Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 low amh of 0.2... visited 2 docs one suggested dheapreg(dehydroepiandrosterone-micronized)- 25mg thrice daily and the other suggested the same twice...for 3 months.. what is the accurate dose.. i have no other problem.. all other hormonal levelss, usg. hsg test are normal.. my husband s sperm count is 61 million with 35% aggressive motility .. can i concieve on my own or should i go for ivf ..will i need donor eggs... had 7 failed iui s... should i go for lap dye test and hysteroscopy before ivf.. if i need to go for ivf should i go for it after completing the dose for dheapreg... can dheapreg and ovofar( clomifene citrate)-50mg be taken together on d3-d8 of menstrual cycle.. or should i stop dheapreg for the 5 days i am taking ovofar please help we are both 35 and will love to get ur advise ### REPLY: Hi, Thanks for your query. I have read your query & I understand your concerns. The dose of DHEA you are taking is adequate.  I absolutely see no point in you wasting any more time. Please get FSH levels done and also AFC checked. Based on these 2 parameters hurry with IVF as your AMH value of 0.2 is extremely low. Please see an infertility specialist in an IVF center immediately. 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: I have been experiencing chest pain in between my breasts (feels like breastbone or muscle) It feels like a pulling sensation and only happens at night when I move a certain way..last night the pain radiated from my breast to under my arm.  I have no shortness of breath or dizziness.  I had bronchitis about 3 weeks ago and mostly over it except still coughing up some mucus.  Is the pain I am experiencing from the bronchitis or am I experiencing angina?  I do smoke, trying to quit, but its been difficult but am down to around 5 cigarettes and I am smoking them at night.  I took 2 aspirin and the pain subsided. ### REPLY: Hi welcome to ... You have chest pain along with radiation of pain toward left side arm ... So it could be coronary artery stenosis like case for ex...angina ... For that investigate with ....1. Blood pressure checking 2. Stress test 3. Echocardiography If coronary stenosis present arbitrate given for relief of stenosis ... And antiplatelet .  ... You have cough and mucus also, so thus could be bronchitis chest pain also ... For that chest x-ray and spirometry done with CBC . If needed antibiotic given for that ... Take care. . Consult pulmonologist for this ..... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I am a 57 year old female. I weigh 192 pounds and I am 56. In 2009 my gall bladder was removed because of gallstones. Back then my liver enzymes were elevated. I recently had my enzymes checked and the results were AST 86 and ALT 47. I do not drink alcohol or take any drug or medication. I have been tested for hepatitis and the results are negative. How should I proceed? Thank you. ### REPLY: Hello, elevated transaminase have several possible causes. In your case it seems you could benefit from an appropriate diet. Fatty liver is a common cause of asymptomatic enzyme elevation, resulting mainly from increased body weight. Your next step should be a liver ultrasound which is an easy way to diagnose the most common conditions related to elevated enzymes. Other tests might be needed depending on the results of the ultrasound. I hope I've helped you. Good luck! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been experiencing pain in my mid back - radiates to my right side. I thought it was like lower back pain, which I have had for many years, but this pain is sharper. I get some relief from icing, but I get up & it returns. also thought it was related to my job, office work-sitting 8 hrs a day because I had something similar, a couple years ago. stretching, swimming did bring relief at that time. going on daily for over 1 month. started swimming again in june, saw my DR. & he suggested to not swim for 1 week, but still no relief. i am 5 2 & weigh 225, have also been dieting 4 wks also & lost 15 pounds - balanced protein, carb & fats. I sleep well, no pain at all when I am laying down. ### REPLY: Hello, I have studied your case. Most probable reason for your symptoms could be postural problem as you may be sitting for long time and obesity. I will advise you to do MRI spine to see for any disc bulge or spinal canal stenosis. And also check your it B12 and it D3 level. Medication like methylcobalamine and analgesic will reduce pain. You can continue yoga exercises and focus on spine extension exercises. Some exercises which can be done include-Spine extension exercises, Lying on your stomach flat lift leg 6 inches from ground, do it for other leg. Now lift both hand and leg simultaneously, 6 inches off the ground and supposition for around 10 breathes. Core stabilizing spine exercises will help. You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case. If not relieved you can take epidural injection. You can cure disease by doing all modalities with balancing your posture habits. Hope this helps. Wish you a speedy recovery.  If you find this answer helpful do not hesitate to rate this answer at end of discussion. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my 6 month old has had diarriea for over a week now and is having about 10 dirty nappys a day, they are very smelly and she seems to be in pain while she is doing one, she is on sma stay down formula milk, has she has reflux she has been on this milk about three months now, what could this be? ### REPLY: Let me assure you that it is normal for a child of this age to pass stool 10 times a day or even after each feed. It is not a cause for concern. Most formula milks are cow milk based and hence difficult to digest. Undigested food matter can be degraded by intestinal bacteria to give foul smelling stools. In case diarrhea actually occurs, it is generally due to a virus called rotavirus and is a self limiting condition. The reflux could be due to inadequate burping. You need to hold the bay upright for about 20 mins after each feed to prevent reflux from occurring. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 abrasions on the vaginal labia. what home remedies/over the counter medications can I use to treat it. I am 5feet and 3 inches tall and weigh 144 pounds. I remember getting it scratched with a sponge  while I was showering. I did not think it would develop to a redish spot that looks like a wound and is painful when I pass urine. ### REPLY: Hello, Thanks for the query.It's better to get thorough examination done by a Gone. In the meanwhile you can do the following. You can apply Ghee (clarified ghee) on that area. If Shatdhauta Rita is available, its better. Mixture of honey and ghee can also be applied. It aids in wound healing. Orally Turmeric powder 1 SF with milk / lukewarm water twice a day after meals can be parentheses will help in healing in a couple of days. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I (male) have been diagnoised with low hemoglobin (9.0) due to a recent loss of blood (ulcer). I am feeling really tired and was told by my family Doctor that it would be a slow process to regaining my normal degree (12.0 -14.0) Can I request a blood tranfusion? ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  But till possible you should avoid blood transfusion. He level 9 is low but not an indication for blood transfusion.  You should take oral or injectable iron. Because there are many risks of blood transfusion. So consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My baby is almost 7 months old and he passes stool 6-7 times a day after feeding or eating something.  I met Dr. Baldev Raj in Sonepat he gives me medicine Verlak and Meftal spas is that ok.  i gave him boiled water and electrol so many times in a day.  How i prevent my son from this, he is going weak like. ### REPLY: Hi, Thanks and welcome to  .7 months baby passing 6-7 motions /day soon after feeds is quite Normal. It is because of brisk gastronomic reflex present in infants. Continue feeding as usual. At best, you may give Sporadic one sachet daily for 3-4 days. You need not worry about this. As the baby grows everything will set right. Hope this reply will serve your purpose. Please feel free to ask further queries if any. . V. Subrahmanyam. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am concerned about my children being around a person with lung cancer that is spitting up blood and phlegm (sputum).  