to 50k, but some time no black spot on body some time raise to much, yest she has bleeding from nose and spots in mouth... dont know wat to go,,, Plz suggest some treatment/Dr anywhere in India ### REPLY: Hello dear. As you said she is a case of chronic ITP, i would like to ask, has she been screened for autoimmune diseases like SHE?or chronic infections like HIV? I hope she has been given IVG and corticosteroids during the acute phase...???you can go for anti-D and /or rituximab after your doctors advise. You should also talk about splenectomy to your daughters treating physician, as about 64-88 % child . Ask your daughters treating physician about the availability of romiplastin and eltrombopag in your country and the data regarding their success rate. Hope it will help. Wishing your child good health :-) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is 36 years old she has been exposed to be bugs recently and now her arm look black and blue swollen maybe even blistered could bed bug do that?She is in no position to pay for anything is there any free information out there that is totally put there to help people not just to make a buck??????? ### REPLY: Hello dearWelcome to .come have gone through your concern in depth. @ This indicates Hematoma formation (secondary to cellulitis following bug bite)@ Suggestions for better recovery # Keep the hand in elevation position (arm sling) # Apply ice over it every 4 - 5 hourly for 10 minutes each # Keep it clean with antiseptic liquid wash # Need of antibiotic, anti-inflammatory . Feel always free to ask any further questions regarding this. Thanks for patience evaluation of my answer. 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 12-year old has been out of school for 5 weeks... can t figure out what s wrong, Lower Abdominal pain extending into her back. CT showed wedge-shaped abnormality or her right Kidney, Doctors didn t seem worried. Had her in for an Ultrasound this morning & the tech took about 35 pics of that Kidney & her Gall Bladder. While taking pics of her Gall Bladder she typed in CMD, what does that mean? Also, any thought or suggestions? She is in the most pain in the morning & night... Thanks! ### REPLY: Hello, There are a lot of different diseases called CMD. I doubt congenital myasthenia disease is involved.  Cytomegalovirus is quite common in childhood, indeed most of us get this common mononucleosis, and it can cause a variety of problems and lymph node swelling is the most common sign of it.  If it were a lymph node on the scan, this would explain things and there isn't much to be done. Cannot say in your case and there's a wide variety of reasons for wedged shape growths.  There are probably signs of it NOT being cancer if doctors are ignoring it. The main sign of NOT cancer is it not changing or getting less when looked at 3 to 6 months later, but I cannot say in this particular case. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: having severe pain in the esophagus area between my breasts when I cough...slowly calms down but when I cough again the pain in almost unbearable...dont know if this is a start of a cold...my husband has one.  I do have gerd and take dexilant daily but have never felt this before.  I am 58. ### REPLY: Thanks for your question on . I can understand your situation and problem. Possibility of worsening of HERD (gastroesophageal reflux disease) is more in your case. HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of Central burning chest pain. Along with .  1.  Avoid stress and tension. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Go for walk after meals. Lose weight if you are obese. 4. Keep 2-3 pillows under head in the bed to prevent reflux. Avoid smoking and alcohol if you have these habits. You will mostly improve with all these. If not improving than get done chest x-ray to rule out lung infection. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im a 16 year old girl who is currently researching for information on transplants.I was just wondering what organs and tissues have been successfully transplanted since 1950?and also what are the problems of having transplants e.g. a heart transplant.Any answers are appreciated :) Thankyou x ### REPLY: You have posed an excellent question. With only a few words, a textbook is opened. Truthfully, this is a discussion that should be personal with not one but many professionals whose job is nothing but transplantation. For overview, societies such as the American Organ Transplant Association and American Society of Transplant Surgeons are good resources. For heart specifically, the American Heart Association is the best resource. For a more personalized and detailed history of heart transplantation from an individual, you may wish to contact  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mom is taking airisept along with vesacare. She is having epsisodes where she thinks people are outside her bedroom and the police needs to be called. She has also told me recently that little children have been running in and out. Could these be hallucinations or delusions? She has dimentia with possible lead into alzeheimers. Please advise me .Thanks ### REPLY: Hi, thank you for using . I can understand your concern. As you report your mother is suffering from dementia. Person with dementia have lost there ability of cognition. Cognition is a collection of mental processes by which person have perception and interaction with surroundings. So because of this lost ability many times reality testing becomes impaired and person may have hallucination or delusion. So this is abnormal perception or belief which result due to cognitive impairment. Still this time there is no definite treatment which can reverse the cognitive impairment. Medicines like donepezil(accept) and cementing has some efficacy in preventing further impairment. For treating her current symptoms you should consult psychiatrist who will be able to help her symptoms with benzodiazepines or antipsychotic medicines. You should also consult mental health care worker who will guide you for non-pharmacological measures, which is currently the main line of care along with medicine. Non pharmacological measures are method to changing the atmosphere of person with dementia according to his/her need. I hope this will help you. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My five year old has had a fever for the past few days. She has a cough. Her temp has ranged from 99 to 102. I took her to a local peds office and he told me she has a cold virius and keep giving her fluids and motrin. But it didnt seem to work i have switch to childrens tylenol. It seems to keep her temp down to 99.8 or so. She has not voimited or has any other issues other not really interested in eating thou should i be concerned or do i just have to wait it out and hope for the best. ### REPLY: Hi dear welcome to the , Viral RTI is quite common and frequent during this rainy season. Antihistaminic decongestant containing antipyretic like paracetamol to be with recommended doses. Paracetamol to be given doses of about 15 mg /kg 4 to 6 hourly. Tepid water sponging should also be done when ever the body is heated up. Take care of the nutrition and HY . Hope the query is answered. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, recently i sat wrong or slept wrong and my right testicle was hurting and the last two times my semen was brownish with a little red in it the second time, it does not hurt or burn, feels normal and the pain is almost gone, is it reason to worry or will it go away once it heals ### REPLY: Hi, The seminal vesicle infection that is seminal vasculitis had to be ruled out by ultrasonography of testes, transrectal USG and semen culture.  If the culture shows an organism than the need to be treated with an antibiotic course.  If all report normal than you can neglect one episode of hematospermia.  