Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 bad tooth and the nerve is exposed. It is causing server pain. My question is will gabipintins help until i get to my denist. I have been taking ibuprofen 800mgs for days and it doesn t help. I can t even sleep the pain is so server. Please help ### REPLY: Hi. Thanks for the query. Well it looks like Irreversible Pulpits due to deep infection in the tooth causing nerve exposure. Ibuprofen or any other painkiller can provide temporary relief only but for permanent resolution you need to get the tooth treated. Gabapantin is not suitable for dental pain and if pain is severe you can take Motorola or narcotic painkiller like Tramadol. For permanent resolution you should get an x-ray of the tooth done and if tooth can be saved root canal treatment can be done or else extraction is advisable. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is it possible to have chicken pox blisters only on your fingers and the soles of your feet, and them not be itchy? My daughter reported having small spots on her fingers a couple of days ago, that were tender to the touch. Then the soles of her feet were sore. The finger spots grew larger and more pronounced, and this afternoon some of the spots look more like blister burns, and her feet are showing similar spots. A couple of the spots on her hands now have a whitish center. They have never itched, but she was taking over the counter allergy medicine until 2 days ago. She stayed home from school on Monday afternoon and Tuesday because of cold-type symptoms - tired and lethargic, sore muscles and throat, hot flashes and chills. She was taking Dayquill and Nyquill. Chicken-pox has been going around our schools. She has NO spots anywhere else - just fingers/palms and soles of feet. No changes in laundry soap or diet. ### REPLY: Hello, welcome to , Chickenpox is a highly communicable disease during 1-2 days before the appearance of rash and 4-5 days thereafter. After which virus tends to die out and looses the capacity to transmit disease to normal individuals. The scabbing usually begins 4-7 days after the rash and completed by 30 days. During the scabbing period patient will be sterile and will not transmit disease to others. As your friend is having confirmed case of chickenpox, it is highly infectious and spread by .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 belly button is swollen and there is a small hard lump under the skin. It is painful and red. I was initially worried that I might have a hernia, but then thought it could be chaffing. I am a carpenter and had just finished a job where I was sweating heavily and bent over all day. What would explain this? ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in all the details you gave. I understood the concerns you have. Treatment-Dont be anxious and panicky. You seem to have boil of the belly button, as it with pain and redness. But it could also be tense umbilical hernia, which could be painful and red due to stretching. I would advise you to cool down and wait till you consult with ER Surgeon , which would fix the cause and treat for your belly button lump. Welcome for any more query to  in this regard. Write Excellent review and hit thanks if this reply Helps you out. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Helo sir my. Last period date was september 19 gone for IUI on the 17 th day I went for pregnancy test it showed positive went for an ultra sound on 21stt nov 3 sacs were seen but no yolk sac no fetal note no heartbeat two days after bleeding started so went for another ultra sound at a different place there it was seen two sacs yolk sac was seen but no fetal heart beat and gestational age is 4 weeks 5 days gave an injection and asked for bed rest today again I m bleeding can u reply what it is am I having a miscarriage ### REPLY: Hi, Thanks for your query.  I have read your query & I understand your concerns. There is evidence of yolk sac. Hence, it is reassuring. But I expected heart beat by now.  I advise you to repeat the scan after one week to confirm heart beat. Please go to an IVF center and get transvaginal ultrasound scan done (TVS). Take rest till then. All the best. I hope I answered your query. I will be available for any followup queries you have.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 bit of a medical mystery. My younger sister had an attack about a month ago. She presented with gagging, then had to lie down due to muscle weakness. She couldn t even sit up, she became limp like a rag doll, but still responded to our questions... Although she seemed very confused and didn t know where she was. She was admitted to the hospital due to her state but all of her tests have come back negative. Today she can still not walk without an aid because her balance is off and her leg muscles are extremely weak. She is completely normal when sitting down, but when she tries to walk a short distance she becomes very tired very quickly. She has gotten EEG s, MRI s, blood work multiple times and yet everything still comes back normally. It is seriously affecting her life and we need answers. ### REPLY: His may suggest that she should have a neurophysiologists work out with studies of electromyography and electrophysiologist studies if muscles and nerves of lower limbs, also spinal cord in back spine issues should be searched for to be causative of leg weakness. I am not clear as to what you call gagging...exactly how it occurred has to be elaborated. Motoneuron diseases of nerves should be ruled out by a neurologist. All said and done, physical therapy, TENS or muscle nerve stimulation therapy, exercises, massage should be carried out for maintaining strengthening of muscles. Pregabelin or gabapentin tablets may be indicated to control nerve symptoms. Serum CPM, LDH, Lactic acid levels should be measured.CSF examination test is a necessityConsult in a neurology institute Best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: why does the mandibular 1st molar have 2 roots and the maxillary 1st molar have 3 roots Why does the upper first molar have 3 roots and the lower first molar have two? I am a dental student and there has to be a reason for this and I want to know why? ### REPLY: Dear friend. Thanks for sharing your concern. Maxillary first molar has three roots because of the nature of maxillary bone, which is porous. At the same time the roots are long and rounded too in comparison to mandibular molar for better anchorage and adequate support. Mandibular bone itself is thick, and two roots are well-placed medially and distally in dense mandibular bone to give them a firm support and strength. Hope it helps. Any other reason, your have will be appreciated. Thanks. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 52 year old woman an I donated blood to a blood center in April. I got my results back this week and the screening test HBsAg for hepatitis came back Positive  and they did a confirmation test on called HBsAg neutralization whicChatDoctore back Negative. What does this mean for me? ### REPLY: Hello hope you are very well What Bag indicates is that you were in contact with the virus, most of the patients usually clear the virus and negatively affect Bag. The persistence of Bag for more than six months can tell us about chronicity and in this case it is necessary to perform a complete panel of the Hepatitis B virus to be able to detect if your state was acute, some chronic variants or by vaccination. In addition, it is very important that your family or social circle should be near the detection of Bag, since the main routes of transmission are sexual and blood contact. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is 47. Relatively good health till recently. There has been no trauma, no illness, no allergic reaction. He has been suffering from chronic pain in the right shin area. It presents at all times of the day or night and usually is accompanied by swelling of the ankle. The pain was relieved by naproxen till recently. His blood pressure was slightly high recently... 