The sputum has cancer cells in it and I am afraid if they (all of us) breathe in cancer cells we could contract cancer.  Is this possible. ### REPLY: Hi, Thanks for writing in. Cancer is never spread by breathing cancer cells. If there is a person with lung cancer in the household then it is not a problem to inhale the same air. We doctor work all the time with cancer patients and talk to hem for hours without any risk of ourselves getting it. Child .  It is best to provide him with sputum cups which can be safely disposed.However, it is important to make sure that he does not have any infection that is causing blood and coughing in sputum. Should he be having any infection then please get him treated for it immediately? Lung cancer is never contagious through sputum. 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 have fistula by birth between nose & upper lip dr said it should remove by surgery. it has white discharge in 2-4 days if i will not press it.  it is of 1/2 inch inside center of two nose pore. now my ques. is  if we will not do the surgery. what will happen it will increase or hard to surgery after some yrs. ### REPLY: Hello, Thanks for posting in . Any fistula is abnormal in human body. As such the fistula you mentioned do not have any urgent hazardous effects, but it will be always better to get it corrected with surgery. As you have not mentioned your age here, so it will be difficult to comment on urgency. It might give rise to problems as you have mentioned of rec curing infections or food might go in Bose causing undue problems. But preferably it will be better to undergo surgery and get it closed. Delaying it will not make repair difficult, but complications like above stated might arise. Hope it answers your query. 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: wake up in the middle of the night then all of a sudden spinning n dizziness also like pressure I m assuming, I shut my eyes wen it does this to me happens one or twice a month I really would like to know how to control this .. I have this after I have dreams... ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to pathology in the Vestibular Apparatus in inner ear (it is associated with maintenance of body posture & balance) most probably Labyrinthine or Benign Paroxysmal Positional Vertigo. Symptomatic relief can be obtained with intake of Vestibular sedatives like Betahistine or Linearizing preparations (to be taken only under the guidance of a Physician). If it still persists, then you need to consult your Physician/ ENT Specialist & get a complete clinical examination done. Investigations like estimation of blood pressure, blood sugar levels, serum electrolytes & vestibular function tests will be required to rule out any pathological cause for the symptoms. There is no need to worry, you will be fine. Till then, maintain adequate HY . And also take precautions of getting up from bed slowly & avoid sudden head movements. Wishing you a Good Health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have left side (flank) pain had a CT scan and found small cysts in both kidneys.  Some  they reported  are "conspicuous" or are hemorrhagic or possibly solid and so they recommend an MRI .  I also have extreme fatigue that comes in waves. Could this be a cancerous situation? ### REPLY: HelloThanks for query You had a flank pain on left side and your C. T Scan has revealed multiple cysts in both the kidneys. Normally they are congenital in origin and benign in nature and do not require any treatment. However since they are reported to be conspicuous and hemorrhagic you need to get investigated further to establish diagnosis. Please consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis.1) Contrast C. T scan of abdomen 2) MRI 3) Renal function tests. Further treatment will depend upon result of these tests and final diagnosis. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had unproteted sex on 20th, 21st and 22nd April. I took emergency pill on the afternoon of the 22nd. I am sure /i ovulated on the 20th because I can feel when and which side i ovulated on each month. I suffer from rosacea and have taken one tetralysal tablet each evening for the last 2 days (8 days post ovulation). I am worried that the pill may not have been effective, i have a lot of pregnanacy symptoms (rosacea, right side lower abdominal ache, general cramping and since the 23rd have had increasingly tender breasts with sensitive nipples). Im now worried that if the pill hasnt worked, that my baby will have deformities because of the tetralysal. What is the liklihood of a) me being pregnant and b) my bay having deformities? Thank you ### REPLY: Welcome to , Betrayal belongs to tetracycline group of antibiotics which can effect the action of emergency pill. There is a chance that the emergency pill may fail. Betrayal is not supposed to be taken by women who are pregnant as it may result in malformation of the fetus. I recommend you to wait for your next period. If you miss your next menstrual period do a urine pregnancy test. If it turns out to be positive visit your gynecologist who will take a detailed history and decide on the pregnancy. Hope that answers your question.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: why is it that even after treatment of amoeba in my children they still complain of stomach pain and yet the medicine used was very effective to stop the diarrhoea. Also one of them, the stomach feel abit harder than normal.  How can we make the pain go away and are there some food we should keep off. ### REPLY: Thanks for your query at ! I went through your query! Amebiasis is caused by Amoeba histologic which is a protozoan. The trophozoites penetrate and invade the colon and cause tissue destruction and cause bloody diarrhea colitis. There are healing ulcers which usually cause pain even after treatment. There is a possibility that they have other infection for which you can get stool examined for ova/cysts/larva. Treatment will depend upon the finding. You can give them anti-spasmodic (Dicyclomine) to relieve pain. Consider deforming. You can visit a pediatrician if symptoms persist. Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, I am 29yrs old female. Me and my husband are trying for a baby last 8 months. Nothing happend. So we did a check up with doctor. I took all the basic tests and found out that I have hypothyroid problem TSH 5.78. This level of TSH could be a problem ? As per doctors prescription, I am taking 25mcg of Thyroxin tablet for last 1 month. Now I have pain in lower waiste area. Is it because of this medication ? Could you please sugest ? ### REPLY: Increased appetite, weight loss, heat sensitivity, excessive sweating, headache, hyperactivity,nervousness, anxiety are the common side effects of thyroxine medication. Waist pain may not be related to thyroxine tablets. Other causes such as nutritional deficiencies, renal stones or pelvic causes should be ruled out. Kindly continue the tablet and monitor the thyroid levels every month. Dose adjustments are done based on the results. Hope I have answered your query. Let me know if I can assist you further. 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 im 18 and last night i just noticed a small hard painless lump on my right breast. its very small. i just noticed it which means its very recent like it just showed up in the past couple days. What do you think it might be. Im extremely scared. Please Help ### REPLY: Welcome to  .1. No need to get scared, it's not the age to worry about the lesions in the breast.2. You are giving a very short history since you are seeing that lump.3. Generally in few cases this kind of symptoms are seen, they turn up as dilated ducts or focal dilatation.4. More over you wait for a week, if its asymptomatic, and feel again - Then see your doctor.5. An ultrasound scan will help to evaluate what It's and what it contains.6. Hope it helps. 