Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 diagnosed with Mild Anisopoikilocytosis. And my HB has dropped to 7.4. My periods last for 15 days since last 2 months. It is scanty but when checked the sonography report says there is a simple cyst on right ovary. My weight is 90 Kgs. Is this the reason for all these issues? ### REPLY: Hi, DEar, thanks for your query to . I studied your query in depth.1-In My opinion the ovarian cyst-indicates the disturbed hormonal cycle of your body 2-The reason for your anemia / Anisopoikilocytosis and low he count -is the metrorrhagia and should worry about it -as it's the cause of your ill health.3-I would advise -1-to consult glance for the metrorrhagia -as ti needs control of your disturbed menstrual cycle and requires treatment under close observation.4-Hope this would solve your query.5-Wellcome for any more questions on new or this subject also... Hava A 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: Will any muscle reaxing medication relax the mucles surrounding the sciatic nerve muscle that is sezing up in my right side back just below my waistline or will a specific exercise aleviate the swelling in the muscle. I have live with this for many, many years but this is the worst one yet. Thank you for your assistance. Kathy ### REPLY: Sciatic nerve supplies the nerve innervation to posterior part of thigh and leg muscles. In sciatica these muscle causes pain and spasm. Ibuprofen (analgesic) along with muscle relaxant such as thiocolchiside will be beneficial to you. Stretching exercises of hamstring muscle and spinal flexion exercises will decrease the spasm. Hope this helps. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having pain in the centre of my chest with dizzy spells and cold sweats , I have also been getting pains in both my arms.  I went to the doctor today and he said my blood pressure was low and iron storage levels were low.  he performed a ekg which read as normal ( 66).  Could I still have heart problems. ### REPLY: Hi Thereafter going through your query I understand your concern. I would like to tell you that chest pain and cold sweats are indicative of both heart diseases and anemia. As you said your ECG is normal and low iron profile, that indicates you have anemia. Anemia can be a big cause of chest pain as anemia can cause shortness of breath, dizziness, headache, chest pain, cold hands and feet etc. so It's advisable to correct anemia with iron rich diet and iron supplements, and you will be alright. Hopefully this will answer your query. 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: Hi, I just went to my dentist because I was having sever pain on one of my wisdom teeth, he said it was infected and either needed to be pulled or root canal. I am on ibuprofen 600mg and penicillin 500mg, and vicodin 500mg all of them every 6 hrs. Ive been taking them for two days now and the pain has gone away but now i have another wisdom tooth on the other side hurting. This tooth hurts sometimes for maybe a day or two then goes away this pain i have now is very little and only hurts when i eat so its not bad like my other tooth. My question is could the infection spread from my left wisdom teeth to my right one? Shouldnt the penicillin kill the infection? ### REPLY: Hi, Thanks for posting the query, No the infection could not spread from one side to another, I would like to tell you that wisdom tooth is the last tooth to erupt in the oral cavity and is often impacted, tilted, or maligned it is difficult to clean and often gets carious, there is inflammation of the gingival surrounding it leading to Peritonitis, Since your both wisdom tooth are infected and paining, get them removed . The infection would have resulted from food judgement, improper cleaning on both the sides separetlyHope you find this as helpful, Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I lost my mother four months ago. I am experiencing confusion at work. Things that I do normally, all of sudden has become a problem. I am a good worker and this has become frustrating. I am easily distracted and I think I hear instructions but evidently not comprehending like I used to. I am going to therapy through hospice. I was my Mom s care giver for the last few weeks with them. I am the one that found her when she died. In therapy, it was discovered that I am extremely lonely as my mom was also my best friend. I would call her several times a day. I am worried that I am getting dementia , My father s sisters all had allheizmers late in life. I am 61 years old and female. ### REPLY: Hi, Thank you for posting your query. It is possible that you have depression with anxiety after your mothers' death. These could lead to confusion and memory lapses. It need not be Alzheimer's disease, based on your symptoms. You require an evaluation by a psychiatrist as well as a neurologist to determine the underlying cause for your symptoms. A CT scan of brain, vitamin B12 level, and thyroid profile may be helpful too. Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, does relcer gel has a side effect to the body when going to urinate and blood coming out from the virgina after urinating, although i just finished my menstral period last week tuesday(3rd of july 2012) ,saw my period on 30th, june 2012. please i need your help now. ### REPLY: Hitler gel is an antacid. It can cause nausea, bad taste in mouth, diarrhoea or constipation. Vaginal bleeding does not occur with the . Polyps or fibroid in the uterus can also cause bleeding. Thyroid problem, Hormonal imbalance, infection of the cervix, or cancer of the uterus can cause abnormal uterine bleeding. The above causes should be ruled out. Hope I have answered your query. Let me know if I can assist you further. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband kicked another player with his foot night before last while playing soccer and yesterday came home from work because of the severe pain.  Today the big toe is extremely red and swollen.  Do you think this is something that can be taken care of at home or should he go to the doctor? ### REPLY: Hi, In my opinion he may start icing it for the first 48 hours. Applying topical gels is helpful, elevating his feet on a pillow and avoiding vigorous actions. NSAIDs like Advil tab is recommended in addition to Acetaminophen tab is effective for his pain. Chymotrypsin, Trypsin and Diclofenac for swelling if it is massive. If swelling and pain persists you will need to visit your physician for some imaging and physical examination for evaluation. If there is any minor fissures or fractures which I think is only a tendon or muscle sprain. Hope the above information helps you. Any further clarifications, feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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/ maam....i am suffering from hair lose before 3 yrs...but continuously i have taken care for my hair...in generally i use Dove shampoo, oil massage 2 days of a week, juice of lemon in 1/2 days in a week, egg, hena/mahandi of ayur in 1 day of a month....but still the same of the condition....i am 23 years age of girl of siliguri..i am studying m.sc in applied microbiology in Bhubaneswar...and hv completed my graduation from kolkata...how can i stop/decrease my hair loosing problem???please help me...!!!thank you...Abanti Bose ### REPLY: Hi, I would recommend you to go for certain lab tests to find out the cause of hair loss. Get your hemoglobin, thyroid function tests, serum vitamin D, serum vitamin B12 levels and serum ferritin levels checked.Meanwhile, use anti-hair fall like coliseum and take oral hair supplements like tablet collinear. These need to be continued for 4-5 months to see significant results. