Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is Elena. I was diagnosed with Hepatitis B and I got my blood work results today. Total Bilirubin is 0.38 Direct Bilirubin is 0.10 AST - 40 H ALT - 57 H Alkaline Phosphatase - 77 Total Protein - 7.0 Albumin - 4.3 Globulin - 2.7 Albumin/Globulin Ratio - 1.6 Do I need to be concerned? Is my liver damaged? ### REPLY: Dear Friend. Hi, I am , I have read your query in detail, I understand your concern. Since you have Hepatitis B infection. We need to find out it is acute or chronic. Your LFT appears to be normal. I recommend you to get investigations to check for chronic hepatitis B. Also, get an Ultrasound Abdomen done. After the reports if it is chronic, you may require a liver biopsy to see for its stage and decision of treating it. If you are sexually active / Married, your partner needs testing too. This is my personal opinion based on details available here.  If you want to discuss your issues further, you may please ask stay Healthy. , MD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just had a tooth prepped for a crown. No pain. I do not like to take NSAIDS My dentist suggested I take 2 now and 2 6 hours later to help reduce inflammation. Is not my body capable of doing that on its own and wouldn t the NSAIDS inhibit the body s natural healing processes? ### REPLY: Hi The defamation needs to be reduced to hasten proper healing. Though you are right that your body has its own mechanism to heal but a healthier environment fastens body healing process. Since even instrumentation and high speed aerators used for crown cutting are forms of external irritation a mild dose of NSAID has been correctly prescribed by your dentist to negate the summative effect of all procedures as well as the defamation present before the procedure. Rest be assured just two doses will have more benefits than do any harm. 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 mom has heart disease and kidney disease. She is dizzy all of the time to where its affecting social and family life.  She gets lost driving and her memory is getting pretty bad. She also has severe gout including her hands which is awful to look at.  I can just imagine her pain. But the dizziness is really getting her down. Thanks, pam ### REPLY: Hi thanks for contacting . Cause for dizziness has to be searched for and treated .... According to history here cardiac cause seems to be causative factor.... Left ventricular failure by hypertension or other cause might be causative for dizziness. So if LVF there treated with diuretic. If still dizziness there then vestibular neuritis or otological cause searched for. If still cause not clear then CT scan done for neurological organic cause detection. Vestibular sedative like cinnerazine useful . Avoid  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 baby boy is 16mos old...he started to have a soft to watery, brownish stools 4-5 times a day, 5 days ago.. He started to have on and off low grade fever 2 days ago....The odor is on and off... Generally my son is not acting like sick, except that he s irritable at times... ### REPLY: Hi Thanks for contacting us. Your son is 16 months old and now has loose stools, low grade fever and irritability. There is no red signal in your history except for duration (5 days). May be u need to start with antibiotics covering aerobic and anaerobic bacteria with probiotics under a pediatrician guidance because if it has been of viral etiology it should have got settled. Keep feeding the kid with bland diet and replenish with fresh fruit juices with no added sugar and tender coconut water ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Husband has high blood pressure, sometimes running as high as 190/115.  He is on blood pressure meds but still seems to have high readings.  Recently, his doctor raised dosage of meds. and he seems better but, doesnt want me to know what his BP is because he knows I will be worried.  What can I do? ### REPLY: Hello! Thank you for asking on ! I understand your concern and would explain that it is important to closely monitor his blood pressure frequent times during the day. You should refer those values to his doctor in order to make the better treatment choices. You should know that uncontrolled high blood pressure can lead to brain hemorrhage and also chronic vessel disease. That is why high blood pressure should be treated properly. Besides, possible secondary causes of high blood pressure should be investigated. I would recommend performing some tests: - complete blood count- PCR, sedimentation rate-thyroid hormone levels-kidney and liver function tests- aldosterone and cortisol plasma levels-fasting glucose-blood lipid profile-blood electrolytes. You should discuss with his doctor on the above issues. Hope to have been helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor , For the past seven years I was suffering from focal fits and temporal horns in brain with mild dilatation. Now i m taking mazetol 100 mg tablet for 6 years. Past one year i have not taken the tablet, few weeks back i suddenly got fits. I have to continue the tablet fo all my lifetime. Is there any cure for this ? Please advise me im going to be married with in three months. ### REPLY: Hello, from what I could gather is that you were prescribed this medicine and without the doctors' knowledge you stopped it abruptly and most probably that was the reason you're throwing fits again. See you have to gauge risk to benefit of the medicine taking it for long time. If you are supposed to take it and that too in a particular dose, but you are not having it/taking lesser dose of same, in that case there are increased chances of having a fit. So it is always better to abide by what your neurologist has prescribed you and am sure that he will, in time taper off the dose as required. And as regards cure for this, if you take the medicine regularly there are fair chances you're getting rid of the ailment for good. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 (22 months) has been having foul smelling grainy/ loose stool, about 3-4 times a day. A pimply like diaper rash has developed. She has been easily adjetated/ moody. She also has been having a hard time sleeping. Waking for 3-4 hours in the night. ### REPLY: Hi, Thanks and welcome to . Your history indicates the child may be suffering from diarrhea. Ofloxacin and ornidazole combination syrup 2 times daily will control infection. Sporolac one sachet daily prevents diarrhea. Cyclopam syrup 2-3 times daily will make the child free from colicky pain and make them comfortable. Avoid wearing diapers for few days till diarrhea is controlled. Local application of clotrimazole ointment for diaper rash. Hopethis reply serves your purpose. Please feel free to ask further queries if any. . V. Subrahmanyam. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: its hard to explain but it feels like my heart drops (like your stomach when your on a roller coaster ride) and i loose my breath, i was dignosed with anxiety disorder in 07 but it dont feel anything like that, what do you think it might be? should i be worried? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should first rule out heart diseases for your symptoms. So get done ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry about heart diseases. You are already having anxiety. So worsening of stress and anxiety are more likely for your symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic . Don't worry, you will be alright, but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has elevated liver enzymes and now has pain in his liver area on his back side. He can feel the pain in the front when you push on his back.  His doctor just took him off his cholesterol medicine thinking that this will lower his enzyme levels. What can cause this? ### REPLY: Hi, Thanks for posting your query. I am . K and I am pleased to assist you. Elevated liver enzymes can occur in a number of different conditions like viral infections, alcoholic liver disease, non-alcoholic fatty liver disease, metabolic liver disease, autoimmune diseases, certain medications and toxins. Yes the medications taken to control cholesterol which is called statins is one of the common cause of elevated liver enzymes. His doctor did the right thing by stopping it. But tests should also be done to rule out the above-mentioned causes. I hope that answers your question. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 31 year old female. Since last 6 months I am having following issue:1. Pain in right knee. Consulted an orthopaedician who on examination and x-ray diagnosed some problem in patella and advised for few exercises & rest plus given medicine (Diacerein tablet). This is showing improvement. What is your advice on this?2. Also, since last 1 month having severe back pain with unbearable pain. On X-ray of back, doctor said that backbone is very week. Have started taking vitamin and calcium tablets and injections. And also going for physiotherapy from last 10 days but there seems to be absolute no sign of improvement. Kindly advise what might be the issue and any alternative treatment because the pain is not coming down. Thank You.Regards,Rachana Aggarwal ### REPLY: Dear Rachael I, your knee problem is called as patella femoral arthritis, and at your stage taking exercise is more important than Diocesan(This . Now at 31 years, it does not fit that you have such severe osteoporosis that it has started causing severe pain, let me tell you its fracture due to osteoporosis that causes pain not the osteoporosis, and since you say your pain is severe, I would recommend you to consult a spine specialist, maybe you are having other problems which needs correction. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is having a course of interferon for Hep C. He has a platelet count of only 60, so he cant have a liver biopsy. he has severe cirrhosis but relitavely good liver function, considering the condition of his liver. What is the danger if his platelet count drops further? could this be potentially deadly?  What other risks are involved? ### REPLY: Hi, This is serious disease and quitting alcohol is the most important thing that should be done. Also, medications which are hematologic should be avoided. This is necessary to prevent disease progression which is lethal in most cases. At early stages it can be treated with these measures but in case of progression, only liver transplantation may help. Diet should be balanced and healthy and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had  acid reflux for almost six weeks which was made worse by steroids 4 weeks ago. I have been treated for urti with lots of antibiotics. Then one doctor said i actually was suffering from an allergy. I have a post nasal drip also but not sure if from acid reflux. Been on nexium last month hasnt really worked. Now have constant pain in sternum area I think you call it. Have lost 9 kilos in this time frame. Booked for endoscopy in one week but am worried it wont find cause. Im worried I will never feel well again..... ### REPLY: Thanks for your question on . I can understand your concern. Possibility 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 central chest pain. Along with .  1. Avoid stress and tension. 2. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. 3. Go for walking after meals. 4. Keep 2 - 3 pillows under head in the bed to prevent reflux. 5. Quit smoking and alcohol if you have these habits. 6. Lose weight if you are obese. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i am a 32 year old female. i noticed some red discoloured patches all over my breasts and upper back last week. i dont know how long it has been there but since i was just recovering from typhoid , I assumed it was a reaction to the drugs. the patches are still there and am getting worried. sometimes i also experience a tingling in my breasts and nipples. Could it be cancer? ### REPLY: Hello and welcome to ChatDoctorTyphoid is associated with faint red colored patches called rose spots. They are 2-4 mm in diameter. They occur in groups of 5-10 and are seen on days 7-12 after getting the infection. They occur as a result of bacteria being carried to the skin. These spots are common on lower chest and upper abdomen. It is difficult to tell whether it is a side effect of .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 baby is two n half month old..my breast feed is very low and I have to give formula milk to fulfill her requirement.bt I dont know how much quantity should be given to my baby in each feed and its preparation bcoz as direction on pronan ...feed seems concentrated ### REPLY: Let me emphasize on the fact that the breast milk is the best possible feed for your baby. As the production of breast milk depends on the sucking of the baby which in turn depends on the babies hunger, if you give top feeds, the hunger comes down and so does the amount of breast milk produced. If you give NAN Pro 1, it is to be given as per the demand of the baby. Typically, babies of this age take around 4 ounces of feed 6-8 times a day, but the amount can vary from baby to baby. It is to be prepared by mixing one scoopful of formula in one ounce of lukewarm water to reach proper concentration. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 karlie. I know this is premature to think about but i have a question. I want to be a bone marrow Donor when im of age. What exactly is the age for that? Also, what are the key things I need to know about when it comes to the donating process? Thanks. ### REPLY: Hi, Thanks for writing in. Voluntary bone marrow donation is an appreciable act and good to know that you are a willing donor for patients who are sick and in need. You need to ab an adult above 18 years in most countries and in good health. A small blood sample will be taken from you to determine your tissue type. This information is kept on the register of voluntary bone marrow donors. Should their be a requirement from a matching recipient then you will be informed about the need. The commonest procedure is peripheral blood stem cell donation. For this you might receive injections for 4 days to increase the circulating stem cells in your blood. On day 5 blood will be .  This process takes place in the hospital and might take 3 to 5 hours and might be repeated the following day if required. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, how can I know if I have a air bubble in my heart or lung? I just felt a sharp and fast pain under my left breast. It felt like  a bubble was going through. I got a bit sick from a stomach and felt like fainting but I dont know if it was caused by the pain or me getting scared. what could it be? Thanks for any advice... ### REPLY: Thanks for your question on . I can understand your concern. Possibility of gaseous distention of stomach and related air bubble is more likely. But better to get done ECG and chest x-ray first. If both these are normal then no need to worry about heart or lung related diseases. Take pantoprazole and levosulperide combination on empty stomach twice daily. Avoid hot and spicy food. Avoid junk food. Avoid stress and tension, be relaxed and calm. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i got my semens anaylysis test report.... Total sperms count 53million 1% sperms actively motile 2%sperms sluggish motile 97%sperms non motile 20%sperms are abnormal RBCS....nill WBCs....15-20/HPF Epithellal.....nill 1 want to know how to active dead sperms and how much time it ll take....i totally vegeterian....never take any type of drugs...... ### REPLY: Hello, Welcome to , I am , Firstly, Sperm count is within normal limit (normal is > 20 millions /ml as per WHO 1999).  Motility is very much low (normal is > 50% as per WHO1999).  Pus cells are very much increased. It indicates an ongoing lower urinary tract infection.  For having back the normal condition, you have to take antibiotics.  Consult with an infertility specialist/ general physician for prescribing ciprofloxacin group of .  After completing the course of antibiotic you have to repeat the test again.  Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After taking my medication regularly doing all that I should I had two unexplained breakthrough seizures what could have caused these? It is very frustrating because I have done everything I have been expected and yet out of nowhere not one but two seizures happened in one day! I take a beta blocker and have had palpitations I was wondering if it could have anything to do with my heart triggering the seizures? ### REPLY: HIT hank for asking to ChatDoctorNo this is may not be due to the beta blocker or due to the heart palpitation certain condition are there, which could be the likely cause of your seizures late onset of Grand mal seizure is one of them, you have nor mentioned your age and gender, and it was required here to discus certain condition which are highly related with this information, I hope you could understand this have nice 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: my child is always saying that she feels hot inside like shes burning up we have to keep the house really cool for her and if shes outside to long she gets really overheated what could cause this 5 1 11yrs old 105lbs two sinus surgerys 1@5 and 1@ 7yrs, viral meningitis at 8yrs old ### REPLY: Hi... Thank you for consulting in . The symptoms you quote don't fit into any known clinical disorder.  A far-fetched possibility is a gastroesophageal reflux. Keeping in mind the age and gender of the kid, I feel you should consider hyperventilation and other conversion reaction like symptoms. But I reiterate the fact that this is a diagnosis of exclusion after ruling out all other physical diagnoses. I am considering this diagnosis as the symptoms you quote do not fit perfectly into any known clinical syn .  I suggest you see your pediatrician. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my nepheu is being emotionally and phisically abused by his girlfriend and mother of his 11 month old son. She has kept him away from the people who love him see what she is doing to him. What can I do to help him?The latest thing that happened was, she was arrested for leaving her 4 year old daughter and baby in the car at night in the parking lot at wal mart to go inside to get a money gram. He put his bank account in the hole to bale her out and then acouple days later she posts on facebook that she bought her children wonderful birthday presents and their dead beat dads did not get them anything. He is the one who takes care of that baby. he is the only one with a job, he makes sure they are fed and have a roof over thier heads. he has been late for work to the point of getting written up because when its time to go to work she is not there to take the baby and he has to scramble to find someone in the family to take him. she has phisically attacked him, cheeted on him, and left him with the baby for two weeks while she traveled to another state. he is a very inteligent person why cant he see that she is not good for him or the baby? other family members have said things to him about the way she treats them and have been kept from seeing the baby by the mother. What can I do to help him understand he needs to get out of that relationship? ### REPLY: HelloThanks for using  for posting your query. I have gone through your query and I can understand what you are going through.It's a social issue and it can have different perspectives. He is your nephew and hence you will feel bad for him, but you should be ready to hear the other side as well. Your nephew is a grown-up and can take his own decisions. He has decided d to stay back and that could be for a reason.They should meet a marriage counselor. Thanks and regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been in and out of hospital with my belly swollen, in a lot of pain, bloods have always came back clear, I suffuse a lot of water infections, and when I have had ultra sound scans and X-rays they have seen a shadow over my blader but failed to find out what s wrong with me, can you help? YYYY@YYYY ### REPLY: Hi Natasha, Looks like you are suffering from a sensitive intestine.  Worthwhile discussing your sonography report with your physician and understanding it. If there was an abnormal swelling/shadow in stomach you may need a cat scan to rule it out. Also, worthwhile getting a stool examination done if you have recurrent diarrhea.  Can upload your reports to see what is happening. Hope this answers your query. Wish you a speedy recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m getting a sharp pain that runs along my left ring finger. It started last night and kept me from sleeping.It has continued at random times today returning every so often.There are no stings or bite marks so I m assuming it s internal, maybe nerve? Any thoughts? Thanks,Eddy. ### REPLY: Hello Eddy, I am sorry to hear about the discomfort you are suffering from. The sharp pain from which you are suffering is probably due to irritation of a digital nerve. You should definitely visit a hand surgeon if the symptoms remain the same as there maybe a neuroma or compression of ulnar or median nerve. In case of compression they will perform a decompression surgery or in case of neuroma they will excise it under local anesthesia. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 16 year old daughter is 6 days post surgery (tonsillectomy and adenoidectomy). Needless to say, shes miserable. Barely tolerating swallowing water, but Ive noticed a bright red flush to her cheek(s) depending on what side shes sleeping on. Is this normal or could it be sign of infection? Thank you. ### REPLY: Hello, Welcome to  .com, and thanks for sharing your concern with us. As you mentioned that these red flushes are dependent on which side she's sleeping on so Such red flush are just contact reaction due to sleeping position which is not of much clinical significance and will resolve on its own. If any fever, pain, swelling, warmth around area develops then contact your healthcare providers. I wish you good health. Best . OMAR ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 23 5 ft 7 and around 9 stone I have been suffering from stomach problems for around 6 months, in those 6 months my stomache has been in a lot of discomfort, I have been havin at least 4 bowel movements a day which i didnt have before the onset of stomach discomfort. my bowel movements are ever so slightly yellow in colour and feel kind of sticky. I also  get a burning sensation throughout my whole digestive system.my stomache is always bloated. In the 6 months I have had this I have had 3 bad outbursts where I was paralysed by the pain and my stomach swelled to the point where i looked at least 6 months pregnant. I am to and from the doctors and given a different diagnosis each time-gall stones, stomache flu, IBS ect. None of which I am satisfied are the answer and im constantly dreading the next outburst. I dont have a history of any kind of stomache problems. Help! ### REPLY: Hi ! Good evening. I am  answering your query. The first advice from me to you is to stop eating from outside completely if you do specially the fried, oily and fast food. This might be causing recurrent intestinal infection because of poor cooking hygiene. Apart from the hygiene, some food components specially in the fast food from outside may induce sensitivity to the intestinal mucosa, leading to all your symptoms which you just described. This sensitivity could be due to anything like a lactose sensitivity, and gluten sensitivity, the incidence of these disorders being underestimated in most of the places. Once intestinal infection is excluded, sensitivity to a particular component of the food can be diagnosed by gradual exclusion of that particular component from your diet. This can be well controlled by a qualified dietician and the moment that particular component is excluded, the person start feeling far better.Thus, the treatment varies from one to the other. There has to be a high index of suspicion of these not very uncommon pathology. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have been trying to have a baby for last 9 months but no result. i used to take b.control pills. i have been to my doctor n done some tests which says that i have an enlarged uterus and ovary [14.3 in size]. my doc says that the reports are normal n prescribed me Letrol and to visit her after 4 months. its been so long im really anxious.. have done my husbands tests, everything seems normal with him too. im 32 years old. Guide me please ### REPLY: Hello, Thanks for the query to . Forum. In my opinion, since you are trying to conceive 9 months with no success. Now your gynecologist prescribed Petrol i.e. female. This is used to stimulate ovulation in female. In my opinion get in follicle study and ovulation study. So consult one more gynecologist and get his opinion. Ultrasound study will be helpful in such type of cases. But mind it continue Petrol as prescribed by your treating doctor. Good luck.