140/90 but overall does not have a significant history of any health problems. MRI, Ultra sound and xray all negative and blood work negative . We are stumped. ### REPLY: Hi, thank you for providing the brief history. A thorough neuromuscular assessment is advised. As the MRI, Ultrasound and x-ray are normal, then the injury is not major and the symptoms are totally muscular. Also, pain the shin are and swelling are related to the venous insufficiency and also the fatigue. The shin area of the leg, hardly contain much of the muscles and due to which possibility of getting pain is common. Checking with the physical therapy, and undergoing sessions under them, should provide good result. Usually, in my clinical such cases are more of the chronic and over use injuries, which gets treated well with physical therapy. RegardsJay 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: Is there currently a treatment for reversing cirrhosis of the liver? How about chronic pancreatitis? I have recently taken Harvoni which reduced Hepatitiis C viral load significantly despite excrutiating side effects from the Harvoni. Can you answer me now since I have issues concerning viruses on my personal computer. ### REPLY: Hello thank you for posting your query in . I understand your problem. Cirrhosis is an irreversible condition. Treatment depending on the cause, and precautions should be taken to prevent from further damage to the liver. Depending upon the symptoms, severity of chronic pancreatitis, it is treated either by medically or surgically.  Hope I have answered your question. If you have further questions I will be happy to 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: My name is cierra I received the nexplanon implanon nov27 2013 six weeks after I had my son. I did not have a period before I received nexplanon so I was told by my doctor to wait a week before having unprotected sex. My husband and I only waited 4days before having unprotected sex. For the past 2weeks I have been experiencing many symptoms so I would like to know if I m pregnant or if something is seriously wrong. I have back pain, severe fatigue, awful heat flashes, my body temperature seems to be warmer than usual, weight gain, increased appetite, dizziness food cravings, nausea the smell or taste of certain food makes me want to throw up, cramps but not period, cervix pain, vivid dreams every time I sleep gas, sore boobs, mood swings, very tired. Over all I just feel very sick and its getting worse. The only other time I felt like this is during my pregnancies ### REPLY: Hi, Welcome to  forum.  It appears that you have the symptoms of an infection, it may be the urinary tract infection, or some other.  Anyhow you can have the home pregnancy test to exclude the pregnancy.Sometimes it may show the result early.  Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to have blood and resistance against the infections.  I advise you to consult a physician for diagnosis and treatment.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a software proffessional. I am suffering from Back pain from last 1.5 years. It started suddenly. One day I got a sudden pain in my stomach and back at a time. That day onwards I am getting lower back pain. If I bend for a short time also I am getting pain. This pain spreads to the left leg if I keep on doing the work. I can not lift weights also. Sometimes If I sneeze or cough also I am getting back pain. Some time I get middle back pain also. Please let me how you diagonize this and what you suggest? which doctor do I consult and can I get rid of this permanantly? ### REPLY: Hello, Back pain radiating in a limb suggests compression of one of the nerve roots exiting the spinal column.  The most common cause for the compression is disc herniation, displacement of one of the cartilage discs located between the vertebrae.  Chronic changes to the vertebrae with formation of osteophytes, bony spurs, compression the nerve root are another cause.  The best means to diagnose it is a neurological physical exam and a lumbar MRI, I would start with a neurological consult. Most cases improve gradually, but it may be a recurring issue, as our columns continue to age with the passing of the years often it is difficult to get rid of it permanently.  Physical therapy is important to prevent recurrences. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my vagina is itching and burning after passing urine what is wrong? iam itching at the vagina and burning after passing urine. ### REPLY: Welcome to  Forum could be either a urinary or a vaginal infection. Is there any white or any other colored discharge, or a foul order from the vaginal discharge? Will need an examination, a urine test and medication.  Avoid intercourse for some time, and visit a gynecologist. Also keep the area clean, wash from front to back after each visit to the restroom, cotton panties, avoid scratching, plenty of water and less tea/coffee/alcohol. Takecare. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering with lower back pain for two and a half years, having sought help with chiropractor, physiotherapy, laser, and acupuncture treatments.  Have now had a MRI and met with a neurosurgeon who has indicated he can preform back surgery on my L5-S1 vertebrae. He said he would chip (removing bone) a passage way between the two.  I understand this procedure could also possibly be done by endoscopic surgery.  Is one better or safer than the other? ### REPLY: Hi, thanks for writing to . As all modalities of treatment have failed to provide you complete relief from pain, the next available option is surgical decompression. As you rightly said, endoscopic surgery is a better option than conventional open procedure. Endoscopic discectomy offers early return to your activities and generally, no bed rest is needed after this procedure. But, it has to be done by a surgeon having adequate experience in that field. Hope this information is helpful. Good day ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My brother has pain in the right side towards his back, he has been to A &E in Switzerland and our own Doctor who say he is constipated...he has has Movicol and I gave him some Dulcolax, he has now passed a motion, the pain goes and then returns, he is not eating or drinking much as food taste horrible, ### REPLY: Hi did review your concern. Such a pain described by your brother with constipation can be due to bowel problem, kidney problem, pancreas problem or vertebra bone problem. I would suggest an Ultrasound of abdomen to start with and a stool analysis as well as proper examination of his back and belly. Does he have any pain shooting to his legs? Also, if need be get a CT scan abdomen done, to rule many things out, however not needed at this moment. I hope this helps. Wish you a very healthy life ahead ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 headache witch I rarely get , I ve been to the dentist because I thought I had an absence on my right side dr. took xray nothing wrong with tooth . Said it might be nerve above tooth my question is could it be sinuses ? Had pain in my eyes last night , now pain behind eyes. ### REPLY: Hi. Thanks for the query. Yes, your symptoms can be due to sinus infections or Sinusitis as there are large sinuses behind the eyes. So my suggestion is to get a PNS view x-ray done to rule out the exact cause. If it is Sinusitis then antibiotics, anti-inflammatory painkillers like Ibuprofen and decongestant nasal spray like Xylometazoline can help. Along with it doing saline nasal irrigation, steam inhalation can help. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is rajith i am 30 years old .. my first Seizures with Epilepsy was attached at the age fo 13 years.. and continualsy attached 2 times with year gap in between.. at at the age of 16 the lost attack.. after so many log years alsmost 13 years .. again it attached 2013 March.. ### REPLY: Hi, Thanks for writing in. Seizure is due to abnormal electrical activity in your brain. It happens when there is a focus of small electrical discharge in the brain. The seizures in humans can happen even after many years and this can depend on the cause. It is important that you consult a neurologist and get clinically examined in detail. A CT scan and electroencephalography might be required. CT scan will tell if there is any structural problem that is causing your seizure and an encephalopathy will rule out any persistently discharging areas in the brain that can cause future seizures. Medications must be taken regularly to control seizures even if the cause of seizure is not known. These medications will raise the brain threshold of electrical activity in your brain and prevent precipitation of seizure. Please do not do high risk activities like .