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i m in 22 week now and from 20th week my doc has prescribed me to take Loprin 75mg once daily. my bp was a high i.e. 145/90 etc. what will medicine do? will effect high bp will have and why do i have hi bp? ### REPLY: Welcome and thank you for asking on ! I have gone through your question. You probably are suffering from PIN(pregnancy induced hypertension). Joplin will decrease the complication sand there severity. If BP is not well controlled throughout the pregnancy you send risk of fits, your baby my have problems like decreased growth(IUGG) and rarely a bad outcome of pregnancy. High BP (PIN) usually is seen in first pregnancy and in people who conceive at an older age (>35yrs). You will get more information from your obstetrician who will take better care of you as well (I am sure)Hope to have been helpful! Wishing good health, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I have what I believe to be a wheat allergy rash on my hands and arms. I have antihystamine tabs and cream for it, but wondered how long before it starts recovering. I first noticed it about 5 days ago but paid it little heed until it got worse. I started treating it today 6 july. Is there anything else I should be doing to aid recovery? Thank you. ### REPLY: Hello, True wheat allergy is rare, whereas wheat intolerance is quite common. Allergic rash secondary to wheat allergy is unusual, and this might be a coincidence. You are more likely to have idiopathic urticaria that might get worse after eating certain foods and long-acting antihistamines for 4-6 weeks is recommended. If you continue to have itchy rashes, continue for 3 months. Fexofenadine 180 mg/90 mg and/or cetirizine 10 mg is standard treatment options. I hope that was useful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So my lab came back and this is what it said.Ketonese have trace. Occult blood 3+. Protein trace. Rbc 10-20. Squamous epithelial cells 10-20. And bacteria few. My calcium was also 10.3. No one is giving me answers just making me do more testing. Im scared. I just want the prognosis. Do I have cancer ? ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Presence of blood along with squamous epithelial cells and few bacteria indicates a possible urinary tract infection. However, if you are above 50 years, a diagnosis of cancer needs to be ruled out.2. Get an ultrasound to identify any pathology in the kidney. Urine culture will help in identifying any infection. Based on sensitivity, appropriate treatment can be taken.3. Until a renal biopsy is done to identify the cause, cancer or other cause cannot be confirmed. Get an ultrasound and if a pathology is present, a renal biopsy may be done for confirmation. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my i had done my CBC my wbc count was 14,600 which was high so doctors treated me with injection and glucose with monocef injection for 3 days.for several times and after 3 day i rechecked my wbc it was 14,500 means only 100 less after a long treatment what you think it is and why so? is it figure out hiv or cancer i have some pain in my right abdominal too. ### REPLY: HelloWelcome to  You might be having abdominal infections. You have not mentions other symptoms like fever or others associated. So I can't tell you about other diseases present or not. For that you have to consult your clinician, clear your doubts an and get the necessary tests done. After treatment high WBC may be due to ineffective medicine or resistant of bacilli to monomer. So consult your doctor and ask him/her to change the medicine after necessary examinations and tests. Take care... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor,i am female 25 years,i have problem,when i am sleeping,about to be in deep sleep,suddenly my breathing stop,and due to this my heart beat increases and i wake up,it happens daily,evening time acidity is the problem, so please guide me,as i am not getting proper treatment, ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. I would like to know more about your symptoms like whether you have recurring nose allergies, nose obstruction, sinus symptoms, stress, etc. From your given history, I would think of 3 possibilities:a. It may be obstructive sleep apnea, usually due to nose obstruction due to allergic rhinitis, sinusitis, etc. or some other obstruction in upper respiratory airway. In that case, I would suggest you to get examined by a ENT specialist who will examine your nose from inside and may identify the cause.b. It may be gastroesophageal reflux causing choking at night. As you have acidity, this is also a possible cause. In that case, I would suggest you to take an antacid like sanitizing daily before meals for at least 4 weeks.c. It may be night terrors, especially if stress is a problem for you. In that case, relaxation and consulting a psychologist may help you. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead. Thank you & 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 Premature Venticular Contractions (skipped heart beats)? Why is it that on some days I am ok then others, maybe for a week or so they are real bad.I am 63 a type two diabetic. I was diagnosed with PVCs about two years ago. I take Bystolic 5mg for them but it does not seem to be helping very much. They seem to be more at night. ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. You should not worry I'll try to explain you something and give you my opinion. Premature heart contraction are a rhythm heart issue. They are electrical impulses that generates in some part of the heart different from normal sinus rhythm. You feel this like skipping beats, palpitations and anxiety. There are different causes of this rhythm issue like simple stress, coffee and alcohol consumption. Pathologies like anemia, hyperthyroidism or ischemic heart disease might be other causes. As you are a diabetic person it is very important to exclude ischemic heart disease. So, if I was your treating doctor I will recommend some examination like an electrocardiogram, a cardiac echo to evaluate heart function and if it is possible a stress test to exclude ischemic heart disease. If it is possible after checking your frequencies we can rise the dosage of your medicament up to 10 mg a day. This can better control the premature heart beats. So I recommend you to do all above and discuss them with your doctor. Hope I was helpful. Wish you good health. 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 i am 23 yr old and i started masturbating wen i was 15 by rubbing my penis on bed and pressing it even harder wen i was about to cum..this was almost a daily routine.now for the past 10 days i am feeling a continuous stomach pain..is it coz of excessive masturbation or any other harm to my urinary bladders sphincter???plz reply soon???? ### REPLY: Hello, The masturbation is safe and pleasure giving procedure. Sometimes excess masturbation can lead to groin discomfort.  But it cannot lead to stomach pain and it doesn't affect balder sphincter etc. So don't worry about that. For your stomach pain, you can be prescribed omeprazole like an antacid.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi there, i went for a gastric bypass three years ago, i am very healthy now and have shed 90% of the weight and have maintained it.   i have to take calcium(caltrate plus), iron(autrin) and a multivit(DS24) everyday.  the Autrin is very very expensive, is there an alternative suppliment that i could take.  Cara, SOUTH AFRICA ### REPLY: **1. Iron deficiency and anemia are common after gastric bypass or other weight-loss surgery, especially in women and one has to look for levels of other vitamins like Vitamin B12, folate which may be altered after gastric surgery since there deficiency causes neurological and hematological deficit also.2. Don't take calcium supplements at the same time you're eating iron [hampers iron absorption].3. Avoid Antacids, phosphates, fates, tetracycline which makes complexes with iron and impedes absorption.4. Take vitamin C rich diet [since it is required for absorption of iron].5. You may take prescription medicine like Punarnava Manner, Manor Malt along with AMLA, carrot, meth, and since iron tends to cause constipation take soluble fires like peas, soybeans, oats, barley, prunes, avocados, berries, ripe bananas, skin of apples, pears, broccoli, carrots, sweet potatoes and onions.PS. Iron sulfate and iron fumarate are the more commonly prescribed iron pills. The numerate compounds are more easily absorbed and are easier on the GI tract. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hard bump near my bottom lip and i am not sure what it is . I do not think it is a cold sore but i dont think it is a pimple either . Yesterday i did think it was a pimple so i poked it with a safety pin and alittle puss cane out but not that much . It was painful at first like yesterday but now its not sore anymore unless i press hard on it ### REPLY: Hi! Good morning. I am  answering your query. If I were your doctor, I would first advise you not to poke on the lump as it would increase the chances of recurrent infections and might increase the lump. I would prescribe a broad spectrum antibiotic along with an anti-inflammatory and a proton pump inhibitor .  An antiseptic cream might also be added to it. Considering your poking the lump with a safety pin, I would also verify your immunization status for tetanus, and give a shot of anti tetanus vaccine if needed. In case the lump goes on increasing, I would advise you to see a general surgeon in your area for a clinical assessment to rule out any other missed diagnosis/pathology in the lower lip. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had sex with my boyfriend 15 days back , we used the condom but it slipped , and now i missed my date yesterday...generally i dont miss my dates on the contrary i get it 2 to 3 days earlier...but now i m really very confused of being pregnant please suggest me what should i do ? or how will my date start.....? ### REPLY: Hi dear, and thanks for your query. If your cycle is regular and if you haven't had any delay periods, you should get a pregnancy test to rule out pregnancy. If the test is positiver than consult with a doctor to have other examination done, like transvaginal ultrasound. If the test is negative there are many other reasons that can cause delay periods. You can take duration 10 mg 2 * 1 per 5 days, to breakthrough periods. ALL THE BEST ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi.. My mother has gallstones and nodules on the liver.. Those were seen on her ultrasound and ct scan result.. She had also done the upper endoscopy procedure, and her doctor diagnos that she has an esophagitis.. My question is, is it possible that the liver nodules are cancerous or they may only affected by the gallstones and esophagitis? Thanks ### REPLY: Hi and thank you so much for this query. I am so sorry to hear about the findings of these nodules and the inconveniences this has caused you. Not all liver nodules are cancerous. Some represent just simple exaggerated growth. Others may presentment cirrhosis, abscesses, hematoma, cancers, etc. Much information has to be gathered and the findings of the ultrasound and CT scan put together before making a diagnosis. At times, a biopsy may be needed. Gallstones and esophagi tits do not cause liver nodules. They would need to be investigated and managed as liver nodules. Cancer is one of the possible causes of liver nodules but not the only cause. I hope you find this helpful and it ad .  Thank you so much for using our services and feel free to ask for more information and clarifications if need be. I wish you the best of 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 chest pain that is heavy and tight and spreads into my throat. its mainly when im walking but recently ive noticed even when im walking slow its getting worse, like heavy. also i am sleeping so much. i could only have been out of bed for a couple of hrs and i cant keep my eyes open. jst feel achey, everything is an effort and so tired. ### REPLY: Either it is a severe depression or a cardiac problem. You need to see a pulmonologist and get some basic tests done to evaluate properly what we are dealing with. Your symptoms of breathlessness on walking are typically suggestive of cardiac disease however I have no idea of your age nor your past cardiac and hypertension status. Feeling sleepy can be due to a lot of reasons even when you lack vitamins and antioxidants in your diet ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 8 month old baby has a fever 39.5. I gave nurofen but fever persist, has a runny nose, mild cough, keeps on sticking tongue out.  Just saw a doctor and he said baby had tonsilitis and prescribed antibiotics. What worries me is the tongue sticking out all the time! Should I fear something more sinister like whooping cough? He has only coughed 6 times today... ### REPLY: Hello, Thank you for asking at . I went through your sons history and would like to make suggestions as follows:1. Were I treating him, I would prescribe him paracetamol for fever (only to be taken for temperature more than 101 F) and a cough syrup containing a chlorpheniramine and decongestant for 3-5 days.2. As your doctor has examined your baby, I would suggest you to complete the antibiotics as suggested by him, although most commonly such infections are viral and antibiotics do not help much.3. Tongue sticking out all the time may be due to nose obstruction, and he may have to breathe through mouth. I would additionally suggest saline nasal .  I don't think of anything serious in tongue sticking out.4. Please assure continued breastfeeding and adequate fluids to ensure HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 daughter is nearly 11 months old. Last week I noticed a spot on her top tooth that had only just broken through a week before. After a couple days watchin I noticed another spot on her bottom tooth and one on her tongue. I took her to the doctors to get it looked at, he gave me Nilstat to put on 4xdaily. Since then the ulcers have spread to the inside of her lip, over her tongue and a little at the back of her throat. Her tongue is also white. And tonight when I was brushing her teeth, I only just touched her top teeth and her gums started bleeding ### REPLY: Hello, I can understand your concern. The description of the symptoms give the indication that the child is suffering from fungal infection. Thus, the treating doctor has also given antifungal medication to control the infection. However, since the white patches have not decreased and instead increased along with formation of ulcers, it seems that the child is suffering from viral infection. The bleeding in the gums can be due to presence of debris or plaque at the gingival margin of the top teeth which should be cleaned by a dentist after the ulcers are healed. For the ulcers and white patches, I would recommend that you should consult a pediatrician or a periodontist (dentist who specializes in oral cavity problems of child . I hope this information helps you. Thank you for choosing . I wish your daughter feels better soon. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a very severe pain in my left butt cheek which really only hurls while I am lying down. I am a 50 yr. old woman, and I didn t lift anything. It doesn t seem to radiate out too far to my back. I can sit and walk without difficulty; although, I do get an occasional stabbiing pain from that area. It just started about a week ago. Any help you can give would be greatly appreciated. Thank You! ### REPLY: Hello, As what I understand from the history is this could be a disc degenerative changes happening in the lumbar spine leading to the symptoms you are facing now.  As your age is 50, and we can suspect some minor / major changes of the lumbar discs. Having a physician examination by an orthopedist and an MRI will be surely of great help.  