Hope I have answered your query. Let me know if I can assist you further. Part Goswami, General & Family Physician ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a growth on the first joint of my right middle finger, It is verry read around the outter area. It is about /4 inch in diameter. It is also very tender around the outter area. There is a clear thick sticky substance that came out of it and at one time there was a little blood in it. It does not seem like it will heal. It continues to fill with something. This has been going on for almost a month and I am about ready to visit my doctor. Would like light you may shed on this. ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in full details updated from you. I understood your health concerns. Based on your query data, In my opinion, Dear You seem to suffer from DIP joint Mucous Cyst of the Synovial sheath of joint. Its also called Ganglion Cyst of the DIP Joint of Middle finger. Thick sticky discharge and refilling of the joint cyst confirms the nature of the Cyst. This mucous cyst is formed after the arthritis of the DIP joint of the Middle finger. Remedy-Get the x-ray done and CT study would fix the joint origin of the mucous digital Cyst of the Middle finger. Excision of the joint synovial sheath-treats the digital mucous cyst of the Middle finger. Recurrence is the possible as in the Ganglion Cyst of the wrist joint. Antibiotics and NSAID course of medicines would take care of the redness due to arthritis and infection of the digital mucous cyst of the Middle finger. Team of GP doctor and Ortho-Surgeon would be needed to treat your health issue. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. . N.M.S. Genl-CVTS -Senior Surgical Consultant ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had 2 cervical  spinal fusions in the last year, recently my left arm and left hand are falling asleep. Also my left leg has constant pain, my hamstring, my thigh, the top and bottom of my left foot. It almost feels like I stepped on something in my foot that infected or buried in the foot. Now in the last couple of days my vision is blurry and hasnt gone away. Also its difficult to keep my balance. ### REPLY: Hi, Thank you for posting your query. Based on your symptoms, you have problems in lumbar spine region (lower back) and eyes, in addition to the cervical spine. You would require further evaluation, including an examination by a neurologist and MRI of the cervical and lumbar spine. An eye examination would also be helpful. I hope it helps. Please get back 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: I AM USING GLYCOLIC ACID CREAM FOR HYPERPIGMENTATION . MY SPOTS ON SKIN ARE VANISHED. MY QUERY IS THAT WHETHER IT IS SAFE TO USE THE CREAM REGULARLY. I AM USING THIS CREAM ONLY AT NIGHT.I AM ALSO USING SUNSCREEN ON OUTING. PLEASE GUIDE ME FOR TO AVOID RECURRING PIGMENTATION. ### REPLY: Hi, I can understand your concern for recurring pigmentation. If I were your dermatologist then I would have suggested you to use atelier acid cream or Comic acid cream or glycolic acid cream or licorice extract or routine creams at nighttime in guidance of dermatologist. The most important part is to use a sunscreen regularly in open environment and on exposure to sun. Take a proper guidance and follow up with a good dermatologist so that all the problem can be dealt best for future time. 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 was chewing guthka due to which Ive limited mouth opening. However Ive quit the same.Now Ive a problem with my wisdom teeth as they are not alligned properly for which I am suffering from swelling gums and pain. Now I want them to be surgically removed but my limited mouth opening is creating problems. Kindly suggest ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have reduced mouth opening due to chewing habit of tobacco, this can be due to fibrosis in buccal mucosa. This condition Oral Submucous fibrosis is treated by medicine and surgical removal of fibrous band You can do Mouth opening exercises by consulting your dentist. Apply ointment Tess on cheek twice daily for 15 days. One Tablet vitamin A once daily for 15 days. One Tablet Antioxidant twice daily. Consult dentist for exercises and oral examination Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor, Im suffering from ESRD from 1 year. The ESRD was caused due to NSAID. Right now my creatinine is 11. However all other parameters (calcium, phosphorus erc) are within range. I do not have blood pressure or diabetes. I have been advised dialysis. What are the risks with dialysis and what stage should I opt for kidney transplant ### REPLY: helloThanks for query. You have been diagnosed to have End Stage Renal Disease (ESD) with your serum creatinine being 11 which is very higChatDoctorpared to normal value of serum creatinine (1.2).ESD is a progressive disease and persistent high levels of creatinine will lead to hypertension and hepatomegaly failure. You should consult qualified Nephrologist for assessment and start Dialysis at frequent and regular intervals to keep your creatinine levels at acceptable minimum levels. There is no risk involved in dialysis and has to carry on regularly till you are prepared for Renal Transplant. With creatinine level of 11 you can opt for transplant now itself if matching donor is available. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 in 1984 with Hep C via biopsy . My SGOT/ SGPT have most always been slightly elevated. Just recently a cyst was discovered on the back of my tongue just over the clif with another suspicious nodule next to it. The cysts will be removed and nodule biopsied April 19th. The ENT doing the surgery ordered presurgery test, including a CT of my entire throat area. It came back multiple bilateral nodules on my thyroid gland . I also had presurgery blood tests done. The SGOT/SPOT levels are high, SGOT -253/SGPT-245. Could the thyroid situation cause the elevation in the LFTs? ### REPLY: Hi ADN welcome to . Thyroid disorder shouldn't be related to your LFT except in some autoimmune disorders or after using specific . . It is much more possible that Hepatitis cause causes it. Hepatitis usually has phases in which your symptoms and liver enzymes from time to time show aggravations and improvement. Focus on your planned surgical procedures and after that you can manage your liver problem(u should do ultrasounds and viral markers in blood) and maybe start with interferon therapy. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a bad case of Vertigo a year ago. I was prescribed 12.5mg Meclizine.  It worked along with physical therapy, but now it seems to be coming back.  It is not as bad, however, it seems to be constant causing me to worry about falling.It is the worst if I lay down on my back.  What advise do you have about this situation? ### REPLY: Hi, thanks for writing to . Apart from taking medicines, there are a few things that you should follow to prevent vertigo. They are as follows -* Change your position slowly, especially when going from a lying or sitting position to a standing position. When you get out of bed, sit on the side of the bed for a few seconds to gain your orientation and allow your circulatory system to adjust.* When walking, focus on distant objects. Do not look down at your feet. Avoid walking in dark areas or on unstable ground. * Use a cane, walking stick, or walker for support and to give additional pressure and touch (tactile) orientation.* Avoid activities that move the head up and down repetitively.* Try to avoid keeping the head tilted back for long periods of time, for example painting or dusting above your head.* Be cautious when using medications that may cause balance problems as a side effect. Hope this information is helpful. Good day ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am about two weeks pregnant and i have been getting painfull lumps under my harm leg and button i went to the doctor he drain them and put me on antibiotics but about a week ago i got another one on my belly but it burst for it self why am i getting these cysts ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  You may have enlarged lymph nodes due to some infection or some cyst formation.  