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have hip dysplasia and osteoarthritis. I am expecting hip replacement surgery at some point during my life. I have received two treatments of cortisone injections for pain. The first treatment helped for 4 days. The second one did not help at all. Are there other treatment options besides surgery? ### REPLY: Hi I appreciate your concern. I understand that your hip developed osteoarthritis due to dysplasia. People use steroids in to release pain, but it seems short term gain to some pts. I avoid this. Other .  Some are oral medicines others are injection in joints, giving promising results and minimize pain without painkillers. Most of my patients of OA knees are happy. Changing the wt loading area of femoral head by using arthrosis may help but depends on how much area of bone is affected. Your or tho expert may help u. thanks. I will be happy to answer any future query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a first year graduate students and I have a huge qualifying exam in three days. For about a week, I have been experiencing periods where it feels like my throat is closing up and I am about to pass out. They normally last an hour, maybe two, but I don t actually have any trouble breathing or swallowing, it just feels like I do. I think I am just having panic attacks, most of my family struggles with and is medicated for various types of anxiety disorders. I guess I am just looking for some confirmation that this is most likely what is going on. The last time it happened I was drinking coffee, and this time I just ate some peanut m&ms s. The overactive brain inside me is convinced I m going into anaphylactic shock, but I ate peanut butter every day last week, and nothing happened, and I don t have any known food allergies, so I feel like that s pretty unlikely. Thank you ### REPLY: Dear serve understand your concerns went through your details. PANIC ATTACK a sudden overwhelming feeling of acute and disabling anxiety. Panic disorder is different from the normal fear and anxiety reactions to stressful events. Panic disorder is a serious condition that strikes without reason or warning. Symptoms of panic disorder include sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart. Panic attack always happens due to an underlying anxiety disorder. So you need to treat anxiety disorder. Anxiety disorder is treated with the help of counseling and psychotherapy. You should consult a psychologist. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. 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: hi sir!.have  a  nice day,..i wanna know if  whats  the  meaning of  this doc.AST-26 IU-l 15-41  conventional units 26.IU/L 13-41ALT 13 L IU/l 14-54 conventional units 13.IU/L 8-54what the  meaning  of  this?i am  positive  of  hepa b?thank you.joanne ### REPLY: Thanks for using . I understand your concern. Brief answer: No. Detailed answer:The liver function reports(ALT, AST) are within normal limit and suggest that your liver is functioning fine. ALT, AST levels are commonly elevated in viral hepatitis.However, if you had succumbed to any risk for getting hepatitis B, advise you to screen for Bag(Surface antigen)assay test. Hope this information helps you. If any further questions, happy to answer you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear sir,             I am manoranjan das from odisha.My father is a kidney failure patient. Now he undergoes for dialysis for twice a week.some time once a week since 1year.He has sugar since last 2years.As you know dialysis in India is very expensive and we belong to middle class family.For that sir, I want to know is there have any ayurvedic or harbal treatment which reduces the frequancy of dialysis.Or is there have any final solution.As i saw many of people told if we take ayurvedic  medicine along with dialysis it results more harmful for patient.For me my fathers life is very important.But now we are not too strong about fainacial condition.Please suggest me proper guideline. ### REPLY: **1. Since both kidneys are not functioning properly thus one has to look out for Pre-renal/Renal and/or post renal cause of the same, but since your father is undergoing dialysis which means that his attending nephrologist has gone through the possibilities. 2. since he is suffering from sugar also, which implies two things:. Diabetic Nephropathy. Diabetic ESD [end stage renal disease], so along with alternate system of medicine one has to keep his blood sugar level within normal range along with normal levels mainly for blood urea, serum creatinine, serum potassium.4. . Take normal quantity of carboy . . Avoid potassium containing food like: tomato, fruit juice, coconut water, potato, chocolate, papaya, banana, grapes, cheese, and leafy vegetables. For calcium take plenty of milk, guava, fish. If serum creatinine increases, then protein intake has to be restricted. Be in constant/regular supervision of Urologist or your physician and check with the tests periodically since kidney function can/may deteriorate unexpectedly. You may ask for prescription medicine like: ravisher, sheet parfait, Chan ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 think i have a infected tooth it just started to chip away little by little but now i can start to taste puss in my mouth. I want to do a coconut oil pull to see if that remedy works. How dangerous s it to be tasting this puss and possibly swallowing it at times ? and what can i do to prevent it and will the oil pull work? ### REPLY: Hi. Welcome to  . As per your complaint it seems that infection has reached below the root tips of the infected tooth leading to Dental Abscess formation. Swallowing excess of pus can at times cause infection in stomach as well as throat. Oil pull can cause temporary relief but for permanent resolution consult an Oral Physician and get evaluated and an x-ray has to be done. In case if tooth can be saved then Root Canal treatment of tooth followed by antibiotics and painkillers can help. In case of gross decay extraction can be advised. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I m a 28 yr old male and lately I ve been waking up with very strong back pains which I m sure is due to my wrong sleeping ways. I ve been suffering from muscle knots and pinched nerves since then. My question is, I m having shortness of breath from time to time and slight numbness in my arms and muscular pain in my middle back, is that related to the pinched nerves and muscle knots? Heart beats are always normal,and so is my blood pressure. Also I was a heavy smoker, I used to smoke 2 packs a day and I suddenly dropped to 5 cigarettes a day. Could the shortness of breath be part of withdrawal? Thank u in advance. ### REPLY: Hello, I have studied your case and can assure you that shortness of breath is not due to with .  I would suggest you to get chest x-ray as chronic smoking may have damaged your lungs.  Other common cause of breathless can be due to anxiety. Nerve compression in the back never causes such symptoms.  I hope this answer will be useful for you. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a kid who is 13 months old. He does not eat well it is hard for me to make him eat. So i informed that to my Pediatrician and he gave me fortiron syrup. I just wanted know whether it is good to give my son the syrup. Whether it will cause any side effect. Do my son really suffer from Iron defecency so he is not eating ??? ### REPLY: Hi, the syrup name that you have mentioned contains iron and is an iron syrup which is given in child .  Iron syrup should not be given without proper evidence of iron deficiency anemia. You should do blood test like complete blood count with peripheral smear, iron studies and hemoglobin electrophoresis if your child is anemic. Based on the reports, proper treatment needs to be started. I hope this 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: After riding the Lawn Tractor over very rough terrain. When I got off the Lawn Tractor I immediately had a pain in my Right Buttocks . I realized that my wallet had been pounding on that area during the time I was mowing. There is no obvious bruise and it only hurts when I stand and walk. It get worse the more I am walking. Sitting and lying does not hurt at all. What is it? I think it is an inflamed bursa. What should I do to get some relief? ### REPLY: Yes, you are absolutely right.it's an aseptic inflamed traumatic bursitis of gluteal muscle. It may be due to localized pressure given by purse to the buttock muscles. Rest, icing and anti-inflammatory such as ibuprofen will give immediate relief. Hope this helps. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 24 years old guy,i had intercourse with my girlfriend adter a couple of weeks i felt slight pains in my penis and then when i wanted to urinate,it stopped for a while then later every morning i see a whitish discharge at the tip of my penis,the test i went for came back negative so i to doxycycline it stopped for a while and now i see the whitish discharge again but it is minimal this time,what is wrong with me?,or do i take cipro? ### REPLY: Welcome to  .1. Generally similar symptoms are seen in the STD (sexually transmitted diseases).2. I would recommend getting an appointment with your doctor as soon as possible.3. In your case I would ask for an urethral smear/discharge test done to find out the pathogens (infection cause) 4. After that a course of antibiotics accordingly.5. Do not delay as they give further complications in long run. (urethral strictures/infertility)Anything to ask ? Do not hesitate. 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 am a 34 yrs old male. never had any health problems! about 3 weeks ago i was diagnose with several blood clots in my lugs. i hospitalize and given heparin . Then i was put on loverax. for some reason i believe that medication raised my liver ensyme. all of my pass liver ensyme were well until i started taking loverax. i am stopping the meds and decided to start a rich diet of vitamine e and d supplements ! do you think this is a good idea??? i dont want to be on anymore meds that will cause me to have futuristic [roblems ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have blood clots in lung.  So you have high bleeding tendency.  You should take warfarin or aspirin.  If you don't take any blood thinner then there is high chance of clotting and leads to life-threatening events.  So don't stop any blood thinner without advice. 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: Have a hard mass in knuckle part of hand. Very painful and throbs, bringing tears to my eyes at times.  Had xray and MRI. Shows bone erosion. Could missing bone be bone cancer? I am 41 with no family history of bone cancer. Dr. Has not seen this before and doesnt know what it is. ### REPLY: Hi, Thanks for writing in. It is possible that you might have a bone cyst or a benign swelling which is causing your symptoms. The pain might be arising from stimulation of the nerves in the area. If it has happened slowly over more than 6 months to a year then it is a benign swelling. If it has increased in size within 3 months then a suspicion of cancer or an acute inflammation is to be thought of.However, the pictures of the bone erosion are to be evaluated in detail to know about any pattern of destruction on the lines of a cancer. Please upload your images and report if possible, and we can discuss the bone changes in your knuckle accurately. A FNAC from the swelling might help and this is a simple investigation by which few cells from the problem area are looked in to using a microscope. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 69 years of age, weight approx. 59 kilos and have had aplastic anemia for about 5 years.  I have received the Atgam treatment and have had what is called a partial recovery.  I have continued on cyclosporine until about four months ago.  My recent blood test shows my platelets as around 50. I have just noticed a very large bruise on my leg.  Is this a danger sign?  Should I recommence the cyclosporine? ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You have plastic anemia.  Your platelet count is reduced with signs of bleeding.  You should consult your doctor urgently.  You need platelet transfusion first. Then plan for cyclosporin according to your doctors' advice. 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. Don't forget to click, 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: Ive noticed very recently shortness of breath and the inability to take a deep breath. Its come on only recently and sporadically, but in the last few days has occurred more frequently and now comes with a little tingling of extremities. I am a 29 year old male who works out (lift weights) every day, very healthy diet, no smoking, only social drinking, etc. ### REPLY: Hi, Thank you for asking question on  Your symptoms suggest that it may be bronchial asthmatic occurs when you are exposed to some triggers or viral infection, if you have a family history of asthma or allergic skin disease like eczemaBetter consult a physician to confirm or rule out this possibility Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my nephew was just told by his tutor and in his iep that he could be borderline autistic and he cant learn anymore. he is 13 and i just dont see it. his grades are terrible and he wants to do well, and i think he can with attention from his mother(which he is lacking). how can i help him? ### REPLY: Thanks for the question.my experience says a borderline autistic can lead a normal life. But near and dears must take pains in teaching him various things. Instead of focusing on grades focus on his liking and try to develop it to the extent that it can be utilized for earning in later life. In this case lack of attention from mother, as said by you, may be the only factor causing bad grades. Which may be the sole cause for all the problems. Little extra love and encouragement shall help him. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi  Im 27 years old, Ive nightfall almost regular for 3days or sometimes gap of 7 days,become very weak, pain in back bone, penis shape has been changed. when my penis touch my bed, during errection in night its ejaculate even i awake some time, please save my life what to do? ### REPLY: Hello, The nightfall usually doesn't cause weakness. The semen usually discharged after few days because new semen constantly form in three to five days.  So you may need not worry about semen nightfall. It might happen because you might not practice masturbation. You can investigate with CBC, serum TSH estimation and serum calcium estimation for further workup. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with a staph infection on my right labia. I have had this reoccur 3 time in the last 5 years. Because the doctor caught it early this time, and there is only minimal pain, she has prescribed me an antibiotic (Bactrim) to heal the infection instead of draining the swelled spot. I had the last two drained, one in the ER and the other in surgery. It was very painful that time, and I never wanted to get it again. So here I am, missing work, and in pain.....doing what she asked me to do. I have taken lukewarm baths, and kept the area as dry and clean as a can, and have been taking the antibiotic. My question is this......is there ANYTHING else I can do to speed up the healing process? Also, How long do I have to wait until it is safe to make love to my husband again? ### REPLY: Hello, Thank you for your contact to . If I am your doctor I advise you to do sensitivity of the isolated staphylococcus. As you infected repeatedly it is advice to you to take the complete course of antibiotics according to sensitivity. I advise you to take diclofenac for analgesics and seratopeptidase for healing enhancer. If you have to ask me anything you can ask me. Thank you. . Infectious disease specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I found 2 bumps behind the ear near the hair line on both side of my 7 week old grandaughter. I am very concerned she appears very healthy growing and doing great. I hated to say anything to my daughter as I hated for her to get so upset before her next Dr. appt. on the 17th. They are about the size of a bb and do move with the skin, and appears that it does not hurt. Please hope you can give me some good news. She is our main life right now and I pray it is nothing. On the right side about 1/2 inch below the one at the hair line is another tiny one on the neck. I feel it is lump knobs but why would this happen? ### REPLY: Welcome to  I am  and I will help you with your problem have gone through your question. It appears to be posterior cervical lymphadenopathy, mostly commonly caused by upper respiratory tract infection. Viral is more common than bacterial. Bacterial which is usually staphylococcus and streptococcus, needs antibiotics. While in viral infection the lymphadenopathy is mostly self limiting, requiring no treatment apart from spy paracetamol for symptomatic relief. I hope my answer will help you. Do rate it, if you like it. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 2 yr old has had slight blood shot eye for over a month and in the last few weeks ive notcied a growth or lump on the edge of her iris. today i think i saw a nother lump starting bleow the first . its on teh side away from her nose close to her ear but on the iris ring itself .. what can this be from. when she was born she has up beating nystagmus which has calmed down so much its almost gone. her vison was fine when tested last year. she has hod tonsilitis for 3 months straight atm and still currently on antibotics for it . shouldi be worried about the growth forming on her iris? ### REPLY: Hi. Thanks for your query. Growth / lumps on the iris, on the edge of the eyes in a girl of 2-year-old has to be worried about, as this is the rarest to occur. First you have to Consult a Pediatric surgeon as well as the Ophthalmologist to see what the diagnosis is, whether this is related to the local growth or some sort of tumor to be worried about, If needed go for excision and biopsy to get a confirmed diagnosis to get the most proper treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter has 5 year old is suffering with dry cough .the doctor says she has some as ma problem.but in her five year old the cough is only noticed two more time. so he suggested the following medicines  1 OMNACORTIL SOLUTION 5 MG 2 AZITROMYCIN ORAL SUSPENSION 200 MG 3. LEVOLIN SYRUP FOR TREE TIMES ### REPLY: Hi, it is difficult to tell from a portal whether she has asthma or not. She requires further testing and observation. If her cough is relieved with those .  It is too early to conclude that she has asthma. A careful followup of her symptoms would help. Try to find out the factors that are triggering cough in her. An allergic panel test for common antigens and IG E levels would help immensely in identifying the cause of recurrent allergic cough. Hope this helped. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 done for drink driving,  I am an alcoholic but have taken milk thistle for fifteen years, but have to have a medical before i can get my licence back. I have to have a urine and blood sample. I have done numerous urine test strips at home for bilibrubin and eurogloblin and they are negative. But the blood test involves ALT AST and GGT I am worried that they will be high. I cant tell my GP, and i cant do the blood test myself.  How can I   a.. find out if they are high or   b ..reduce them if they are.  Thanks Ellen ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. GGT will be definitely high. ALT, AST will depend on the liver function.2. Unless you don't give your blood sample, there is no other possibility.3. Urobilinogen can be tested in urine by holding it in a test tube and shaking it. You can appreciate yellow foam, if present. Bilirubin, however requires laboratory test. If high, you could have citrus, and jaundice. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: LUMBAR SPONDYLOSIS . DIFFUSE BULGES OF L3/4 AND L4/5 DISCS WITH POSTEROCENTRAL PROTRUSIONS. WHY THIS HAPPENS AND WHAT IS THE TREATMENT FOR THIS AND EFFECTS ON OTHER PARTS OF THE BODY IS THERE ANY OPERATIONS FOR THIS PROBLEM IF SO WHICH PART WILL OPERATED UP ON. IS THERE ANY MEDICATION CURE FOR THIS PROBLEM REPORT:Multiplanar multiecho MR imaging of the lumbosacral spine has been performed scoliosis of the lumbar spine is seen with convexity to right. The discs show variable hypointense signals of T2 weighted images suggestive of defeneration. The L3/4 and L4/5 discs show loss of height. Rest of the discs are normal is height. The L3/4 and L4/5 discs show diffuse bulges with posterocentral protrusions resulting in bilateral foraminal narrowing and indenting the thecal sac . ### REPLY: Hello, Thanks for the query, Please note that these MRI findings should be interpreted with caution as these finding are commonly seen in patients with back pain. The treatment for such patients largely depends upon the clinical signs elicited by a neurologist. If there is pain alone, the patient will improve with medications and physiotherapy. But if the patient has neurological deficit along with pain, he/she may benefit with surgical removal of the disc which is causing the problem. The cause of the problem is degenerative changes in the disc bones and muscles and ligaments. Hope this helps Best wishes .  .com/doctors/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, thank you in advance. I generally take tylenol ES(500mg)I take 2 pills every 4 hrs for herniated discs and thoracic outlet syndrome. I accidentally took 1500mg in one dose. Am I going to have liver damage? I don t exceed 4000mg in one day. Thank you! ### REPLY: Hi, Age, gender, purpose of taking Tylenol, any associated illness or alcohol intake not mentioned. If taken in larger doses it may cause liver damage. For adults normal dose of Tylenol is 325 mg to 1 gram orally every 4 to 6 hours. If the daily dose for adults exceeds 4 gram per 24 hours then the liver damage occurs. Taking 1500 mg of Tylenol in one dose is usually not going to harm the liver however, if a person is an alcoholic or taking some other medications which are known to cause liver injury may increase the risk of in liver damage. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, My one month old baby stuck in the space between wall and the bed. Her body was on the bed and her face was below the bed with face facing downwards and she was on her tummy. It was found that her position was changed to rolling position from the normal lying back position when her head was stuck. she was crying badly and her face colour was blue. No swelling and no bruises were found on her face or head. After one week she started vomiting initially with little amount and then with high qantity and with high force. Later on, when she was 13 Weeks it was found that she had a chronic brain hamerrage but she needs no treatment, she was just kept in the hospital under observation for a week or so and her head circumference was monitered but she was perfectly fine and normal and was discharged with no treatment but just a routine and follow up check ups. Now she is 13 MONTHS old and her physical and mental growth is absolutely normal. My question is wheather that incident happened when she was just One Month can be a cause of her brain hamerrage and what is chronic brain hamerrage. And for her chronic subdural brain hamerrage its important that she must had any swelling or bruises on her face or head, which she didn t had at that time. Her head was stuck in the space between the bed and the bed but she didn t fall from the bed. And I want your expert opinion about my baby subdural brain hamerrage and what you think what would be the cause of her subdural brain hamerrage. And if that incident when my baby s head stuck between the wall and the bed is a probable cause of her brain hamerrage then why there was no visible swelling and bruises on her face or head. Or if the vomiting can be the reason of her brain hamerrage then kindly explain how? and whether that initial incident have any relation to that vomiting episode. thank you very much. ### REPLY: Hello, I do not think the vomiting is the reason for the chronic subdural hemorrhage. The abnormal position and twisting while she was on the bed could be the reason for the subdural hemorrhage. But as she is developmentally normal now I do not think there is any reason for you to worry about this. But to answer your question the hemorrhage could not be because of the vomiting but rather vomiting is the effect of the subdural hemorrhage. Hope I have answered your query. Let me know if I can assist you further. Take care.