Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 noticed that by the end of the day my ankles are quite swollen.I mostly sit at a desk, but I also get up and move around during the day as well. I don t just stand on my feet for long periods of time. Also I try to drink at least one bottle of water while at work. It doesn t hurt per se, I was just alarmed when I saw that my ankles were very swollen at the end of the work day. ### REPLY: Hello, Ankle swelling at the end of the day may be due to venous insufficiency of the lower limbs. Other causes are an incipient heart failure, kidney or hepatic causes leading to fluid retention. A simple test like HBO, urinalysis will give some clue. Doppler's study of venous system, both lower limbs may be undertaken. Hope I have answered your query. Let me know if I can assist you further.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i missed my period and took 3 pregnancy tests, whicChatDoctore back positive. a week later my period came with abnormally big clots and white/greyish tissue. i suspect im having a miscarriage. it has been 4 days since i started bleeding and i m still cramping and passing clots. do i need to go to the hospital if i were only 3wks pregnant or will it just pass? ### REPLY: His have gone through your complaints. You are saying you missed your periods, and positive pregnancy test & now passing grayish vaginal discharge with blood clots means its miscarriage only. Its important to consult doctor to assess whether complete abortion has happened or any retained products to evaluate cause for abortion. What is your general status like whether you are anemic, evaluated when you meet .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, yes sir, thanks. I have a past left calf injury (8 yrs) where some tendon popped or attachment tore. Now, from time to time it feels like I am about to c ramp, but it never goes full blown, nor is it ever actually painful. Both the left and right ankle pulses are about the same. I m thinking blood clot but maybe it s just assymmetrical use since I need a right hip. ### REPLY: Hi, From your description you have good blood supply to the lower limbs and even the blood .  It's possible that you have a deep muscle tear of the calf or snapped tendon(plantar is) which is constantly annoying you like cramps and your gait alteration caused by the painful right hip would stress the left limb more. Another possibility is increased pressured to a leg compartment which causes pain when you start activity and gradually builds up forcing you to stop. Your doctor needs to examine you for this. If a compartment problem is not the cause then physical therapy with Ultrasonic massage will help ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i need advice form a neurologist . I had the left lower 3rd molar extracted and dental implant inserted at the same time on 13 March 2013. 7 days later i started getting messeter muscle spasms and pain in L side of face. Dentist removed implant on 26 March 2013 and said it is most likely a dry socket. i can not open my mouth at all now since 24 March and if I try I get the most excrutiating pain in the masseter muscle . I am taking anti-inflammatories, Flagyl antibiotics, muscle relaxents but still no improvement. The muscle is in constant spasm but how can i prevent the acute spasms when trying to open my mouth Kathleen ### REPLY: Hi, Thanks for asking the query, Pain can be because development of .  Take complete course of antibiotic and analgesic . Use saline water gargles 3-4 times daily , use antiseptic mouthwash gargles twice daily this will prevent infection and promote healing. Avoid eating hot and spicy food. Maintain a good oral hygiene. Your Dentist can even clean the socket to remove the debris and place a  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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,I have been subscribed a medicine called Veltam 0.4 . I am 26 years old and after reading the reviews I came to know that it is not for young male since it reduces semen count and there are many other side effects as well. what should I do ? please HelpRegards,Vishy ### REPLY: HelloThanks for query. You have been prescribed Delta 0.4 mg once daily. You have not mentioned the reason for it being prescribed to you.Maybe you are facing problem of pain in abdomen due to stone in ureter. Veltam is alpha blocker that relaxes smooth muscles in bladder neck, prostate and ureter and is generally prescribed for obstructive voiding symptoms, poor urinary stream or to help to pas down the stone in ureter. Since it causes relaxation of bladder neck, during ejaculation it causes semen to enter in bladder instead of moving forward in to urethra what is called as Retrograde Ejaculation. This retrograde ejaculation is the cause for low volume of semen during ejaculation.However, the problem gets resolved after you stop taking it. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother today woke up with a sudden pain in her wrist and the back of her hand. She can barely move it and she s in a lot of pain. The pain begins on the back of her hand and her fingers and moves down to half her forearm. She claims she hasn t been doing any lifting and that the pain started just today; she s 45 years old and has never had any signs of arthritis or any syndrome of that matter. But she has been recently bitten by a wild tick. ### REPLY: Hello I have read your query, Carpal tunnel syn . In carpal tunnel there is edema over tendon at wrist below flexor retinaculum. Due to increased pressure there is compression of median nerve leading to pain and stiffness. You can ask your physiotherapist for therapy for Carpal tunnel. Physiotherapy with ultrasound and Tens will help you, for early healing you can take Tab Colin [it C] and antioxidant with anti-inflammatory [Tab enzymic plus]. Another possibility of cervical disc bulge leading to stiffness in hands. Clinical examination from your doctor will confirm diagnosis. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Sir,I am Popat Jadhav from aurangabad maharashtra (india).I have a child named ajinkya having age 9 years old. he is suffering a problem of autism .At the age of 1 year he have a fits , when fits comes he falls down momentarily . after then we starts treatment and get medicine regurarely ,but there is no big difference in his helth ,he can t speak and can not do his regular activities.Please sugest something. ### REPLY: Hi.... I understand your concern and empathize with your kid your. Your kid has two different problems for which the management is entirely different. First of all seizures should be controlled with anti-epileptic .  I think that it should be complex partial seizure by what you have quoted. The other problem with your kid is having is Autism which is not to be taken lightly, and he should be managed with behavioral therapy and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Shoulder surgery a week later I have a lump in my arm pit that hurts but I dont think its a ingrown hair because its kinda a big lump but wonder if it has anything to do with my shoulder since I havent been able to move my arm and arm pet stays almost kinda moist with out deodorant ### REPLY: Respected user, Warm welcome to .come have evaluated your query in depth.* There seems different conditions possible for such lump as - development of boil througChatDoctorpression effect post-operative - reactionary lymph node enlargement following some procedure - infection at operative site.* Needs check up with ultrasound examination. Always feel free to ask further queries. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: . I am type 2 diabetic and gave my self a shot before bed. Woke up with a blister on my lower stomach right side. Felt it sore in the middle of night. Went in to urgent care and Docter lanced it. He burned my skin. Since than I have returned 3 times. It seemed to be healing but now it is purple around and cheesy looking in the middle. I have been swimming the last cole days. ### REPLY: Hi, Perhaps the skin there has got infected. Central yellowish looking floor and surrounding redness are signs of it. Uncontrolled diabetes predisposes to skin and soft tissue infections. I suggest you to use an OTC topical antibiotic, e.g., either Newsprint Ointment or Mupirocin 2% ointment, twice daily for a few days.  