Most cases respond well to conservative management like - medication and exercise. For time being use hot water bag, lumbar brace and rest. After a week you can slowly start strengthening exercises if the pain is below 5 on a vassal of 0-10. In my clinical practice, most cases reports with similar complaints perform better with conservative management. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had large bumps at the top back portion of my tongue since March. I felt like I had something on my throat and I looked in the mirror to see. My tongue was brown and I scrubbed it off with a toothbrush. I then noticed what I believe are enlarged circumvallate papillae at the back of my tongue. I did some research and I quit using the Listerine whitening mouthwash. I am not sure how or why I have them or how to get rid of them. In January I went to the dentist and had dental crown procedure and received my temporary crown. When I went back the dentist was not satisfied with the fit and took another mold and put my temporary back on. The same thing occurred on my 2nd visit. It seems the irritation started between my 2nd and 3rd attempt to get my permanent crown put on. I saw my doctor and he have me some lozenges for thrush mid March. It is now May and they are starting to make my throat feel more irritated and dry. It doesnt hurt to swallow.  I have also been a smoker for several years. Any ideas on what may have cause this and how do I get rid of it? ### REPLY: Hello thanks for the consult at .yes it is enlarged circumvallate papillae which is called capsulitis, u need multivitamin therapy,and u also have thrush -- I think u may be need topical antifungal and systemic also,do salt water gargle, then clean your tongue with a soft brush.keep your tongue clean, do visit your oral physician and general physician too, for a check-up and treatment,since it is not coming u may need culture and some blood test too. Hope it helps,TC ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 is 8 months old. She only weighs 15lbs and recently we had her blood drawn to find out if there may be a problem. All of her liver enzymes are elevated, her WBCs are double the normal amount and she is dehydrated..We have to get an unltrasound on the liver and several other blood tests.. ### REPLY: Hello welcome to Ask A Doctor service. I have reviewed your query and here is my advice. Your reports suggestive of acute infective etiology most probably along with hepatic involvement. Your further test required in form of blood culture, USG abdomen scan and peripheral smear examination. According to reports further management plan decided. Kindly attach your reports to check it. I suggest you to consult pediatrician for examination. Hope I have solved your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a learning disability ever since I was a toddler. I also believe, I have ADD. I am a very mellow (very low blood pressure) person. I do stress out a lot when I struggle to learn. But I keep it private. I do not want to go through a battery of tests. I would like to take a drug to help me to relax. I do not have any addictions. I do suffer from severe insomnia. Any suggestions for me? I am currently not taking any meds. I am a 55 yr. old female. I would like to be able to have better focus on what I am doing or learning as I mature. Thanks for any advice. ### REPLY: DearWelcome to  understand your concerns went through your details. I suggest you not to worry much. Self diagnosis is dangerous. You should undergo the psychometric tests of assessment. What if your worries about ADD and learning difficulties are just an illusion?. What if you were just imagining them and acting as if you actually have them? That is where you have to be careful. Please visit a clinical psychologist and get yourself assessed and be peaceful and get treatment if the problems exist. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having pain on my sides by top of the ribs. I had the flu with a lot of coughing. The severe pain started on the right side and after 3 days it is now on the left side as well. Aleve, tylenl or motrin do not seem to help. I there something I should worry about? What should I do? ### REPLY: Hi. Flu has a very bad character of causing inflammatory action in the cartilages on at the insertions of muscles with the bones as are there in the ribs. The Cough will strain further the already ailing areas. So this type of pain. You are already trying the medicines. If these medicines do not help, I would advise such patients the following with good results (provided you are not diabetic). Deflazacort, lasix, serratiopeptidase in appropriate doses. As these are prescription medicines, you have to discuss this with your Doctor to get a prescription. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 11 teeth extracted on wed of last week since then I have had servere pain and swelling in my cheeks?The xtraction was upper.I went to ER to get Antibotics since Dentist did not and I have nothing for pain,it hurts soooo bad,started antibotics at 11 last night and then again at 4am and then again at 11 am and now again at 6 due to driving home from work,yes working whiel this is going on.....what to do???? ### REPLY: Hellooo...read through your query....pain in the cheek is obvious after extraction of teeth...but don't worry...it will be healing.but continue with antibiotics as prescribed by the dentist...also do take painkiller(diclofenac) whenever pain is there.also try to have soft diet...try not to bite heavily on that extracted areas(i KNO its difficult but u try maximum not to bite much)for a week.and do salt water gargle as many times as possible (minimum 2 times).while spitting don't spit with too much force.just be soft spitting...also while brushing don't touch the areas with toothbrush or fingers.and tongue...follow this for a week.and still if pain persists just go and meet your dentist...(I feel if u follow this strictly pain will be relieved).be cool and calm...stress will increase pain.hope your benefitted something from this reply.have a healthy day!!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have plaque at the back of 3 teeth i have noticed that all three are slightly wobbly and the gum at the front has gone down and at the back if i put a finger down my side of the tooth you can feel underneath its not painfull or bleeding but i am really worried i am going to loose the teeth i have a dentis apointment next week but its really stressing me out and making me worried ### REPLY: Thanks for using . Read your query. Relax, inflammation of the gums will not necessarily lead to the loss of the teeth. The bleeding gums, plague and inflammation of gums is caused by chronic gingivitis. Since you have already on an appointment with the dentist, he will have your teeth cleaned and polished and if additional treatment required will be done. Do chlorhexidine mouth wash gargling. Maintain it well after the treatment with proper brushing and follow-up care accordingly. Hope this was helpful. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mother is of 72 years having high blood pressure , she is taking prozopress xl2.5mg,arkamin,s-numlo2.5mg twice a day. Recently her heart rate goes to 190 doctor haS prescribe TACHYRA200 THRICE A DAY,SELOKEN ONCE A DAY,CLOPILET ONE A DAY.KINDLY ADBIVE MERAJESH ### REPLY: Hello, first if she is having high BP then she needs to be medicine and should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once.  