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 just recently found out i am 7 weeks pregnant and due to my prior pregnancy i found out i am also rh negative i lost the baby in my prior pregnancy and i am currently in the process of moving back to dover ohio at the end of next week will my baby be ok until i can schedual an appointment at the dr s office the following week. When i can get a shot because i recieved no shots once i found out i lost my last baby. ### REPLY: Hello, I have gone through the query and here are your answers: 1. If you did not receive any anti-D immunoglobulin injection soon after your previous pregnancy and if you do not Rh positive or negative, you need to get immunized in this pregnancy. Ideally, the first dose is given at 28 weeks gestation with or without a booster at 34 weeks followed by another injection within 72 hours of delivery if the baby is Rh positive. If you are already sensitized, you may need a first trimester injection. 2. It is better to avoid travel by any means in the first trimester. If it is absolutely necessary, make sure you do not face any jerky experience during travel. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i had an ultrasound on my kidneys the results where i had hydrophrosis on my left kidney which was also large 14 cm but also my right was small 8cm and the wall was slightly thinned i went for further tests ct scan and 2 other scans a renagram and mri i think when i went to talk about my results whith the urolagist he was not concerned with my right and didnt say much about it and the left kidny will require surgery to remove a blockage he also said i was born with this but i am worried because i have read many things on the internet saying that slightly thinned cortex is kidney disease can you help me ? ### REPLY: Good day, and thank you for being with  ! The Ct scan and the genogram would say a lot about renal function and since your Urologist is not concerned with your right kidney then I wouldn't be worried as well. On your left kidney you have a condition called ureteropelvic junction obstruction (UPJV) which would require surgical correction. I am thinking maybe the thinned renal parenchymal is on the left side which is common on UPJV.yours truly, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an episode earlier where I went to reach down to plug in a light and I immediately experienced severe abdominal pain on my left side. It felt as if something large was trying to get through a small opening and this sensation, with intense pain associated with it, move around in that general area. This happened a week ago on my right upper abdomen. Same circumstance, except that I was sitting in a car and reach to the floor to get something our of my purse. This pain last for about 15 minutes, intense and then it subsides. Afterwards, the area affected is extremely sore. Do you have any ideas as to what this might be? ### REPLY: Hello this is . Thanks for the opportunity to help you. Before answering your question properly kindly tell me if you are overweight?yours is a classic case of muscle spasm due to stretching of muscles. You can apply muscle relaxant creams or sprays when this happens. Just keep an observation if some swelling arises above the abdominal wall while straining or coughing. Rarely u can have ventral hernia due to weak abdominal wall. Chances of spasm or hernia are much more in obesity. Kindly get a USG abdomen to rule out any intra-abdominal pathology and any ventral hernia. If hernia there, and you are having pain then contact your  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 been struggling for over 3 years with chronic abdominal pain in the slightly upper abdominal area on her right side. Her doctor as well refered specialists have done multiple tests on her gallbladder ,and a colonoscopy both about 2.5 yrs. ago. currently she has had a total decrease in appetite for going on 2 wks, and feeling severely weak often. so overall, symptoms are getting worse daily. ### REPLY: Hi Martha for choosing , you did not state anything the test result of your daughter she has gone through, what the specialist told you what was his diagnosis, what treatment he gave to your daughter at that time, it would be much convenient for me to come on any conclusion, looking to chronicity of complain it must be some upper gastric region pathology go for MRI test this will clear the picture, You did not mention the age of your daughter,,, Good day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have PCT; sporadic, tested at mayo clinic, being treated in Minot ND have had 10 phlebs, ferritin was at 153 before the 10th phleb, I am seeing a blood specialist, I ask him questions about arthritis and skip problems and he will not answer any questions and gets offended like I am a idiot, his answer too arthritis was that pct does not help cause arthritis,I asked him how long he has known about pct and hjs answer is that he has been a doctor for 25 years, that was his answer, who do I see in North Dakota that can answer my questions, my PA did not even know what it was, I went to a arthritis specialist with all the blisters on my swollen hands in Minot ND and he knows nothing about pct, i asked the blood specialist if he did a liver function test before the 10th phleb and he says maybe we will on the next phleb,am I being treated and tested properly, I just want some forsight into how bad my liver is or what damage they think I may have to my body, I started having symtoms 3 years ago and advocated for myself until they finally sent me to a dermatologist and he figures out what I have immediatly, any suggestions? ### REPLY: Hi, thank you for posting. I read your query very carefully, and I understood your problem. I think that I can help you. I think that Porphyria butane tardy(PCT) is an almost treated disease. If the treatment is correct, the prognosis is usually excellent. You need to follow strictly phlebotomies program. You should avoid alcoholic . Avoid high ferritin foods. Avoid exposure to sunlight. Take needed medicines. If you follow these precautions you will have a good health condition. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 twin boys who are 2 1/2 years old. Lately both have had bowel movements that are very large balls that are somewhat hard and waxy. Any ideas what could be causing this? Diet has not changed - they actually eat a pretty well balanced diet. Although I have been wondering if they have been getting enough milk/water on a daily basis. ### REPLY: Hi... Thank you for consulting in . I think your kid is having habitual constipation. I have certain questions and suggestions for you. Questions:1. Did your kid pass motion or meconium on day one of life?2. Since how long is the kid constipated?3. Does the kid have any bleeding along with hard stools?4. How much milk does the kid consume per day?5. Does the kid eat fruits and vegetables (fiber diet) appropriately? You can get back with answers at the following link -www.ChatDoctor .com/doctors/ .  Natural methods are the best to relieve constipation.2. Constipation is a risk factor for UTI3. Maximum milk consumption per day should not exceed 300-400ml4. Minimum 3-4 cups of fruits and vegetables to be consumed per day5. Toilet training - that is - sitting in Indian type of lavatory daily at the same time will help a lot. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MyMIL Was to start chemo today. She has secondary liver cancer, primary colon. Her bilirubin levels are very high and her calcium very. She is very weak and sometimes cant make it to he bathroom in time. Her family thinks she might get better. I think this is wishful thinking. Any thoughts? ### REPLY: Hi thanks for asking question. Noted secondary metastasis present in liver. So bilirubin is very high by affection of liver... Do yes for colon carcinoma with met chemotherapy can be taken... Let me know you as tumor is metastasised to liver prognosis is not good ... So start chemotherapy as advised by doctor. And in malignancy metabolic rate high with anorexia so cathexis with weight loss present. Weakness is because of it. 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: Hey I m 21 years old, i currently have two bumps on my penis i presume to be mosquito bites that s itchy. The shaft of my penis and upper thighs(near pubic area) and butt cheeks are also itchy. I had been using ketoconazole and sodium thiosulphate solution that had resolved it for awhile, as I diagnosed it to be a fungal infection. I stopped the treatment and now i itchy everyday. Could you help me please. ### REPLY: Hello, Welcome to , The history and symptoms suggests me that you are having a fungal infection, but it should be confirmed by physical examination. Don't be embarrassed to show and confirm the diagnosis. The fungus is the normal commensalism of this area which will be kept under control by the helpful organisms, whenever there is a change in environment because of multiple reason this fungus will multiply and produces the symptoms. I would suggest you to follow1. Keep the area . 