In addition, I suggest you to take an oral antibiotic e.g., either Amoxicillin or Cephalexin, thrice daily for a week.  Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my appendix out in march, beacuse i had pain in my right hand side they wernt sure if it was my appendix or not so they had a look inside but could not find anything else so they took my appendix out now since having the operation i still get pain in my right hand side the doctor told me it will just be scaring but the last few weeks the pain has got alot worse, i feel sick, pain in the right hand side, pain up the side of my right side of my back, high temperature, hurts when i go for a wee just at that side of tummy, going for a wee more than noraml. I have been signed of sick now for three weeks! I have had lots of tests done, eg blood tests, urine samples, ultra soundscans, internal examination but found nothing! any ideas???? I have seen a gynecologist at the hospital and they did an internal and found nothing but now the doctors are sending me back to them ### REPLY: Hi. Thanks for your query. I can understand the plight you must be going through as you are having pains in spite of the surgery for looking inside, which was normal, and they removed the appendix. The symptoms of potential appendicitis are : Pain starts in the upper abdomen and shifts to the right power qua .  Your problem looks to be related to IBS: Get remaining tests of CT scan of the abdomen and Colonoscopy to rule out other diseases. If all the investigations are normal, this is a case of IBS- Irritable Bowel 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, ive smoked Cannabis for now 2 year, i realised that ive smoked alot so i decided to quit. And for now a month, i spite everyday, black stuff. I dont know if its kinda TAR or beceaus i have lung cancer. And i would like to know how to Clean , if possible, my lung from it. ( the black things, are like little black particules ) ### REPLY: Thanks for your question on . In my opinion you should consult pulmonologist and get done1. Chest x ray2. CT thorax.3. Bronchoscopy and BAD(Bronchoalveolar lavage) analysis. Cannabis smoking can cause particles to settle in alveoli. And on long run can develop lung infection and lung cancer. So, chest x-ray and CT thorax is needed to rule out these possibilities. Bronchoscopic evaluation will be helpful in removing particles. You can do therapeutic BAD to clear airways from particles. So consult pulmonologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a 33 y/o female diagnosed with a bacterial vaginitis diagnosis from my obgyn. Antibiotic treatment in the form of flagyl and clindamycin tablets and creams do not work. They relieve the symptoms but as soon as the prescription runs out, returns. Just looking for another opinion. Any other things I can try? I am already taking a probiotic, wear cotton underwear and drink apple cider vinegar diluted with water. I ve also been told to douche 1x / month with vinegar and water, but I m waiting until the latest course of antibiotics runs out ( they are not working). ### REPLY: Hello, Welcome to , Bacterial vaginosis is not caused by a single bacteria there will be overgrowth of various bacteria in the vagina. Normally, there are different types of harmless bacteria in the vagina. These bacteria help in the defense against harmful germs, whenever there is a change in the balance of the normal bacteria in the vagina, certain bacteria multiply produce the symptoms of bacterial vaginosis. Metronidazole vaginal cream placed inside the vagina can be used, and it has the same ability of oral metronidazole to clear Bacterial vaginosis. It should be used for 5-7 days for effective treatment. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I smell paint, but there is no source... Why do I smell this paint-like smell? I can smell paint where ever I go. I haven t been painting recently, nor been near any paint projects. The thing is, it is always strong and no matter where I go, it stays the same, so I think it s on me. I ve checked for paint and washed myself, but there are no signs of it. It would help if someone could explain this chemical smell. ### REPLY: Dear serve understand your concerns went through your details. Olfactory hallucinations or Phantasma is the medical term for an imaginary odor (phantom smell). Most phantom smells go away in time and are not caused by anything serious. But, for the patient it could cause distress and anxiety. Causes include nasal infection, nasal polyps, migraine, dental problems, exposure to certain chemicals etc. You can talk to your doctor regarding this. But there is no need to be panic. If you require more of my help in this aspect, please use this URL. http://yyyyy.gl/yyyyyyyy. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor .my father aged 64 had diabetes and CKD...he was on dialysis before in goa...i brought him to bangalore in manipal..his creatinine is 3.6 doctors told us he does not need dialysis..he is on medication and he is advised inj espogen twice weekly..why doctor? ### REPLY: Most of the CKD patients are anemic because of many reasons like decreased life span of RBC, iron deficiency, b12 / folate deficiency and also due to erythropoietin deficiency(hormone secreted by well functioning kidney). Supplementing erythropoietin is useful in correcting anemia when all other factors are taken care of.... So there is no harm in taking spoken twice-weekly but make sure she doesn't have iron Deficiency ...and his BP at the time of injection should be less than 150/90...since it causes hypertension supplement other elements with Cap. Nephrofe /Tab. Folvite 5 mg. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had chronic pain in my lower back and joints since i was 15. ive been to the emergency room and doctors offices countless times and they always just give me a handful of vicodin and send me away how can i get a full years script of oxycodone without going to mexico? ### REPLY: Dear patient There is no way you can get full years' medication without visiting doctor. Your back pain need full investigation. First I would advise radiograph of lumbosacral spine anteroposterior and lateral views to rule out bony abnormalities. Also go for MRI of lumbosacral spine with screening of whole spine which will be useful to rule out soft tissue abnormalities. Check for blood levels of calcium, phosphorus and alkaline phosphatase to look for vitamin D deficiency. Visit expert back pain specialist with all this reports, and you will definitely find the plane NT solution for your backache. Hope this was useful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It seems that I am having symptoms of a bladder infection, but not sure.  I feel pressure in my left lower abdomen, almost like something is in there pushing to get out.  I had severe pain in the area of my ovaries last evening, but it went away.  Any ideas of whay it may be? ### REPLY: Hello! I read carefully your query. There are many causes of a left lower abdominal pain. The pain might be due to urinary tact disorders, bowel disorders or reproductive tract disorders. To differentiate this causes is very important to know other possible related symptoms.-This pain may due to urinary tract infection. In this case other common symptoms include fever, frequent urge to urinate and/or frequent urination, a burning sensation during urination, blood or pus in the urine, and pain in the back, side, or groin.-This pain may due to intestinal disorders such as Diverticulitis, Irritable bowel syn . -If the pain originate from reproductive tract disorders there are many possibilities:-If you are around your periods this pain may due to this.-If you have vaginal discharge you might have pelvic inflammatory disease. Other possible causes are Endometriosis, Ovarian cysts, uterine fibroid. I suggest consulting a doctor and get examined. The doctor according to your medical history, other symptoms that accompany pain, and physical examination will focus on one of these tracts(urinary, digestive,reproductive). You probably need to do some tests such as :-complete blood count, urinalysis,vaginal swab, abdominal ultrasound. Hope my answer has helped. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I was wearing heels two day ago and fell on my knees, mostly my right knee. There is a visible bruise on my knee. The pain is not unbearable but it is bothersome and it throbs. My calf feels very tight and so does my hip. I injured the same leg a few years ago. Should I see a doctor? ### REPLY: Hi, you have a knee bruise and tense calf after the fall.it is possible that you have developed deep vein thrombosis of the leg. You have not mentioned if you are on any medication.Anyhow this will need a checkup and Doppler scan of the limb which will tell you exactly what's going on.Meanwhile, you will need some tests to know the clotting capacity of the blood along with a general blood profile. Regards and hope you get better soon! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor ,   this site recomended by my wife ,   I am 51 yrs old, i surf a few times a week, i swim laps (around 1-2 ks per day, )   over the last 18 months stopped drinking Cola as sugar was high, I have lost 12kgs in 18 months,  recently i get symptoms of a really chemical smell,  sometimes feel really sweaty with the smell, today had a slightly pins and needles in my hand ,  starting to worry about these symptoms ### REPLY: welcome to  and I can understand your concern. Swimming is one of the good exercise to keep your body fit, as well as to reduce weight. Yes cola contains lots of sugar. If you are diabetic i.e. high blood sugars, fasting blood sugar >100 and post postprandial sugar level>140 considered as diabetic. If you are diagnosed as diabetic as u have control your sugar level first, by diet like using more of wheat, ragi, vegetables and avoid rice, sugar added food, by doing regular exercise like walking or swimming, and you have to start antidiabetic . If your sugar levels gone too high, then you may suffer from usual breathing, in that bad smell comes out from your mouth. But it is rare. Common other causes of bad smell breathing are oral candidiasis or any bacterial infection. Tips1. Maintain oral hygiene2. Use mouthwash after each meal3. Do gargle with hot water and salt and about your pin and needle sensation, you might be having peripheral neuropathy because of diabetes.I hope I have answered your query thank 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: "i have a bump it hurts and wheni applied pressure on it some puss came out. it is locolized over a broken baby tooth. i have had one before. both times when they had started my dentist said that he would not fill them because they are baby teeth. it hurts ### REPLY: Thanks for using . Read your query. In your query you have not mentioned your age. If all your permanent teeth are erupted, you have to get the baby tooth removed. The pus and pain suggests an abscess formation in relation to the tooth which has to be removed. If the permanent are not erupted, then you can go for lumpectomy to save the tooth till the permanent tooth erupts. Antibiotics on advice from the dentist is to be taken. Do salt water gargling. Hope this was helpful. 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: Okay. I m 15 years old, kinda overweight but not as in fat,I work out everyday on a crew team. I had 2 seizures during school within two weeks and both days it happened right after I woke up. I was sleeping in a study hall the 1st time and i was sleeping on the crew bus the 2nd time. I went to the hospital both times and they said they couldn t find anything. Ive done many tests like EEG, EKG,and MRI s. I m not epileptic and have no record of seizures in my family. Just today I was found coughing up blood and was sent home. I feel a little bit of chest pain every now and then and get light headed sometimes when i stand up. The 1st time i had the incident I went for a check up and the doctor said i might have POTS (Postural orthostatic tachycardia syndrome) but my blood pressure didn t change as much as it needed for me to have POTS. I didn t eat lunch but I ate a big breakfast. How would I every find out whats wrong with me? Is the anything anywhere that says this has happened before? Also, should i stay home for a while, people keep telling me i should but I m to committed to my school and sport. ### REPLY: Hello, As you had mentioned that you had two episodes on seizures, you need to be careful in future while traveling. Kindly get yourself evaluated by a cardiologist because valvular heart disease can give rise to seizure, tachycardia, blood in the cough. Normal ECG does not rule out any heart disease. You should be taking anti-epileptic to prevent a further episode of seizure. Also, check for your hemoglobin levels. High hemoglobin levels can also give rise to seizures. Please more water. Avoid deny .  Regarding staying at home, you can carry your routine activities but avoiding traveling or staying alone since you already had two episodes of seizures. Better to be safe and careful. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 20 days late and today makes 8 weeks from the first day of my last period. I took a blood test a few weeks ago and it was negative. I took a hpt today and it was negative. Could it still be to early for the hot to show up positive ? I have been feeling very tired and sick. ### REPLY: Hallow Dear, If even after 8 weeks from last menstrual period your urine pregnancy tests are negative, you are not pregnant. The delay in your period could be due to some hormonal imbalance - could be reproductive hormones or could be Thyroid dysfunction. Please get your blood examined for FSH, LH, Progesterone, Estrogen, Prolactin, T3, T4 and TSH. Depending upon the values and the diagnosis, the treatment will have to be planned. Meanwhile, you may take some progestational preparation like Devilry for 5 days; 4-7 days later you will get with .  Though missing a period is the cardinal symptom of pregnancy, pregnancy is not the only cause for missing a period. You have to get investigated to find out the cause of your delayed menses. Please report to your Gynecologist. I hope this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...Hello Doctor i got operated in 2001 for fistula and again from this august i got pain and when i got check and all done . They had done fistulagraph and find out that i got Perianal sinus.Please i dont want to go for surgery again. ### REPLY: Hi thanks for asking question. In perianal sinus surgery is not needed if sinus is not infected. But once it is infected then surgery is advisable. Here is some suggestion. Make that area clean and . Remove hairs from that area. Eat lots of fruits and green leafy vegetables. The garlic will be helpful if added in meal. Add Epsom salt in warm water and take anal bath with that for 20 minute. In the early morning take honey with water or milk that is helpful as having antioxidant property. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 developed numbness and tingling in my finger tips. Have lower back problems as I broke my back as a teenager and have arthritis. I am on thyroid meds for Graves Disease which was treated with radioactive iodine in 2011. I also have a low immune system (low igg antibody) and have frequent infections. Should I be concerned with my new tingling sensation in my fingers and feet. ### REPLY: Hello. I have been through your question and understand your concern. Tingling in the extremities are a common feature and usually temporary and benign. Still, since you have a rich medical history I recommend you to schedule a Neurological consult and an electromyography plus a nerve conduction study to better evaluate if the tingling is a serious feature. Basically you should not worry because it is very common but still you should consider a neurological consult. Hope this helps Wish you the best health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have really bad back pain, going on for almost 4 years. I had 3 pilonidal cyst surgeries done almost or more then 4 years ago.I even asked the surgeon, if they hit a nerve, he said no we don t have anything to do with that.I had Xray and Mri done a year ago, all came negative.As I type, I have lower back pain, and pain in my left foot, going down to my feet.Please help ### REPLY: Hello, Thanks for your query. After going through your query I came to know that you are probably suffering from lumbar disc prolapse. It can be confirmed by MRI scan. You have said MRI one year back came negative, it has to be repeated because it is radiating pain. Treatment is rest in position of relief(generally lateral position with both knee bend), neurotopics such as mecobalamin and analgesics (Diclofenac). Second possibility is muscular pain. Treatment of it is rest and analgesics for nearly 5 days. In my opinion it has nothing to do with colonial cyst surgeries. You can discuss with your treating Doctor about it. I do hope that you have found something helpful, and I will be glad to answer any further query. 