I think the dose of minipress can be increased and ark amine can be stopped. Also, sumo can be 5 mg once a day rather than twice, if not needed can be stopped. Since her pulse rate is going high she'll need spoken which also has BP lowering effect, and also tachyon but dose tachyon should be decreased after 1 week of initiation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just had an ultra sound done because I had a trace of blood in my urine and when the test was done they found a spot on my left kidney. My creatine levels are on the upper end of normal. I have an appointment for a MRI to do look further. Are all spots cancer or are there any other things that could create spots? ### REPLY: HelloThanks for query. You had a hematuria and your ultrasound scanning has revealed spots in the Left kidney. This could be due to one of the either two reasons 1) Infective process 2) Tumor either benign or Malignant. You need to consult qualified Urologist for clinical evaluation and get following basic tests done to confirm the diagnosis .1) Urine routine and culture.2) C. T scan of abdomen and pelvis with and without contrast .3) MRI Further investigations if required and 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: Hi, I have an enlarged spleen and I had an abdominal u/s this morning. I have been having dull pain on my left abdomen for the last week or 2 (worse after eating or drinking and thought to be spleen being crowded by other organs), but now the pain is greatly increased and radiating into the upper tip of my left shoulder (worse on lying down and on inspiration). Ideas? Thanks, Wendy ### REPLY: HI. The spleen causing such a pain is not known unless there is a rapture or so. The pain which gets the worst on eating or .  The refereed pain on the left shoulder can be due to the irritation of the under-surface of the diaphragm by perforation of the stomach ulcer/ pancreatitis/ splenic abscess. You have to really rush to the ER, get a reference/ admission in the hospital, urgent investigations like the ultrasonography/ CT scan./ Upper GI endoscopy/ blood tests. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have Charcot disease in my feet and wear special bracing boot type shoes. I fell this am and I am pretty sure my foot is broken. It feels asleep ever since I fell and hurts. Do I need to see a dr and get an ex- ray or just wear my shoes and stay off my foot? ### REPLY: Hello, Charcot disease is a condition where you may not have much sensation in the foot or the joints, and therefore they are at risk of increased injury. Even with a fracture, you may not feel pain. If you fell and now feel something is different, I would advise you to get a X-ray. Please be sure to have your previous X-rays available for comparison. That would better enable the doctor to see if there is a new fracture. 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: my husband experience calf muscle tightness for two years now.he was an atlethe before and stop after he experienced calf muscle tightness. he is 50 years old and he has 95 kg with a height of 6ft.he doestn t want go to a doctor.and not even make exercise.he stop from everything what he used to do before.it can be cure thru home treatment? can you give me some advice for home treatment? ### REPLY: Hello, I read carefully your query and understand your concern. The symptoms seem to be related to a muscle cramp. I suggest using muscle relaxant such as Baclofen three times a day. I also suggest using magnesium supplements for muscle relaxation. Furthermore, I also recommend to use warm compresses for local application. Hope my answer was helpful. If you have further queries feel free to contact me again. 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: Dear Sir, This is liton from Bangladesh. I am working at HR dept. in a multinational company. Now in our country present situation is hot. Our workers are becoming sick. In last week, 10 workers have taken leave for fever. Please advice to take precaution so that we can circulate to our peoples. ### REPLY: Hello Heat stroke is a common thing due to hot and humid environment. The best way is to avoid physical work. If necessary consume plenty of fluid, water (with proper salts and minerals in it). Physical cooling with sponging, fans, cooling blankets and even ice baths should be initiated immediately in conjunction with intravenous fluids. So order your employs cover their head with some cotton clothes, .  Avoidance for hot and humidity is the best way. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a burning throat for some time, and salty phlegm. I found that cutting out milk products and wheat helped, but a recent blood test suggested either I was dehydrated or had a kidney problem. I was advised to have a repeat blood test. Could there be a link between the burning throat and a kidney problem?I am 59. Female. Teetotal, non-smoker. 5ft 3ins in height, on no medication. Healthy. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have burning throat and phlegm.  It has no relation with kidney disease.  You may have some respiratory tract infection.  You need to take antibiotics like azithromycin, amoxiclav or levofloxacin for that. It is prescription based medicine so consult your doctor and take treatment accordingly. Take plenty of water.  Repeat your complete blood count and serum creatinine level.  If your creatinine level comes high then you need to go for complete kidney function test to search the cause. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an asthma attack few days back. That was the first time i had to go to hospital to treat it. When i first went there, my bp was 140/90 .. after what ever is done with nebulizer  it was  130/80. I dont have usual high blood pressures.. is this normal for bp to rise? Ive read on somethings that bp lowers... ### REPLY: Hi Their would like to tell you that a BP of 140/90 is considered to be normal. There is no need of any medicine for your BP rather I would like to suggest you to maintain healthy lifestyle habits like daily morning walks, low salt diet, no smoking, avoiding junk food. Anxiety is one of the most common reason for sudden rise in BP. Yes when an attack of asthma happen it constricts our airways making breathing labored and difficult which stimulates the sympathetic system of our body leading to some increase in BP and heart rate. Wish 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 went through medical check up then they found that i am polysystic ovarian.. i gain weight 40% of my normal weight ang i dont have monthly visit. doctor give me metformin to take 2x a day. is there any posibility i will get pregnant im 28 and just get married. ### REPLY: Hi, you can get pregnant.  In pod patients the problem is with ovulation.  So, the periods doesn't come in time. Medicines are available for that. Metformin helps in PRO patients by increasing insulin sensitivity.  Whenever you plan pregnancy, consult a gynecologist.  You can use some oral contraceptive for now if you don't want pregnancy because it is also a treatment for PCs. 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: hello, m madhavi, intern at JLN hospital, my father is having dull pain at right hypochondriac and periumblical region off and on since six months. pain was prominent before meals.endoscopy was done which revealed esophageal candidiasis and fluconazole*14 days OD was given but pain is still persisting and increasing in frequency. plz guide me about the illness: diagnosis and treatment. ### REPLY: welcome to ChatDoctori had gone through your fathers history and I can understand your concern towards your dad Madeira, Candidiasis is a fungal infection caused by yeasts from the genus Candida. Candida albicans is the predominant cause of the disease. Esophageal candidiasisPatients with esophageal candidiasis may be asymptomatic or may have 1 or more of the following symptoms:Normal oral mucosa (>50% of patients)DysphagiaOdynophagiaRetrosternal painEpigastric painNausea and vomitingTreatment 1 Esophageal Candidiasis requires systemic therapy with fluconazole for 14- 21 days.2 Parenteral therapy with fluconazole may be required initially if the patient is unable to take oral medications. 3 Daily suppressive antifungal therapy with fluconazole 100-200 mg/d is effective for preventing recurrent episodes, but it should be used only if the recurrences become frequent or are associated with malnutrition due to poor oral intake and wasting syn .  