You should consult your gynecologist and go for examination.  If needed go for biopsy.  Don't take any . 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: i been notice swelling of my ankles i been on over the counter potassium taking 3 tabs daily 550 mcg daily was not on potassium,my heat had a bad spasm,with also leg cramps my dr put on a blood pressure diovan/htz 80.12.5 for 6 years now,am i taking too much potassium? ### REPLY: Dear patient Potassium excess In blood leads to all symptoms you described. Potassium is an electrolyte and leads to fluid retention which is seen as ankle edema.  It also alters membrane function and leads to muscle irritability and muscle spasm and cramping pain. Excess of potassium is bad for the heart and has life-threatening side effects. I would advise stopping potassium stat and check for your serum electrolyte level. If its raised you need to take urgent visit to expert physician.  All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have had a lump on the right side of my neck, where you can feel your heartbeat, for about three years now, and have been to several different ENT doctors, including the MAYO clinic.  It is extremely painful and shrinks and grows depending on certain things such as when i take my adderall it hurts it more and also any kind of smoke makes it inflammed.  i have had a cat scan and mri done to the area but it showed nothing expect that my lymph node was slightly swollen.  None of the ENT doctors have been able to find anything wrong, but after doing research on my own I am beginning to think that this could be a sign that something is wrong with my heart? I have never had a chest xray done but i think that is the next thing i should have done.  I am starting to get very worried that something is seriously wrong because the left gland where you can feel the heartbeat is also now swollen. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have enlarged cervical lymph node. It can be due to reactive hyperplasia, tuberculosis or lymphoma.  Ct scan, MRI will not help. It has nothing to do with your heart.  You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: is any doctor online now?my grandma says she is dizzy ...i took her blood pressure and its 158 with 90, pulse 75, which is her usual blood pressure- i told her to lay down and hydrate herself.. do i need to worry further? i can also add that she is 75, no diabetes, a little overweight. ### REPLY: Good day to you. Thanks for your query. Check your grandmother blood sugar also, although she is not diabetic. Also check her Blood pressure while sitting and again while standing to see if there is .  Is she taking any blood pressure medication? Ask her to take some rest and again check her blood pressure after half hour. If still she is having same complaints, consult some doctor to get her examined. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just had a therascopic wedge resection of center right lobe of Lung , 24 hrs after suregery chest tube was removed and waited 4 hrs did a chest x-ray all looked very good sent me home have been home 2 days and I can hear fliud in chest cavity, is this a problem ### REPLY: Thanks for your question on . In my opinion you should first get done repeat chest x-ray. Post procedure pleural effusion can be seen in many conditions, but the common ones are1. Reactionary effusion. 2. Infective effusion.3. Leakage from bleeder (small arteries may leave open by mistake and slow blood trickle can be seen. So better to get done chest x-ray again. If fluid quantity is more than you may need diagnostic aspiration. And treatment according to the cause. So better to consult pulmonologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having brown stringy discharge for 4 days now, my period was due yesterday. Ive been having cramps off and on for a week.  Ive never had brown discharge before my period nor for this long? Is this normal? My husband and I are trying to conceive for 6 months now, could I be pregnant, I dont have any pregnancy symptoms? ### REPLY: Hello, thanks for using . Brown stingy discharges are not normal and are usually an indication of a genital tract infection. Genital tract infections could be severe particularly in the case of pelvic inflammatory diseases. Pelvic inflammatory disease is severe in that it is a frequent cause of infertility, lower abdominal pains and fowl vagina discharges. As for the pregnancy, you need to do a pregnancy test with early morning urine. You need to see a gynecologist for detail evaluation and tests and for follow up. Hope this helps you. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi...MY Uncle is depicted with hole in his heart at his age of 45.doctors say its from birth.he also says that lungs have gone weak.He never had any problem till now but started with the breating problem now.What should be done?could you please let me know what kind of operation it wld be n what wld be the estimated cost in india. ### REPLY: HelloThanks for posting here. I have gone through your description. Before jumping to the idea of surgery, we must ascertain whether he really needs surgery or not. A hole in the heart should be evaluated by a 2D echo. It will show us where the hole is located, its size and severity. The need for surgery can be decided on basis of that. Also since you mentioned the lungs are weak, we need to document as to how weak. He must undergo a PFT or pulmonary function test to establish the baseline lung function. It will give us an idea as to how severe the lung is compromised and treatment can be given accordingly. Since he has had no symptoms of hole in heart or cardiac defects, there is no need for surgery at this point. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with cirrhosis four years ago. I was a two beer drinker seldom used hard stuff, only 6 times in my life. I m now 77 and have stage 3 varices. I had triple open heart surgery 6 months ago and my bp is 112 over 62 most of the time. Looking into banding soon. DR has conclude that my cirrhosis is hep C caused. My medical is provided by the VA. ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. Yes, Hepatitis C and cirrhosis is closely linked.  Hepatitis C has potential of chronicity and ultimately lead to cirrhosis. Because if this there are a varices and protein deficiency. To halt the progress of the disease I advise you to stop .  Take the liver protective, probiotics. It will help you further progress of liver disease. I will be happy to answer your further concern, you can ask me 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 friend was slightly bitten by a dog in october 2011 in a residential area by a dog walked by the owner ( He forgot to ask if the dog has been immunized since he did not realize that he was bitten by a dog, and only after he reached home, he saw his back of his upper knee with impression of two front teeth) Same day he visited E.R, but the doctor said its superficial bite and next day, his physician also said its law that the dogs are immunized in Maryland and neither of them gave him any shots ( but prescribed antibiotic ).  He did not complain about any pain at the site of bite for 2 months. But he is complaining of sciatic pain for the past 3 weeks. Is this connected with rabies? ### REPLY: Hello, Welcome to , As your friend was bitten by a dog on the posterior aspect of the knee for which he has visited the ER, and they have not given any shot of vaccine, stating that all dogs were vaccinated in that country. Rabies is a disease which is transmitted by dog bite, which is 100% fatal but 100% preventable by proper and adequate treatment. If the dog is vaccinated also you need to observe the dog for 10 days. So I would have advised you to take at least three doses of anti rabies vaccine on days 0,3 and 7. As your friend is complaining of sciatic pain it may not be the symptom of rabies. So I would suggest you to consult the neurologist for further evaluation and treatment. 