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 had my teeth cleaned 6 days ago and have been in severe pain ever since. I do have receding gums on the upper teeth. I have taken ASA and and aneseptic mouth wash , salt water, ore gel  and sensodyne toothpaste . It gives only very short relief. Not sure what else I can do, also cant stand anything hot or cold. I wanted to call my dentist at home, but didnt . The pain is over the top. Im not a pill popper , so dont really want pain drugs. Hope you may have some ideas. Many Thanks Marci O. ### REPLY: Hello. By the symptoms you say, you suffer from Periodontal Disease. It is a pathology that involves infection of gums and surrounding tissues. In addition to what you are applying, is necessary to take antibiotic and anti-inflammatory . I treat my patients with Amoxicillin clavulanate 500/125 + Naproxen 500, both thrice a day when periodontal disease is the diagnosis. Please consult your local doctor for a prescription. I wish you good health.(If the answer has helped you, please indicate this) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I do have  back pain for which I have has facet in my spine over the last 8 months.  I get electrical shocks in my legs and Doc  sys that its because  of the lack of oxygen becaue of pinched nerves from a 3 herniated disc.  I have had the nerves burned, but apparently one did not take and now we fight with my insurance.  Could this also come up in to my  left arm,   hand ### REPLY: Leg complaints are due to pinched nerves in the spine due to stenosis. Low back pain has nothing to do with arm however similar situation may be present in cervical spine with subsequent stenosis leading to arm pain. Treatment depends upon MRI findings and your disability in day to day life. Sometimes epidural block helps to relieve the leg pain and definitive treatment would be surgical decompression of the nerves. 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 recently have had an incident where me and my partner had unprotected sex. He did not ejaculate in me, or at all for that matter, but ever since, I have had strange symptoms. I had my period in March that ended on the 12th (the following week is when the unprotected event occured.) My period has always been irregular, but I do get it every month. Hopefully I get it this upcoming week, but about a week after the unprotected event - I spotted once. I went to the bathroom, went to wipe, looked at the paper, and there was a light pink blood, not a lot, just enough to notice. And that was that. This has never happened to me before. Is that a sign of implantation? Also I have had incredibly sore breasts, feel exhausted all the time, occasionally cramp, and am moody. I usually get moody and sore breasts before my period, but not like this. Am I pregnant? If the spotting did indicate implantation today would mark a rough guess of 3 weeks or so. Is it too early to use a home pregnancy test? ### REPLY: Hello, Unprotected sex by with .  Pre-cum or prostatic fluid (released before ejaculation) contains small amount sperm and causes pregnancy in some percentage. Though it depends on fertile days. Pink spotting may indicate implantation bleeding. To confirm, you need to undergo one blood test for beta-ChatDoctor & TVS scan around 4-5 weeks (from LMP) for accurate result. Following test report, consult with your gynecologist for next line management. 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: Hello Doctor,My mom is a resident here in Hyderabad, she is 55years & in good health. She used to have allergic reactions to sea-food & some other food items earlier but I write to you about a recent incident which has caused concern. She was travelling Uk & USA & had eaten out....for first time this reaction was so bad that her face & body got swollen & didnt subside too much. 2 days back she came back to hyderbad & her swelling got better. But last night she had food outside & now developed terrible allergic rashes on her body & face...its itchy but not painful.Where can we show her in Hyderabad (hi-tech city area) for this allergic reactions? Please help us.  thank you ### REPLY: In my opinion you should see nearby doctor. As such no definitive cure for allergic reaction. We can prescribe medicine & she will be fine but if she eats seafood again surely allergic reaction will develop hence AVOIDANCE of allergic food is only the definitive treatment. Secondly watch out for breathlessness, wheeze,flushed face, swelling of tongue n neck if these symptoms occurs you must have to rush to emergency department as early as possible. Please go to nearby doctor for present allergic reaction treatment. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 12 years old and while he was being checked for a cold his blood was drawn. Upon this blood draw, his bilirubin level came back 2.3. His liver enzymes were all normal but I am still concerned. What could be going on? He eats well, is 5 3 and weighs 115 lbs. He was doing a lot of activities during the time his blood was drawn but since the swim season is over he is inactive. We eat a lot of take out, which I know is not good. I am worried about fatty liver disease etc..... ### REPLY: Hi! Your son is not an overweight patient as his body mass index is about 20 which is within normal limit, as his liver enzymes were normal so chances of fatty liver disease and intrahepatic/extrahepatic biliary obstruction is almost excluded. Now to rule out exercise induced hemolysis you should repeat his total bilirubin and simultaneously go for his indirect bilirubin, hemoglobin, MTV, RBC count, reticulocyte count, platelet count, serum hemoglobin, serum LDH and urine urobilinogen level. Assessment of this laboratory test will rule out or confirm any ongoing hemolysis. 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 mother is > 60 years old and had an angioplasty 6 months back. Subsequently, she has been having uti almost every 3 months. She has never had utis this frequently prior to the angioplasty (may be once a year perhaps). Could the angioplasty/medications after angioplasty be related to the recurring uti? ### REPLY: Dear Friend. Welcome to . I am . I have read your query in detail. Furthermore, I understand your concern. No, Angioplasty and its medications have no relationship with her recurrent UTI. If she is a diabetic, that can cause heart problems and UTI both would advise you to get following:1. Urine R/E2. Fasting And Post Radial Blood Sugar3. Ultrasound KUB4. X-ray KUB5. Urine Culture6. Urine for This is my best advice for you with the available details, if you have any further query, please ask us. Stay Healthy ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been having some breathing problems and I was wondering if you think I may have asthma. I feel like I can t get a good breath, I ve had a cough since the beginning of June and when I laugh or cough it s very hard to catch my breath, and my chest has a tight feeling. This seems to flare up mostly at night. I have two cats and I m not sure if I have allergies. ### REPLY: HelloWelcome to  Thanks for your query. I think in your case first we have to evaluate you properly before diagnosing you as an asthmatic, or you had developed allergy towards your cats. First you should take a chest X-ray and consult with a pulmonologist to rule out other pulmonary conditions. A simple peak flow meter testing for peak expiratory flow rate will give an idea about you problems. Further your can stay away from your cats and see if you get better. To confirm your allergic condition you can do specific IGE tests or radioallergosorbent tests (Lasts). Treatment for your pulmonary problem might involve administration of antibiotic therapy, antihistamines therapy (such as cetirizine), and albuterol can be helpful for the relief of bronchospasm (Chest Tightness). Consult pulmonologist and take further suggestionsWish you a good health. . S ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 got typhoid 3 years ago and also got treated. Last week i had fever for 2 days then my fever was gone. I was feeling week and had some kind of taste in my mouth. So i went for blood test and it showed positive for typhoid. But my doctor on seeing the report said that i dont have typhoid , i am normal and can eat everything. Plz let me know whether i hav typhoid or not ### REPLY: Hi thanks for asking question. I can understand your concern. You want to know whether you have typhoid or not. For that you collect blood for serum tidal test. If it shows high title then typhoid is present.