2. Topical antifungal cream should be applied.3. Tab Rifleman, 150 mg single dose will help to control the symptoms.4. For itching, you can take anti histamines. 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 m male 37 yrs old. I have been told that the inner stitches from my appendix taken out when I was 5 yrs old have somehow mended together. I m having discomfort on this side including internittent aches in thigh and less the calf muscle and the groin on the same area. Can this influence urination because during the last few weeks I ve been feeling a slight pain, almost the feeling of pressure. Any ideas? Thanks ### REPLY: Hello! Your history of appendicitis is not significant anymore as it was 32 year ago. Your symptoms are characteristic for urine tract infections and urine tract stones. That is why the first step you should take is to have urine test performed and abdomen ultrasound. The other reason of your chronic thigh and calf pain might be a Sciatic nerve compression. So if your pain does not go away for a long time you should have MRI of your backbone performed. Hope this will helpmate 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 developed a swollen lymph node in my neck area under my left ear about three weeks ago. It grew quickly overnight, but then came down dramatically after taking antibiotics for ten days. It has gone down quite significantly and keeps going down every day...I cannot see it anymore, but I can feel a small swollen area under my skin. Went to the the ENT doctor two days ago and all checked out fine...no cancer in tonsils, mouth, vocal cords, throat, etc. But they want to do an excissional biopsy to remove the lymph node and check it for cancer. Makes sense? Also, I am taking pantoprazole, simvastatin, lisinopril, amlodipine and coreg...could any of these medications have caused the swollen lymph node? ### REPLY: Hi, Welcome to  forum.  The reasons for such a growth of a lymph node may be some infection, in the surrounding area. As the infection is controlled the lymph node has receded. The palpable node may persist for little longer.  If you are attending the E.N.T. surgeon after the treatment of the enlarged gland by some else, the surgeon might be thinking that you are having the pain in spite of the cure of the gland. Or he would have found something in the mouth.  Anyhow once he speaks, it is better to have the biopsy to exclude the possibility of malignancy.  Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to have a good health.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my brother is suffering from internal hemorrhoids.he complains of pain and irritation.nearly two years of diet control and creams have not helped.is surgery an option?he is seemingly frustrated with this problem and its affecting his work and studies.Please help. ### REPLY: Welcome to . I am . No need to be frustrated because this is curable. Hemorrhoids are swollen blood vessels that may occur inside the rectum (internal) or outside the rectum (external). Internal hemorrhoids cause bleeding and leading to anemia(low hemoglobin) and if not controlled as you told about your brother that nearly two years of diet control and creams have not helped In such conditions surgery is only option. Till then start - Tablet- Dawson 500 mg thrice a day -very helpful  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 low bach ache...... severe.......... associated with altered bowel habits........ i am preparing for my medical pg entrance.......... initially i thought it was coz of sittilng for long hours n studying... but nw since a week pain is increased so much dat am nt able to concentrate... no sprays ointment gives relief ### REPLY: HiT hank you for your question to . From what you have described and if there is no other obvious inciting event your pain is likely coming from prolonged sitting. The solution for this would be muscle relaxing exercises and stretching. You will need to learn these from a physiotherapist and once you understand them you can keep doing them on your own. It is understood that your time is important as you are studying for medical PG entrance exam however doing these exercises thrice every day will keep the pain under control. Also, you can take a tablet consisting combination of analgesic like diclofenac or diclofenac and muscle relaxant like chlorzoxazone on full stomach if and when pain interferes with your studies. Hope this is helpful. Wish you the best for exams. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a frontal lobe stroke 25 years ago and last year had two strokes, one in the frontal lobe and one in the cerebellum. I don t know what type of stroke the cerebellum was, others were ischemic. This past Sunday, she fell off the couch, unable to move her left side, face drooping. Husband called 911 for ambulance. Doctor told her they don t think it was a stroke, probably a pseudo stroke which can happen a year after original stroke. How could we tell the difference? ### REPLY: Hi, Thanks for writing in. Pseudo-strokes are non-strokes which manifest rapid neurologic deficit progression and therefore mimic a stroke. These account for 2% to 3% of strokes. Causes of pseudo-strokes are included in the differential diagnosis of a stroke/TIA. They are due to other causes of stroke like symptoms which includes hypoglycemia, tumors, old strokes, encephalitis. To an onlooker, the difference between a stroke and pseudo stroke will not be clear, and it is not possible to tell the difference. Even next time she gets these symptoms, it is important to take her to hospital and then treat the cause of pseudo stroke after clinical examination. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hairloss problem...i m taking homeopethic treatment from last 8 months, but no positive effect of it...now doctor has prescribed me iron capsules Fefol-z or R B lene...shall i take this medicine...?i have gone through Ferritin test also ....report says 64.7ng/ml.my sex is male. ### REPLY: You may be having an . Since you ferritin levels are reasonable taking iron supplementation is not going to help. I would advise you to take regular nutritious diet with proteins and micronutrients wit lots of fruit and vegetables. . You can use sodium laureth sulfate shampoo with conditioner for gentle cleansing andwashyour hair every other day. Donor use harsh treatments like hot combing and straightening. You can also use Minoxidil 5% lotion locally at bedtime.i addition you can take tab Finasteride 1 mg daily. Continue the treatment for at least 12 weeks before you will notice improvement ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 38 and he have been having sezuire a total of 3 the e.r doctor prescribed phentoin sodium and now he can not function well all he do is sleep most of the day and has become stiff in his legs my husband walk on a cane but has been very out going before this happen I am afraid to leave home,sleep or go outside the house he is scaring me he seem to be off balance also ### REPLY: Hello ! I read your question and understand your concern. I would like to know if he has had seizures before the 3 last seizures you mentioned. The increased daytime sleepiness may be a side effect of phenytoin sodium. This happens in the beginning of therapy or over dosage. But in this situation I would recommend to make further tests to find the cause of these seizures. If I were his doctor I would perform an EEG and a brain MRI or CT besides full blood work. Seizures at this age may be caused by a brain lesion, probably tumor or vascular, infectious, etc. This lesion could also cause stiffness in legs. Hope to have been helpful! 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 have had jock itch for 6 months or so. I have been using Loprox and it is slowly improving. Within the last week I am getting a rash over my torso, arms and legs that I suspect is Tinea as well. ( I also had that issue as well but it cleared up for a while). My question is do you think that I should try an antifungal pill and if so, what pill and should I have a liver test first? ### REPLY: Hello, Thank you for posting on . Proper management of Tina is incomplete without oral antifungals. I usually recommend proper course of oral antifungal .  