Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 woke up this morning with a large purple mark on the side of my big toe n directly under it is a gooshy lump and its tender when i extend my foot it causes pain i did not bang it at all also to the foot in question i had 9 surgeries due to a doctors mistake doing a bunion ectomy i have had several nueromas but this is an area which i normally dont have any abnormal things happening but i do walk alot on that side of the foot due to the exstwnsive surgeries on the oppposite side.also my calf feels very uncomfortable ive had a weird feeling in my knee and also ankle pain. please help im very unsure what to do and very concerned because of the already existing condition of my foot ### REPLY: Hi, Dear,Welcome to . Based on the facts of your query, You seem to suffer from-Excessive-Friction Melanonychia with Purple Sublingual Hematoma of Big Toe, caused from ill-fitting Shoes causing extra pressure on this side of the foot-This excessive friction on the foot in question is due to the compromised other side foot, for which You underwent 9 surgeries. This has caused extra stress of the knee / calf and ankle muscles, giving fatigue pain. Remedy-Do as follows--X-ray of the Big Toe and plantar arch of the affected foot/ Blood Tests-Second opinion from Podiatrist or ortho-Surgeon for assessment of the cause of this purple gushy Lump of the Big toe.-Under Antibiotic and painkiller . -Don't worry if you follow above steps urgently. Hope this reply would help you to plan further treatment with your doctors. 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!!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 extremely dry skin where my two butt cheeks meet, like in the crack of my butt. It itches terribly, and often leaves a burn of flakey dry skin in my underwear. I know that I have psoriasis on my scalp. I was just wondering if it can affect my butt cheeks and also my genital area? I ve had vaginal itch since I was young. Yeast infection medicines dont work, rarely will an anti-itch cream work. It was localized on one side of my vagina for 10 years and had since spread to both sides. My family doctor just says to use anti-itch, but I think there s a bigger issue or a better answer. The left (original) side had turned a darker color and is thicker. What exactly could be the issue? ### REPLY: Hello and welcome to  Psoriasis is a likely possibility as it can very well involve the body folds. Psoriasis classically involves the extensors like scalp, elbows, knee, shins and lower back, but sites like maxilla, groin folds can also be involved either together with the extensors or solely, where it is classically known as inverse psoriasis would advise that you see a dermatologist for a confirmatory diagnosis. Psoriasis in the body folds responds very well to topical steroids as well as topical immunomodulators like tacrolimus/pimecrolimus ointment. An OTC antihistamine once daily e.g. cetirizine would help you symptomatically with the itch. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been recently detected hepatomagaly with 1.6 cm dia smooth wall anaechoic cyst in right lobe liver. I n feb 2013,the ultrasound impression was slightly enlarged liver and mld hepatomagaly. I am very anxious as i am very careful about my health.the result was seen through routinecheckup without any complaints. What should i do.Can it be corrected.How pl suggest. ### REPLY: Hello USG findings suggest mildly enlarged liver. Liver enlargement may be due to many reasons like hepatitis, inflammation,fat deposition(fatty liver), obesity,alcoholism etc. You may also need investigations like routine hologram, random blood sugar, liver function test, lipid profile. Hepatic cyst in liver usually doesn't require many treatments. It may only require follow up. Treatment depend upon findings. If liver function test are normal then it is not a matter of concern. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a emergency gall blatter surgery over 4 years ago. Today my belly button was super crusty when I cleaned it out I noticed the bottom of the old incision  was oozing a puss like greenish fluid. I put peroxide on it and let it breath but it seems to only be getting worse throughout the day. I dont understand how it could it could get infected after all this time. ### REPLY: Hi, Thanks for writing in. It might have got infected a while back, and you realized that now. It may only be a superficial infection and not necessarily gone inside the abdomen. The belly button area can get infected because of the sweat formation. Please consult your surgeon, and they will examine for any significant pus discharge. The pus may be sent for culture and sensitivity and antibiotics given accordingly. Please remember to keep the area .  Take complete course if given antibiotics. 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 have creatinine question regarding my moms healthMy mom is above 65 she is havig hi blood pressure and her creatinine level is 3.5 what can we do.She is taking blood preassure medication but the preassure is not stabalizing.Also to mention she was diabetc before. ### REPLY: Hello and welcome to . As a Urologist, i fully share your concern. Your mother has most probably, diabetic nephropathy, where the person has, diabetes, hypertension and kidney failure, among various other symptoms. She must get treated by a nephrologist. She should avoid sugar, excess salt(6g/day), low protein diet(40gm/day), and 2000 calories/day diet. She must get her urine protein, blood routine, urea,creatinine, uric acid, sodium,potassium and ultrasound scan of abdomen. After seeing the reports, the nephrologist will be to give an expert treatment. You may send the reports to me, as a direct question, for an expert opinion. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Have been having chest pain over the last year and have had stress test that ruled out the heart, but continue to have  intense chest pressure, like a belt around you just at lower rib, leading too vomiting and pain so intense that I cant sleep, have heard the term nutcracker syndrome nothing I do seems to relive any of the pain any ideas would be welcomed. ### REPLY: Thanks for your question on . I can understand your concern. Yes, nutcracker esophagus is a possibility. It is due to sudden spasm of esophagus. Another possibility is HERD (gastroesophageal reflux disease). It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of vomiting, chest pain etc. So for the diagnosis of both these conditions, you need upper GI (gastrointestinal) copy. Treatment is avoidance of stress, tension, hot and spicy food. Proton pump inhibitors and prokinetic .  So don't worry, consult gastroenterologist and discuss all these. You will mostly improve with all these. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My dad is at stage 4 liver cancer . Hehas 4 tumors in the liver. He went into the hospital for pancreatitis 2 weeks ago, and now he is a nursing home . He is eating very little and he started throwing up flems today. Are these symptoms of the final stages? What can we expect? Projections as to how long hehas? What can we do for him? ### REPLY: The critical thing is about pancreatic cancer, not liver. Stage 4 disease means the survival is less, weeks. Our duty now is how can we give comport by decreasing his problems, agony during this short period. This is called Palliative treatment. Doing things what he wants, will give him some sort of positive psychiatric strength to him. There will be some nursing homes specialized in taking care of terminally ill patients. Better, if possible, he should be under care of these persons. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Father in law had recently undergone a complete knee replacement for right leg and had a past history of Coronory Bypass as well in the year 2000 and takes medicines for the same. As he was not able to sleep during the night, he had been suggested Nervmax capsules one at the time of sleeping. He has already been taking alprex for a long time now. However, even after taking 1 capsule, he has not been able to sleep. Please advise if he should continue using Nervmax and the side effects of using the same. ### REPLY: HiI understand your concern. Sleep disturbance is common in post-operative period and Generally in old age. Due to history of past coronary surgery choice of medicines should be cardio safe . Lorazepam 1 mg is ideal choice in cardiac patients. Sleep disturbance in old age can be treated with lorazepam 1 mg or 2 mg but dose is depend upon age and renal/liver function. Nervmax is pregabalin it is not a choice as a sleep remedy it is neuroprotective. Besides this following will helpful. Avoid smoking or alcohol. Avoid tea or coffee before getting sleep. Fix time schedule for sleep. No day time sleep. Treatment of underlying psychological stress is must if any. Still have query then feel free to ask. 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 daughter was diagnosed with a kidney infection and placed on antiobiotics yesterday morning. Now 36 hours later the pain is still intense, she still has a fever and cannot eat. Should we give the antibiotics more time, or would a visit to an emergency room be the best course now? ### REPLY: HelloThanks for query. Your daughter has been diagnosed to have kidney infection hopefully your family Physician. She needs to get examined by a qualified Urologist and get following basic tests done to establish a diagnosis .1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis.In the meanwhile continue taking antibiotics that she has been prescribed Ensure that she . 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: 1.Moderate degree of disc desication noted at T12-L1,L2-L3,L3-L4 and L4-L5 levels. 2.Broad based posterocentral and right paracenral herination of L4-L5 disc causing compression of transversing nerve roots at Right lateral recess and right neural foramina. Kindly suggest what is the action to be taken. Regards, Rachana ### REPLY: Hello, With my clinical practice of 12 years most of the cases with disc herniation, disc degeneration, disc prolapse have responded well to a physiotherapist. As mentioned by you about the MRI report but the main thing which is missing is the clinical symptoms like - pain in lower limb/s, tingling, numbness etc. As MRI is a diagnostic procedure and not a diagnosis we need to compare the clinical symptoms with the MRI reports. If there are no clinical symptoms the MRI cannot be considered as a diagnosis. It is a diagnostic tool to correlate the clinical symptoms. If you have any of the above-mentioned clinical symptoms than the treatment part will be this way. If the pain is radiating in nature then first need to try out McKenzie maneuver which you can find online, as this maneuver helps to centralize the pain and thereby stopping the radiation of the pain. Post acquiring the McKenzie maneuver position one needs to use hot water fermentation over the lower back to provide the soothing effect. Post which once pain level falls below the level of 5 in was Scale of 0-10 where 0 is no pain and 10 is maximum pain. Exercise the core, extensors group of muscles of the spine, hip, thigh, leg, in short, the whole lower limb. In case you are non-diabetic then using icing post-McKenzie maneuver position will also be okay and rest steps as mentioned above. In case you're trying for the first time and not getting an idea of how to perform in accuracy than taking guidance from a physiotherapist should be helpful. My experience of 12 years has produced a maximum recovery with the equal support of the patient for this condition. Most of them are now playing squash, marathon runners, mountain climbers etc. A normal life and more than that can be achieved is a good interest is provided in the case. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I AM 53 YEARS OLD OVERWEIGHT AND ALWAYS HAD A HIGH ESR VAUE OF BETWEEN 65 AND 80 RECENTLY I HAD MY GALLBLADDER REMOVED DUE TO STONES COULD THE HIGH ESR VAUE BE BECAUSE OF THE INFECTION IN THE GALLBLADDER I ALSO HAVE MICROSCOPIC UNEXPLAINED HEMATURIA HIGH BUT CONTROLLED BLOOD PRESSURE HIDH URIC ACID LEVELS OF ABOUT 7 AND AM HYPOTHYOID ### REPLY: Hello, Thanks for the query to . Forum. There was stone in gallbladder so removed, in my opinion high value of E S R is not too due to gallbladder stone. Usually chronic infection anywhere in body is responsible for high value of E S R (normal 5-8 mm of Hg in male) . One thing you mentioned in your query that you have microscopic unexplained hematuria. High level of uric acid that 7 (not too high). Age 53 years, Over weight, In my opinion you should consult a urologist and get his opinion and deal accordingly. Hope I have answered your query. If further any question I will reply. 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 has been receiving dialysis but woke up vomiting her last night meal and vomiting bile what can I give her over the counter medication or home remedies.. I know that if I take to the doctor they will keep her in.. do the usual and release her and will tell me its her kidneys getting worse. Is there anything I can take care at home ### REPLY: Hello and welcome to . As a Urologist, I can understand your concern. Maintained dialysis to maintain kidney function, vomitting is common. The causes are various, including electrolytes disequilibrium, . P.fluctuations, etc. The safest step is to avoid home or OTC remedies and take him to hospital. His tests will tell us the cause and start treatment and dialysis if needed. He should take low salt and protein diet, avoid fresh fruits and take all  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 1st year after marriage we got pregnancy so that time we don t want baby so we aborted . Now we completed 3 years . So we decide to get a baby . For my wife now 40 days completed and we tested the ChatDoctor with home test . But we got negative results . So pls suggest us ### REPLY: Hi dear, I have gone through your question and understand your concerns.Delayed periods can be due to pregnancy, stress or hormonal disturbances like hypothyroidism hyperprolactemia or polycystic ovarian disease. If the urine pregnancy test is negative, then the pregnancy is ruled out. I will suggest her to get her hormonal profile done. Hope you found the answer helpful. Wishing you good health. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a bad back ache that gets worse whdn o get up and try ho work aroud the house. This started after being onbed woth Vertigo fpr three days. The backache first cme on frpm beong inactive anf on bedrest. Shpuld I try to exer ise this current pain away? ### REPLY: Hi, From history it seems that you might be having cervical spondylitis producing vertigo first and then backache. Both problems can be due to spondylitis. Go for X-ray cervical spines and vertebrae for cervical spondylitis. Treatment of this ailment will cure your both problems. Physiotherapy, short way diathermy will be helpful. Avoid putting pillow under your neck. Take calcium and vitamin A and D supplements. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my sister was born at 27 weeks. she has grade 3 and 4 bleeding in her brain and has csf fluid being drained by a shunt wire coming out of her head. what are the long term problems associated with this. and do children ever recover the damage in the brain and become normal ### REPLY: In case of preterm births, developmental maturity is not achieved at birth. The inner lining of the brain is very fragile and bleeding from there is not uncommon. Usually the blood gradually gets absorbed, but remnant debris may cause blockage of .  In such a case a shunt might need to be placed as in case of your child. But there are possibilities of the shunt getting blocked, and the shunt might need to be replaced from time to time. Human brain has high level of plasticity and reallocation of the brain functions occurs eventually, especially over the first 5 years of life. Developmental interventions are greatly beneficial in this regard and may lead to significant regain of function and many of such child ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 cut the top part of my thumb very very deep by the crease with an electric wood blade I was using to renovate my cabinets. went to the urgent care the next day, but was told it was too late for stitches. Was told not to bend my thumb and given a splint. But now 4 days later, my thumb is extremely swollen and almost numb to the touch. extremely painful to bend it and the thumb seems to be frozen. ### REPLY: Hi, Thank you for providing the brief history of you. A thorough neuromuscular assessment is advised. As you are using the spent the numbness is because of lack of circulation and restricted neurological impulses. Also, try performing quick icing for the area around the thumb region, like the dorsum of hand and palm to reactivate the neural signals. Pain will also come down with quick icing and also the swelling will be reduced. Kindly keep patience as you might have made a deep cut, so soft tissue healing will take some time. Once healing is completed, the movements of the thumb can be performed. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my period is 3 months late already. Is there a possibility that I might be pregnant? We have an unprotected sexual intercourse with my bf 3 days after my period last September 4. I dont experience spotting. Last few months we have a vigorous training and I suffer from weight loss. But now, I was wondering why I have clear nipple discharge from both of nipples. ### REPLY: Hello, I hope I can help you today. First, any woman having unprotected intercourse is at risk for pregnancy. In addition, missing your period is the most common sign of pregnancy. Weight loss due to exercise can also cause you to miss your period, so there is no way to know if you are pregnant based solely on symptoms. However, nipple discharge can be caused by other hormone abnormalities that can also cause irregular periods. An excess of the hormone Prolactin, which stimulates milk production, can be produced as a side effect of medications or even from a type of benign pituitary tumor. Depending on your age, abnormalities of the breast ducts or even rarely, breast cancer, can cause nipple discharge. So if you have not yet done so, you should perform an over the counter pregnancy test and if the results are negative, I recommend you see your local physician for an evaluation of your hormone levels. I hope I was able to adequately answer your question today and that my advice was helpful. Let me know if you have further queries. 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: can lichen nitidus last for more than one year? how can i be sure it is lichen nitidus? taking into consideration i visted many doctors and no one told me the same diagnosis... one told me it is pearly penile papules, one told me it is frodyce spots, one told me it is malosum conaginasium and the last one told me it is lichen nitidus...please help me ... these spots drive me crazy ### REPLY: Hi I do not noses postwar are any tests for lichen nitrous. Yes the differential diagnosis of lichen nitrous can be pearly penile pa pules, molluscan contagious or force so. Only MC can be treated with extirpation otherwise they are quickly infected. Other conditions are noneffective and even if they are not treated anything to worry, they are only treated for cosmetic grounds. Try macro gel over the lesions 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 I have sarcoidosis, and had my spleen removed due to the sarcoid..I was on prednisone for 2 months and it helped clear the lesions on my lungs and Liver, redid a pet scan it showed the lesion on my pubic symphasis has metabolic action increase fromb 6.9 to 8.5. what do you recomend I should do? do you think it is sarcoid or bone cancer ### REPLY: Thanks for your question on . In my opinion you should get done biopsy from the pubic symphysis region. Sarcoid is an inflammatory lesion. So on PET scan it will show positive (hot spot). And malignant spread will also give positive uptake on PET SCAN. So if PET scan shows positive result on pubic symphysis than it can be due to either sarcoma or malignant spread. So to rule out between these two biopsy is must. And only biopsy will confirm the diagnosis.  So better to get done biopsy from pubic symphysis lesion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife (31) suffers from complete heart block (AV block). Some doctors say it is congenital. She, however, feels that she was absolutely fine before she, in her 14th year had a severe drug reaction (caused by Quinine and Paraxin ?) that caused these symptoms like bradicardia (hers is 45 bpm). Doctors say if she gets a syncope she should get a dual chambered pacemaker. Can alternate medicine help? ### REPLY: **1. Patients with third-degree AV block [complete heart block] typically experience. . Bradycardia (low heart rate: 45 in your wife case), Hypotension [low blood pressure], and. Hemodynamic instability: as the heart cannot react quickly enough to sudden changes in demand or sustain the higher heart rates required for prolonged activity.PS. Prognosis is generally poor without therapy [dual chambered pacemaker is the best alternate] along with medicines to control blood pressure and atrial fibrillation, as well as lifestyle and dietary changes to reduce risk factors associated with heart attack and stroke. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently had blood tests showing low levels of Vit B s, Magnesium, underactive thyroid, low DHEA etc. I am a type 1 diabetic but eat pretty good. I had a vit B12 shot at the Doctors office yesterday and felt pretty good. Around 4:00 today I started feeling a crash. Now my muscles are tight and kind of numb. I already took 350 mg of Magnesium. I m getting cramping in my feet. Could it be due to the B12 leaving my system? He just gave me a test dose and said it would be out of my body in a day or two. Am I taking too much Magnesium and not balancing it with other electrolytes? Thanks, ### REPLY: Dear friend, Greetings from ... I understand your concern ... YOU GOT IT RIGHT you need to take care of all the electrolytes ... Check your serum sodium/chloride, potassium / ionized calcium ....because, low potassium/ calcium could be the reason ... you don't take magnesium supplement alone .... you have to consume a product which gives you all the vitamins and minerals together in a balanced form (nutritive daily / revival etc., ) you have to take good amount of green leafy vegetables, fruits, nuts, (banana & coconut water rich in potassium)...daily ... to meet the needs of minerals for your system ... thank you . Do contact us for more queries ... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 and tingling bilaterally in my hands primarily in the distal forearms, wrists, and thenar eminences. My grip does not appear to be weaker and am not having difficulty holding onto objects. A few weeks ago I had these same symptoms but ice massages and nabumotome seemed to help with the pain. I have tried friction massage with very little success. This new flare up occurred approx. 3 days ago. I am also noticing loss of balance on occasions but have not fallen. My biggest fear in life is ALS. ### REPLY: Hello, Your symptoms are not at all suggestive of or indicative of a motor neuron process (mainly based on the symptom of pain in the distal forearms.  I think what you can benefit from is a good NEUROLOGICAL ASSESSMENT and evaluation.  My first thought based upon your symptoms is to examine the carpal tunnel in both arms and test function of the median nerve though you are noticing any specific weakness in holding onto objects.  It is not unusual for CTS to present as PAIN before weakness. Also, does not typically do this as it does not involve sensory ganglia at all in its outset or presentation. 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: hello doctor.. day before yesterday i had lower abdomen pain.. and i went to doctor, they pressed that area and said it seems like appendicular area and gave me some pills for 3days. After that no pain for me, but i just want to conform that i have appendix or not. is this danger if i delay this. reply me soon. im afraid.. ### REPLY: Hi. It depends on which pills they gave it to you. If are analgesics then I suggest you to stop taking them and see what happens. IF pain comes back then go to ER again. If you have antibiotics the . Usually when such patients come to my hospital we take blood test, and we recommend that patient comes again for 24 hours to repeat those tests and see is there any progression of inflammatory markers. We don't give any pills... Some serious appendicitis infection usually develops through 5-7 days and symptoms are constant pain in right-lower abdomen with loss of appetite and nausea. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 39 years of age and am trying to conceive.  My doctor called with the results of my bloodwork and stated my prolactin his high.  She said it is at 13.6 and has recommended I see a fertility specialist.  Im afraid that I wont be able to get pregnant.  What are my chances with this condition? ### REPLY: Hi, if your prolactin levels are high, repeat it in fasting state if not given prior in fasting.  If its high again, medicines are available for its treatment.  So, it can come back to normal, and you can conceive.  But, your age is slightly on a higher side, so you can take some medical help in conceiving fast. You can take some medicines for growth of your follicles and track your follicles' growth by repeated ultrasound.  When follicles reach a size more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days. Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 months.  If it doesn't work then you can go for GUI.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father in law gt admitted in hospital this sunday witChatDoctorplain of chest pain . he is a heart patient. dr confirmed it was not  a stroke, but fluid collection. He was on a medicine call lasix.he was nt taking it sonce last 2-3 weeks.as of now also he is in ICU, as his BP is 90/150 and still not coming under control. Is the situation very risky? ### REPLY: Hello! Thank you for asking on ! I understand your concern and would explain that his symptoms could be related to heart failure. You should know that lasix, also called furosemide is a diuretic, used to eliminate excessive amounts of fluids from our body. It is helpful in the management of fluid retention from heart failure. So, just relax! His symptoms are not related to any adverse effects of lasix, but to his organs condition. A cardiac ultrasound and further blood lab tests should be done to establish the possible cause of his problems. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am suffering from back pain for the last 8 yrs the last year the pain is getting worser i have been going to physiothereapy no good i have had 4 sessions of accupuncture no good i have been now refered to hydrothereapy for 8 weeks what i wont to know is if my doctor can refere me to a sauna for my back pain. one more thing how deep is the water for hydrotherapy because i cannot swim. i have been diagnosed with chronic back pain could you explain in detail what that means my physiothereapy says that i facet joint syndrome nerve root irritation ### REPLY: Hello may have good relief with physiotherapy like IT [Inferential therapy] and TENS[Transcutaneous electrostimulation] along with ultrasound. So if possible you can start that. MRI spine and image guided fact injection may help you. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 (2years and 7 months old)is having cold and mild cough&fever (99).doctor told he is having mild vizzing.doctor listed some 5 medicines.crocin Ds for fever,cosome ,betnesol(tab),bricarex,bromolin DT(tab). i just started all the medicines,now i read some review about cosome and scared.which are the medicines i can follow?plz can u guide me ### REPLY: Hi Dear, Understanding your concern. As per your query your child have symptoms of cold, cough and fever which seems to be due to upper respiratory tract infection or poor immunity of body. Need not worry. Avoid intake of cold carbonated beverages. Avoid intake of sharp spicy food. You should apply mist humidifiers in room and take throat lozenges. Visit ENT specialist once and get it examined and start treatment after proper prescription. You can go for blood and sputum tests as well. You should take proper course of antibiotics along with anti-inflammatory medications. Furthermore, you should maintain oral hygiene. Do warm saline gargles. Hope your concern has been resolved. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, about 3 weeks ago I received oral sex, no penetration. About a week ago I have been getting a very prickly/sore feeling on my foreskin. The head of the penis is ok and no sighns of rash or anything also no pain when touched or urinating. I have tried thrush cream but it s still there, more so towards the end of the skin near the tip. Any ideas? ### REPLY: HiT hank you for asking . I have gone through your query. Your problem can be due to irritation or infection after oral sex. A urine examination and swab should be done to rule out that. Antibiotics will be needed. Usually I advise norfloxacin if UTI, Azithromycin if not. Local broad spectrum creams witChatDoctorbination of Aureomycin dexamethasone and clotrimazole also will be helpful. Hope this may help you. Let me know if you have any further queries. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir, My child has one MCDK, Now he is 2yrs old? Really I am afraid for the problem every day, I have only one question, Any life-threatening in this issues at elder age, and it is possible to continue to long life within one kidney. Please I need your ture answer. Thanks and regards Sathish ### REPLY: Welcome to , if only one kidney is missing, the chances of survival are excellent, since the remaining kidney is capable of handling the workload of its absent partner. The situation is different for babies with both kidneys absent. Around four in 10 babies with both kidneys absent (bilateral renal agenesis) are stillborn, and the remainder die within a few hours of birth. . A baby can manage with one functioning kidney, since the organ enlarges to cope with the extra workload.  So nothing to worry hope this explains ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 April first 2014 I was admitted to the hospital, I was at home and I pased out and paramedics took me to hospital, in the ER I was given to bags of blood because I had bleeding in my stomach, I was in the hospital for five days,when I was discharged doctor told me I had anemia and H pillory bacteria, I did the treatment for the bacteria and I was given meds to take at home, iron pill stool softer and Prilosec for three months, the problem I m having is that if I walk a flight or two of stairs I winded and sweating from my head profusely any minor exertion I start to sweat a lot I m 44 years old and never had any medical problems, what is causing me feeling winded and the severe sweating ### REPLY: Hello, Welcome to . Due to bleeding in stomach and H pillory infections, you have very low hemoglobin. It causes iron deficiency anemia which leads to weakness and sweating and tiredness. To rule out any cardiac cause, consult your physician. Take green veg, . Take orange or lemon juice or buttermilk after lunch and dinner, will help you in absorption of iron in small intestine, leads to increase hemoglobin but slowly. Hope this will help. Thanks for contacting. 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 slipped on the stairs a few days ago. I can t sneeze or cough. I feel Micky ward kit my on my left side with force. the stairs david waltham mass Just trying to find out why it hurts so much while sneezing and coughing I have asthma not that fun for me. ### REPLY: Hello Thanks for writing to us, I have studied your case with diligence. As per your history of trauma there is possibility of rib contusion. Rib contusion is not always visible on X-ray. You may need to do MRI or HRCT to see details of injury. If there is lung injury then there will be increasing pain with every breath, coughing and sneezing. I will advise consulting to orthopedic surgeon. Medication like muscle relaxant and analgesic will reduce pain along with it use rib support belt. You may consult physiotherapist for pain management. He may start TENS, or ultrasound which is helpful in your case. You may need to take rest for early healing. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not forget to give rating at end of discussion. Wishing you good health. Take disregards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Mt 2 year olds right tonsil has been enlarged for at least 2 weeks maybe more , as this is only when i noticed it.... the doctor said there is no infection about 10 days ago but it is so big it covers half her airway and she wakes up coughing and spluttering , is this something to be concerned about ?other than that she is very tired in the day i presume from waking in the night coughing , Also her very back teeth are coming through could this be causing it? ### REPLY: Hi, It's very hard that your child is not able to have peaceful sleep during the night. The most common cause for consular enlargement is due to upper respiratory tract infection (Viral /Bacterial).  