(>1:200 title mostly). The another test is you can do stool and blood culture over special media that is Wilson and Blair media. If typhoid bacilli present then black colony will be present. I hope this two test will help you to know whether typhoid present or not. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have REACTIVE results the last two medical test i had. meaning i have hepa b. its 3 years from  now. No symptoms . Im taking spirulina tablets and vit. c and other food supplements. Does it help my status ? or should i take another medicine/drug more? thank you ### REPLY: Hi.thanks for posting query. HepB can not be eradicated completely in patients infected with it. However, complications can be prevented with proper care and treatment. Treatment is advised if AST and ALT are > URN and HBV DNA count on PCR is very high. Liver enzymes and Bag status and HBV DNA PCR maybe done regularly every 6 to 12 months, Visit hepatologist for proper interpretation of results. Hope to answer concern regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My grandson is 2 and about 3 weeks ago he developed a yeast infection in his diaper area the next day he broke out in a red rash all over his body and now the skin on his trunk(back, sides and stomach) is rough and flaking off. The tips of his fingers and the soles of his feet are peeling really bad. There wasn t any fever at all. The skin on his face is also red and flaking as well as his scalp. We have taken him to the doctor and they don t know what it is. ### REPLY: Hello, my name is .  I understand your concern. Some advices that I can give to you are:-Use antifungal creams or medicines.-preventing diaper rash may be done by applying barrier creams like zinc oxide (A+D Ointment, Design, Diapering) or petroleum jelly (Vaseline, Aquifer) to the diaper area after bathing.-Frequent diaper changes with the super absorbent disposable diapers create an environment that does not let yeast thrive-Air exposure is also helpful. Hope my answer was helpful, if you have any other questions I'll be glad to help, thanks! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had very painful episodes at the bottom of my tailbone for approx. 18 yrs. now...they usually wake me up in the middle of the night. Last night i had one of these episodes, which make me break out in a cold sweat, vomiting and feeling as thou i may pass out. I had a colonoscopy about 5 yrs ago, but they found nothing?..What should i do next? ### REPLY: Hello. Thanks for writing to us. The pain in the tailbone that you are experiencing is likely to be due to coccydynia. Mild painkillers in combination with muscle relaxants and a regular hot fomentation will take care of the symptoms you are having. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About a year ago, I had a root canal on a tooth. Yesterday I went to my dentist because I thought the filling had fallen out. Turns out that the tooth was cracked and split in two. The dentist pulled the loose half out. He suggested a crown but said I had to wait until the area heals. Today, the material from the root canal fell out. I called my dental office and was told that as long as it doesn t hurt, I m okay. I don t know what to do. ### REPLY: Hello, thank you for consulting with . Actually when a tooth is split in 2 halves then the treatment depends on two things, if the split is extended till the gums then you have to go for extraction of tooth, as there can be further infection. And if the doctor is asking you to wait this means that the split is superficial, but still if material has come out then you should go for re-restoration. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a lot of pain in what everyone calls their stomach.the drs.have checked all my bloodwork about 15 times in the last 2 yrs have given me a myrade of pills and still don t have a good reason for all the pain.not to mention all the tests.i think it might be my liver.would that show up in a blood test? ### REPLY: Hi! Good morning. I am  answering your query. Yes ! The pain could either be due to any liver problem, or any pathology in any of the organs inside your abdomen. However, these intro abdominal pathology might not be possible to diagnose simply by blood tests. If I were your doctor, I would also go for an ultrasound/CT scan of abdomen for this kind of chronic pain abdomen of yours before labeling only the liver as the culprit organ. Blood tests should also include a CBC, Blood sugar test, LFT, serum Amylase and Lipase. Further management would depend on the results of physical examination at the time of pain and reports of the investigations. 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: Hello Doctor, woman aged 38, for last one year, coughs continuously for 1 to 2 minutes once or twice a day while awake and for 1 to 2 minutes once or twice a day while asleep. She underwent Pulmonary Function Test and was diagnosed with Early Small Airway Dysfunction Below are the test results: Please let me know if this is curable and if so, what is the treatment? Thanks a lot. Parameter Pred Pre %Pred Post % Pred Change % Change SVC L 2.79 - - - - - - FVC L 2.79 2.96 105.9 3.05 109.2 0.09 3.1 FEV 1 L 2.42 2.15 88.6 2.32 95.7 0.17 7.7 FEV 1 / FVC % 81.88 72.53 88.6 75.95 92.8 3.42 3.4 FEF 25-75 L/S 3.73 1.39 37.4 1.83 49.0 0.43 26.9 FIVC L 2.79 - - - - - - ### REPLY: Thanks for your question on . In my opinion you should start inhaled bronchodilators. As small airway obstruction can be due to 1. Acute bronchitis2. Early COPD (chronic obstructive pulmonary disease)3. Asthma. So better to start inhaled bronchodilators for 15 days and get done repeat PFT (pulmonary function test). Compare with current report. This will tell you about disease, you are suffering from. So no need to worry, consult pulmonologist and discuss all these. Small airway disease is treatable. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: gud mrning sir, my sisters son had high fever 2  dys back and he got convulsion due to that,and he was taken to the doctor and the fever was subsided and he was ok now.the problem is we cant recognise the fever and he will get fever suddenly.why and whether antthing is serious.but he is very active now. ### REPLY: HI, thanks for using healthcare had a febrile seizure. This is a seizure that occurs along with a fever. It occurs most commonly in child . Febrile seizures can be simple or complex. If it was simple febrile seizure then the risk of future seizures is very low. You can use a thermometer to help diagnose the presence of any fever. You should be able to obtain one of these from your local pharmacy. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: infant 8 m.;healthy active .c/o freq [7-8]of loose motions-greenish semi solid-occassionaly watery;low grade fever;caterrh-cough;no vomiting-apperent dehydration.what should be line of rx especially anti ameobicidals/antibiotics if required.