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I noticed today a small pain when siting down. Once I got home I went n the bathroom only to discover a small lump between my butt cheeks. I had my room mae take a look and while looking a head apeared and it popped. There was a thick white pus to come out and a clump that was harder than any normal pus. I am in a lot of pain and I have no idea what this could be. Should I. Go to the emergency room because it wasnt there this morning when I washed. It just appeared out of nowhere ### REPLY: Hello, You had noticed a lump today at the advanced stage of popping out and has developed underneath the skin over the last few days. The bruise in the butt cheek got infected and got burrowed with infection underneath the skin there. As its deep down with more cellulitis, its more painful. Treat it with surgeon consultation with antibiotics or anti-inflammatory . After recovery adequate surgical  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor,My daughter have fever and throt infection. We went to doctor for this and he told to test the blod. The value of aso titre is 210 and ESR is 60. is this a dangerous sistuation,Her mother have rhemuatic herat disease and valve has been replased. Please help me in this regard. Thanks . ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She has upper respiratory tract infection by streptococci. She should take a course of antibiotics like azithromycin or amoxy-clav. For fever, she can use paracetamol as and when required. Warm saline water gargles are useful. These antibiotics are prescription based medicine so consult your doctor and take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . 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: Hello Dr. Samuel,Today is the 3rd year anniversary of my hysterectomy as well as the removal of my left ovary.  I have been trying my best to stay healthy, but despite my best efforts, it has been really a struggle to keep my stress levels down since I also take care of my little boy who has special needs.  I had been having a lot of discomfort on my right side and it was discovered last November that my right ovary has also developed a cyst.  My primary physician Rx vit. D3 as well as some iodine and the ultrasound shows that it is not cancerous, but recently I have been experiencing a lot of pain once again.  I guess my question is:  If I have to have this last remaining ovary removed, will this force me into premature menopause?  And if yes, will taking hormones be risky for my heart?  I currently see a cardiologist for an enlarged heart due to high blood pressure.  Thank you so much for your time. ### REPLY: Hello, Welcome to . Just a simple cyst in left ovary usually does cause a severe pain abdomen. Please repeat an ultrasound abdomen. Cyst in ovary may cause severe pain if it undergoes torsion. If nothing found then do an MRI abdomen. Right side abdominal pain may be due to Appendicitis, colitis, Internal Hernia, etc. Now you have only right ovary left. If this is also removed, definitely it may cause premature menopause. Because removal of both ovaries may result in depletion of estrogen and progesterone.Thus, Hormone replacement therapy becomes essential to decrease the side effects of depletion of hormones. Earlier it was thought that HRT increases the heart attack, deep vein thrombosis and stroke. But now if it is concluded that HRT significantly reduces the risk of mortality, heart failure, or heart attack, without any apparent increase of breast cancer, deep vein thrombosis or stroke. So better consult cardiologist and taking HRT is essential before removal of your right ovary. Hope this Helps. Take care. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had anal sex with my boyfriend a few days ago and have now noticed a small, hard lump near the entrance to my anus . I am very concerned about this. Before having anal intercourse my anus was itchy and sometimes there was a little red blood on the toilet paper but I think it was because I wiped too hard. It is now hurting when I sit down and I feel like there is a mass in my anus. I am so worried that it is something like Anal Cancer . I do suffer from IBS though by the way. Please Help! ### REPLY: It is highly unlikely to be anal cancer by the picture that you have given. It is more likely to be a localized infection which got aggravated by the intercourse. I would suggest you to take a tub full of warm water, put a tablet of potassium permanganate in it and sit in the tub for 15 minutes thrice daily. Also take Tab ciprofloxacin 500 mg twice daily and apply ointment nitroglycerin (just a small amount) at the anal opening before passing stools. Avoid constipation and anal intercourse. If the symptoms don't get relieved in a week, show yourself to a surgeon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 currently 29 years old. 6 years ago (age 23), I had to have an emergent double cardiac bypass related to inflammatory occlusion from my Takayasus aortitis. I am otherwise very healthy an have not had any complications following surgery and my grafts are patent. Is it okay for me to ride steel roller coasters? Is there anything about the shifts in gravity that would be contraindicated? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you should not ride on any roller coaster ride. These rides can damage operated vessels. Actually, there is sign board stating that bypass patients are not allowed in roller coasters. This is because they are not safe such patients. So better not to take ride in such roller coasters as it can cause sudden death in such patients. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am Swachetana. I am not happy with my life. I dont have anything to live. Have you ever seen the continuas death of your dreams?? my carrier has lost, I am a looser nothing alse. I just can not bear this pain that I am loosing everything. Everybody around me is successful. I dont know how long I can bear this pain. I am 27 years old, married. and I am only daughter of my parents also. If you see me nothing is absurd in my life. But ........................... My father suddenly got cardiac problem, that time I was there in Anmdhra Pradesh. i came and i stayed in Calcutta for his treatment. two months I stragulled against death. At last He survived. Just after this my husband lost the job. and I went there with him. but every day is just impossible. I also started trying for job but dont know whethere the world is agianst us or not. I can not speak to anyone, can not cry, can not do any thing so that I get some relief. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I sincerely suggest that you are victim of your own negative thinking. You cannot term your current state of mind as clinical depression. Rather, this is just disappointment. Disappointment which arises out of unforeseen life events do bring such symptoms like sadness, irritation, anger, lethargy, lack of interest, lack of appetite etc. Please understand this fact and make sure to introspect. Talking to your friends, outdoor activities and being creative should give you relief. Find the reason for your disappointment and consult a psychologist if need be. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 9mm module on my gallbladder and my doctor wants to wait 6 months. I have had pain and have been sick for the past 4 weeks. I also have been heading sever headaches and unalbe to sleep so he gave me sleeping pills ......my WBC count was at 12 and I also have an ammune diease which is making me really concerned. I am now at the point that I need a sceond opinion. ### REPLY: HIA nodule which is symptomatic should be removed as early as possible and specimen should be sent for biopsy to rule out if polyp is malignant or not however most of the polyps less than 10 mm are usually benign. Elevated WBC count can be due to inflammation in gall bladder, Sometimes inflamed area is infected by bacteria, as you already have an immune disease polyp should be removed at the earliest. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have constant ringing in both ears, my balance is off, I am dizzy ears have occasional shooting pain. Went to an express care facility was told I have and ear infection. was given ear drops to put in 4 times a day.I have done this for 2 days and it seems worse. I may need to go back. ears feel weighted. ### REPLY: Hello, it seems local antibiotic you took is not working on your ear infection. What is the antibiotic you are using? There are several reasons for the persistent symptoms. Maybe the antibiotic is not sensitive for the bug.  