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had pain in the clavical , chest, and very painful biceps that will NOT go away. A shoulder X-Ray was normal no further action - so was told I had Frozen shoulder - end of story - take pain killers- could last 3 years. I am in agony morning noon and night and can t sleep. I am a musician - unable to play piano or other instruements-- more than anything I conduct mass choir (300 in number and need both arms) . My life seems to have come to an end. I am 74 - and lead a very active life. ### REPLY: Hi, The location and movement of a pain gives clues as to what is going on. Frozen shoulder is a pretty simple straightforward condition: the area gets scarred if there is inflammation and lack of moving it. Mild cases are FIXED by physical therapy and maybe some aspirin like .  More serious cases need surgery first. This is going to be limited by pain. Steroid injection can fix it enough to start the physical therapy. It's a bit of a balance between moving the shoulder enough to free it and moving it so much as to injure it BUT, it takes a LOT to injure it. Piano, pretty okay, Trombone or cello, not so good. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my dad is 49 years old and is mildly active. hes recieving chest pain that are deep, aching throbbing pain for about four days and no injury to cause it. its getting worse and hes getting back pain, shortness of breath, a cough, his voice is hoarse, and he is having trouble swallowing and so far nothing has happened to him before. ### REPLY: Hi thanks for contacting ... According to history your father can have respiratory lung infection along with laryngitis ... Consult physician for examination.... Posterior pharynx also needs to be examined. Chest x-ray done ... If needed spirometry also done ... If evidence of bronchoconstriction by investigation bronchodilator can be given . If seems lower resp infection then antibiotic given ... If needed short term steroid can be given... Steam inhalation can be useful.... . ... Avoid smoking... 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 boy is 6yrs and 5months and he has what is called shark teeth on the lower jaw, but he is been telling me that his upper front tooth is hurting and when I looked there seems to be a bump kind of redish in color on his upper gront gum. is that another tootChatDoctoring or or what? ### REPLY: Hello, Thanks for consulting , Read your query, as your son has reddish bump on upper front gum and upper front gum is hurting don't worry it can be due to eruption of permanent tooth may be there is eruption bulge is there, I will suggest you to consult periodontist and go for examination of reddish bump on gum and irregular eruption of teeth. Advise him to do warm saline rinses that will help him. 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: I have a small red square spot on my arm. It doesn t itch, it doesn t hurt. I have no symptoms that I can tell. It s been there for over a week so far. It started out as a red circle though when I first noticed it. I thought it was going away when it started turning into a square and looks like dry skin but still red. Still no pain or itching. But having muscle pains on and off sparatically. ### REPLY: Hello, Causes of muscle pain are:-Injury-Blunt trauma-Sprain or strain-Cervical Spondylosis-Spine-related problems-Improper posterior that, I would like to advise you the following:-You can take the tablet diclofenac. -Apply diclofenac gel or cream. -Apply ice locally. -Do x-ray and MRI back and hip region. -Treatment mainly depends upon underlying conditions. Kindly follow with detailed history or consult with orthopedics. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Dr. Jain,I suffered an ectopic in 2006 and subsequently underwent and right salpingectomy. I recently got married and I went to see a gynaecologist as I was beginning to experience excruciating pain during my menstrual period. He therefore did a biopsy which was fine and suggested I get pregnant in the near future. My gynaecologist put me on Primolut. A day after I started spotting. I went back to him and he has now prescribed Primolut N. I am not sure why I am spotting...and he has not explained that. What are these drugs for? He seems to be treating me but i am not sure what for and how it works. Can you help?ThanksTamara ### REPLY: Hi there,Pain during menstrual period could be due to a condition called endometriosis. It can't be diagnosed with a biopsy, you may require a laparoscopy to know exactly what is the cause of this pain, especially if it persists. The primal is a progesterone hormone tablet and may help with spotting, but again you need to know the cause of spotting. As long as you are taking the primal you will not get pregnant. Its best that you get evaluated thoroughly with a laparoscopy and hysteroscopy which will give a cause for the spotting and pain that you have. 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: Hi, I am married for 1 year and 6 months now, trying to conceive but not sucessful yet. I underwent few tests and they were all normal. Now am advised to have Fertyl 50mg from 3rd to 7th day of my menstrual cycle. I want to know the reason why i cud not conceive still and will fertyl be helpful. I want to conceive as early as possible. Kindly advise. ### REPLY: Hi, The reasons for delay in conception could be many. The timing of intercourse should correlate with ovulation, ovulation should be normal, tubes should be patent, uterine factor, cervical factor should be favorable, there should be normal male factor and so on. Ferry is given to induce ovulation when natural ovulation fails or is low and irregular. Even with natural ovulation, induction will help enhance the process. Please follow your doctors instructions and have a complete evaluation for speedy and good result. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I normally suffer from Bronchitis when I get sick. But being a single mom, I don t have time for myself, I take regular medicine, haven t gone to a doctor in 5 years, I do not smoke cigarets. I have been feeling tired, my chest feels like it has fluid, when I cough I have lots of flem, & reeently I feel like their is something on my throat that s stuck there ### REPLY: Thanks for your question on . I can understand your concern. You probably had an infection which has worsened your bronchitis. Get a chest x-ray done to rule out infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, you will be alright. 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 Doctor, i m 30 years old,single. i have habit of masterbation. i do masterbation 2-3 times a day. it effects me a lot. it make me weak, my mind is weak. i m sw engineer. this habit of mine effecting not only my personal life but professonal life also. i do masterbation when i go to bed either in night of any time. and when i go to bed i can not resist myself from doing this. i do yoga . i want to get rid of this habit any psychatrist could help. i know and heard from many people and doctors on net that this habit is natural but this habit is spoiling me. so i want to get rid of this habit. my mail id is YYYY@YYYY . Regards Surjit ### REPLY: Dear surjitWhen ever any habit crosses the limit it calls for check or treatment. As you know from forum as to what is natural but when an individual feels upset over it we recommend it to be checked. Yoga will take care of body and if you start meditation then you will develop control over mind and can govern to stop it even without medication. If it appears difficult then have Cap. Ashwagandha, and get shirt Dhaka. Start reading some holy book while going to bed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Would early pregnancy make me get drunk quicker? I m not sure if I am pregnant. I have a doctor appointment tomorrow, but would like to know if its a possibility. I have also been feeling really sick and completely tired all the time. Along with constant headaches and dizziness . I have also had a small increase in my appetite . ### REPLY: Hi, It is always advisable to avoid the alcohol, coffee and related .  