----indian standerds. ### REPLY: Hi... Thank you for consulting in . It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a small Lump in my mid back right side next to my spine. Most nights it wakes me up with aching pain in that area , wraping around on right side. Been to my Dr, a couple months ago said it was nothing to worry about. In the mean time been to a Chiropractor, I think it helped sometimes. ? He was worried about treating me , my age is 55 He mentioned my neck should curve and mine is straight. I was thinking the lump could be on a nerve causing the pain. Last night the pain didnt come and its the pain is mostly at night. Going on for about 3 months . At night I do sit in bed and do stuff. ### REPLY: Hello and welcome to , A painful lump on the mid-back can be due to soft tissue swelling. A MRI of the back is required to assess the nature of the lump. Nerve associated lumps can common in the spinal region. After MRI, an aspiration cytology of the lesion is required to know the probable origin and extent of the swelling. Definitive management can be planned after knowing the exact nature of the lesion. 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: Hello DocYesterday I was doing Yoga in the morning - which I do regularly a posture called The Dhanurasana. After that when I was getting up to go for shower - I felt a reeling / spinning sensation in my head which was reasonably strong so I just went back to the lying position and this went away after some deep breathing.  Then again in the night I woke up to go to the toilet and felt that there was a similar sensation but milder . I am male - 56, 176 cm, 70 kg, non smoker. occasional social drinker (wine only -no beer or spirits) till now do not have BP, Cholesterol or blood sugar problems  go for swims and thrive mainly on low red meat diet.  Yes during weekends some times there is an indulgence at get together parties  with some oliy and spicy food. Take a few supplements like fish oil , Glucosamine Chonditrin - can you please help?Can you ### REPLY: Hi and thanks for the query, You are right to practice Yoga and take supplements. However, under such circumstances with such symptoms, it is important in my opinion to obtain a complete clinical review from an internist. A clinical review to exclude heart and neurological symptoms is important. Syncopal episodes should be excluded. A cardiac ultrasound and an electroencephalogram me could be necessary Based on associated symptoms such as fainting, history of epilepsy, history of heart disease in the family and breathlessness are important to be considered when doing your evaluation. I suggest you book an appointment with an internist for a complete clinical review. Thanks and kind regards, Bain LE, MD. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi dear sir, I was passing right now from the street at 1:00 am and in the street dog bites me on my leg at 2 different places but at this time doctor is not around so what to do plz tell me and even its paining where it bites..Thanks..SencerelyIndian guy.. ### REPLY: Hello, Welcome to , The disease which is transmitted by dog bite is rabies which is 100% fatal, but it is 100% preventable with proper and adequate treatment. The treatment of any animal bite includes1. Thorough wound wash under running water for 15 mins with the detergents.2. Antirabies vaccine on days 0,3,7,14 and 28. The vaccine should be administered intramuscular to the deltoid.3. Rabies immunoglobulin (Rigs), should be administered in and around the biting wound on day of bite.4. Inj Tetanus5. Oral Antibiotics like Tab Autoclave 625 mg for five days. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I hurt the bottom of my right foot after i jumped off a small wall onto concrete. Ive done this before but it hasnt hurt asmuch as this. If i walk on it for 10 mins the pain lowers but if i dont walk on it for 10/15 mins when i try walk i cant because its very painful plz help ### REPLY: Dear patient You have got trauma to your foot and possibility of fracture needs to be ruled out. I would advise X-ray of involved foot anteroposterior and oblique views to rule out bony abnormalities. Visit radiology center nearby you and get it done. Meanwhile, avoid putting weight on involved foot and take tab diclofenac plus serratiopeptodase combination twice a day for 5 days.  You need to consult expert orthopedic surgeon with report.  All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I had an MRI because of a significant increase in migraines last year which identified numerous scattered small FLAIR/T2 hypeinrtense involving the subcortical white matter in both cerebral hemispheres. The findings are radiographically nonspecific . My neurologist went on maternity leave before I could consult with her and when I contacted the office for someone to interpret the report for me I was told that the results were normal. I am wondering if someone is able to provide a better interpretation. I am a doctoral student and know just enough about the brain to be dangerous!! ### REPLY: Hi, Thank you for posting your query. White matter hyperintense lesions on MRI brain are commonly seen in patients with chronic migraine. In isolation, there is no need to worry about this finding. However, if other vascular risk factors such as diabetes, high BP, high cholesterol or smoking is present, there may be a higher risk of getting brain stroke. So, please continue the anti migraine medications. Wishing you good health, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After high fever and joint pain a month before i am still unfit due to joint pain. my age 70/female. what remedy you suggest for me. kindly reply. sandhya mukherjee asansol/WB/India ### REPLY: Hello, Joint pain after fever may be due to presence of mild inflammation. Such type of pain can be relieved by having a good anti-inflammatory analgesic medicine like diclofenac or proximal on prescription. You may also start some knee exercises which will help you to strengthen your thigh muscles or muscles around knee. You may also apply an analgesic ointment over your knee. Doing warm fomentation with help of a water bag will also help in reliving pain. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 30 years old male. i have a major problem of PE. when i contact (kissing and touching) with my girl friends i ejaculate on the spot without even touching my private part. I have been suffering with problem from my college days. I donot have any stress, anxiety related issue. I consulted the doctor regarding this and he advised me to take Duralast 60mg and Lvate (twice daily). Now i am more concern about its side effects. Please advise can i take this medicine or should start ayurvedic medication. and also how can i control on my mind to delay ejaculation. and should i continue doing masturbation. i do it 3 times a month. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No there is no harm in taking the .  You can also masturbate and there will never cause any problem to you. Muralist is the aphrodisiac and have some side effects but can be help full in your case. You have to do yoga and meditation to make your mind strong. This way you can prevent PE. Second way is you can think that you can do the sex without  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am 38 yrs old Female and have had an ama test come back positive. I have had a liver function test whicChatDoctore back normal and a ferratin level of 9 but I am not anaemic. I have intermittent pruritus but I am otherwise well. I swim for 30 mins every day, walk the dog at least 1hr a day and do 1hr cardio and weights 3 times a week. I weight 8st7lb and have no other history of illness and none in my family. My husband and I have been trying to conceive for the past 6 months with no luck. Is there any reason if I do find out that I have primary biliary cirrhosis that I would not get pregnant. I have just had 21 day progesterone ovulation test whicChatDoctore back positive 1st time and Im due to have a follow up blood test to check  LH and FSH. I am aware that you can have PBC for years without any progression but want to know if it will interfere with conceiving? I am not taking any medication. ### REPLY: PBC without progression is QUITE UNLIKELY to cause infertility. As such, your age is 38, and so we advise starting diagnosis and treatment soon. So, we should not blame PBC right now. Rather we need to find out whether there is any other reason for infertility. SO, please consult infertility specialist and investigate both husband and wife (husbands semen, wives HSG, USG, TSH, Prolactin, FSH, LH, AMH). Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your healt5 days ago i was doing dishes and got this pain in my lower back that goes around my side into the left side of my stomache. It hasnt got any better seems to be getting worse my chest on left side is starting to hurt and still have constant pain in back and constant in my stomache now too. Do you think it could be my kidneys or something im n alot of pain ive been drinking lots of water but its not helping please help meh queries right now ?  Please type your query here... ### REPLY: Dear patient Is your pain constant or intermittent? If pain is intermittent and hoes from back to left stomach is mostly due to renal stone. This is known as colicky pain. I would advise ultrasound of kidney ureter and bladder to confirm diagnosis. Visit radiology center nearby you and get it done. Meanwhile, start tab pastoral plus twice a day for 5 days.  You need to consult expert urologist with report.  All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor how are youi am a PCOS patient and was on glyciphage and aldactone for like almost 2 years. now we consulted a fertility specialist who discontinued these medicines and gave me oosure plus twice a day and MCBM 69 once a dayhow wil it help in controlling my weight as well,> are these meds ok.? i am very concerned as this becomes like a vicious circle, weight , pcos, infertility, weight and so on..email : ### REPLY: Hello, Oosure plus and MCBM 69 medications are quite helpful in facilitating your conception chances. They have supportive role. However, you have to undergo other fertility test to rule out exact cause:1) Husband semen analysis test.2) Ovulation test-Serial follicular study in mid-cycle to check proper ovulation.3) Tubal patency test-by HSG (mystery salpingography) or laparoscopy.4) Complete hormone assay including D-21 progesterone, thyroid profile, blood sugar & prolactin test.5) Test for cervical factor-Post Coital Test (PCT), Anti-sperm antibody (ASA) etc. For weight reduction, you have to undergo regular physical exercise by means of Jim workout/ treadmill/ cycling/ ab exercise etc. Low carboy . Kindly, consult with your doctor for complete evaluation with above-mentioned tests. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Ive been on Loette for a bit over a year and I realised the other day that I had missed one of my pink tablets and I just skipped it since I couldnt remember not taking it. I only waited 6 days not 7 of continuously taking the pill before having sex with my boyfriend and my period is now 6 days late and Im quite worried even though I know the chance of me being pregnant is quite unlikely. Should I take a pregnancy test or has my period just been skipped?  Im almost on medication for miagranes but Ive continuously taken that and havent had any problems. Thank you! ### REPLY: Hi and thanks for the query, as you rightly put it, it is very unlikely that it should be a pregnancy. The chances are low but nor impossible, however. Missed periods in young females of reproductive age is not a rare phenomenon. But I suggest you get a pregnancy test done. I do not think that the migraine medication has actually interfered in anything, considering the fact It's never really done so i the past. Exclude a pregnancy and regularize more your birth control medication. Thanks and best regards, Luchuo, 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 have a large hole in my tooth which i have had for over two years now. the nerve has died and i dont get pain anymore but the hole goes deep into my gum. there isnt much of toth left now but am worried what the long term effects are....will it lead onto serious things like a desease or even cancer?? ### REPLY: Thanks for your query, I have gone through your query. The decayed tooth where the pulp or the nerve tissue is dead or non-vital can be restored with root canal treatment followed by a crown. If you do not get it restored, the infection can spread to the root tip and the surrounding bone and result in pain, swelling, limited mouth opening. So consult an endodontist and take a radiograph to rule out whether the remaining tooth structure is sufficient to proceed with RCT. If the tooth structure is not sufficient then the tooth has to be removed. 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: I have a vein on the back of my knee, in the crease area on the inside of my leg that is swollen and has a red area that extends down to my calf. It was aching on Friday and swollen by Saturday and has been swollen ever since. what could be causing this to happen? ### REPLY: Hello, As the complaint is about the popliteal fossa region any compression over the area due to soft tissue or other ways might lead to swelling of the same below the injury site.  We need to check out for thing like - medial collateral ligament injury, bursitis, varicose veins etc. Having a physical examination of the same can provide more insights. As the history do not mention any kind of injury mechanism this cannot be a ligament injury. But the doubt will follow to the bursitis or varicose veins. In both of the conditions, there is a possibility of swelling below the knee region.  Allowing the rest for the knee and avoiding any forceful movements of the knee joint like flexion and extension should avoid the trauma. Also getting it checked will be of good decision.  Left ignored will not be a wise decision. Try keeping the leg in hot water and do ankle movements. Post which keeps the leg elevated over the pillow, so the swelling comes down. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have this small bump by the corner of my lower lip. At first I thought maybe it was a cold sore even though I have never had one before. But it itches and doesn t hurt. What could it be and what could could I for it? I m in college and don t want a weird bump by my lip. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have infection or some benign cyst like lesion on your lip.  You should go for biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, From last 2 months, I am getting continuous pain in my left upper abdomen And back.On doing ultrasound sonography , mild. inflammation is seen un left kidney... I got ultrasound done 5 times. And took many medicines and antibiotics for urinary tract and kidney infection . Currently I am taking mikacin injections also.please advise. ### REPLY: Hithankyou for consulting ChatDoctorsir, after going through your complaint swat I feel is you might be suffering from renal infections that too persistently, inspite being on medication, is just because of overlooking the focus of infection which could be a calculus somewhere down in the urinary tract which most of the time we can't detect it through ultrasound abdomen, what I suggest you is got an X-ray PUB and CT abdomen done while you're on your meds, ...hope I have answered your query at par our satisfaction ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was told a year ago i have crumbling spine, i had loads of phisio and aqupuncher. It was really painful and i cant say it really worked. For the last week the pain in my neck, right arm is really bad, i am taking pain killers but don t no if helping. i don t know how to get rid of the pain. Im 52 Lin ### REPLY: Hi, thank you for providing the brief history of you. As you are 51 and having cervical spine issue which is leading to radiating pain across the upper limbs I feel you should take one MRI scan and a DEXA scan. Apparently due to less mineralization of the bony regions this kind of scrambling spine occurs and needs a vitamin and calcium supplement. As you said PT and Cairo didn't work well, it could be a muscle fiber malfunctioning which needs a protein supplements for the muscle to grow and have good fibers. Since the muscle supports the skeletal system I will advise you to regain the muscle fibers which are a protein tissue and needs a supplement followed by exercises. In my clinical practice we check all the possible factors taking to muscle and bone, take measures according to the same and provide a good input for the medical attention and physical therapy later stages. It just needs an in-depth understanding of the problems and things can be fine sooner. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my sister in law is at the end of he battle with colon cancer. she is swollen in hips and legs and feet, jaundice and has now started throwing up small amounts of black vomit. I am looking for a time line- I know its iimpossible to tell me exactly but I think we are looking at days rather than weeks- I would like to tell my husband but he thinks we still have time. ### REPLY: Hi and welcome to . I am sorry about your mother. It is hard to predict as you know. This is definitely terminal stage, unfortunately. What about her mental condition, breathing and heart function. Those 3 signs can tell the most about life expectancy. If she is confused, disoriented, breathe shallow and have no appetite these are her final days. If not, she might have live for week or 2,not more than a month. Wish you 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: ive had a yeast infection for 12 days. i tryd monistat 1 and cause major pain and didnt work. then i went to the gyn and she gave me Fluconazole which seems to not be really working. This is my 1st infection and the only thing ive been doing different is im on a high protein diet and i take oxyelite pro. could this be the cause of the infection? Also i am expected to start my monthly cycle next week could that be a reason for it taking too long to clear? ### REPLY: Hiwelcome to ChatDoctori can understand your concernTreatment for candidiasis be managed with either topical antifungal agents or a single dose of oral fluconazole. A single dose of oral fluconazole (150 mg) in acute episodes of Vaginal candidiasis. In chronic patients, the recommended regimen includes fluconazole 150 mg every other day for 3 doses, followed by weekly fluconazole 150-200 mg for 6 months. If you are taking fluconazole for 12 days, just wait and watch.Don't worry. Your high protein diet nothing to do with yeast infection. Your periodic cycles and yest infection are not related to each other take care thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, My brother got HBSAG +ve, hbeag -ve, LFT is done before yestarday. in that report SGOP and SGOT are quite high. he got recently married , so is there any madecine for this ? what precautions he and his wife sholud take for the future baby?? Now plz tell us , Is there any risk for my brother as infected by HBSAG +ve, What is the best medicine for this. Best regards Girish Bangalore ### REPLY: Hi. Please let me know the complete LFT profile especially the SGPT and GOT levels. Since he is Head negative in most cases he would an inactive carrier .however with high SGPT and GOT we still need to be certain. For that we need to go for quantitative HBV DNA levels .this tells us about the viral load in the blood. If the viral load is high there are medications which can control the virus.  You also need to check him up for signs of chronic liver disease. Test would include and ultrasound, an Upper GI endoscopy to look for varices etc. A newer test Fibrosis (which is like an ultrasound) can detect the liver stiffness without a biopsy.  As far as family is concerned they need to be screened for Bag (everyone including his wife, yourself, your parents, your siblings etc.). If you'll are negative for Bag then you need to take Hepatitis B vaccine. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: good day doctor,  I am 29 yr old female.I am suffering from a UTI which is a reoccurence after5 months. the symptoms are frequent urge to urinate, pain while urinating,little vomiting sensation.Four months ago i got a urine culture & a vaginal swab test done.while the urine culture didnt show any bacterial infection swab test did come up with E-Coli infection. was adivsed by the consulting doctor to take Amikacin for 5 days but due to certain conditions i was unable to take it.at present i am on board a ship in vietnam as my husband is marine engineer.so i am unable to take amikacin at this moment as well as it comes only in the form of injection. Plz advise alternate medication which can be taken orally.plz advise more than one trade name .Also plz advise if URISPAS will be helpful or not?Thank you.KIM ### REPLY: Hello I hope you are not pregnant now. After observing your test reports, I suspect you were suffering with uncomplicated Urinary tract infections .if you are my patient I would advise you to take Macro bid 100 mg twice daily for 7daysMacrodantin100mg 4 times foe 7daysFuradantin 100 mg 4 times for 7 days. Also use crisps tablet for 7 days twice daily.it will relieve the spastic pain during voiding. I hope you are satisfied with my clarification. Wish you good health.  Rate my answer. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: How is klebsiella diagnosed? I had it show up a few years ago and now I m not sure if it was a urine or stool test but the doctor never treated me for it. I have a lot if swelling(edema) and not sure if this could be a cause. I ve also had Lymes and food sensitivities and just want to be sure this isn t something to check into and who to go to especially because the dr who saw the test did nothing! Thanks for your help! Julie ### REPLY: Hello, THX to contact us. I understand your concern. If I am your doctor I advise you that Klebsiella pneumonia in the stool has no importance. So if the K. pneumonia bacteria is isolated from the stool it will be considered as communal flora of the Castro Intestinal Tract. But if it is isolated in urine, it is necessary to treat it. I will be happy to answer more of your concerns, kindly know me, Wish you a very good health at . . Infectious Disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 took terbinafine hydrochloride for a period of 10 days. I had problems getting erections around day 6. I feared that the tablet could be the reason for that and I stopped taking tthe tablet. It has been 5 days since I stopped, but I could not see much improvement again. ### REPLY: Hello, I would like to ask you if you have a depressed feeling or a feeling of low mood. There is some indirect relation of terbinfine with mood disorders which can lead to decreased sexual .  If you stop taking this medication, look if problem solves. If not you need to proceed with hormonal profile like testosterone, FSH and LH. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 16 years old and I had been on the birth control pill lo loestrin fe since March to help my periods become lighter. My gyno had told me that if I skip the sugar pills all together than my period will stop completely. When I first started birth control the physical symptoms of my period completely went away but I was 10x more emotional. At the end of July I decided to stop my period by skipping the sugar pills. Well as soon as that happened I literally could not stop crying. I ve never been very emotional and when something is bothering me I can usually push it to the back of my mind and when i go back to it later it no longer bothers me. Well when this happened I was freaking out over everything and I could not get passed it. I ve always been pretty independent and I d never been the kind of person to be needy or clingy but now I m pretty sure I m more needy than i was when I was an infant! I stopped the pill around August 7th and during that time I was on my period (as soon as I stopped taking it I had blood stains but no heavy bleeding ). Now I haven t taken it since then but my mood swings are horrible! I can t control my emotions and it s making my relationships suffer. Is this normal? When will this go away? What should I do? ### REPLY: Hi Hope this message finds u in good health. I have gone through your msg and understand your concern.it may be due to some sort of hormonal imbalances or variations in the body, though there may be other reasons as reclothing to worry about, You should eventually get back to normal. Take multi vitamin and calcium supplements Do consult a gynecologist if symptoms worsened back to me for any FOLLOW-UP QUERIES anytime. . .(MBBS, MS,MCH) ### END