Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 taken my mt pill yesterday i have still not started bleeding. It says after taking the 1 big pill of 200mg on 1st day u r suppose to start having abdominal cramps and started bleeding with clots. now should i take my third day pills (4) of the Kushi MT kit or not. ### REPLY: HelloThanks for writing to us with your health concern. I hope you have consulted a doctor before taking the kit. The pregnancy should be confirmed and dated by a gynecologist before taking the medications. There are unforeseen complications such as infection, bleeding, unsuspected ectopic pregnancy etc. You can bleed anytime after taking the second part of the kit (4 pills of Bisoprolol) also. A follow-up scan after 15 days is vital to rule out incomplete abortion. All the displease feel free to discuss further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, My age is 44 years and I have been undergoing infertility treatment for past 6 months. I have done IUI in Oct but no results. Next cycle was put on medicines and after 44 days my legs started to swell. Had met the doctor and she advised for tests and all tests normal. My endometrium is 13mm thick and one folicule is available now in right ovary. pls advise why my legs are swollen and any effect of thick endometrium? ### REPLY: Hi, Welcome to  forum.  The causes of the swelling of the feet are hypovitaminosisB, anemia, heart failure, etc. I advise you to consult a physician for diagnosis and treatment.  In such a health condition, with one mature follicle, the chances of conception are very less, still you can try.  Take more of green leafy vegetables, pulses, sprouts, and protein rich foods, to provide relief of some conditions.  Wishing for a quick and complete 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: starting on sunday, I had a stiff neck and swollen glands....Monday added back of my head.....Tuesdayadded my ears...they are red and swollen......tuesday night added sides and top of head....this morning added red and swollen areas on my forehead......I have a few sores on my scalp, back, and ears ### REPLY: Hi ! Good afternoon. I am  answering your query. With your kind of history, it seems that there is a spreading infection due to the sores on your scalp. If I were your doctor, I would start a broad spectrum antibiotic specially effective against staphylococcus and streptococcus. The spreading infection has caused the reactive lymphadenitis, giving rise to the swollen glands. Once the infection is controlled, all will be ok. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ive been facing some problems with sperm release for about one month. Before, when my sperm ejaculate it goes for a long distance with a high pressure and a big amount. Now, when my sperm ejaculate it only goes for a too short distance not even more than 5cm with a low pressure and short amount of sperm. why is that happening, and how can i cure it and become like i was? ### REPLY: Degree understand your concerns went through your description. I suggest you not to worry much. You should not worry much about such things. Ejection length depends on just one factor, and that is the viscosity of the semen. If the viscosity is less, or semen is watery, it ejects for a long distance. If semen is thick, it is sticky, it travels lesser distance. Along with age, the quantity of semen and viscosity decreases. Emotions, anxiety, stress, fatigue etc. are also other factors. Bur there will not be any problem for the effectiveness of semen. I sincerely advice you that you have nothing to worry. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello.. my last period was 3rd august.. and I started my yasmin pill on 6th august.. on 7th august @ night I forgot to take so I took next morning.. and again I forgot to take on 11 august so I took 12th august morning.. after thn I took my pills regular but not on same time 2-3 hours late.. now I completed my pills.. today 5th day but still I did not get the period.. I took the pregnancy test. It came negative. . So am I pregnant.. what are the chances? ### REPLY: HI, thanks for using  Oral contraceptive pills such as Yasmin are highly effective (99%) at preventing pregnancy when used appropriately. Women commonly forget to take the pill some days or make take it a little later than normal as happened to you. By taking the forgotten pill the next day along with the pill that was due for that day, you should still have been covered. If you had forgotten for 2 days straight then your contraceptive cover would not have been adequate. Pregnancy tests can normally detect pregnancy by day 11 to 14 after conception. If this time had passed when you took the test, it can be considered accurate. If this time has not passed you may want to either consider an early detection kit or a blood  level, these can detect lower levels of the pregnancy hormone, . You should rule out pregnancy before restarting the pills especially if your periods are normally regular. 