If you are not sure about your pregnancy, you can make it sure by urine test through the kits available over the counter at medical shop. It has very simple method. The kit can only be done after 6-7 days of unsafe sex. The feeling off tiredness and sick may be due to another causes for which you need to visit your physician. For constant headache and dizziness, you can take the pills available over the counter and increase in appetite can be due to winter season or pregnancy. Pregnancy can be rolled out by pregnancy testing kit.  Take care and all the best for the test. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 forehead above my right eyebrow, also my eyebrow and a bit under my eyebrow/brow bone is very sore to touch and hurts constantly when not touching. It throbs. No bruise present. No impact to the area. headache aswell. Feels like bad bruise, tender bone. No bruise visible. Been like this for 2 days... ### REPLY: Hi. Can understand your concern. As per your query about pain in your forehead near eyebrows can be due to sinusitis especially in relation to your frontal bone space. It may have been gotten aggravated due to cold weather, or you may have taken cold . Sinus of the face and head gets infected in sinusitis. If you feel you are having cough and cold also it may be due to this. To confirm the condition you should go for X-ray head or frontal bone. If it is there you need to take antibiotics for that like amoxicillin. Till then, you need to do steam inhalation with a Picks lozenge in it to open the sinus spaces. I hope the information helps you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my daughter aged 36 has just had a mammagram & ultra sound which showed no problems, she then had a biopsy as she has quite a large swollen lymph node under her armpit, it has been there 2/3 mths she was given antibiotics a month ago but did not help. My daughter says that it throbs sometimes and she is feeling not well. She has breast implants (behind the muscle) three yrs ago. Recently she has been taking amphetamines (prescribed slimming pills) could they have anything to do with the lymph node? She is beside herself as my grandmother died of lymphatic leukemia. Also what percentage of biopsies show positive for cancer? Would appreciate an honest straightforward answer, (I m sure you do anyway) thanking you in advance, from mum who loves her daughter from the bottom of my heart regards M ### REPLY: Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion your concern is valid, the lymph nodes are usually either due to infection or as times due to malignancy, and breast and lymph carcinomas are one of the main causes, the best way out is to remove one node and get a biopsy done to clear all doubts. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. Special note-Any medication prescribed needs to be taken after consultation with your personal doctor only. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doc am frank from kenya n have skin problem entailing pimples n dry skin with rashes all over my face i previously was using xraderm hoping for a solution but its stopage further worsened my face a hv been told to try sapat lotion but am far much afraid of the results please doc help me regain my self-esteem please doc n a matter of consern is that i dont have a credit card to pay for your services ### REPLY: Hi, FrankThanks for your query. It seems you have been applying traders cream which contains a steroid, antifungal and antibacterial agent. It is not indicated for pimples or .  You have not mentioned the duration for which you have applied traders. Any ways it is good that you have stopped using it. Don't be depressed and lose your self-esteem, this is a very common condition we come across almost daily. Your face will be better with treatment. You may follow these general measures:-Use a mild cleanser for face. -Get your black heads and white heads extracted on regular basis.-Use a clindamycin and benzoyl peroxide combination cream on pimples at night. -Use a comedogenic moisturizer for  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im 52 years old about 2 weeks ago some spots came up ontop my left foot no ich,1 week ago spots moved to right foot and still on left,,i have out ringworm ,creams foot creams hydracodone creams on them,no help still no itch,,just small spots some look like scabing,,now its on my legs and i have been running fever and sick at stomach,went to doc they said not flu,dont know what spots are ,can you help ### REPLY: Hi thanks for asking question in . Here infection mostly seems to be tine alike fungal infection. Wear clean cotton cloths. Clean affected area with warm water and soap and . Especially clean the area between skin folds and between toes. Change slacks daily. Clean towel used. Apply clotrimazole containing cream over affected area. Itraconazole tablet can be used. I hope this will mostly help you.Don't worry... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have problem before 12 day ago with swelling left Parodist gland first 8 day pain full now no pain , swelling bit of but am have swelling wen am eating after 4 min eating again swelling going of bit my blood test look like viral infection am on antibiotic thanks and sorry for my pore English ### REPLY: Thanks for your query, I have gone through your query. As far as your problem is concerned regarding the parotid gland swelling, I have two possibilities. The first cause can be a sloth or a stone in the salivary gland or a duct that will cause obstruction to salivary flow and results in swelling. It occurs when the stimulus like food or any smell of food taken. The other cause can be secondary to bacterial or viral infection called sialadinitis. If I am your treating doctor, I would have suggested you to get a biography done to rule out these two conditions. If I am your treating doctor, I would have suggested you take an antibiotics like amoxicillin 500 mg and metronidazole 400 mg TID for 5 days (if you are not allergic) and after that you can get the stone removed by surgery if it is diagnosed as smallish. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir/Madam I am suffering from Sevier back pain while 1, bending down2, long time sitting (my nature of work is long time sitting)3, lifting the lug4, jogging5, bending to wear clothes and shoesAnd I am gaining weight in normal diet, before 2 year 62 kg and now 78 kg, because of back pain I cannot do any exercise.As per my medical report doctor suggested me for surgery. I want to know whether I can avoid it Previous treatment details and MRI report are enclosed here with it. But  after all these treatment I am having the back pain as Sevier as before. Thanks ,Jestin AbrahamKannur, Kerala ### REPLY: Dear patient from all your complaints I think you're suffering from spinal instability with mechanical backache. I cannot find your MRI report. There are many ways of treating back pain, but I should be aware of your MRI report. Also, kindly get radiograph of lumbosacral spine anteroposterior and lateral views. You are putting on weight which also increase stress on your spine and increases back pain. So try to control weight and reducing weight will lead to back pain relief.I cannot comment on need of surgery unless I see your MRI report., so please send it, so I can plan your treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, my wife gets Fatty liver grade I, how she can get normal liver in shape( i get to know after altra sound).can you suggest some medicine and prescribe a diet chart with considering my monthly income is very moderate. thanks & regards. jagat YYYY@YYYY . ### REPLY: HelloFatty liver may be due to many causes like obesity, hepatitis,alcoholism, metabolic disorder etc. She may need few more investigations like routine hologram, random blood sugar, lipid profile, liver function test, urine RE/ME. Fatty liver often get reverse with treatment of underlying cause. She may need few medicines after complete investigations. She should avoid saturated fat and go for brisk walk regularly. Take a lot of fruits and vegetables in diet. She should also try to reduce her weight if she is overweight. 