Other thing is even if the infection is settled edema and inflammation inside the middle ear take few weeks to settle. So vertigo and dizziness may take few was to fade.  Any way if the infection not settling we have to do culture Pabst of the ear discharge. Sometimes fungal infections also produce similar symptoms. But the treatment differs. Hope this helps.thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have Complex PTSD, Bipolar 2 with a history of psychosis, major anxiety (probably due to my PTSD). I have a past history of bulemia and a current history of overeating. I had a past history of cuttiing until last night. I take 200mg of Lamictal 2x a day, Wellbutrin 75mg in the am, Klonopin 1mg, 1 during the day and 3 at night, Seroquel 75mg, Trileptal 300mg 2x a day. I started to feel a little more depressed so my psych allowed me to increase my dose of Wellbutrin to 1 1/2 tabs. I then became severely depressed, unable to get out of bed for several weeks. I cut back my Wellbutrin dose to 75mg and after about a week became hypomanic with some hallucinations. I am now experiencing quick cycling as well as major depression and self-esteem. I hurt so bad inside last night that I cut myself, superficially, but I wanted to cut all over to make the pain and voices inside stop. I also wanted to die. No plan, no desire to actually kilk myself, but a desire for the madness, so to speak end. I am coming to you for help because I have a new psych doc that I cannot get in to see for almost 2 weeks. I would go to the hospital but since I am not actively a threat to myself or others, I would be released quickly. As for now, is there anything I can to to safely change my meds dosages to help? ### REPLY: HiT hanks for using  In your case, you need a good mood stabilizer like lithium or valproate. Capital and Oriental may have .  Your dose of capital is very high and there is need to taper it down gradually. It could cause serious skin side effects. You can take high dose of Seroquel for control underline depression. Better to consult a psychiatrist to readjust medication and in case, you need my help, you can ask. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 12 year old daughter has extensive vitiligo which developed when she was 6 years old. I am reluctant to give her any drugs unless absolutely necessary. I am sure you are all advocates of the HPV vaccine but.....not sure what I am trying to ask. Will it make the vitilgo worse, affect an already too strong immune system? She is a very healthy (one cold in 5 years) tall, slim young lady. Thank Regards Susan ### REPLY: Hi, Vitiligo is an autoimmune disease with genetic influence. It is a unpredictable disease. Sometimes it may clear by itself without any treatment. In many cases it may become extensive. While in few cases it may remain stable. Anything wrong or right for the body may exacerbate or improve the disease. It is very difficult to answer about your query, HPV vaccines effect on vitiligo process. You have to decide what you wish. If the vaccine is necessary, you may give. You consult dermatologist personally to have better ideas about vitiligo. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am looking into birth control. I have never had intercourse, but will be getting married and we are not looking to get pregnant right away. I have never taken a birth control. I have a high stress, constantly moving career, and am in need of a birth control that will not create to much of a disrupt in my life. What recommendations could you make ### REPLY: Hello misunderstand your concernNewer birth control pill like yam, ya mini and felon have very few side effects. I advise you to take any of the above birth control pill. You have to use pill regularly on the same time. You have to make habit to take regularly by putting reminder in the mobile. As you are using it first time there may be chance of delay period. If you miss one pill then take it as early as possible or on the next day with the that day of pill. If you will miss two pills then take two missed pills along with nest day pill and use barrier contraception like condom foe next 7 days. Other option is barrier contraception. So convince your partner to use condoms. Hope this may help you Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 21 year old healthy son has started getting palpitations, shortness of breath lasting about 15 seconds. almost always at night in sleep, or at night watching TV. episodes in last 6 weeks. ekg, echo and holter monitor all negative. he doesnt drink or smoke or do drugs,. he is not over weight, doesnt excercize much. normal kid otherwise. all blood work all normal. dr s prescribing beta blockers, but we looking for a 2nd opinion before starting any meds. thoughts? ### REPLY: Hello! Thank you for your asking on ! I read your question carefully and understand your concern. I would like to explain that as long as all his performed cardiac tests result normal, we can exclude any cardiac related disorder, causing this clinical scenario. Anxiety (panic attacks)can be a cause of this symptomatology. Thyroid hormone imbalance could also mimic these symptoms. As you refer, these episodes usually occur at night during sleeping, so a sleep disorder with autonomic reaction (like nightmares), can't be excluded. I recommend performing some lab tests like: a complete blood count, thyroid hormone levels, kidney and liver function tests, blood electrolytes to exclude a possible metabolic disorder related to his symptoms. A polysomnography may be necessary to exclude a possible sleep disorder. If all the above tests result normal, .  Hope to have been of help! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father is 63 years old..due to his difficulty in walking,incoordination movement, stroke and HTN,i go to doctor..doctor suggest for MRI test.. findings: of MRI report is bilateral perventicular T2-FLAIR hyperintense areas are seen.faint T2-FLAIR is noted in both ganglio thalamic regions.the lateral and the third venticles are dilated.others are normal. impression: mild central cerebral atropy with bilateral periventricular chronic ischaemic changes. what happen in my father..will he be dead..what can i do..sir,thanks a lot for your answer..i was visited neurologist..he said that, it is not curable..nobody(neurologist) in the world can treatment for this diseases..he also said that,my father gets to worse gradually..what can i do?please please give me advice.. ### REPLY: Hi, Thank you for contacting . MRI and clinical findings are suggestive of brain strokes due to decreased blood supply to the brain. He needs treatment with antiplatelet agents such as aspirin. In addition, risk factors for brain stroke should be identified and treated. These include diabetes, hypertension, high cholesterol, heart disease, etc. Please consult a neurologist. With good treatment, your father can have a long life. Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got my wisdom teeth removed on Monday and I am 14 and I only got 2 on the left side out. And right now the bottom periodically bleeds and throbs and there also is a "flap" there too and I can still feel my stitches, I am worried that this is a dry socket, should I go get seen before my follow up appointment with my oral surgeon?. ### REPLY: Thanks for your query, I have gone through your query. The .  It might be suture material what you are feeling. The bleeding could be because of the inflammation. Once you meet the surgeon get the stitches removed after 7 days of extraction. And get the extracted socket region irrigated with saline and Betadine. Maintain oral hygiene by rinsing your mouth with saline. 