4 Recommended alternatives for fluconazole-refractory disease include itraconazole, voriconazole, caspofungin, micafungin, anidulafungin, and amphoteric B. I hope I have cleared your query thank you take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my child is 5 years old. she has 102 fever. she has cough also. she has been advised by the doctor to give bromex plus and wikoryl DS. iam also giving her crocin syrup.but there is no relief.she is also complaining pain at her left ear.please  suggest any remedies ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. For cold, you can use Cetirizine at 0.25 mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear sir,My daughter is 10 months old, all of sudden last night when she slept she started vomiting after every 25 mins and that continued for atleast for 6 hours and after that she started having losse motion, Dr. Please advice me what should do and what could be the reason of it?Age 10 months, weight 9.05 ### REPLY: Hi... Thank you for consulting in . It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had three weeks of radiotherapy after a left breast lumpectomy, and had no side effects until yesterday, when I developed an itchy heat rash mainly in an area not covered by my bra. Is there anything I can put on it to reduce the itching? I am using Aloe Vera Gel already. ### REPLY: Hi. The itchy heat rash is called radiation dermatitis. It is secondary to radiation induced skin damage. During radiation therapy you can minimize radiation induced dermatitis by the following:1. Wear loose fitting clothes. Tight clothes will rub against skin worsening skin damage.2. Wear 100% cotton clothes. Avoid silk, nylon, polyester.3. Avoid wearing undergarments (brassiere) 4. Keep using aloe vera cream5. Use aqua based creams. No oil based as they form a layer on skin thus increasing skin dose by radiation therapy.6. Avoid applying body sprays/do . For the radiation dermatitis already there, apply 1% HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lower back pain which make my legs around my knees ache. I cant set still very long either. I have had shots in my back with nerves burnt. Mr Doctor wants to send me to a spine specialists. Please help I cant sleep at night without my legs kicking. i take medicine for restless leg. But nothing is working. ### REPLY: I think you may be having nerve compression at spine, so it would be better if you see a spine specialist.  He may ask you to get MRI of your spine to check whether you are having nerve compression or not.  If report come positiver than you may to need to take gabapentin and methylcobal tablets. I still consider if nothing comes on MRI than you need to get x-ray of knee if there is some proven with knee that is causing all these issues. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 acid reflux but I have been wheezing in the mornings when I wake up , I also think I might have allergies. My question is would the allergies make the larangoreflux worse and cause me to wheez when I in hale? Also would like to mention I also have been spitting up acid usually when I wheez is that from the reflux ? ### REPLY: Hi, thank you for providing the brief history of you. As due to acid reflux there will be a deep pain in the chest like burning sensation and due to which you might be feeling wheezing symptoms. As to control both the wheezing and the acid reflux you need to improve your diet and lifestyle changes along with regular workouts. As indigestion will not be good on a longer run as well. In my clinical practice, such cases are advised to modify the lifestyle changes and also regular exercises to boost the digestion. 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: The bone in my forearm (the bigger one) is very painful at my elbow, when i even slightly lean on it my arm, from elbow to finger tips goes numb and doesn t regain feeling for quite a while after? The bone in my elbow sticks out a lot and you can feel it when you touch the area it is without applying pressure. My other arm is not like this. What could it be? Im 21, 5ft5 and don t know my exact weight. Around 160lbs. ### REPLY: Hello, I read carefully your query and understand your concern. The symptoms seem to be related to a pinched nerve in the elbow. I suggest using anti-inflammatory medications such as Ibuprofen to relieve the pain. I also suggest using gentle stretching exercises. Cold compresses can also be helpful. Hope my answer was helpful. If you have further queries feel free to contact me again. 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: My son is two and half year old. His weight is 17 kg. He has cold and cough, and also feel uneasy to breath. When consult pediatrician they suggest to give Asthalin & Omnacortil syrups. But he not able to sleep properly bcoz of cough. Can you suggest is it fine to have this syrup to continue? ### REPLY: Hi...by what you quote it seems like that your son has got wheezing and moreover he is overweight for his age. In over weight kids it is difficult to control in winter when they get this wheeze. Your doctor is probably right in prescribing him a steroid and wheeze medicine. I suggest you continue it in the prescribed dose and if your kid is becoming breathless or his distress is increasing, then take him to the nearest emergency room. 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 doctor,i m 35 yrs old with one child who is 6 yrs old.from last one year i was trying to conceive but nothing happen.beforethat i was taking crisenta as my periods were always beforethe time and very heavy(on dr s prescription ).now suddenly i gain 10 kg,specially around the belly and having some hair growth on chin(very few but long).before period my breasst enlarge n have itching also.i m also suffering from itching in palm and sole which only reduce if i take anti allergic.my ultra sound ,insuline etc r ok but my dr says that it might b hirusitism.i m again prescribed krimson35,with metmorfin500.but my problem still persist.kindly guide me.i m also having ibs . neetu ### REPLY: Hi Meet, Treatment of hirsutism & infertility are different. Treatment for hirsutism won't allow you to get pregnant & vice versa. First decide your priority & accordingly get treated. Though Crimson might reduce hirsutism after 3-6 months of continuous treatment, it acts as contraceptive & pregnancy will not be possible. If hirsutism is your main concern & you don't want pregnancy right now, you can take the prescribed medicines. If pregnancy is your first priority, it's better to consult infertility specialist & get treated (& stop Crimson). Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 64 and i was just told by my doctor i have fat in my liver i bought a 7 day cleansing program from the gnc  store and i am wondering if these and the liver cleansing produces r any good i am try to find a good diet i can sick to but i am not much of a fish celery or a lot of the raw veg eater ### REPLY: Hi. I went through your concerns regarding your condition of fatty liver.It's a condition in which triglycerides are deposited in the liver. In 20% of patients which causes inflammation in the liver, the condition is called NASH.NASH is more dangerous than fatty liver. 20% of patients with NASH will develop cirrhosis of liver. Your fatty liver is a control able condition. The first line management is achieving weight loss by lifestyle n dietary modification. You should avoid junk foods, oily foods and sweets. If you fail to achieve weight loss then I will suggest that you should start combination of capsule ursodeoxycholic acid 250-300 mg once a day and capsule vitamin E 200-400 mg once a day. This combination has shown promising effect in clinical trials. Ursodeoxycholic acid is a safe .  It has narrow spectrum of side effects like nausea, vomiting, diarrhea, headache, dizziness and dyspepsia. But most of the patients tolerate it very well. I wish you good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have had a lumpectomy of the breast as I had been diagnosed with a fibroid and this grew considerably.  