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 Doctor My mom is about 62 Yrs and is under medication for Hypertention. She is seeing  a cardiologist and he has put her on Losacar 75 mg, Nebuvas 10 mg and Rosuvastatine. But lately she has noticed that her pressure is always around 150/98 max and usually around 140/92. Should we be alarmed? ### REPLY: Hello, Thanks for writing to , I am . High BP is major risk factor for major diseases like HD, stroke,.HTN can be due to many reason but most time it is due to idiopathic THT there is no cause n called essential hypertension.some causes can be renal, metabolic,endocrine etc....ideally in high BP pt need BP caring twice daily for ate last 5 days n then consider that it is high BP.in high BP 1st need to do lifestyle modification include take low fatty diet n low salt diet with DEC wait n inc exercise n monitor BP for up to 6 months n still inc BP then need to be put on med n then need monitor bps til to adjust dose...it is done for pt who are recently DX...as your mother is already known pt of HTN n having high BP need to optimize dose n still have high readings then add on TX need to be considered n if there underlying factor that increasing BP may need to eliminate too...in old pt vessel become thick n hard n lead to inc BP while in young it dilates/constrict Sacco ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 SIR,THIS IS ZAFAR IQBAL (MR.) FROM KARACHI PAKISTAN, SINCE 6-7 MONTHS I AM FACING THE PROBLEM OF LIVER, CURRENTLY I DID LFT TEST WHICH IS AS FOLLOWS:-BILIRUBIN TOTAL 1.4MG/DLBILIRUBIN DIRECT 0.5 MG/DLSGPT 78 U/LALKALINE PHOSPHATASE 5.1 MG/D1AND MY CBC TEST IS AS FOLLOWS:-HAEMOGLOBIN 14.8 GM/DLR.B.C. 4.06 X 10E 12/LHAEMATOCRIT 35.7%M.C.V. 87.9 FLM.C.H. 36.4 PGM.C.H.C. 41.7%W.B.C. 6.6 X 10E9/LNEUTROPHILS 45%LYMPHOCYTES 50%EOSINOPHILS 03%MONOCLES 02%PLATELETS 1,78,000SERUM URIC ACID 5.1 MG/D1SIR, I AM IN BIG TROUBLE SINCE 6-7 MONTHS AS ALWAYS FEELING VERY TIRED AND FEELING WEAKNESS, I NEED YOUR FAVOR TO PLEASE KINDLY GUIDE ME AS HOW I CAN BE NORMAL AND HOW CAN I GET MY SGPT, BILIRUBIN DIRECT & ALKALINE PHOSPHATASE AS NORMAL,.KINDLY ALSO RECOMMEND ME THE DIET SO THAT I CAN RECOVER.YOUR KIND ADVICE WILL BE HIGHLY APPRECIATED.,THANKING YOU IN ADVANCE FOR YOUR KIND COOPERATION.,REGARDS.ZAFAR IQBAL (MR.)EMAIL ADDRESS :  YYYY@YYYY  /  YYYY@YYYY SKYPE: zafariqbal183CELL NUMBER 0092-322-0000 ### REPLY: Hi, thank your for posting. After I saw very carefully your results I can say that you have light damage of your liver. The causes maybe are caused by viral infection, different intoxication, internal disease(this is related with other organs), etc. To complete your lab results you also need an ultrasound to see liver and gallbladder function. You should make functional proof of liver test, this shows if the disease is early or acute. You should eliminate spicy foods, animal fats, coffee, milk, salt, fried foods and alcohol from your diet. You should use a lot of soup, fruits, boiled vegetables and olive oil. You should contact a hepatologist. 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 WIFE IS DIAGNOSED FOR AUTO IMMUNE HEPATITIS AND ADVISED TO TAKE OMNACORTILE 40 MG + 20 MG = 60 MG DAILY AT 6 AM FOR 10 DAYS. OTHER MEDICINES ARE FOLVIT (ONCE A DAY) AND URSOCOL 400MG ( THREE TIMES A DAY). PLEASE TELL ME THAT WE ARE ON RIGHT TRACK OR NOT? Email :  YYYY@YYYY ,  YYYY@YYYY ### REPLY: Hello, Thanks for using . I had gone through the data posted. For autoimmune Hepatitis the treatment you have mentioned are good, and you are on correct track. You need to continue same treatment and be on regular followup. Next time you can upload the Auto antibody panel report so that we can suggest more. Steroid will help to decrease autoimmunity, polite and protocol will help for hepatoprotection. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am having PCOD s , from last 3 months i am taking siphene 100mg, and i am undergoing folicular study every month.. i am ovulated on 13..14..12th day of my period..still i am not a pregnant. my question is the doctor said the egg is released on right ovary consecutively for last 2 times. and i am have not delineated on right when HSG test performed. with this note we are expecting an egg on left this time.. wht are the chances to get pregnancy this time? if so having intercourse before or after ovulation helps us ? ### REPLY: Hi, Chances of conception with ovulation induction (Sphere) in POD are 25% per cycle, which is equivalent to normal couple. If your HSG has not delineated right tube, it's better to go for laparoscopy to know real tubal status if you don't conceive within 6 months. Chances of conception increase if you have intercourse before ovulation (It's better to have intercourse daily around ovulation/after egg size >10 mm) to not miss the opportunity. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It s been about 9 months after acl reconstruction, I still a little bit pain, and i decide to go back to sport, and i fine out the back of my knee have bruise but while I practice it doesn t pain or knee pop, I don t know if its ok, and how do i know if i tear my acl again? ### REPLY: Hello, ACL reconstruction doesn't fail or break again until it's a major accident. So be assured you got the good ACL reconstruction. I will advise you to do balance board training as that is the one which helps the joint proprioception to be active and give good results out of the knee. Usually, this is missed out on the rehabilitation of the knee in many cases and most patients have similar complains after some months of ACL reconstruction. But in my clinical practice with balance board training as a last part of the training, we have been implementing on almost all patients who visit us in the last 12 years.  Inline recommend you to undergo balance board training, and you will find amazing results. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a hard lump on the inside of my lower lip. It s formed after I kept accidently biting that spot every time I sneezed. Finally I got fed up and poked it with a pin. A mucus like substance came out of it. It finished draining and now is a sore inside my mouth, the skin that was swollen seemed to die. Might you have a clue as to what it was? ### REPLY: Hello hope the answer helps you. As your history is very evident that post traumatically on lower inner lip where thousands of minor salivary glands are present gets hurt led to a mucus retention cyst as HARD SWELLING you mentioned. Now you have ruptured it and it's dissolved with some skin swelling no worries now. You use oral detain gel twice or thrice daily for soothing and vitamin C in diet or supplemented form to accelerate healing hope this works within 1 week. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having frequent chills, no fever. A few months ago, I had a CT because I had a concussion. Results indicated I had a chronic upper sinus congestion. Have had a lot of thick mucus drainage at back of throat, if I can cough it out, it is bloody and greenish looking. cskaercher ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you should consult ENT doctor and get done nasal endoscopic examination to rule out chronic sinusitis. Because greenish, blood mixed mucus suggest possibility of 1. Fungal sinusitis 2. Nasal polyps 3. Early cancer 4. Chronic bacterial sinusitis. So nasal endoscopy is must for the diagnosis. You should also get done culture of nasal secretions for the diagnosis of causative organism. So consult ENT doctor and first diagnose yourself and then start appropriate treatment steam inhalation 5-6 times a day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have recently taken Cipro for prostatitis and did not equate the Cipro use with my Achiles tendon pain. PMH of patial Achiles tear. Have an appointment with Orthopedic, but not for 2 weeks. Icing and heat seem help as well as the topical Voltaren. Any other thoughts or assistance while I wait for my appointment would be greatly appreciated. M ### REPLY: Hello, You are having tendon tear. For that anti-inflammatory medication can be prescribed for five days.  