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 dad is 72 and had a heart transplant 13 years ago, the anti rejection drugs have destroyed his kidneys, he now suffers with cronic kidney failure his kidneys are only working at 8%. he is due to start dialyse in a couple of weeks, he has and a fiscula set up. at the moment he has a urine infection and is in a lot of pain. he has had this for 3 weeks. is this the normal for people with kidney failure? ### REPLY: HelloThanks for the query It looks like you father is suffering from a urinary tract infection which is common in elderly men and not particularly in people with kidney failure. He needs to be treated with anti bionics like levofloxacin for a period of 7 days, or he can also be treated if the urine culture has grown an organism based on the anti biog ram picture. General condition tends to improve after one goes on dialysis as the uremic toxins are removed from the system during dialysis wish you dad good health and a speedy recoveryRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went to er Friday night for severe lower back pain. They did a ct scan and it was normal. They said it was probably a muscle strain and gave me pain meds and muscle relaxer. It s been 2 days and I m still in pretty severe pain. I can t walk, sit down, stand up, sit up from laying without a lot of help. The pain radiates into my hips,legs and sometimes groin area. I can t reach far with my arms without causing pain in my back. I can t move my legs very much without pain, I can t even wipe myself when going to the bathroom. The only relief I get is slightly reclining in a reclining chair and thats still painful. Should I go to my primary doctor tomorrow or give it a few more days? ### REPLY: Hi, You said you underwent a CT scan, and it is normal. Then it will be literally a muscle spasm. By meeting up a physical therapist he will help you a lot. Ask for a Therapeutic Ultrasound therapy and TENS for the pain. It will help you reduce the spasm and pain as well. Doing a little of core stability exercises will surely help and make your core stronger to avoid any aches and pain in the future. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 newly diagnosed diabetic 53 yr old female. First abnormal ekg. Sinus rhythm old anteroseptal infarction. How concerned should I be. No history of heart disease. Have high cholesterol, controlled on meds, but still have high triglycerides. Blood pressure usually normal, but bottom number slightly elevated this appt ### REPLY: Hello, There, being a diabetic predisposes you to atherosclerotic heart disease. And to add to this, diabetics are more likely to have no symptoms or even have atypical symptoms of heart disease due to diabetic neuropathy.  The ECG finding of anteromedial wall ischemia proves that a blood vessel in the heart had been having low levels of oxygen most likely due to cholesterol build up in its walls.  Also having high cholesterol levels adds up to the risk of heart disease. Therefore, all of your risk factors should be controlled in order to have an optimal heart health.  Proper control of blood sugar and cholesterol is paramount, and heart medications should be taken in order to prevent a heart attack.  And I would recommend a consult with a Doctor or a specialist for proper treatment. Hope I have answered your query. Let me know if I can assist you further. Take care .  Dion, 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: Hello, my wife is 8month pregnant and she is having worse tooth pain due to cavity. the tooth should be extracted or been root canalized. I need to know that is their any harm of using local anesthetics for tooth extraction???? if it is harm then is their any other way for tooth extraction? Please answer my question in detail. ### REPLY: Hi heartland for the query first of all if your dentist has given you option for root canal therapy or extraction then always go for root canal therapy as its more important to save the tooth rather than losing your tooth forever. Tooth loss at your age might create functional loss i.e. difficulty in chewing etc. moreover each tooth is as important as any other body part. Now your scenario is little different as you are a 8TH month pregnant, try to postpone it till your delivery. Moreover any of the dental procedure which involves local anesthesia or strong medication (root canal therapy/ extraction)is only done in 2nd TRIMESTER of pregnancy as that is the safe period. Some dentists do take risk but it might or might not affect the baby but Why to take risk. You can take safe medicineRXTAB AMPICILLIN 250 MG - BDT AB PARACETAMOL - BD TWICE DAILY FOR 5 DAYS after good meals only. Rinse your mouth with warm saline rinses 3-4 times a day (half cup of Luke warm water + half tbs of salt to it).in case pain still persists, visit a dentist and get a pulp caping or pulpotOMY in single sitting to avoid exertion of treatment under mild anesthesia WITHOUT ANY STRONG MEDICATION, and complete the root canal procedure post delivery.thanxregards and good luck for new arrival in family. Take care and. GOD BLESS. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Dr. Mia Lundi, Im new bee of using contraceptive. and i m taking althea pills . How can i use althea for emergency contraceptive. We had a unprotected sex last 28hrs ago. Can you please help me? I take 1 active pill 8hrs ago. When is my nex take of active pill and how many? Please i m too nervous right now. Thanks, Dr. ### REPLY: I have a lot more experience with leavonorgestrel or norgestrel birth control pills. However, the same principle holds with Althea as a morning-after pill. I would suggest 4 pills now and 4 pills in 12 hours. You can then take the rest of the pack as usual one pill per day. But it is not necessary for the emergency contraceptive effect only for ongoing contraception. Emergency contraception may work as long as five days out. It is not however Hun .  If you miss your period entirely you need to do a pregnancy test. Another alternative would be to make an appointment at the clinic and have a Arena IUD inserted. Using oral contraception as emergency contraception has the disadvantage of causing nausea because of the high dose of estrogen. Also, it would not be advised if you have high blood pressure. I hope everything works out for you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,i m 34, and detected with low sperm count. not too low 20 million. further i also have been  dettected with vericocele. i want to go for IUI. but before starting treatment of iui my doctor  has  adviced to take vdm-kit for myself and wife.should i consider it. will it have any side effect. ### REPLY: You can take VDM kit as it clears any underlying infection before GUI and leads to higher chance of successful pregnancy. Side effect are uncommon. I am giving a list of side effects it can cause but don't panic its very rare Abdominal pain, Abnormal liver function tests, Agranulocytosis, Alopecia, Anaphylaxis, Angioneurotic edema, Arrhythmias, Homeostatic jaundice, Confusion, Constipation, Convulsions, Darkening of urine, Deafness, Depression, Diarrhea, Dizziness, . I. Upset, Glossies, Headache, Hepatitis, Hepatotoxicity, Hypersensitivity, Hypokalemia, Insomnia, Leukemia, Liver damage, Metallic taste, Nausea/vomiting, Neutropenia, Nightmares, Peripheral neuropathy, Pruritic, Psychosis, Rash, Skin rashes, Stevens-johnsons syn ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi. when i was about 7 years old my neck began to click. after awhile i realized that i could click it whenever i wanted. then when i was 10 my mum was rubbing my sore neck and  found i had 3 lumps on my neck under the skin.they were as hard as hard marbles. they did go away but i keep asking... why did i have those lumps on my neck? ### REPLY: Hi. Thanks for your query. Noted your history of clicking in the neck on movement and found out the 3 hard lumps which ultimately disappeared. You have had 2 different issues. 1. The clicking sound is due to the rubbing between the inter-vertebral joints. 2. The hard marble like swelling which go ways must have been lymph nodes and not related to the clicking. Since they are gone, nothing can be investigated now. Would have been due to some scalp infection. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 almost 3 year old daughter is sick, she s clammy and has a bad cough with phlegm that she can t seem to cough up/spit out. She was a preemie weighing barely 2lbs, I ve heard respiratory infections are a huge cause for preemie hospitalization...but my question is, since she s passed the 2 year mark, does that still apply to her or can I wait till the morning to see her doctor? ### REPLY: Thanks for your question on . I can understand your concern. Yes, you are right. Your child was having low birth weight at the time of birth. These child .  And this kind of risk is there until age of 5-6 years. Her current symptoms are more suggestive of lung infection. So better not to wait at home and consult pediatrician immediately. She will need chest x-ray and blood reports for infection. She might need higher antibiotic and other supportive  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently started having a rash. Red, slight burn, not really a lot of itching. It comes and goes. On my chest, arms, legs, top of feet. Not eating or doing anything new. However, I have been suffering with sinus issues. Rash appeared before I took any medication. ### REPLY: Hi, I feel that you suffer from allergic urticaria. Consult the dermatologist for the perfect diagnosis and proper treatment.  There may be some allergens responsible for the disease. Sinusitis is also due to allergy. Trial and error method may be done to find out allergen. Those may be some dietary factors like dairy products, seafood eggs, cows milk, soy protein, banana, fermented food or some contact ants like perfume, grass, pollen, wool, dust, soap, insects, etc. Tab. Fexofenadine thrice a day will alleviate your ailments. Apply soothing lotion like calamine lotion. If needed, the oral steroid in a tapering dose may be taken after visiting your doctor. 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: Dear Sir, My wife is very arogant, Becomes angry every times and when she is angry she can do anything, she can pluk her hairs, beat me, my daughter, beat the mate servant, tells slangs, beat her mother even tries to suiside also... But when she is good (which is a rare situation) or if somebody outsider meets her cant understand anything.. she is a housewife , not much educated, she have a brother who is a brilliant student. Her parents always campares her with her brother and made her feel bad about that. After we got married, mu mother also reacted badly with her and didnt try to fulfill the place of her mother. we are basically from West Bengal but stay at bangalore..I took her once to the mental doctor, but there she acted like she is very normal as I tols you earlier. Doctor have asked for family therapy. What happens in this family therapy? Is this curable? How can I get my wife back and lead a good life??? I want to visit you also if required...Please help me.... ### REPLY: Hello; thanks for the query & I feel sorry to hear your state of plight. Based on your description; your wife seems to have some set of personality disorder (PD) most probably cluster B (emotionally unstable, borderline type). PD per se not an illness cured by medications but a form of extreme behavior defying societal norms, causing distress & dysfunction for patient himself/herself & family members. PD is usually treated by talk therapies known as cognitive behavior therapy (CBT). Additionally, considering that your wife has endured a lot of adverse conditions at her parental home & with mother-in-law; family therapy (FT) was advised to you. FT is also a talk therapy; where a set of desirable & undesirable behaviors; contingencies for family members; behavior modifications etc. are suggested. Additionally, if your wife is suffering from mental health problem like depression; that too can be diagnosed & treated. Since you live at Bangalore; you can visit SIMIANS Bangalore for all these therapies or revert to me for further help. Good Luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend has a lump in her thigh on the backside. It is not on the surface. It is at least the size of a walnut. She discovered this when she lost a significant amount of weight and was able to feel it more easily. She says it does not hurt. Any ideas? ### REPLY: Hi.noted history of non-painful lump on the patients posterior thigh. It may be a case of lipoma (fatty deposit), fibrous (fibrous tissue formation) or a cystic formation. Other lesion types such as malignancy must also be ruled-out. It is best if you bring your friend to a doctor, preferably a general surgeon, especially if the lesion is bothering her. Diagnostics and management (medical and/or surgical) will be directed accordingly. Definitive management is surgical excision of the lesion with proper antibiotic regimen and daily wound care thereafter. Hope this helps. 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 a 28 year old male, 58, 160 pounds.  Whenever I sneeze there is an immediate, intense, and sharp pain on the left side of my chest that I believe is derived from my heart.  This has been an ongoing problem for many years.  I was on beta blockers for a short time last year to help with heart palpitations, but I quit taking them because I ran out.  I also was taken to the hospital 9 years ago for severe chest pains.  I have a 5 year history of frequent marijuana use, although I have not smoked in 3 months.  I also had a 6 month period of time when I used cocaine heavily, but I have not used cocaine in 4 years.  I was a pack-and-a-half a day smoker for about 6 years, but I have given up cigarettes, as well.  I still dip snuff 5 or 6 times a day. I take hydrocodone for knee and joint pain about twice a week.  I am worried that the sharp chest pains I feel when I sneeze could soon lead to a major health issue.  How can I prevent this pain from reoccurring? ### REPLY: Thanks for your question on . I can understand your concern. Since you are having history of cigarette smoking, Marijuana smoking, snuffing etc., we should definitely look for lung diseases for your symptoms. Chest pain on sneezing can be seen in pleurisy (inflammation of pleura) and pleurisy is commonly due to lung infection and bronchitis. So get done 1. Clinical examination of respiratory system 2. Chest x-ray to rule out lung infection. 3. PUT (pulmonary function test) for the diagnosis of bronchitis. If both these are normal then no need to worry about lung diseases. Sometimes musculoskeletal pain can cause similar kind of pain. So apply warm water pad on affected areas. Avoid movements causing pain. Don't worry, you will be alright. But first rule out lung pathology. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I am concerned about little lumps (i would call it spots inside the skin) in my right labium, I found one earlier this week that sarted swelling up quite a lot and hurt terribly, it was difficult to find a way of sitting down comfortably. Now I found a second one in the same labium further down, a bit smaller, also tender to touch, if that starts swelling like the other one I wont  be able to sit at all. Then i started looking for more, and found one that is where my leg starts already, so away from the genital region at the start of the pubic hair area (loin/lumbar area). I am now really worried and would like to know what that could be, before I go to a doc as it is quite embarrassing. Thanks for your help ### REPLY: Hi, Dear Thanks for the query to  virtual Clinic. I studied your query with available details given in your query. I understood your health concerns. Cause of the painful and swollen lumps on labium-From the facts given in your query, you seem to have-infected hair follicles/Boils, as your story goes by. The lump on the pubic area nearby confirms it being boiled. The chances of it being Carolina Cyst are less in your case because of the weeks' history when the first lump in right labium got bigger and was tender, not allowing you to sit even. So Don't worry.It's not cancerous but is infective lump. This would help you to plan treatment with your doctor, whom you should plan your visit urgently, before it complicates anymore.Don't Self-treat or medicate in your case as the case may go in to further complications. Hope this reply would resolve your query and would help you to plan treatment with your doctor. Hope this would relieve of your health concerns. Welcome for any further query in this regard before final suggestions are given in your query. Wishing you fast recovery. Have a good day. . N. Senior Surgical Specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ive been having binging on food for about a month and a half to 2 months (eating till i wanna throw up, and eating or snacking every hour or 2.) and am already seeing a psychiatrist (for depression, and anxiety) what would be the odds of getting vyvanse to help control my symptoms ### REPLY: Hello user, thanks for contacting  for your health related query. Your symptoms are suggestive of binge-eating disorder and seemingly Vyvanse is prescribed for that only - it contains lisdexamfetamine which is a stimulant class of medicine. Although currently there is limited data for its efficacy, a clinical trial had shown its efficacy in about 50 % of patients taking 50-70 mg/day dose, these patients were those who had quit binging for 4 weeks period, apart from these in many other patients the binge days decreased and the .  