You can additionally use antifungal dusting powder containing ketoconazole during daytime and a soap containing ketoconazole for rinsing of affected areas. Take oral antihistamines for itching as required. Maintain hygiene over those areas and avoid wearing tight undergarments. Hope your queries are resolved and wish you best of health. Kindly spare some time to rate my answer and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a concernd grand mother. My grandaughter has being having seizures since she was 3 years old and she is now 8. Her seizures got worse through time but then stopped in the last 12 months. But she has now had a couple of short ones. I have been looking into the ketogenic diet. My daughter is not pushy enough to ask for this help. How can we look into it more. My daughter has already asked about the diet but is not getting any response from anyone. I feel i need to help both my grandaughter and daughter with this as as i said my daughter is too shy to ask. They attend Walsgrave hospital and only go to Birmingham on the odd occasions. Not enough appointments in my eyes. ### REPLY: Hi.... I understand your concern. In your query you have said that the kid is not having any seizures for the past 12 months. Then in that case I don't think a ketogenic diet will be necessary. Ketogenic diet can be tried only for intractable seizures. The other option which you can try if the seizures start again and uncontrollably - is using by Pyridoxine at 40 MG per day on doctor advice. Regards - .  Samantha ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: on my penis inside of it i feel like little lumps and they seem to spread round in a circle just underneath the helmet or sorta at the bottom of my helmet it never really botherd me but it hurt today and still hurts and spread even more when i urinate it doesnt hurt or burn but when i masterbate it burns the lump thing burns what is this ### REPLY: Hi, Dear,Welcome to . Based on the facts of your query, You seem to suffer from-Post-Friction Balanoposthitis from the burst out -HPV pa pules on the glans/coronal Julius and around. Second Opinion from Dermatologist-With Ardabil anti-HPV Vaccine Shot-With Acyclovir Tabs for 4 weeks would take care of it. Tab Coquitlam with Antibiotic-Septran / Oxacillin would recoup it fast. Proper Congenital hygiene with Detail Spending and Coconut-Oil smearing would reduce its recurrence. Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. suggests Good Day!!  . S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was attacked polio in the right hand shoulder a the age of four. Now I am 50 years old. Now though I can write , eat with my right hand, but my right hand shoulder has been dislocated and I find  the Shoulder area has become thin to a greater extent. I also feel pain some times. How I should be treated ? Where I should go for immediate medical treatment ? Is there any possibility for the Polio again ? ### REPLY: Madam if you had polio attack in right upper limb in childhood shoulder girdle muscles and upper limb muscles will be wasted, and that is cause of thinness which you noticed now. All dislocations are emergencies, dislocation of shoulder means shoulder joint ball(humerus head) has come out of socket (glenoid). It will be very painful, and probably you will not be in a position to write. Neglected dislocations are seen.  Where exactly do you feel the pain madam/sir, once polio is affected it means your neurons have already been damaged. And it is the reason for wasting, there is no possibility for polio 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: hi, today is my 14th day of periods, i am going to do follicular study this month. today i have two follicules in my left ovary . the follicle size is 18.8x 16.1 another one is 20.2 x 13.1. my doctor is asking to put injection tomorrow morning , the inj name is ChatDoctor 0000mg. i have any chances to get pregnancy for this month,what we do next? ### REPLY: Hello. Thanks for writing to us. According to the report, you have two mature follicles in your left ovary. The injection is given so that the follicle ruptures and the ovum is released. The chances of conception are present in this cycle. You need to have regular sex after taking the injection. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i got sick last night and vomited up something dark and was anywhere between 4-6 inches long and round at the ends, right before this happened I had been coughing, before I could really tell what it actually was, it had disappeared when it was in the toliet. I dont think it was stool, scared me and still worried as to what it could have been. I still dont feel up to par.  Any ideas on what it might have been? Thanks for your time. ### REPLY: Hello understand your concern. The first thing to define is can you explain more clearly you had a cough or a vomits? I mean if that black substance came out of the lungs or the stomach, because they have different plans of diagnosis and treatments too. If you say it was a vomiting you better to do a procedure fibrogastroscopy for the stomach and if it was a cough a fibrobronchoscopy for the lungs. If you are a heavy smoker or work in dirty environment it might be the lung problem but if you . I will advise you to see a GP than to decide about the procedures I explain. 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 have a blood clot in my right shoulder from my pregnancy(my son is 9 months old now), Im on coumiden still, but lately have had a burning pain in my right shoulder blade. Was wondering if it was related to my clot, and how long it will take for my clot to go away? ### REPLY: Hi, As shoulder blade pain cannot be related to a blood clot and will have an insertion of the Trapezius muscle inflammation leading to pain. There will be weakness of the inter-scapular muscle and also the posture will not be proper. Correction of posture, using hot water fermentation, doing strengthening exercises for the neck muscles, inter-scapular muscles, and shoulder girdle muscles should help reduce the symptoms. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my son is 3 yr 10 months, having high fever (beteen 102 to 103) for last 12 hrs, I have given Crosin syrup thrice but fever comes down a little bit only that too for sometime only, I am giving sponge as well to reduce fever, what else I can do to reduce fever, pls advice. Thx a lot Saleem Mumbai ### REPLY: For high grade fever ...please give proper dosage of paracetamol ...dosage is 15 mg per kg and for your child dose will be approx 7 ml of syrup Robin containing paracetamol 125 mg per 5 ml and dosage to be repeated exactly 8 ...if this does not work give it 6 hourly .and if still no effect den in place of syrup Cronin...u have to give syrup ketogenic plus (magnetic acid 50 mg and paracetamol 125 mg per 5 ml) but DAT have to be given 12 hourly ...besides this give plenty of liquid to child ...and get her CBC done to rule to bacterial infection and malaria also to be ruled out ...usually high grade fever is viral and does not need antibiotics... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have had a pea sized lump right beside my Adams apple for the last 6 weeks I had chicken pox 6 weeks ago so I thought it was just something to do with that. But it hasn t gone away yet I feel no pain from it but if I touch it or swallow it moves, any help would be great thanks, p.s If It helps I m 22 years old ### REPLY: Hi! Good evening. I am  answering your query. One of the commonest cause of a lump in the area is a lymph node apart from other common swellings from a thyroid gland and both of these move with swallowing and could be mobile on touching. With a history of the lump persisting for six weeks, if I were your doctor, I would first give a try to a broad spectrum antibiotic for a week. If it did not work, I would go for a thyroid function test, a thorough examination of the oral cavity including head and neck and a FNAC (fine needle aspiration cytology) of the lump which would establish the diagnosis for further management. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doc, I am male, 42 I have been regular in Excercise since last 10 years and weigh 145Lbs with 167 cms Ht. Recently checked my pressure and found it Hovring around 145/97 , My pulse is always less than 72 and i run around 6 kms 3 days a week . What can be the reasons. i do not smoke or drink ### REPLY: Hello! Welcome and thank you for asking on ! I read your question carefully and understand your concern. Do you have any family history for arterial hypertension? What about your past medical history. You should know that there are different causes of high blood pressure (besides obesity and sedentary life): - kidney and liver dysfunction- high salt and caffeine intake - diabetes- a .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell 10 days ago and possibly broke a rib. Have broken ribs before and realize no treatment is usually required. The pain is gradually subsiding, however, I ve notice the last few day, when I take a deep breath I hear a popping sound and feel a twitch. Is this normal? ### REPLY: Hi Hope this message finds you in good health. I have gone through your complaints and understand your concern. You are right, the sound you are getting may be due to a broken rib underneath. During breathing, increased chest pressure causes it to pop out making that sound. I suggest you get a X-ray to find out the exact cause. Physiotherapy, analgesics,anti-inflammatory . Nothing to worry about. I hope your question has been answered. If you have any follow-up queries, feel free to consult me anytime. Thanks, Take care, God bless. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sudden sharp intense pain that came on out of nowhere Saturday afternoon on lower right side of abdomen. Feels like I need to pass gas or have a bowel movement but I don t actually need to do either one. My bowel movements are still normal & regular. My entire stomach is bloated & extended. No fever No vomiting. Hurts to lay flat on my stomach & feels like there s a ball where my stomach hurts. ### REPLY: Thank you for sharing your complaint on , dear friend as you described your complaint it seems just gaseous abdominal discomfort. Take simple painkiller like paracetamol+dicyclomine with omeprazole/omeprazole and also take ayurvedic preparation like unienzyme for gaseous discomfort. The complaint will be covered. don't take spicy and oily food that make difficult digestion. If severe consult your family doctor first. For more queries please don't hesitate to ask. Get well soon dear friend ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: On my scrotum there are white bumps under my hair. Also on the bopttom of my penis on the underside close to the scrotum theres the same thing its kind of itchy. And I. Think I cut a small spot when trimming theres a little lump and I popped it oozed blood help me ### REPLY: HelloThanks for query. You are likely to have Sebaceous Cysts over scrotum and at the base of the penis. The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Since you have injured one at the base of the penis resulting into bleeding you need to take broad spectrum antibiotic like Cefuroxime along with anti-inflammatory . Ensure TH wash genitals with warm water twice daily. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Stephen and am from Kenya. I have a sister and she s 20yrs old, the thing is that when she was around 5yrs old, she was attacked by a strange disease and when my parents took her to the hospital, they were told that it was cerebral malaria and by that time she had lost almost all of her memories; she couldnt walk,talk or even seat upright she couldnt even know us. Since that day she s been reggaining her memories slowly and now she knows us(family) she can eat. the problem is that thats the only thing she can do. She cant walk, she cant talk so basically we everything for her. Is there anyway you can help me? ### REPLY: The problem with your sister is that her brain got damaged in childhood due infection of brain by malarial parasites. The brain is one such organ which once gets damaged does not recover unless its treated early. The recovery from this illness depends on the severity of illness and onset of treatment.  The brain is very fragile in younger age and mild damage can have severe residual consequences. The center part of brain is important for walking coordination ABD memory integration and this part is called basal ganglia. This part is severely involved in cerebral malaria. At this age of your sister i sorry to say that nothing much can be done to your sister except physiotherapy and some multivitamin and neurotrophic .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 in year 5 of congestive heart failure with a defib/pacemaker. His BNP test came back 2407 and had a paracentisis done on 12/28 with still distention on left side. His ultra sound shows moderate live enlargement and left kidney slightly enlargered. I am very concerned and am trying to get a prognosis. ### REPLY: Hello, Congestive heart failure patients may develop liver enlargement. This is called congestive hepatomegaly common in heart failure patients.  But left kidney enlargement may be due to infection or stone. Until etiology known it is difficult to treat. Please consult with your cardiologist he will examine and treat you accordingly. 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, doc my mother is 58 yrs old and she have a angioedema ( allergy ) problem since last 8 years i have to check her for lots of dermatologist and other md s but the problem exits. recently we are going a allergy test of her and she have allergy in following items :- S.No. Items Allergy in Points 1- cucumber - 1.70 2- tamarind - 1.20 3- cauliflower - 2.20 4- groundnut - 2.00 5- ladyfinger - 1.60 6- aspergillus fumigatus :- 1.90 7- cockroach dust - 1.10 8- house dust - 1.70 9 - house dust mite - 3.80 10- paper dust - 1.40 11- perfume - 1.70 12- doxcyclin - 0.70 13- oxacyclin - 1.60 14 - penicillin - 0.80 15 - tetracyclin - 0.90 16 - sulpha - 1.20 If she have a allergy attack is come then she have lots of fever and joints pain, swelling of her complete body, symptoms like angioedema and also lots of itching on her body. Please suggest me sir what should i have to do. I am living in sagar madhya pradesh,india pin - 0000 my cell no is +0000 my email id is YYYY@YYYY ### REPLY: Hi Kamil, Welcome to . I have gone through the report of the allergy test to have posted. Based on the reports your mother seems to be allergic to many substances (Allergy point of greater than 1.2 is considered Positive) except for Sulfa, tamarind (1.2 is usually considered borderline), cockroach dust, penicillin, Tetracycline, perfume (less than 1.2 is considered negative). As the allergy test predicts allergy to very few substances, you mother might be allergic to some other substances as well. The Definitive treatment of Allergy is avoidance of allergen. Medicines can only give symptomatic relief. But the hard fact is you mother can be allergic to substances other than those predicted in allergy test, and it is difficult to find out. Using preparations like Montelukast in combination with Levocetrizine is known to prevent recurrence. But these are not useful in acute attacks, and they need to be taken for longer durations to be effective. Taking medicines like Evil(contains Chlorpheneramine which is .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, this is about -semen analysis: volume-2 ml color-whitish. Liquefaction time- 30 min. Total super count - 50.0 millions/ml motility- active-3%. Sluggish - 2%. Dead- 95% pus cells-5-7/hpf. What each indicates and what is the problem in my sperms how to over come these problems. ### REPLY: Hellene by one I am answering, so please read it carefully:Volume 2 ml (normal 2-6 ml but depending on abstinence i.e.if longer period more in volume). Color Whitish (normally gray whitish, but in your case it is normal). Liquefaction time 30 minute (normal 30-60 minute). Total super count 50.0 million/ml (normal 60 120 million/ml, in your case somewhat low, but this is not a cause of concern because NORMAL fertility is associated with sperm counts >48 million. Ml). Motility active 3% (normal 100 %, normal fertility is associated with motility >63 %, so in your case it is too low)Pus cells 5-7 .HP(normal 0-5, this is not a cause of concern and just antibiotics for 3-4 days will cure). In your case you didn't mention the MORPHOLOGY of sperm, that is also important, so either upload on this site or consult an INFERTILITY specialist and get his opinion. 