Avoid strenuous activities and take rest. You can apply ice wrapped in a cloth over the affected part. Avoid running and brisk walking. Avoid further usage of ciprofloxacin as it can aggravate tendon Tear. If not heal until you consult orthopedic surgeon than surgical management might be needed.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I HAVE HAD SURGERY ON MY BACK {L4-5}AND THE ANOTHER TO PUT A PLATE AND TWO SCREWS ON THE SAME NOW TO FIND OUT THAT MY C2-3 MY CAUSE ME TO NOT BE ABLE TO WALK IF NOT ATTENDED TO SOON IT IS CAUSING PROBLEM IN MY HANDS {DROPPING THINGS NUMBNESS FROM MY KNEES TO MY FEET STUMBLING} WHAT IS YOUR SUGGESTION. ### REPLY: Hi If c2,3 levels are implicated, an MRI may show extent of pathology. Use a cervical collar, and do isometric cervical exercises under a physiotherapist. Consult orthopedic doctor if traction is needed for relieving any nerve impingement in neck to account for hand symp3. Take lyrics 75 mg twice a day and moral twice a day after meals. Your surgeon may decide future course of action after evaluation Best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 31 years old, i am 166cm tall and i weigh 81 kilo.  I have recently lost 23 kilos on a balanced diet and exercise regualry.  I have CRPS in my left foot from a accident at work other than that i am generally very healthy.  I have a painfull lump at the bottom of my right rib cage which is hard to the touch and about the size of a golf ball. ### REPLY: Hi thanks for contacting ... This lump has to be examined for its consistency, fixation to underlying tissue and palpation whether arise from superficial tissue or from deep organs ...USG examination will be helpful for it ....Then if possible FNAC has to be taken for determining whether it is infective or neoplastic one. ... According to cause treatment guided. ... If detail investigation needed than CT scan is the higher non-invasive investigation ... Take care. . Consult surgeon for examination of lump . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive noticed that a week or so before my period I have painful lumps in my right armpit and also on the side and underneath my right breast. I also have some achiness in my right arm and in my right leg, behind my knee. I dont really notice having these symptoms much any other time, could these all be related? Possibly hormonal?? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have pain in right maxilla and underneath the right breast at time of menstruation. It can be due to fibroadenomas. It is due to hormonal changes.  .  Furthermore, it is prescriptions based medicine so consult your doctor and take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 66, good health, annual physicals, etc. taking multi vitamin, Lipitor and aspirin 325mg daily. I have notices dark brown wartish looking things on my testicles. Some have a small lump others while they don t itch, I can feel their presence. Any idea what these are? ### REPLY: helloThanks for query. You have multiple Sebaceous Cysts over scrotum. The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac). .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi. i have a toddler he is almost 3, he just got his endoscopy done because he had unexplained belly pains, often hiccups (since he was born on and off hiccups) and since 2 months or so now almost every day those strange rashes mostly groin area and down the legs. last friday his lower lip swoll up and both his feet too, big swelling on right wrist and body rashes, not itchy, more blotchy and with the endoscopy we found out his one stomach muscle is weak and sore around and his esophagus is inflamed. doc took biopsy from the esophagus tissue. now we have to wait... he also did blood tests like C1 Inhibitor , C3 und C4, CBC, sedm.rate, etc. My son is very allergic that we know since almost a year. last year he had 2 months unexplained diarrhea , then we did allergy testing, he is allergic to rice, egg whites, molds, trees etc a lot of stuff which we avoid as much as we can. but he never had those strange rashes. our GI doc thinks he could have HANE Hereditary Angioneurotic Edema. What is your oppinion? the eosophils in blood tests always evlevated, low lymphocytes etc. and he sometimes complaines that eating cereals (like cheerios chocolate / there is no rice in it) hurts him in his throat or esophagus. and than he just dont eat it. and since he was born he has a noice when he breathes, not every day, but a lot. please answer. thanks so much. god bless u! Mandy ### REPLY: Hi, Thanks for query, Your toddler is having many problems and require evaluation, and you have already undergone investigations. Let gastroenterologist take decision. But I have to add something which may be helpful. As he has high eosinophils and recurrent gastric complains, go for Stool test for ova and cyst of worms, thread worms or round worms which is known to give all symptoms like, allergy,high eosinophil count, loose motions. Ok and bye. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My boyfriend had liver abscess nearly three years back. His liver is sensitive. He doesn t eat junk food but last night he had loose motions and he suspects little blood in the vomit. He passed a lot of loose stools.Help me know what s the matter and what can be done. He is 21 years old. ### REPLY: Hi, Welcome to  forum.  As you describe it appears to be the food poisoning, means infection of the foods, they need not be the junk food related. Sometimes the home foods also get infected due to storage problem.  I advise you to consult a doctor for diagnosis and treatment. He may need to have infusion of I.V.fluids for correction of deny .  I usually prescribe to my patient with such symptoms injections of metaclopramide, cefotaxime, tablets of lactic acid bacilli, ofloxacin, and risperidone, and operative.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father 88 yrs is saying unless he puts fingre in anus he cant pass stool. Can it be a surgical problem or is psychological?Pl. help. He is very weak now but insists in using Indian/ Orissa wc pan as in english toilet he is unable to put his hands down and unable to use fingre. ### REPLY: Well, let me explain you simply how defecation or passing stool works. One aspect is the tube that transmits the fecal matter and other aspect is the gate that opens to release the fecal matter. Now the gate opening mechanism or medically known as fecal outlets is a very complex mechanism and involves many organs. (for e.g. sensing the matter is just air or solid and act differently in both occasions) well generally with old age this mechanism falls apart. So I have few questions1. Is there any change in his posture?2. Is he complaining of backache?3. Did he have any other complaints?4. Does he have any neurological complaints or past history?5. Does he have any other medical diseases? ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: a recent blood test showed psa levels at 14.3.Previous results...last 10 or more years have always shown "in range" results.This recent test was performed using the Siemans chemiluminescent method.The results showed 14.3.As mentioned previous results were always Age 59, weight is 155 consistent, no health problems.  