Hope I answered your query, if satisfied please rate the answer. Any followup queries are welcome ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 some type of fungus on my finger. It started on my knuckle, looked like ringworm dark round cracking skin then when I thought I cured it, it came back on the inside of the same finger where it bends it started to blister up and cracking where my finger bent. the wound became very painful cause I always use my hands, it had a deep crack for awhile until it healed, then in that area I had scar tissue eventually it gone. Now my tip of my finger is the affected it is very hard, skin tearing and very small bumps(blisters) are on my finger from my knuckle and close to my nail, but that s the only place I have them. tip of finger is tearing cause my skin is cracking and tears when I snag it in something also sore ### REPLY: Hello, thank you for your contact to . If I am your treating doctor I would like to advice you tell you that ring worm cis the cutaneous infection. It never goes deep into the skin. But it may be some other fungal infection. I advise you to go with fluconazole tablet 150 mg once a day for at least for a month under your doctors' guidance. I advise follow-up after a month. If you want to ask me anything you can ask me. Thank you. . Infectious Disease specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife age of 25 yrs. She is suffering with following diseases: 1.) Since last 15 days she is suffering with fever of 102 to 103 regularly. 2.) Also, since last 15 days she is having dry cough but before 15 days that she was having wet cough (not dry). 3.) Also, as per chest sonography report there is right pleural effusion (approx 600ml) ### REPLY: Hello, It seems that your wife has lung infection which could be bacterial or tuberculosis. I would suggest getting a pleural tap done, and examined for gram staining, Ziehl-Neelsen (ZN) staining, and cultural sensitivity for aerobic and anaerobic bacteria and tuberculosis infection. I believe you require taking treatment according. In meanwhile, you must take antibiotics after prescription by your physician. Eat a protein-rich healthy and balanced diet with multivitamins and calcium supplements. 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 doctor,I am trying to get pregnant from past 3 months ..  i was adiviced siphene 100 mg  from Day 3 to day 7 of my periods...and folicle study was done to find the folicle growth and also the folicle was ruptured but still i have not conceived?...Can you please tell me what would be the reason?......This month cyle started 4 days prior to my original date of my periods?....Can you please tell me what would be the reason? ### REPLY: Hello, There are so many reasons of infertility in spite of proper ovulation or follicle rupture. These include progesterone deficiency, uterine & cervical factor, tubal blockage, thyroid deficiency, husband abnormal semen etc. Yes, sphere will help you to bring regular cycle and conceive. You have to regular unprotected sex for 6-12 months close to ovulation day or fertile days to maximize the chance. You can use ovulation prediction kit. Along with, you must take folic acid & vitamin-E supplement with balanced diet. If fails with above treatment, you must consult with infertility specialist to proceed relevant investigation to rule out the exact cause. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes, Thank You. I was diagnosis with ovanian cancer. in 2012 and was cancer free for all this time. Now I find out that it has returned as many tumors. It is a rare type called an yolk sac tumor even rarer because I am 62 years old. Can you explain this to me? ### REPLY: You are right. Yolk sac tumor at your age is quite rare as it mainly affects young women. So first thing you should do is to make sure you have the right diagnosis. If you are showing at a standard cancer center then its alright, else take a second opinion from one. If it indeed is yolk sac tumor, and it has come back, then the best option for you will be to have chemotherapy and then if there is any residual disease after that then to undergo surgery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: well im 31 weeks and 6 days Today(March 11,2010) and my due date is May 7,2010..but im just wondering who could be my baby s daddy the 1st boyfriend or the 2nd boyfriend.me and my first boyfriend been together for 5-6 months but we broke up in the middle of June 2009.we been together(Feb.22-Middle of June)but me and him did unprotected Sex more then 8 times.But after we broke up we didnt see each other for a while.but right after we broke up a month after i didnt have my period...then on August 9 i had unprotected sex with my 2nd boyfriend only 2 times but i already didnt have my period that time because i had my last period before my second boyfriend...plus if my baby s daddy was the 2nd boyfriend wouldnt i be due in the end of May or the Beginning Of June...Who could be the Baby s Daddy? ### REPLY: Hallow Dear, I would have appreciated had you mentioned the date of your last menstrual period. However, the very fact you had your last menstrual period before you had intercourse with your second boyfriend; i.e. after you have separated from the first boyfriend, the chances of first boyfriend being the father of this child are nil. It has to be due to the intercourse which has taken place after you had your last menstrual period. So naturally, your second boyfriend happens to be the responsible person for this pregnancy. However, if you are still in doubt, you may get DNA test done for confirming the paternity. I hope this resolves your confusion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For several months my WBC has steadily risen, from 13.0 to 18.4 , with neutrophils at 13.9 and my iron is at 41 and ferritin at 16  , also showing large platlets. Doctors have been dismissive until now I have been refered to a hematologist at a cancer center. Could it really be cancer?? What could some possibilities be?? ### REPLY: Hello and welcome to , A rise in white blood cell count (ABCs) and associated rise in neutrophils is suggestive of infection especially bacterial infection. Thus, a clinical assessment to look for focus of infection is required. If infection is ruled out, then neoplastic conditions have to be looked for. However, neoplastic condition is associated with very high blood counts so possibility of neoplastic condition is low. Iron level of 41 and ferritin level of 16 is low and thus investigations have to be done to look for the cause of low iron and ferritin. Thus, consult your hematologist for further management. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 20 weeks pregnant. About every other day, I am having what I believe is a gallbladder attack. I spoke to my ob at my last visit and described my symptoms and she said it was my gallbladder. She advised me to take zantac 2x daily and watch my diet. I have been taking the zantac and eating no fat. ### REPLY: Hello and thanks you for your query. I am  and I will try to help you as much as I can with my answer. This is caused by gallbladder stones and may happen in pregnancy as well. You should continue with diet and recommended media and after labor, you should consider gallbladder removal. I hope I have answered you query. If you have any further questions you can contact us. Kindly regards. Wish you a good health. ### END