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 am having cough and my tonsils are paining. I am also having slight fever and body ache. I feeling weakness and my eyes are also burning. I have taken vicks action 500 medicine but there is no relief. What should i do so that my body can recover quickly. ### REPLY: Thanks for your question on . I can understand your concern. You are mostly having tonsillitis. Infection is the most common cause for this. Recurrent tonsil cause eye symptoms, cough, fever, body ache etc. So better to consult ENT doctor and get done clinical examination of tonsils. At present, you need antibiotics, anti histamine and anti-inflammatory .  Warm water gargles 5-6 times a day is also beneficial. Once this acute episode is over, you should undergo tonsillectomy (surgical removal of tonsils) because tonsils are prone for recurrent infection and symptoms. 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: Can excessive consumption of diet coke cause severe stomach pain that cannot be diagnosed. Tests have been done to check for complete array of possibilities and now 2 different types of antibiotics have been prescribed and that is not working. Have had a colonoscopy, MRI blood work, prostrate exam and all of these have come back okay. Could the diet coke be causing the problem. I have been drinking them for a long time, I drink at least 6 a day ### REPLY: Diet Coke contains aspartame, a chemical sweetener that is generally very safe but can have side effects including stomach pain, nausea and diarrhea. Diet Coke also contains caffeine which in large amounts can cause increased bowel motions nausea and pain. 6 Cokes a day sounds like a lot. I would recommend decreasing your intake slowly over a couple of weeks and seeing whether this improves your symptoms. Hope you feel better soon!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went for pelvic scan and I discovered that I had overian cyst,my period was also irregular as at then,my gyn prescribed duphaston to be taken from 5th to 14th of every month and my period have been regular ever since.although Im still on duphaston,will it stop me from getting pregenant? ### REPLY: Hi and welcome, I am sorry as I am not clear form your question if you want to get pregnant or want to know if phaeton will act as a contraceptive. So I have tried to answer it both ways. Taking phaeton from day 5-14 of the cycle may not prevent pregnancy. The regimen that you are taking is not related to contraception and is not supposed to provide contraception. It is a progesterone analogue. The initial part of the menstrual cycle is dominated by estrogen hormone and progesterone comes in the later part. So theoretically, phaeton may prevent or delay ovulation by altering the hormone levels, but this is not a guarantee. The cycles have become regular because of the .  Ovarian cysts usually prevent ovulation, so regular cycles with phaeton does not necessarily mean that you may be ovulating. This means that if you are taking this  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: elo doc.i just want to ask if hepatitis c grey zone has a chance of transmitting the hep c virus to others?i take hcv test and the result is non reactive grey zone.i am so worried that my love ones will have this.is hep c virus grey zone is dangerous?is there any treatment for this???thank you so much. ### REPLY: Before getting excited about transmission of hepatitis c the antibody test should be rechecked along with a hepatitis c RNA viral load to see if you actually have hepatitis c or not. If you do actually have it, the chance of transmitting to others is low except with blood or needle contact. It is not passed with casual contact. Please have retesting done as I have suggested to help know what you are dealing with. If you have the actual virus newer treatments are available to get rid of it. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am currently on 20mg Lexapro. I have been on it for a month. I cant sleep, think straight and feel depressed. I was previously on Effexor 75mg and it didnt do anything either. I dont think the Lexapro I am on is working but I dont have a clue as what I need to be on. My doctor is leaving it up to me but I dont know what to do. Help. ### REPLY: Hi, Lexapro and other SSRIs can take around six to eight weeks to show their full response. So I feel that you need to be on 20 mg Learn for a few more weeks to be able to say that it is not working. While 20 mg is an adequate dose for Learn, for Effector the dose that you tried was just the starting dose and should have been built up to around 150 to 300 mg per day. If Learn shows no response even after a few more weeks, there are many strategies to augment the effect of Learn. Addition of bupropion, buspirone, thyroxine, lithium etc. are well known measures. Psychotherapy is also a good option. Please do not worry. If you have not consulted a psychiatrist so far, then please do so as it is possible that your family physician may be finding it difficult to manage your depression now. Hope this helps you. 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: Hello, I m a 23 year old collage student and I keep getting dizzy and a ringing in my ear(s) after looking down for long periods of time like when I take tests, read, or draw. I never had this problem when I was 21, but over the years it has very slowly gotten worse. The dizziness and ringing seem to go away after laying down for 1 to 2 hours, so these good news there. I was just wondering what this could be, because it s starting to make shool just a bit harder then it should be. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint the symptoms of dizziness and ringing in ears also known as Tinnitus can be due to disorders related to inner ear known as Labyrinthine or Deniers disease or Benign Paroxysmal Positional Vertigo. I would suggest you to consult an Otolaryngologies and get evaluated, and he can advise you investigations like MRI Scan, Vestibular tests, blood evaluation for serum electrolytes can help in diagnosis and treatment can be planned accordingly. You can be advised to take medicines like Linearizing for relief but should not self-medicate and should take a medical advice. You can also be advised to avoid sudden head movement and stress should be avoided. Maintain good HY . . Hope this information helps. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Missed my metoprolol pill (25mg) at noon. After supper (~6:30 p.m.) I noticed the AF flutter and irregular heartbeat, reminding me of the oversight.  So I took a 25 mg metoprolol right away. It is now 10 p.m. There has been improvement in the degree of irregularity but the beats are not the normal even pace. What should I do? I am not experiencing any pain or shortness of breath.  I am 73. I normally take one 25mg tablet, twice a day (noon and before bedtime). ### REPLY: Hello. Thank you for your question. If this was a paroxysmal episode of atrial flutter, then there is only a slight chance that missing of a single dose of metoprolol causes it. This episode warrants treatment aiming converting this arrhythmia to sinus rhythm. The efforts in doing that should be undertaken in a healthcare facility where cardiac monitoring is readily available. This consists in compensating the possible electrolyte disturbances (mostly potassium levels), giving digitalis derivatives in intravenous route to slow down the heart rate with a chance of self-converting, or administering pharmacological therapy (amiodarone, propafenone) or electric shock (if hemodynamically unstable). After converting into sinus rhythm, proper therapy to maintain this rhythm should be instituted. I hope I was helpful. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have Symptoms and diagnosis that are clinical. Could this be something else? 1. Back fusion surgery with nerve damage in legs/sciatica 2. Glaucoma cyclitic crisis 3. Clinical diagnosis of undifferentiated spondyloarthropathy 4. Severe fatigue after exercising 5. Hypotension 6. Dizziness and fainting upon standing 7. Severe verifies veins 8. Diverticulitis (HLB 128 gene negative) 9. Low back pain 10. Chronic fatigue after exercise 11. No problems with insomnia All of these symptoms and clinical diagnosis still. What about a neuromuscular disease? All of these symptoms and still no real conclusion what s causing the fatigue and pain ### REPLY: Hi, Thanks for writing in. The symptoms of neuromuscular dystrophy might include the followingFrequent fallsDifficulty getting up from a lying or sitting positionTrouble running and jumpingWaddling jaywalking on the enlarge calf musclesMuscle pain and stiffnessLearning disabilities It is not important for a patient to have all the symptoms. The diagnosis is made after detailed neurological clinical examination. The important tests used to make diagnosis of this condition are.1. Enzyme tests such as creatine kinase (CK)2. Electromyography3. Genetic testing4. Muscle biopsy5. Heart-monitoring tests (electrocardiography and echocardiogram)6. Lung-monitoring tests ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 12weeks and I work at a hospital. I transport patient through out the hospital via;wheelchair,inpatient beds and litters.Should I be doing this? I feel shortwinded sometimes and I have to use my stomach muscles a lot on the beds and litters.I was just a little concerned. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have breathlessness. Well there can be many reasons for symptoms you mention in query like asthma attack, pneumonia, heart attack, atrial fibrillation, pulmonary embolism or anemia. I would suggest you to consult chest specialist for proper examination. Doctor may order chest x-ray along with sample from lung for lab testing. Doctor may prescribe antibiotics along with anti-inflammatory and decongestants. Doctor may also refer you to cardiologist for heart problem. For now take proper rest and take steam twice a day. Hope your concern has been resolved. Get Well Soon. 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: Hello! I got my wisdom teeth out about 2 weeks ago, and got an infection. It all cleared up with some Penicillin, but now I am experiencing pain in my lower jaw near the sockets again. I have been cleaning the sites well with the syringe, but Im afraid the infection may have returned. Do my concerns have any merit? Thanks so much!Hannah ### REPLY: Thanks for your query, I have gone through your query. The pain in the lower jaw could be because of the gum infection near the socket region or there can be a sharp bony spicule in the extracted site. Consult an oral physician and get it evaluated. If required you may have to take a radiograph like IOP AR to see the spicules. You need to get the socket irrigated and clear the debris. 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 pain in lower left abdomen and soft stool and urging in morning. stool test shows semidigested stool and no blood and parasite. sonography normal but have retroverted uterus .i had ascaris cyst detected in stool 1year back when this pain started.took treatment.now what can be reason of pain.is it pressure due to uterus or otherGIT PROBLEM.had dark stool but test reveal no blood.i use to be constipated before but not now after this ### REPLY: Dear Sonar SABENA, hello. Retroverted uterus cannot result in soft stool with pain abdomen. It can result in slight pain during mensuration or during sexual intercourse. It can result in mild low back pain but not the symptoms mentioned by you. Furthermore, it seems that you are suffering from some intestinal infection. Please take antibiotic and antiamoebic along with probiotic under medical supervision. This will help you in giving relief. Hope this will be of help to you. 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: hw r u doctormy daughter is 4 yrs old n she has a small lump behind her head..she had it when she was born. this lump is also growing..is it anything serious..what should i dohere we dnt have qualified doctors n i am so scared to show to any doctor.. ### REPLY: Hi, Thanks for query to My  virtual Clinic. And welcome to  services, as the services are rightly for people like you. I studied all details of your query. I understood your health concerns about Treatment of the lump behind the head of your baby-Treatment-As the location of the lump since birth is not given it's very difficult to comment on the treatment as I am unable to assess the cause of the head lump on its back. From the possibilities for such a growing lump, your daughter seems to have Desmond Cyst which is a congenital lump and is of benign nature mostly. Any other cause for these needs to be ruled which your doctor would take care of, as he would have first-hand information, to which I don't have any access. In this background I would advise you to Urgently consult and have a Second Opinion from your Surgeon, who would do CT Scan or Skull X-ray to fix the probable cause of this tumor from the other causes which need to be ruled out in context to examination findings from your Surgeon. Hope this reply would help you in resolving this complex query and anxiety with it. I would appreciate if you hit thanks and write excellent review comments to help needy visiting patients at . Welcome for any further query in this regard. Good Day!! . N.M.S. Genl- CUTS. Senior Surgical Specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im a 16 year old boy with abdominal pain that has been going on sic eye end of June. It will flee up occisionlly, and go awy for maybe a week before flaring up again. The pain from severe to discomfort, and feels like bloating sometimes and sharp pain the next. On two occasions it has been neer unbearable. On this occasions I worried that it my be appendicitis. The pin is lost lets on the right side. Now, Im beginning to feel a little ill, I m burping constantly and have a weird feeling in the back of my throat, I also feel like my arms and legs are light, as though Ive been sitting on them a awhile and blood is flowing back into them. Im starting to get pretty worried. I dealt with constipation from July to late August, it went away after I got on a regular diet. Right now it feels like gas is moving about in my abdomen. Im constipated since yesterday. ### REPLY: Hello, Thanks for the query to . Forum. I would come up with these possibilities for this type of pain, This includes.1 Right side kidney stone, diagnosis can be confirmed by ultrasound of kidney. As burping, pain, bloating tiredness all are characteristic features of stone in kidney.2 Appendicitis as you mentioned in the query that pain is on the right side and pin prick. Diagnosis can be confirmed by ultrasound examination. Physical examination also important .3 One possibility may be of peptic ulcer disease, diagnosis can be confirmed by upper G I endoscopy. In my opinion consult a physician and get his opinion as physical examination is very important in this type of cases. Good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 22 month old grandaughter has been put on apoamoxol(amoxicilan suspension)? for a sore throat and ear infection. She has been breaking out in a rash on her knees and behind her neck. She has really red cheeks and someone thought she had fist (?) disease. Phoned her doctor and she advised my daughter if she has fist disease there is nothing you can give her for her she will just outgrow it. My concern is that I, the grandmother is allergic to penicillan as was my father. My daughter has never had penicillan as or family dr. at the time didnt give it to her because of family allergy. Could my grandaughter be allergic to penicillan? diane ### REPLY: Hi. Thanks for asking us. From allergic history you have in your family. It may be possible that your granddaughter developed these rashes due to allergy towards amoxicillin suspension which belongs to penicillin group. First disease means Measles which is also another expected cause for this rash. Either case your babies rash can be solved by taking anti histrionic syrup and paracetamol syrup if she develops fever. Stop amoxicillin syrup. Use different antibiotic next time if you need arises. HOPE IT HELPS. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A lady in my workout class was complaining about swelling in her fingers, her belly, legs and feet. She has been taking diet pills. Any idea what is causing her swelling. She is traveling on a plane this weekend, and I am wondering if she is safe to go? ### REPLY: Hello, I would explain that the swelling could be related to increased fluid retention. This could be related to diet pills adverse effects.  Anyway, I would recommend performing some tests in order to exclude other possible causes that may lead to increased fluid retention: -a cardiac ultrasound and a resting ECG in order to investigate for heart failure-kidney and liver function tests-blood electrolytes.  Hope I have answered your query. Let me know if I can assist you further. Take care  ### END