In general, good health. ### REPLY: HelloThanks for query. Your recent PSA levels are reported to be 14.3.which is quite higher than normal value of 4. The PSA can get raised in following three conditions 1) Enlarged Prostate 2) Cancer of the prostate 3) Infection of the prostate However it is an international protocol and rule that high PSA is always suspected to be due to cancer of the prostate unless proved otherwise by doing ultrasound guided multi score prostate biopsy. Take antibiotics like Cefuroxime twice daily for 10 days and repeat PSA. If it is reported to be still higher than normal you will need to consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture. 2) Ultrasound scanning of abdomen and pelvis and Trans Rectal Ultrasound scanning (THUS)3) Prostate biopsy (If he detects hard nodule on surface of prostate on digital rectal examination)Further treatment will depend upon final diagnosis .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 5 yrs old, he has silver caps on all his teeth well one fell out tonight while eating it looks almost like his tooth broke off its gross, there is barley anything there now. It also bled alittle, What will they do to fix this, will it require surgery thats what freaks me out. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint if the crown has dislodged off and there is no tooth crown apparent in the mouth then it seems that the crown has dislodged due to breakage of the tooth due to secondary decay. If this is the case and the tooth is a milk tooth then the remaining tooth has to be removed, and a space retainer will be placed so that the space that is left empty after removal of the tooth is not occupied by . . This is the best treatment for loss of milk tooth. You can also send me a picture of the broken tooth and the cap along with the picture of the area inside his mouth by asking me a direct question by clicking "Ask me a question" in my profile. I will evaluate it further and advise you more precisely how to proceed for the treatment. 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: my husband is bleeding under skin .He just has to rub against something and it comes up like a big purple mark .He has a new one inside arm .He says he didnt brush anything .He is 69 years old and been told old age .He has had lung cancer most left lung removed on sertide and asmol spray It seems more than old age what do you think thanks ### REPLY: Thanks for your question on . In my opinion you should consult dermatologist and get done detailed clinical examination of skin lesion. As many cancers can involve cutaneous vessels and cause bleeding. Lung cancer is most common cause in this. Especially small cell carcinoma of lung. So chances of cutaneous vessels' involvement are more by tumor. So better to consult dermatologist and if needed biopsy of the lesion is also recommended. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 last period started on 22 of feb and ended on 25th i had unprotected sex on 28th of feb after which i took an i- pill within two occurs of the same. today. i.e. on 22nd i m expecting my period but nothing, however yesterday i have spotted very little blood and it was the same thing today along with a little red lining but that was like hardly a few drops of blood. actually i had also consumed an i-pill in the month of January which made my period come 2 days earlier than the usual and a little bit of acne but nothing else. this there was a little acne again.. but I am really worried about being pregnant. i always use protection( condoms ) and have never let him cum inside me. it was just once when there wasn t one, still he pulled out i know not very reliable but I m a nervous wreck atm ### REPLY: Hi, Thank you for posting your question here, I will try to answer it to the best of my abilities. Stress can cause the dates of your period change, they can come later or earlier than what is normal for you. An i-pill within two hours of the intercourse was a good move, and it should reduce the chances of you getting pregnant significantly. Take a home pregnancy test and you'll have the answer you're looking for. Although it highly probable that your period is just late this month. 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 am 21 year old female. I was diagnosed with herpes virus this last year. I have only had one or two flare ups and has not been bad. A couple months ago, my anus started itchy pretty bad and has gotten worse. I got little red sores that burned to go the bathroom, wipe, and then after. I went to get them check and my doctor told me that she thought it was just an outbreak of herpes and to get my prescirption filled again. I took the medication and the sores did not go away. It has been about 2 weeks now and they are worse now. What could this be? ### REPLY: Hi madam, welcome to , I understand your problem, its herpes simplex virus, u have to follow the antibiotic like acyclovir twice a day after breakfast and after dinner for 7 days, and the sores will disappear within one month, no need to worry, u have to be in diet, don't take non veg, take oranges, grapes, coconut water must, hope u satisfy with my answer, if u have so much itching then use Triforce ointment apply in nighttimes, thank u ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes i recently moved to a very humid region and have developed small itchy bumps on my forearms what could this be? This happened exacly a year ago when i lived in Korea and now i live in Japan how can this be treated or prevented. I have no known allergies and beleive this is weather related. Im currently using tea tree oil. ### REPLY: Hello, Small itchy red bumps on the skin that disappear with no marks or scars are suggestive of urticaria. Occasionally one can have swellings of the lip sand/or tongue. In most cases (80%) it is not allergic and long-acting non-sedating antihistamines such as Allegra 180/90 and/or cetirizine 10 mg for 6 weeks (minimum) to 3 months (most likely will be required in your case) is recommended. Infections can be a trigger so basic investigations to exclude infections are sometimes helpful. Food allergies are not a cause unless there is a specific food you are aware of that causes the lumps within the hour of having the food. I hope that was useful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 asthmatic since early childhood ,Now since one year I have devoloped chronic urticaria and I have raised IGE Levels normal value is 190 and mine are 350 .What kind of treatment I should have.Im taking Zantac 1BD Fexet 180mg 1 OD Softin 1 HS Zatofen 1BD is this is a right treatment? ### REPLY: Hi, Already you use Fexofenadine 180 mg (histamine 1 blocker) why you again take soften (Loratadine) also histamine 1 blocker.  Tab Sanitizing (Santa) is a histamine 2 receptor blockers. Both fexofenadine and Sanitizing have synergistic effects on urticaria.  Respond to treatment may take 4 to 6 weeks.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my wife is having hypothyroid . She is taking thyronum-50. Also for her depressional attitude she was being treated by psychiatriest & was prescribed fludac 20. But when she was guided by another doctor who told thyronum is enough for treating depression & she stopped taking fludac. Now at every step she is showing symptoms of deep depression. What do you suggest ### REPLY: Hi there, thanks for asking. Depression could be a symptom of hypothyroidism. However, it could be separately present. When stopping the antidepressant has led to depressed mood, it would be beneficial to restart the antidepressant. Sometimes, improvement of the effects of hypothyroidism (that has been present for months or years before it is diagnosed) need additional help for the body. It is quite natural if somebody needs taking antidepressant in this condition. She may take the medication under supervision of her doctor and she may need just 6 to 9 months to take it. Doctor will know when to decrease it. I wish her 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: When asleep, I am woken with a vibrating feeling on the left side of my chest. After a minute or two upon awakening, it stops. I had examinations for my heart but all was normal. Doctors I have been to cant explain it and suggest it is from  stress, adrenaline surge, etc. But whatever it is it wakes me up every night and when I fall asleep it starts again. I am a 58 year old woman, and my other health problems are headaches when the barometric pressure falls, and some food allergies. Thank you for your help. ### REPLY: this kind of vibrating good feelings in your chest while you are sleep or surprising because if you are sleeping soundly you should not feel anything otherwise it is sign of nightmares, and it can be part of your anxiety neurosis and these can be due to poor eating habits of fatigue a lack of exercise or not to doing or keeping idol avoid these are panic attacks or vibrating feelings you should do regular exercise walking for an hour or so and doing some biofeedback keeping yourself HY .