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: my 20 week old son - corrected age is 15 weeks , born via emergency c sec i had major previa and haemmoraged and he was born not breathing , with fluid on his lungs nd was revived then ventilated and remained in scbu for 2 weeks - he has a virus 2 weeks after getting his first immunisations but i am concerned about his face being grey around his mouth eyes and nose, chest is clear he has a mild rash and is vomiting. i often thought the grey areas were wind but the eyes and nose shouldnt be so grey should they !? he sometimes wakes up gasping because he has missed a few breaths in his sleep ( apnea ? ) should i be concernedthat his oxygen levels are low? he was also born with blood level of 8.9 but turned out to not need a transfusion, his levels dropped to 8.6 at 4 weeks old but they ave not followed it up since. he does ave folic acid, sodium feredate andd dalivit daily so i presume these help maintain his levels. sorry if this is hit n miss info, so many points to make to try to get a more accurate diagnosis. eoh and he is still feeding and soiling nappies well sincere regards sincere regards ### REPLY: Hi, Welcome to . I have read your question in detail and I know that you are very concerned about your child. Mild rash and vomiting is normal in a 15-week child, for this you have to do burping more. All babies vomit a little milk after feed, this is a normal thing. Greying of face around mouth, eyes and nose with few apnea episodes is a matter of concern. It could be due to congenital heart disease or hypoxia. I think an echocardiography should be done to rule out congenital heart disease. Also, a complete bold count should be done to know the exact hemoglobin levels. It will guide us that whether we should continue hepatitis or not. I hope this will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, I am male with age 38, today I got a blood checkup done and my Cholestrol is 213, HDL is 32, LDL is 135 and TGL is 217, AST is 43, ALT is 55 and Gamma GT is 157, my sugar, creatinine tests are in the normal range. will this be due to my drinking habit, I consume about 6 pegs of alchohol regularly . Please advice what needs to be taken care immediately in addition to reducing the drinking. ### REPLY: Hi dairy GGT is very high. It must be due to long alcohol intake for a long time. In the long run, it can lead to loss of appetite, jaundice, fatty liver or even liver failure. Reduce your alcohol consumption to zero in next 2 days. For medicinal help or to leave alcohol at home I can help you. You don't need to go to a de addiction center if you are with a specialist in proper care at home. Best of Luck!!!!!!!! Feel free to contact me at . Com or call me anytime. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 am AAAA , I was diagonised with neurocysticercosis in left parital region of brain after getting seizure in right side of my body. I was given treatment of albendazole and Trieptal, then shifted to Valporic acid 500mg twice a day morining and evening. I took that medicine for two and half years , my recent CT scan shows healed neurocysticercosis with calcification . Now my doctor has tappered my dose to 300 mg twice , currently taking 300 mg twice for three months. Now my doctor is saying to stopb the medicine as it has side effect. But my problem is that still i get strange sensation in right side and feel like jerk. I also sometimes experience pain in the finger which has first shown the symptom of seizure . I have explained all this all to my doctor , but he is still saying to stop the medicine. I really fear all the time regarding re-currence of seizure. Pls. help me what to do. ### REPLY: Hi, Thank you for posting your query. Neurocysticercosis is a common cause of seizures in India, and several other countries. It is good to note that your cysticercus infection has healed. However, there is a mild increased risk of seizures even in cases of healed cysticercus granuloma. So, I agree with your concern that you could have seizures after stopping the anti-epileptic .  One method to find out whether you could have seizures in future is to do an MRI brain (Magnetization transfer sequence) to look for perilesional gloss (scar the site of infection). If a scar is present, then, it is better for you to continue Tripodal (oxcarbazepine). Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi..im a 23 yr old female..I was detected with malaria 4 days ago and am still under medications. .im am extremely tired all day..I fell dizzy as I walk...my head feels heavy all the time .that I am on bed during the entire day..at night I vomit and have stomach crunches and hence am nt able to sleep properly...I am not able to eat anything at all. Please help ### REPLY: Hello, Welcome to , and thanks for your query. The symptoms you experience are due to malaria and the treatment you took for it. You will feel better in a couple of days. Your abdominal cramps can be reduced with antispasmodics like Tuscan and simple appetite stimulants would improve your appetite. For the present take more fluids like soups and yogurt and rice gruel would help you feel better. I shall be happy to answer any further query. Wish you a quick recovery .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have emphysema.  Nearly a week ago I recovered from nearly six weeks of bronchitis and sinusitis.  I still become much more breathless than I did before this, with minimal exertion.  A couple months ago I could walk a couple miles quickly.  I still have problems with a couple blocks.  What can I do? ### REPLY: Thanks for your question on . I can understand your concern. Emphysema is chronic progressive lung disease. It is further worsened by respiratory tract infection. So your current symptoms are due to worsening of emphysema. So you should take inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone) regularly. Get done PFT (Pulmonary Function Test) every six monthly to know the progress of disease. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am just getting over a head cold and still have a dry cough which wakes me up at night. I am taking Mucinex and coughing up phlegm. I am 64, 5 3 , and weigh 150 lbs. I just noticed that there are bumps on the back of my tongue. Do you know the cause of these and if I can get rid of them? ### REPLY: Thanks for your query, I have gone through your query. The bumps at the back of the tongue can be an enlarged circumvallate papilla. This can occur secondary to any bacterial or fungal infection or trauma. Consult an oral physician and get it evaluated. Meanwhile you can take a course of antibiotics like amoxicillin(if you are not allergic), do saline gargling. 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 Bladder Cancer and I had the Tumor removed 2/21/13. I had BCG treatments following the removal of the Tumor. It was supposed to be an outpatient surgery however it took much longer than it was supposed to because of the bleeding and cutting involved.  Today I had another Cystoscopy and he saw a growth that requires it to be removed again.  Why wouldnt a 2nd Cystoscopy be performed prior to the treatments to insure that all Cancer was removed visually at least prior to wasting 6 weeks of BCG treatment only to discover growth?  It makes no sense to me why one would assume everything was removed if it was that extensive.  Is it an ego thing that the doctor wouldnt consider looking to check his work to insure everything was good prior to jumping into BCG therapy? ### REPLY: Hi and welcome to . Thank you for the query. It is hard to say was it necessary to do cystoscopy. Because BCG is considered to strengthen immune response and prevent tumor recurrence. This is important even when there are no signs of tumor because there can be micrometastases or tumors which aren't visible. SO BCG would be helpful in such circumstances. All in all there is more benefit of BCG than cost. And it isn't so important to establish that there is tumor recurrence. Wish you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I did IVF and had a scan at 5 weeks 6 days where the yolk sac was seen but no fetal pole. My gestational sack measured 5mm and yolk sack measured 1mm. Today I went in at 6 weeks and 5 days and the gestational sack measured 7mm and yolk sack measured 3mm. I believe I had a late implanter but could it have implanted so late to have these pore results. They want me to start a DandC but I just can t yet so I asked for another ultrasound. It is scheduled for 7 weeks and 5 days. Could you please tell me if there is any hope. ### REPLY: Hallow Dear, The very fact gestational sac and yolk sac are showing progressive growth, the implantation seems to be successful in your case. You should try to get the information about the fetal pole in the gestational sac which proves this to be fairly normal conception. Please ask this to your doctor. Meanwhile, please continue to take Tab. Folic acid daily. This will help good implantation and development of placenta and the baby. I hope this helps you.  ### END