Phyllodes tumor has been mentioned but not confirmed.  I am 50.  I have developed recently back pain, there contunuously and have started to get pains in my joints and have developed forgetfulness and can get confused.  I am really worried that the phyllodes I may have is malignant and already spread.  I have 2 young children and am petrified.  I have to wait until next Weds for the results of the operation is there any information or assurances you can give me. ### REPLY: Hi and thanks for the query,I am afraid you might a proper reevaluation. It is vital to redo and reconfirm the histologic aspect of the breast lump. This is so because, in case it's a cancer, it could be signs of spread to other structures. It is very vital to make this possibility excluded. Secondly, the joint pain needs to be properly evaluated. Presence of absence of general symptoms like fever, swelling, general malaise need to be considered. Blood tests to exclude any hematologic disease are needed and x-rays of affected joints if you needed. Confusion and forgetfulness might deserve a neurologists' opinion. The psychological component in your case is an important consideration that could explain the forgetfulness and confusion aspects of the clinical scenario. I suggest you consult the surgeon who got the mass removed for a proper evaluation and planning of further management depending on the findings. Thanks and best regards, Luchuo, MD. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi- My husband is being treated with antibiotics for an abscessed tooth and infection that spread to his jaw. The whole side of his face was very swollen. After 24 hours of antibiotics the swelling went down and now he has a flabby area under his chin, above his adams apple, that looks like a sack that just flops around. Any idea what caused this? ### REPLY: Thanks for your query, I have gone through your query. The swelling below the chin could be a cellulitis, that is spread of infection through tissue spaces. You can continue the course of antibiotics. After completing the course of antibiotics treat the cause of infection, that is treated the infected tooth with root canal treatment or by extracting the tooth. The swelling will subside in 3-4 days. Do not apply pressure over the swelling by touching it or covering that area with hand or cloth. Do not give hot fomentation over the swelling. 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: Hi Doctor , My (3 Years) Son s Brain CT scan shows Mild prominence and dilation of both lateral ventricle suggest early cntral type of diffuse brain atrophy So can you please let me how much expectation should I keep about him. And can you please let me know how to go ahead for his better future. Thansk and regards Somendra Pratap Singh sps YYYY@YYYY ### REPLY: Hi, welcome to . Your child CT scan is showing early central type of diffuse brain atrophy. In early type of diffuse brain atrophy there are some chances that child will have delayed milestones, but this is not definite in all the cases. You have to do an eye check up for funds examination, ERA test to know whether hearing is normal. A monthly neurological assessment with Head circumference measurement is necessary. I hope this has helped you. Take care. Regards - .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have severe pain around my axillary artery . Could this be a blood clot ?I have a good cholesterol rate, blood pressure under control, yet every time I get into a warm shower, I have severe pain around my axillary artery . Could this be a blood clot? ### REPLY: Hello and welcome to , Pain in the maxilla can be due to many causes. In case there is suspicion of a blood clot formation, you can get Doppler study to know the status of blood vessels in the maxilla. In case the pain is due to clot formation, appropriate treatment can be instituted to resolve the clot. Other causes of pain in the maxilla include musculoskeletal pain. Clinical examination will determine the cause of the pain. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Question 1: I have had this throbbing pain on the right side of my body for 3 days now it starts at the shoulder blade and moves its way up to my neck what can I do to relieve the pain? Question2: also on my right side I feel like I m being stabbed by a sharp pain near my ribs but it only happens when I take deep breaths lay the wrong way and just now while I m laying here breathing do I need to go to a Dr? ### REPLY: Welcome to  I have gone through your query and understand your concern. You can take analgesic such as ibuprofen for pain relief. Rest and analgesic are required. Vitamin B and C is helpful in resolving it. Chest related cause can be excluded by x-ray chest. If you have fever also than it will be wise to visit the doctor immediately. Otherwise, visiting doctor is always better. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with a large cyst in my quad groin muscle, as seen on MRI. I am worried that this may be a tapeworm cyst as the symptoms started a couple of months after I was ill on a visit to Pakistan. Where should I go to get a diagnosis of the cyst origin? ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Cause and plan of Treatment-In my opinion on the given data, you need to get to treat it by antihelminthic . So I would advise you to consult an ER Surgeon, who would treat it accordingly. Hope this would resolve your issues. Act fast. So keep cool and Consult your ER Surgeon, if need be, who would treat it accordingly. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to  and be comfortable to resolve your health issues. Welcome for any more query in this regard to . Write good reviews and Click thanks if you feel satisfied with my advice. Have a 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: Hello, I m in my 8th week of pregnancy and am suffering from terrible insomnia. I suffer from insomnia normally but would usually take a nytol every now and again to get back into a good sleeping routine. The herbal nytol doesn t seem to work. I get to sleep ok but then wake a few hours later and can t get back to sleep. Help! I ve not slept properly for nearly 3 weeks now ### REPLY: Hello, I have gone through your query and can understand your concern. Since you are in the early weeks of pregnancy when organogenesis or organ formation begins, it is not safe to use any medication to relieve your symptoms. Instead, you can use simple techniques such as a hot bath at bedtime, a glass of milk, reading some book which you are fond of or listening to some soft music to ease your nerves, avoid all anxiety and restless thoughts, breathing exercises etc. You can also set your sleep timings to when you can sleep sound breaking from the usual routine. Please do not worry, things will settle down as pregnancy advances. Wish 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 went into CHF post cesarian with both of my children... what causes this? i was never diagnosed with HTN, gestational diabetes, hyperthyroidism, or any other abnormalities that might lead to these complications while pregnant.  how likely is it that it would happen again if i were to conceive a 3rd child? ### REPLY: This is called preeclampsia. It is a disease only associated with pregnancy. It can happen anytime after 20 weeks and up to four weeks after delivery. You usually get severe fluid retention and congestive heart failure symptoms. It can be life-threatening. If you had it once, you are four times more likely to get it again. I would let your doctor know when you get pregnant about your two previous episodes. Occasionally they will treat it before it starts. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 grandma is 67 this year. She was found to have lung cancer one year ago, and now is hepatic metastases. The doctor said that due to the press from tumor on liver, her bile duct is obstructed. Is there any treatment that she should receive? What kind of medicine should we give her? And what kind food is good for her health? Thanks! ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She has metastatic carcinoma.  So its very late stage cancer and surgery will not help much. She should go for surgery bile duct obstruction.  And then she should take radiotherapy and chemotherapy according to your doctors' advice.  Take low fat diet. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother got a deep cut on her palm from a weighing machine. We gave her first aid and put on a bandage. After 5 days, it didn t seem to heal and also developed itchiness and redness all over her palm. So she went to a doctor and had tetanus shot and an antibiotic was prescribed.But she has allergy to certain medicines and now got a swollen lip. Also the itchiness is spreading all over her hand. What should we do? ### REPLY: Hi, thanks for using  It is possible that she is experiencing a reaction to the antibiotic that she was given. You may want to consider stopping and contacting her doctor to let him know it has been discontinued. He would suggest a substitute. She should be given an oral anti histamine to stop the allergic reaction, these are available over the counter. The application of a topical steroid would also help reduce the inflammatory response. If the oral anti histamine does not halt the allergic reaction, she may need oral steroids from her doctor. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is 6.5 years old. Suffering from high fever 103 f from past 4 days. Doctor treated with ibugesic assuming viral infection. But she complained of pain will passing urine and in left side below ribs. Urine routine shows presence of ketones and proteins and pus cells more than 250. What can be the reason. ### REPLY: Your daughter has Pyelonephritis, that's why she definitely needs in hospitalization and intramuscular antibiotic therapy: Ceftriaxone should be given 100 mg/kg, divided for 2 times, Vinyl 1 capsule daily for 7 days. Keep her HY . Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your daughter good health and speed recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I got hit in side of mouth playing football on Saturday. Now my gum by my wisdom tooth feels so sore can barely open mouth cant swallow and jawline has started to hurt if press on it.. Also now have cough n bad throat, could this have turned into dental abscess? ### REPLY: Thanks for your query, I have gone through your query. The pain in the gums can be because of the trauma resulting in a bruise or ulcer. The other possible cause can be a broken jaw near the wisdom tooth. Nothing to be panic, consult an oral physician and get it evaluated. You need to get a radiograph done to confirm the diagnosis. Meanwhile you can take an analgesic like diclofenac(if you are not allergic). If it is a bruise, it will heal in 5 days. If there is a fractured bone, it has to be treated by plating. 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: Im 10 weeks and 4 days pregnant. he past 2days i have not been able to get out of bed at all. When i do i get very light headed and when i even just walk to the bathroom i be come very short of breath. I feel very weak and have no energy at all. I have not been sick and have been able to eat. What might be wrong with me? ### REPLY: Hello, I have gone through your query and understood the concern. Transient hypotension is a common phenomenon during pregnancy due to the altered vascular state. You seem to be suffering from postural hypotension, but, other organic causes also have to ruled out. I would ask you to see a general physician for a proper assessment. In addition, if you have had a normal sonogram picture in compliance with your stage of pregnancy, check for abnormal blood pressure, electrolyte imbalances and anemia. Further management can be planned accordingly. 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 have pain my rihgt  i go to hospital and i do utrasound and i take my result she said i have appendix.she said you go to anather hospital to admission when i go thaer the doctor said u dont have appendix.so i till her i have result to my utrasound so this is not trut my doctor she lear he said yes. ### REPLY: Hi. Very odd question!! I would like to clear some points_First you have not given any history. If you have gone for an ultrasonography, there has to be a reason. If you have the following things it may be appendicitis:The pain starts in the upper abdomen, usually above the umbilical region. You may get a temporary relief wherein-the pain may then shift to right lower abdomen. Nausea and vomiting may be associated. Fever may be there or not there. Some stomach upsets like loose motions or constipation may be present. IF you have such symptoms then probably the ultrasonography report is right in saying that you have appendicitis. Secondly in some cases there may be more than 6 m diameter of the appendicitis and may be a regolith and this is classical for the Radiologist to give you the report of appendicitis. Best way for you is to take second opinion of a General Surgeon, who will take your full history, examine you physically to see for the signs of appendicitis. And then the decision can be taken for further treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had problems with kidney stones over the past year. I dont think this has to do with kidney stones though. I started having sharp pains in my lower right abdomen area and started peeing blood when I did anything exercised induced or strenuous. I went to the doctor she said the pain was a cyst. The pain didnt stop so I went to another one and he said it was a kidney stone. I have passed the stone but the peeing blood will not stop. Note: it only happens when I do anything strenuous or exercising; even light excercising like walking. What could this mean? ### REPLY: Hi. Thanks for your query and an elucidated history. Since you are a know case of kidney stones, the suspicion will obviously be related to the past history. The hematuria (blood in urine) on exercises with pain in lower right abdomen is suggestive of ::Stone in the right lower ureter. Blood vessel malformations in the urinary system. Stone in the urinary bladder. Simple test of ultrasonography will give a diagnosis/If USG is normal, you have to go for a CT scan of the abdomen, Urethro-cystoscopy, blood and urine investigations. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 epilepsy as a result of brain surgery twenty five years ago. I understand that more, less invasive surgery, could eliminate the problem by peeling the scab off the injured area. I also understand that this surgery is being performed at Montreal Neurological Centre and Toronto s Western hospital. How correct is my understanding? YYYY@YYYY Thanks Peter ### REPLY: Hi Peter, Your understanding is correct. The scar from the previous operation could be the irritation focus that produces the epilepsy. To try and establish this hypothesis, you would undergo various tests that would include MRI scan and other scans, neuropsychological testing, scalp EEG's including possibly telemetry which includes a period of stay in the hospital where you will be hooked up with wires recording the EEG continuously and a camera recording you as well. After all this, the doctors would sit together and decide if you will need a period of intracranial monitoring where the EEG electrodes are placed after opening your skull over the area of scar. With this further testing to check the function of the surrounding areas of the brain will be done. Following this, the surgery to remove the scarred tissue will be performed. Yes, MINI is one of the works most experienced centers doing this type of work. But there are other centers across Canada and the US which do the same type of operation as well. ### END