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 water skiiing, fell, and bent my back backwards really hard when I hit the waves. There is now a bump on my lower spine that hurts a little when Im exercising. Ive had it x-rayed and the doctors say there is nothing wrong, but the bump wasnt there before the accident. ### REPLY: Hello! Welcome on ! Regarding your concern, I would like to explain that the bump is related to soft tissue injury (muscles, ligaments and subcutaneous tissue), caused by the trauma you have had. But, as long as your spine X-Ray study has resulted normal, and you have no numbness in the lower limbs or difficulty with walking, there is nothing to worry about. You should just be patients, because it will take some time for the bump to resolve spontaneously. Hope you will find this answer helpful! Wishing all the best,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my name is Jocelyn and i am 17 years-old. Im looking for a doctors advice because my mom wont listen to me no matter what i tell her. I havent slept at all tonight because ive had this god awful stomach pains to the fact that i feel like crying. It started out with my lower back hurting for about 3 days and it still does hurt but not as bad and now i feel like i have to constantly poop and vomit. I also have really bad dizziness and I feel really weak. I recently went to the bathroom, and it still didnt help anything, and when i looked it after i wiped it looked like coffee grounds in diarrhea. Not to be gross but im actually starting to get a little nervous. Can you please help? ### REPLY: Hi. Thanks for an elucidated history. Yes, you have a problem-this is gastroenteritis. The dizziness is suggestive of an active infection with loss of electrolytes into the intestine (the reverse process due to infection). You need to consult a Doctor for clinical examination, blood pressure and pulse rate. You may need IV antibiotics and supportive medicines as there is vomiting also. Request your Mother to take you to ER ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 28 years old woman. I have been married for 2 years.I have 1 baby who is 7 months old. My husband does not enjoy sex using condoms .He has been asking me to get copper-t inserted.I want to know the procedure of insertion, it s side effects and how painful it can be during insertion and after insertion.when is the best time to insert it? ### REPLY: Hi, Cooper =T is an intrauterine device inserted by OG inside your uterus. Usually, there is no pain during insertion. After insertion, some women have reported pain or cramps together with heavy periods. If you notice unusual symptoms can consult OG or physician immediately. Be careful when having sex not to remove the Cooper-t to avoid laceration of uterus. It can be inserted any time, but usually after the periods are over. 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: I am 34 years of age and recently diagonized with a gland tuberculosis. I had swellings under in left armpit for about two months now. What kind of medical intervention will help me? what caused in the first place? and what shall I do? Pls help me understand it better. Thankyou very much! ### REPLY: Hello and Welcome. Thank you for your query As you were recently diagnosed with gland tuberculosis, I am sure you are under treatment for the same. Regarding your worry about the swellings under your armpit, they are nothing but the swollen or enlarged lymph nodes due to tuberculosis. A lymph node is an oval-shaped organ of the lymphatic system, distributed widely throughout the body including the armpit and stomach and linked by lymphatic vessels. They become inflamed or enlarged in various infections and diseases, for example in your case, in tuberculosis. I recommend you to complete the course of your tuberculosis treatment, and check for the decrease in the size of those swellings. But if they still persist, you need to check it with your doc, he may recommend a biopsy for the same. Thank Outstay Healthy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: gud evening doctor. i m in my eight month of pregnancy. my stomach gets upset quite often. after every week it gets upset and my motions become loose for 4-5 days 4-6 times a day. my doc recommended me econorm powder when it becumes loose nd stop taking iron, calcium and milk. i just want to know is there anything to worry abou my child due to this and repeatedly quitting iron calcium may pose any problem to my child ### REPLY: Hi, Iron and calcium are supplements given to help mother and baby get adequate nutrients. This is more so in developing countries where nutritional deficiencies are known to occur. It is not an absolute must take them, especially if you are unable to tolerate them. And have got hemoglobin checked? Iron supplements are necessary if hemoglobin is less than 11gm/DL. If iron is low, and you are not able to tolerate oral, you can take injectable iron also. This discontinuation will not affect baby in any way. So do not worry if you are not able to iron and calcium. Another advice is to take diet rich in iron and calcium. 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: My husband has prostate cancer surgery 3 1/2 years ago.  The prostate was removed; however, there were minute cancer cells in one of his lymph nodes.  He is now being treated with lupron.  He is beginning to experience stiffness in his neck & shoulders & I was wondering if this could somehow be related to the cancer. ### REPLY: Hello, Prostate cancer can cause bone metastases. Common sites for bone metastases are vertebrae, clavicle, ribs etcetera. Bone metastases from prostate cancer are osteoblastic. So they can cause pain. So the possibility of bone metastases is high in your husbands case. It can be the reason for his neck and shoulder stiffness. So better to get done bone scan. If the bone scan is normal, then no need to worry about bone metastases. He can take painkiller and muscle relaxant .  But the first rule out bone metastases through the bone scan. 