But usually, both tonsils will be enlarged. Child .  When tonsils are enlarged, it can obstruct the airway, there by causing sleep disturbances. If the symptoms are very frequent and disturbing your children routine life, then it needs to be evaluated. There are few causes for unilateral enlargement of tonsils, such as infection and inflammation. I would suggest you get a pediatric ENT surgeon opinion, who can guide you further. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir, i am suffering from hepatitis A from 16th June 2011 and also was admitted twicw in hospitals. My billurubin level went up high upto 40.54. i was admitted under Dr. mahesh goenka. Now my level has come down to 4 and sgpt is 60 and Sopt is 88.76 which was tested 7 days ago.My age is 27, my height is 186cms. and weighing 116kgs. what is the cause of this high billurubin level ? within how much days i will be able to get back to normal life ? Thank you for your valuable suggestions. ### REPLY: Thank you for posting query. Increase in the level of liver enzymes(AST, ALT) reflect an INJURY to the Liver. Medically, the condition is known as "Hepatitis". High bilirubin is seen in hepatitis too as in your case. Hepatitis maybe caused by:1. Virus (A, B, C, D, E) 2. Alcohol 3.  .  Gall bladder or common bile duct pathology 5." Fat excess" (indicates in your case)and so on you have been diagnosed with HEPA but it advice to rule out herb and HEPA too. HepA virus is a common cause and self limited disease.advice:abstinence from "Alcohol 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 had my gallbladder removed April of 2012. After operation doctor said I could eat anything. Even though he stated that I ve been trying to eat good foods but I guess I really haven t. Present day I m still getting abdominal pain, upper back pain and some bloating. I ve never been given a good diet to follow. ### REPLY: Hello, It can be because of unhealthy lifestyle and eating spicy and fried things regularly. But I would like to know that if pain gets worse after having food or before having food. Also stress for long period can cause these symptoms. As gall bladder is removed 2 yrs back, it does not seem that gall bladder removal can be the cause. I would suggest you to get checked by your Doctor, and you may need endoscopy or ultrasound to be done to rule out the cause after discussion with doctor. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 surgery on my left ankle - inside and out to remove two lipomas.  The inside of my ankle has approx. 7 stitches.  The outside is much larger than I had thought and has approximately 20.  I had the surgery this past Monday and stitches are scheduled to be taken out this coming Thursday.  I am concerned that I still have a small amount of bleeding and wasnt sure how little or how much activity I should engage in.  I did see my surgeon a few days after the surgery and she said everything looked good, but it seems to be taking longer than I thought it would to heal.   Any suggestions/comments/advise would be greatly appreciated.  Thank you. ### REPLY: Hi, Thanks for writing in. Lipoma is a benign tumor and not a serious concern. It is hoped that your suspected lipoma was sent to pathological laboratory and confirmed to be lipoma which is a benign fat containing tumor. A lipoma is easy to operate on, and the entire tumor is excised. The ankle is a complex part of anatomy and contains lots of small muscles and ligaments. Such an operation can take 4 to 6 weeks to give you back your normal strength and range of movements at the ankle joint. The ankle is a joint which is used a lot and is among the most important joints for locomotion. You might get in touch with a rehabilitation clinic and start doing physiotherapy exercises. Please keep your operated ankle over a pillow when you lie down to sleep. Getting heat and cold pack will also help. Application of ointments will reduce any dull pain that is present. 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: My Mother keeps feeling like she is going to faint, but only for a few seconds, and then it goes away only to return within the next 15 minutes or so.  Her heart rate goes up to 103 right before this feeling, and then afterwords returns to 74 or so.  She is 53 years old and took this months Boniva this morning.  She also takes aspirin, norvasc, iron supplement which she just started this week, and insulin. ### REPLY: Hello, Certain conditions are there which could cause such symptoms of giddiness, or vertigo. First, is it could be Transient Ischemic Attacks (TIA). Actually, it is a bit rare condition but cannot be neglected and for that, I would advise for an MRI. Now for other conditions it could be due to vestibular dysfunction, endocrine dysfunction (Diabetes) and last but not least it may be functional disorders. Over all such symptom demands the numbers of work up to reach up to right diagnosis, Medicines or iron supplements may not be the cause. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dr.   Have Diverticulosis....Right now I am having cramps and pains in my abdomen which are really painful.    I am going to have a Cat Scan next week.  I know nothing about this procedure.... and hope ,you can walk me through this.  I am a 82year old women... Have Non-Hodgkins lymphoma.  Had a small tumor removed from my right groin 7 years ago.I have not had a problem since.  I have Arthritis and had surgery on my wrist many years ago and I have it a lot of other places in my body also.   I will be greatfull to you if you can tell me what I can expect will happen when I have the scan.   Thanks ### REPLY: Hello Friend, I am a Homeopath and I will be answering your queries differently. If you are expecting something bad, then you will have bad results. Always expect good things. You may feel this answer as unscientific. We have a mind that is very powerful to make you sick or make you healthy. You have undergone a lot of surgeries of your body, but I feel your doctors have not done any probing of your mind. Homeopathy does it in the best manner and expert Homeopath will select a constitutional remedy that will take care of your health for many more years to come. Be positive. Mind can make you sick even cancerous. Your life situations, your reactions to them, psychological conflicts that remain unresolved etc. can be the causes. Your genetics, constitution, your individuality both mental and physical etc. Are to be probed. Approach an expert Homeopath at the earliest. If you are not satisfied by my answer, you can again ask to . Doctors of Cancer specialty will answer in the conventional with Best Wishes, .  J, Varese, Homoeopath, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 an odd issue when I raise my heart rate quickly (or at the beginning of exercise). It doesn t persist, it s only when I initially get my heart rate up, typically in a quick manner (for instance if I jump on a pull up bar and knock out a set of pullups, then do some dips, etc). This happens nearly everyday - I get an odd sensation in my stomach(?) - maybe more in my chest, but it eventually moves into the base of my throat, like an odd tickle, but there s definitely an odd sensation in my stomach / chest (hard to pinpoint the location). Then my mouth starts to create saliva at a very high rate, so high that I can lean over a sink and saliva will just continue to drip from my mouth (it forms under my tongue / the bottom of my mouth). This usually lasts about 30 - 60 seconds. After that I m good to go and I m able to exercise vigorously (brazilian jiu jitsu for upwards of 90 minutes). Any idea what the hell is going on when I initially bring my heart rate up? ### REPLY: Your heart rate response to activity is normal. The early rise with a change in activity is followed by settling in to a new heart rate over an average of about two minutes. that's why treadmill tests change every two to three minutes. The tickle and salivation combined with your activity capacity suggest reflux to be the cause. Abrupt change in physical activity and swings in the pressure in the abdomen and chest may trigger acid reflux. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother was diagnosed with Muliple myeloma 2 years ago and has been in remission for about 14 months however in recent months her blood tests showed some m protein again and have gradually going up since in the the last 3 months. She recently has noticed to lumps on her scalp, they dont hurt, she has no headaches or other sympoms. What could the lumps be? ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You have high chance of recurrent lesion. Your scalp lesion may be due to myeloma or may be due to some other cause also. Go for biopsy of that lesion and then take treatment according to histopathological examination. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , My current age is 27 years. I had been diagnosed before 5 years with the partially healed calcified granuloma in my right hand part of the brain. After which i felt most of the times , weakness, increased heart beat .... now blurred eye vision , increased BP 90-140 .. what should i do ???Which one will be the right way to get it treated? ### REPLY: Hi, Thank you for posting your query. Partially healed calcified granuloma is a common finding on CT scan of brain. In many cases, it does not cause any symptoms, however, it may cause headaches and seizures in some people. Your current symptoms are most likely not related to the calcified granuloma in brain. Please get evaluated by a good internist to find out the reason for your symptoms. I hope my answer helps. Please get back if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor,I have mild itching on the knees. No other symptoms of cirrhosis. L.F.T. is normal, Globulin, PT and INR are normal. I did a USG yesterday and the radiologists remarks are: " Liver normal in size- mildly abnormal echo structureabnormal nodules on margins. - Early cirrhosis- I have been having fatty liver due to alcoholic consumption for more than 10 years. I have no symptoms of any disease now. I am gravely worried. Can you give me your opinion whether I have early cirrhosis and if so what is the prognosis. ### REPLY: Hi, I am so sorry to hear about your diagnosis. Fatty liver can be caused by excessive alcohol intake (Alcoholic SEATO hepatitis, ASH) or due to excessive fatty food intake and sedentary lifestyle (Non-alcoholic SEATO hepatitis, NASH). ASH is usually the beginning stages of alcohol induced liver damage and is completely reversible if the patient refrains from alcohol. NASH is being much more commonly diagnosed currently owing to poor dietary habits and sedentary lifestyles of people.  If left unchecked, in final stages it may lead to cirrhosis of the liver which will necessitate a liver transplant. In your case, unfortunately, cirrhotic changes have already appeared, which is irreversible. But on the brighter side, it is very early cirrhosis, where you do not have any symptoms. You could go on to lead a completely normal life if you take precautions from now on. 1. Total and complete Abstinence is a must. Multiple research studies have shown that people who quit .  2. A diagnostic upper GI endoscopy will be required to rule out varices (a sign of portal hypertension due to cirrhosis). This will need treatment with medication and possible banding .3. An urgent consultation with a medical gastroenterologist so he can do a complete work up and start prophylactic medications if necessary. I would also suggest a healthy diet and exercise regimen as well. Although there is no time limit on when to get a repeat scan, I would suggest one, once you have succeeded in losing some weight. Hope this helped, and please do not hesitate to contact me for further details - rxsuresh@gmail.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The tooth of my four year old daughter (one of the developing premolars) appeared to be stained or maybe rotten on the top side. We brush her teeth everyday but now the gum on the outer side of the same tooth is swollen. We took her to the dentists who prescribed as some anti-bio. Never worked we took our daughter to a day hospital, prescribed another anti-bio and still there seems to be no change. What can you advise me? Thank you. ### REPLY: HelloWelcome to ChatDoctorYou might have confused because that child . Anyhow I would like to tell you that if there is pain & inflammation in associated tooth then it can be a gum boil associated with abscessed tooth. You need to get an IOP AR done of associated tooth & depending on its clinical & radiological treatment its treatment can be planned like it can go for pulpotomy in case you want to preserve tooth or extraction. Consult your dentist for further treatment. Take Disregards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi Doctor, I am an Indian travel professional working in UAE. I am muslim and married to a hindu girl who has converted and we have a child of 3years. 5 years we are married and we know each other for last 6years. we did love marriage and we are settled here in UAE. Our relationship is stressed because of my wifes boudtful nature. She will never allow me to work peacefully. always will be ralting to any female walking on the road. I shoulod not talk to females, should not look at any female even accidently. i am having affair with some other female. sleeping with anybody such type of emtal torture and not ready to adjust behaviour. I am really fed up. i thought after gettimg a baby everthing will be fine. still the things have not changed. if i am thingking of chaging the job i should not join a company whrere there are females working. i have to call her every hour and update her where i am and what a i doing. Appreciate if you advise how this illness can be treated. I had taken her to pshycitrist but she is not having medicine. Apprciate for your response. ### REPLY: His had gone through your query. It is psychological stress due to relationship. Can be treated with medicines and counseling. In counseling couple therapy or marital therapy It can be treated with medicines like anxiolytic.SSRI like Paroxetine /sertraline/Escitalopram along with Mizoram can help to reduce anxiety and stress. But you require proper consultation and advise from psychiatrist. So consult and get help. Thank you. Get well 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: Hello, My grandson who is 1 1/2 years old & my Granddaughter who is 5 years old has been diagnosed with Hand, Foot & Mouth disease on Monday. (5 days ago). we have an above the ground chlorinated swimming pool (3 feet tall) and they are really wanting to go swimming. I have kept them isolated from other people per the Doctors request. would it be okay if I let them go swimming? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No, please do not allow them to swim. This causes threat to the other child swimming nearby. I also suggest you to take the prophylactic antibiotics to prevent the secondary bacterial infection to your child.HF&M disease is very benign at a time. It can be cured as such. But in some cases it can be complicated. If you found any convulsion or other issues then you can immediately visit the hospital. These is serious issues and can be dealt properly. To treat this infection at earliest please maintain good hygiene take the antibiotics to prevent secondary infection. Keep him isolated. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Me and my boyfriend had sex for the first time last week. we didnt use a condom at first but he didnt ejaculate and then he put a condom on. when he took it out, it was covered in blood and i think it ripped my hyman. im 4 days late, could i be pregnant? ### REPLY: Hello dear, I understand your concern. In my opinion as the ejaculation did not occur inside the vagina the chances of pregnancy are less. But it needs to be confirmed by a urine pregnancy test. I suggest you to do a urine pregnancy test q week after missed period for accurate results. If the test is negative there is no chance of pregnancy. And the delay might be due to stress induced hormonal imbalance. So relax. Avoid stress regarding pregnancy or any. Over all the chances of pregnancy are rare. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Father is 75years old and is having attacks where he is sweating and then gettting chills. He walks the floor all the time. He has been to different doctors in the past two weeks and they are giving him pills for depression but he will not take them he says they are making him worse. What can we do my mom is not sleeping because of this he is wanting to go to the hopital but they will not keep him. ### REPLY: Hello there, I m . Infectious disease specialist. These symptoms chills and sweating is may be psychological but before that we née to rule out infection. If it is along with fever there may be malarial infection. If it is along with caught it may be respiratory. If there is burning micturition there may be urinary infection. To rule out these we need to go for certain blood investigation like CBC, peripheral smear for malarial parasites, urine routine microscopy and culture, sputum (if cough is there) microscopy and culture. And blood culture 3 set. And is there any  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, the past couple of months I have noticed that when I drink fluids, it tends to go down the wrong hole a lot of the time and makes me choke. I ve also been coughing a lot, constantly feeling like I have phlegm. Having strange pains under my ribs and I am now experiencing rumbling on my right sight under my ribs. ### REPLY: Hello, I have studied your case, and It can be due to chest and pharynx infection. This infection can cause formation of thick wall in throat making you feel like chocking. I would suggest you to get an examination by throat specialist. If there is any infection than you need to take antibiotics accordingly. Some time severe bout of cough can cause fracture in the ribs leading to severe pain. A chest x-ray is the best method to confirm the diagnosis. Treatment is hot water fomentation and voting gel local application along with bed rest and avoiding jerky activity. I hope this answer will be useful for you. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My name is Efrain, i have a question about something thats going on with me. I feel chest pains and at times i feel like something heavy is on my chest and i have vomiting and diaharea. I feel out of breath and my left arm goes numb and i feel pins and needles on my face and arm. What could this be? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of stress and anxiety related HERD (gastroesophageal reflux disease) is more. But better to get done ECG and 2d echo first today rule out heart diseases. If both these are normal then no need to worry about heart diseases. Stress and anxiety cause laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of chest pain, tightness, vomiting etc. So avoid stress and tension, be relaxed and calm down. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  For HERD, take pantoprazole and risperidone tablet on empty stomach. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i m kuldeep, today I had acute pain in left side of my chest, my ECG is normal as per doctor, they advise me to go thru tests etc... but I feel normal right now.. I am smoker, carstrol problem and obesy.. do you thing I should go thru these tests.. please advice ### REPLY: Hello, Since you have a history of smoking, are obese and have Cholesterol with pain on the left side of your chest, you should visit ER, or a Cardiologist & get physically examined. For pain, you can take Acetaminophen (Tylenol) & PPI's like Propantoprazol, one so when pained. Get all investigations, CBC, Urinalysis, Lipid function tests, X-Ray, ECG, Stress test, (CT & MRI if required) done to detect any developing coronary artery disease. Your treatment will depend upon the pathology detected. In the meantime stop eating oily-fatty food with trans-fat, red meat, avoid alcohol intake, stop smoking or addictions if any. Stay away from stress & take veggies, berries, fruits & homemade food. Hope I have answered your question. Let me know if I can assist you further. Take care.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in the bottom of my right foot. It is constant, about a 6 on a 1-10 scale. It is worse after walking or sitting for any length of time. It is located in the arch of my foot and is very tender with any pressure. I have not had any injury or trauma. Are there exercises I can do to decrease the pain or should I see an ortho MD? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have severe pain in foot. Well there can be many reasons for symptoms you mention in query like peripheral neuropathy, injury, gout, corns and callus, DVT , soft tissue injury or venous insufficiency. I would suggest you to consult orthopedic surgeon for proper examination. Doctor may order CT scan or x-ray along with blood test and urine test and physical examination to confirm the diagnosis . Doctor may also refer you to podiatrist for foot problem, who may prescribe diuretic along with muscle relaxant, anti-inflammatory . For now keep your legs in hot water tub with Epsom salt for 15 minutes daily and keep your legs elevated while lying down. Doctor may recommend orthotic devices. 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: Hi my question is what is the cause of weak flapping gums and is there anything I can take for it? ### REPLY: Hi, Gingivitis is inflammation of the gums. The treatment includes scaling of your dentist by a dentist. Scaling should be done at least once in 6 months. You should also take care of the following instructions. Massage your gums using your finger after brushing your teeth. Clean your tongue using a tongue scraper. Change your tooth brush once in 3 months. Floss your teeth once daily. Visit your dentist once in 6 months. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi Dr,M husband is 34yrs he had a single episode of seizure on 25 th jan2011,on the same da he got his MRI scan done which was normal , EEG scan had shown some abnormalities later on when he had a repeat EEG scan on 27th it  was normal.Dr had Prescribed Encorate chrono -250 mg for 2 weeks. he has been taking  that medicine for the last 2 days he developed mouth ulcers. he is  also taking Powergesic MR  for his back pain for the last 4days, now the DR has changed the medicine to Levipil -250 mg for 1 week Can he take this now, what could be the reason for this mouth ulcer. anxiously waiting for ur response ### REPLY: Thanks for your query, I have gone through your query. The mouth ulcers on the oral mucosa could be authors ulcers secondary to the stress or medicines. Nothing to be panic, consult an oral physician and get it evaluated. If it is an authors ulcer then you can take topical anesthetic and analgesics like Anabel gel. Apply 3-4 times daily before food and topical steroid like triamcinolone acetone 0.1% 4-5times daily after food. Do saline gargling. If the lesion does not heal in 5-7 days then consult an oral physician and get it examined. 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 chronic abdominal pain . It is in the center right under my ribs/sternum. This pain is usually more pressure accompanied with nausea but not always. However it is a dull pain. This does not always occur after eating but sometimes does. The other pain is on the right side of my abdominal area. This pain is sharp and makes it difficult to breath or move. This is not as frequent but the worst pain. ### REPLY: Hi welcome to  forum.  Thanks for calling to . Forum.  You have got a chronic abdominal pain under the ribs, nausea, it is a dull pain, other pain is on right side of abdomen, it is sharp and difficult to breath or move, it sometimes happen.  It appears to be the gastric irritation, due to peptic ulcer, or due to irritant foods. When it is dull limited to middle, but when it is more extends to the right side and sharp. It may be due to gallbladder pain also.  I advise you to consult a gastroenterologist for diagnosis and treatment. You may need to have gastrostomy, M.R.I. besides other routine tests for confirmation.  