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 have a flu last week and fall asleep on the couch for several hours, when I woke up my right side and lower back was aching, After couple days the pain is not go away and I applied muscle rub at night, I woke up the next morning with rashes on my lower back and abdominal... the rash is not too many only a couple spot some is look like a mosquito bites and it is itch no ooze or bump just red rash... I feel great and have no more flu or cold but still have some pain in my lower back and side eventhough is not too painful... do I have a Shingle or do I have an alergy from the muscel rub? should I make an appointment with my doctor? ### REPLY: Hello. Thanks for writing to us at  Your description of the rash and associated pain does seem to suggest a possibility of Shingles; more so if the rash is arranged in a stripe like pattern across one half of the body, with a sharp mid-line cut off. Shingles may initially start either as rash or as raised patches and subsequently may develop fluid filled lesions. Therefore, absence of fluid filled lesions from the start doesn't rule out shingles. Pain is more of a feature of herpes Zoster; irritation to the muscle rub would have been associated with a burning sensation rather than pain. I would suggest that you visit a dermatologist for a confirmatory diagnosis. A dermatologist would be better able to confirm it or rule it out. There is usually associated pain which may be shooting or stabbing in quality. If Shingles is confirmed to be shingles on visual inspection, treatment would be with an oral antiviral e.g. acyclovir or val acyclovir. Associated pain also need to be managed appropriately with NSAIDsFirst step would be to visit a dermatologist for a confirmatory diagnosisRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has sharp breath taking pain in his middle and lower right rib cage . worst pain if he bumps or is jarred at all. c-scan showed no broken ribs. he is told that he MIGHT have pulled something but we are worried because he has a fatty liver and has  had colon cancer(sigmode) is there any thing to worry about this has gone on for around 1to2 months the ct scan was done with dye. ### REPLY: Thanks for your question on . I can understand your concern. Since CT scan is normal, no need to worry about major lung disease. Possibility of musculoskeletal pain is more likely. So tell him to follow these steps for better symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid forward bending and sudden jerky movements of chest.3. Apply warm water pad on affected areas of chest.4. Sit with proper back support.5. Take painkiller and muscle relaxant . Don't worry, he will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. 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: 2 days ago i developed a small lump (presumably a swollen glad)  on the soft spot of my neck just below the ear lobe.  as the days progress it becomes more and more sensitive and painful.  there is now more swelling around the  area and more and more of my neck (on that side) seem to become swollen or in pain almost feeling like a bruise.   what could it be??? ### REPLY: HI, Dear. Very Good NOON from India. Thanks for your query. I understand your concerns. I studied your query in depth. Need more information to comment on.-I would advise you not to worry still. In my opinion -the swollen neck-lump is of Acute lympadenitis with induration in surrounding neck tissue. Appears mostly due to aggressive . Remedy-a---Advise-Consult an ER Surgeon who would be the treatment from the ER surgeon and would relieve your worry.-Hope this reliefs your worry-some query. Welcome for any more queries in time to come. Have a Good Day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Okay, So I have had intercourse without a condom a few times but it never lasted long and he always pulled ou before he was about to ejaculate. I have been having period symptoms, such as sore boobs and cramps , and feeling tired. School and other things have caused me a lot of stress . Since I have been in school I am always tired and all I ever wanna do is sleep. My diet has been weird, I don t eat regularly, I have not take a test yet, but is it possible that I am pregnant because my period still has not come? ### REPLY: Hello, Unprotected sex with pull out method has high failure rate around 15-28%. Though it depends on ovulation time or fertile days. Therefore, I suggest you to undergo one home pregnancy test with urine at the earliest and may need to do blood test for beta  for confirmation. In exclusion of pregnancy, reasons for late period are hormonal imbalance, ovarian cyst, stress/ anxiety, wt gain/extreme loss, irregular eating habits, psychological factor etc. In such cases, you may require some investigations to rule out underlying pathology through USG pelvis scan, thyroid profile & other hormone assay etc. Consult with your gynecologist and take suggestive measures. Avoid stress / anxiety by regular deep breathing, take healthy diet with vitamin & iron supplements, eat more fruits & vegetables, .  Always practice safe sex to avoid unwanted pregnancy. If you need further consultation with me, then you can visit http://www.ChatDoctor .com/doctors/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband had fever and loose motions 3 days ago. When we consulted the dotors he asked him to go for ultrasound. The results were - Features of Colitis anf Fatty Liver Grade 2, Mild diffuse wall thickening of cecum and ascending colon is seen ( up to 4.6 mm) Can u please explain the disease and its seriousness and diet? ### REPLY: Hi, Welcome to ChatDoctorAfter going through history most likely he suffered an infection by amoeba or bacteria, but colitis it may be chronic and thickening of cecum makes to suspect other diseases like TB and Malignancy. Another thing is Fatty liver common causes are Diabetes, Obesity,High Cholesterol level and Alcohol consumption. You should check for FBS, PPBs and Lipid Profile. If by chance he takes alcohol then stop it completely, rest depend on test result. If thickening in cecum and colon persist after treatment go for Colonoscopy with biopsy to know exact cause of thinking and once cause is known it can be treated accordingly. He should take light and easily digestible diet and take care of potable water. Plenty of fruits and green vegetables cooked in less spicy way may be taken. Good Luck to 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: Dear Dr s, I am aged 36 years, recently i went for a medical check up In which My sgpt is 66 & blood pressure upper 170 and lower 110. All the check ups i.e. ultrasound, x-ray shown nothing. Pls examine on the basis of above and suggest me. Thanking you ### REPLY: Hello, Most probable reason for Sept elevation is obesity and fatty liver. As fat accumulates in the abdomen, it also accumulates in liver leading to liver damage and elevation of enzymes. Also, you should reconfirm the elevation.  Do you ?  Also, you should get one viral marker test done like Bag, Anti HCV, in order to rule viral hepatitis. To confirm the diagnosis, we need ultrasound of liver. Treatment for this is dietary changes like low fat, oily and sugar diet and regular exercise and weight loss.  For BP, it can be age related change occurring early or secondary to some disease. You being a young hypertensive you'll first evaluation for cause of blood pressure. You should undergo test like kidney function test, renal artery Doppler, Sr cortisol and 24 hr Urinary metanephrines.  Furthermore, you should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If BP is persistently more than 140/90 MMH, then you should be on medicines for it like telmisartan or amlodipine. Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 early stage Alzheimers and have been on Aricept for a number of years in the hope to stop the disease in it s tracks. I also have chronic depression and have been on a cocktail of drugs for decades: Buproprion, Lamictal, Lexapro. I also take supplements include Turmeric capsules and other vitamins. This disease runs in my family. My aunt, my Mom, my cousin and my sister (who was 12 years older than me all died of this disease. My sister also had Parkinson ss which ran on my Dad s side. I truly hope you can help. Many thanks, Linda Grishman ### REPLY: Hello there, Well I see that you have been on medications for a long time, you actually have not mentioned your name and sex, the prognosis of Alzheimer's disease varies depending on these two factors. I would like to know if you have been properly diagnosed to have the illness, because depression itself can cause loss of concentration, which reflects as forgetfulness. To be really frank there is no cure for Alzheimer's disease, the medication that you are on can delay the worsening of symptoms, this is a fact that you have to come to terms with. Regular follow-ups with your physician and continuing the medications that you are on right now is the best thing to do. ### END