Wishing for a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My 14 months old suffered an iron burn on his hand 2 months ago. He took one month for recovery. He was on antibiotics during this period. Then he was ill with cough cold and fever. Again he on antibiotics. Again after 10 days there was a bout of cough cold and fever. Now he is recovered. He has lost around 1.5 kgs. The doctor suggested him cypon 5 drops two times a day. Also calcimax 5 ml two times a day and vitcofol syrup 2.5 ml two times a day. Since starting cypon his diet has considerably increased. Although before falling ill his diet was good and he is not a fussy eater. He likes to eat all types of food like deal rice roti veggies boiled eggs mutton soup fish dry fruits. I read about cypon side effects. Pls recommend whether I should continue it. The doc asked to give the entire bottle of 15 ml. ### REPLY: HI your child might have decreased appetite due to usage of antimicrobial for a longer duration. It will result in killing of good bacteria of our gut, causing decreased appetite. We usually do not advise Capon (cyproheptadine) unless severe loss in appetite is there(malnourished) as itself had side effects in child . Try to give foods he is interested in gradually and increase the quantum if he tolerates. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HiIam 30yrs. I had spinning sensation 10 months ago and i consulted neurologist and he asked me to go for MRI scan and later he suggested tablets to reduce high blood pressure. But since 10 months i feel heaviness in head and lightheaded. I feel like i would faint. Please advice. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You have high blood pressure and your symptoms are most probably due to increase blood pressure or may be due to some other cause. You should consult your physician and check your blood pressure. If it is high then take treatment. And if it is normal then search for the other cause 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: Hi, I am having back pain (both sides of the lower spine) for the last few months. I had visited a doctor today and he asked me to lift one leg and both legs while lying on my back and asked me if I had pain. I did not feel much pain. So he said no x ray is needed, it may be due to less strength of the lower back and suggested leg raises exercises every day along with Etova-P 400 (1 morning and 1 night). Is this tablet a pain killer? if so, I feel the pain for me is still bearable and I do not need a pain killer. Also, advise me on my condition. Thanks,Krishna ### REPLY: Welcome to  ! What your doctor has done is known as straight leg raising test. As the test is negative means your nerve roots are not getting pressed. So its most likely mechanical low backache. Etova-P is NSAID .  So even though pain is tolerable, you should take course as suggested by doctor. But the most important thing for you is exercise daily. Consult physiotherapist for exercises and other modalities like SWD/IT. Exercise regularly. If you are overweight, reduce your weight. Stretch your body. Avoid prolonged sitting or standing. Learn proper work postures. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: doctor i have been having jaundice for the last three weeks now. bilirubin level has decreased from 10.5 to 5.5. I have lost 5 kilos in these days. i am used to workouts and a good fitness regime but now all that has come to a halt. when will i know it is the right time to start working out again? ### REPLY: Thank you for posting query at . History of Jaundice. Cause of Jaundice not mentioned. Liver is very important organ and need to rest when it has been infected.it would take 6 to 8 weeks for the liver enzymes to return to normal. If you're suffering from Herb, it may take 3 to 6 months for the viral load to come down to a value where treatment is not required and observation is sufficient. Until liver enzymes turn normal, rest and less activity is advice. You may continue workout after your liver enzymes have returned to normal. However, further advice is:- abstinence from "Alcohol and .  - use lemon juice (lemonade) once in a day-recheck liver enzymes after 6 to 8 weeks. Wish you good health. Further queries are welcomed. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health. Regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sixteen month old had yellow diarrhea now for about 2 weeks...he went to whole milk and then I went back to just straight formula for 6 days to see if it cleared up a little it didn t just wasn t as yellow but was still pooping 4 to 5 times a day still...3 molars are coming in at once I know they say that doesn t cause it but my other two kids def had diarrhea when teething....is it a stomach infection, teething, lactose problem...no fever, seems happy during the day was never a good sleeper so still wakes 3 or 4 times a night...was wondering if I should go to the doctor tomorrow?? ### REPLY: Thanks for your query, I have gone through your query. The diarrhea can be secondary to the eruption of the teeth called teething disorder. During teething there will be itching over the gums, and you will be feeling like biting over the gums. So kids usually put there fingers inside the mouth and start massaging that area. In this process contaminated fingers result in infection and cause diarrhea. Nothing to be panic, it's a self limiting condition. If it does not stop in 5 days, consult an oral physician. 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 am on the nuvaring and i keep all of my period info, times and dates of when to take it out and put a new one in Inside my phone. Well the phone with all that info broke and i lost all the info and the alerts i needed so for the month of Nov. I had to guess when to take out the nuvaring and replace. So when i did i didnt start my period so naturaly i thought i must have kept it in a week too long and skipped it. So i made the decision to leave it out till my period started for this month but it hasnt started yet. I have taken 3 pregnancy tests all negative. And my husband and i used condoms while i had it out. ### REPLY: Hi, Thanks for letting us know your health concern. Well, the most likely cause of the delayed period in the current scenario seems to be hormone imbalance. Failure of contraception leading to pregnancy seems to be a remote possibility since you used double protection. Please remember that home pregnancy tests read well when performed 3-7 days after the missed period with a fresh early morning sample of urine. If you still suspect pregnancy, you can go for the blood test and follow it up with a trans-vaginal sonogram. Further management can be accordingly planned. 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: I am experiencing left foot pain (six months), weakness in limbs when having mild exertion, left arm does not swing, some back pain etc. two MRIs (brain and spine) clear. Not sure what I need to be asking docs when I see them and what the possible causes are. ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would explain that your symptoms could be related to different causes: - neuropathy-motor neuron disease-vitamin B12 deficiency. Your performed MRI have excluded many other causes (like a tumor, stroke, or myelopathy). Coming to this point, I would recommend performing some other tests: - a nerve conduction study and electromyography- vitamin B12 levels, and complete blood count. Hope to have been helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Respected Doctor kindly clarify my doubts as follows:1.My niece underwent miscarriage of her first child in the second trimester period. (end of six month). Now the Doctor referred blood test and the report is a shock for me; My niece conveyed the information as Antiphospholipid syndrome ; She is under full stress and decides to not to plan for a child in future life. KINDLY TELL ME THE SUITABLE OPTIONS.2. Is it a life long medical issue? will it affect the future child after medications?3. I feel apart from her current gynecologist do we need to refer Haematologist  too. WE ARE NOT READY TO FACE OTHER CRISIS.WITH WARM REGARDSGowri ### REPLY: HI THANKS FOR POSTING YOUR QUERY ON HEALTHY CARE MAGIC.GOING BY YOUR CLINICAL HISTORY I WOULD LIKE TO TELL YOU THAT, ANTIPHOSPHOLIPID ANTIBODY SYN . IT USUALLY ARISES IN THE BACKGROUND OF AUTOIMMUNE DISEASES.NO KNOWN CAUSE HAS BEEN FOUND FOR IT.THE CONDITION IS ASSOCIATED WITH LIFE THREATENING THROMBOSES/BLOOD CLOTTING IN BOTH ARTERIES AND VEINS CAUSING HEART ATTACKS, STROKE,PULMONARY EMBOLIC, DEEP VEIN THROMBOSES.IT ALSO CAUSES RECURRENT SPONTANEOUS ABORTIONS.FUTURE CHILD ### END