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: I m 25years old my weight is 60 n height 5.5 . I m suffering from right kness pain not a joint pain from 4years..it ws started in October bt still continue. ..during my period Time its pain badly ..no injury n nothin evn now I m facing problem in my periods.plz help me ...one more some new pain is starting in my left leg foot datz is near my little finger kindly help me ### REPLY: Hi, Thank you for providing the brief history of you. A thorough neuromuscular assessment is advised. As by your history, that you have pain since 4 years, have you ever consulted the or tho for the same. As sometimes, due to the wear and tear of the joints, the pain can arise often. Also, during the period time, there are hormonal changes which leads to weakness in the overall bodily functions, by which there is a tendency to induce more weight on the one side of the body. As for which you can consult your personal gone who can help you understand the situation of hormonal changes better in detail. Also, if you are unsure of any injury in the past or present, then getting a musculoskeletal assessment is advised. Post which is the or tho feels an MRI or x-ray will be advised, if not then you may be referred to a physical therapist. By learning the exercises for strengthening the knee joint and also the overall body conditioning, you can have enough strength to balance the body weight. Also, since you mentioned you have pain in the little finger, you may need to undergo a urinalysis for uric acid levels. With simple medication, the levels can be brought back to control. In my clinical practice, female of your age complaints of bodily pain and also particular joint pain during period. By a proper musculoskeletal assessment and guided physical therapy their symptoms can be controlled. 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: Two days ago I awoke to my heart racing. I checked and it was 137. I had a headache, but I got up and felt dizzy. I measured my heart rate after 15 minutes and it was up to 207. I then took my GTN spray and after about 10 - 15 minutes, it went down to 76. Should I see my doctor? ### REPLY: HelloThanks for posting here. You have definitely got a high heart rate which requires evaluation. Since you said you took GTN SPRAY I suppose you are suffering from heart disease. First it is necessary to determine what type of fast heart rate you have regular or irregular. Irregular fast heart rate is called AF or atrial fibrillation. Regular fast heart rate can be sinus tachycardia or supraventricular tachycardia. All the three entities require medical management. The decrease in heart rate with GTN spray is unusual, and it may be just an incidental finding. GTN tends to increase the heart rate, so next time refrain from taking GTN spray if you feel your heart rate is very fast. You must visit your doctor and get an ECG done. If the ECG does not detect any arrhythmia of fast heart rate, then a 24 hour holder monitoring should BR done which records the ECG for 24 hrs when the patient is doing his normal day-to-day activities. This will help detect the rhythm disturbances and treatment can be started accordingly. Since you have history of heart disease a 2 d echo should also be done to rule out organic cause of arrhythmia. Take care regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my daughter 3.5 yrs has fallen into some steps knocking her front top right tooth. We have had X-rays and the outcome was a fracture. It is now 3 days on and the tooth Itself has dropped 5mm and the gums are red and inflamed. It is starting to effect her speach and chewing capabilities. As it is the weekend we can not see a dentist hence being here.  Any advice greatly appreciated. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint due to trauma the tooth has got PARTIAL AVULSION from the socket and due to it is has hanging in mouth leading to difficulty in chewing and speaking and even there can be pain, along with it there is a possibility that the tooth will completely get abused from the socket and there will be loss of tooth. You need an immediate dental assistance and should consult an emergency room and there you may get a dentist available or can guide you to reach a dentist as soon as possible. In case if the tooth falls you should store it in either milk or mild salt solution or saliva so that when you see the dentist he can replace it in the socket and splint it to save the tooth. In case if the tooth is partially abused the dentist can gently place the tooth back in position in the socket using aseptic precautions and splint it using orthodontic wires along with initiating root canal treatment of the tooth and gradually the tooth will take its place in the socket and starts healing. But you cannot wait for long, and you need to take her to a dentist immediately. As of now you can give her Tylenol or Ibuprofen in case of pain. Hope this information helps. If you find the answer helpful please give me a Five-Star Review and click on found the answer helpful as a token of appreciation. 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: I have being having blood coming from for some months  each time I sleep and weak up or relaxing blood will just come out from my mouth ,upon that I am using month wash only as the doctors instructed if might be gum decease yet it come and go after all my treatment, please advise me on what to do ### REPLY: Thanks for using . Read your query. Bleeding can be due to recurrent infection, resulting from improper maintenance of your oral cavity. Once you get your teeth cleaned from your dentist, ask him to demonstrate the proper method of brushing and do accordingly. Continue with the using of the mouthwash and use a desensitizing toothpaste for a while. If still persistent, please get a general checkup with your GP to rule out any issues with your general health. Hope this was helpful. Thanks and warm regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my blood pressure is 154 over 94 for the past 4 days i have had some pain shooting in my chest my right arm is tingling slight headaches at one stage my head felt like it had exploaded and i have a funny feeling on the left hand side of my face its not numb its just a different felling than my right side is this any thing to worry about i do suffer from sleep aponea thank you for your time sorry my age is 53 i am 57 and my weight is 9st 5lbs ### REPLY: Hello, The symptoms you describe can be because of hypertension itself particularly if the rise in blood pressure is recent onset. Do controlling the same with low salt diet, lifestyle and SOS medication should take care of the same and help prevent complication like heart problem or stroke. Also sleep apnea itself will cause rise in blood pressure, so taking CPAP at night should help you with it. Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 23 y/o male who just since yesterday night progressing to today and has been much worse today has had left lower abdoimnal pains. I thought it was just cramps or gas but it hurts when move, sit, stand and espically cough, it also hurts when i lie down. I didnt feel like running right to the ER so i am looking for some advice, and if maybe i should still wait to see if its gas or something. My stool has been normal yesterday, unknown for today. ### REPLY: Hello, welcome to the .BRIEF.it could be infection or stoneDETAIL. Since from your history the pain could be more likely because of infection, stone in the kidney or just because of gas. Even if you feel some swelling during coughing then it could be because of hernia. Until you get checked by doctor, you may have painkiller tablet (Tuscan)at home and have light food like soft rice and plenty of water. For ruling out the cause you should get ultrasound abdomen ang x-ray PUB done and discuss further. Hopefully my answer will be helpful. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have gone through liposuction surgey on December 2011... I did notice change.. But I was nt satisfied completely.. My skin is loose after the surgery. And I am still gaining weight on those specific areas. Now againim planning to go for this surgery. But with some good procedure . During the simple liposuction surgery, doctor have given anesthesia on my back which was painful and after surgery I have occurred the problem of backache.Please suggest me any other best liposuction surgery. And also the cost involved to it ### REPLY: Hellolaproscopic gastric fundoplication is far superior surgery for weight reduction than liposuction. Yes it may be costlier, but results are good. Till time continue exercise to improve tone, and diet plan to reduce wt. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am on the birthcontrol implanton (sp) the rod in the arm for 6 months. An I have been having to pee alot, tired, moody just not feeling well all around. So I took a pregnancy test yesterday and it came back with a smear and a crooked positive line all in one. What is going on with me? An what does the smear crooked positive mean?! ### REPLY: Good afternoon Don not worry those are symptoms of side effects of implant. The result you got is most likely false positive, I would advise you to repeat the test in nearby health facility. Its also necessary for you to see doctor so that other tests like blood pressure, random blood sugar are done to rule out other diseases like pressure. Hope I have answered your question, if you have any more questions I will be happy to help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 36 years old male, obese, with a renal stone in my right kidney. It is silent and I have not experienced pain for last two years. Recently my legs have started to swell at calves during the day and if I take rest and place my legs higher than my body while sleeping it becomes normal. I have a slight discomfort around my right kidney but no pain. I also have a fatty lever problem also. Kindly tell me what should I do to rduce the swelling and how can I normalize my fatty lever? ### REPLY: Hi, Thanks for writing in. The swelling in the calf regions during periods of activity can mean decreased venous return and pooling of blood. This is not related to your right kidney stone. There are arteries which supply blood to the different regions including limbs and veins which bring back the blood to the heart. The veins have valves at some places to prevent back flow and allow the blood to reach the heart. In some people which progressing and in those doing standing jobs there is malfunctioning of the venous valves and the blood gets pooled in the lower limbs. This opens up connecting channels between veins called perforators and that causes varicose veins which is tortuous superficial veins in the lower limbs. It is suggested that you consult a doctor and discuss the probability of varicose veins and if required get a venous Doppler of lower limbs done. For the right kidney discomfort please get the ultrasound scan done again to know of any dislodgement of the stone which can cause the discomfort. If the stone is not showing Andy increase in size and is in place then nothing needs to be done. There are many causes of liver showing fatty changes (i) Increased intake of fatty foods and alcohol(ii) Over weight and obese patients.(iii) Those who have fatty liver running in family members.(iv) Any liver condition that is changing appearance of liver.(v) Mild fatty liver can also be there in many normal people can get your liver function test and lipid profile done to know if the liver enzymes are raised and cholesterol numbers are increased. Please discuss results with your doctor and take required treatment if your tests results are higher than normal. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi sir my sperm count is 22 million/ML and motility 35% and morphology 65 % i have problem in erection and intercourse my dr have suggested Maxojal and fertyl m 25  to improve sperm count please suggest whether i need to go for IUI or naturally pregnancy will stay ### REPLY: HelloThanks for query. Based on the facts and report of your semen analysis that you have posted You have Oligospermia meaning there by that you have low sperm count. Since you have problem of Erectile Dysfunction too. You need to get your blood tests for Serum testosterone level done. Taking Ferry and Maxima cream does help to increase sperm count. Following measure will help you to increase sperm count. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc 3)Take anti oxidants like Almonds 5-6 every day 4) Avoid alcohol and smoking. A single reading of Oligospermia does not indicate infertility. One can be diagnosed infertile only if their successive reports of semen analysis done at one-month interval reveal Oligospermia Repeat your semen analysis with due precautions of abstinence for 4 days every time before collecting semen sample for analysis. With present report there is every chance of you making your wife pregnant . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 intercourse with a woman that I did not know as well as I probably should.  this was a few months back and she told me a day ago she tested positive for syphilis.  I have recently had terrible sores on side of my tonque and under my tongue.  there are spots on palm of both hands and mt tongue burns. I looked for symptoms of syphilis but they dont seem like what i am experiencing ### REPLY: Hello, The symptoms you seem to suffering from secondary stage of syphilis until proved otherwise. During the secondary stage, you may have skin rashes and/or mucous membrane lesions in the oral cavity. This stage usually starts with a rash on one or more areas of your body. The rash can look like rough, red, or reddish brown spots on the palms of your hands and/or the bottoms of your feet. In view of the above, I advise you to consult your doctor as soon as possible for proper clinical examination and to carry out serological tests to confirm the diagnosis. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir , I had my gall bladder removed in 1998 but have experienced crippling pains on two occasions in the last few years and periodic discomfort around the liver area. I have had CT,MRI scans and told i have dilated ducts. so what is the cause of the pain. ### REPLY: Thank you for posting your query. Briefly, you have pain RUN with a History of cholecystectomy differential is - Postcholecystectomy syn . Meanwhile,- take Medium (omeprazole) 40 mg once daily before breakfast-avoid fats and oil in diet - do NOT eat stomach full-eat small meals wish you good health. Further queries are welcomed. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health. Regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have learnt that I have an obsessive disorder. I used to play the computer all the time when i got into situations of stress. I went to a behavioural therapist and worked out I had this behaviour and have further worked out with her help that foods containing excessive amounts of salt or sugar magnify these feelings. I have since found that I have no need to go to the computer and seem to remain calm, but do often cry when faced with these situations. My son has been through trauma, and last night he went downstairs with a knife to stab anyone who was making noise in his unit. I am going out there today to pick him up and bring him back to a quiter environment, and he is going to a therapist today for a session. Do I tell the therapist of his behaviour last night. What do I do? ### REPLY: Hello and welcome to . Thanks for your query. You have mentioned that you have been diagnosed to have an obsessive disorder and that your symptoms are better after seeing a behavioral therapist. Stress is often a factor which can worsen psychological symptoms. So, in response to your question, I think it is better to tell your therapist about the recent stressful incident involving your son. You can also ask your therapist about street management techniques and coping skills as these will also help you handle your stressors better. Wish you 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: Following a bad fall, I had an infected haematoma on my shin, which is now like an ulcer. Antibiotics have failed to stop infection recurring. Iodine and now manuka honey dressings have changed every other day. Fall was 6 weeks ago. I am a 54 year old female. Why might it be taking so long to heal? ### REPLY: HelloThanks for your thereafter going through your query I came to know that you got injury to your shin, and you got hematoma and now ulcer. Slow healing can be due to diabetes, so blood sugar should check. Elevation of limb is helpful. If you have any further questions then don't hesitate to writing to us. I will be happy to help you. You can also write to me directly on below link:https://www.bit.ly/ask . 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: age-24height-53weight-57  Hi,i have got my sgpt test done yesterday & result is 44 i think my liver is enlarged also at the right side of my stomach i feel slight pain after eating food.I would like to know is it normal or not if notwhat are the precautions i need to take ### REPLY: Hi ! Good evening. I am  answering your query. Your result of SGPT is not very much abnormal to be worried about, and this does not confirm enlargement of liver, which could be confirmed only by a physical examination, and an ultrasound of abdomen. The pain you felt could be due to hyper acidity in your stomach. As a precaution, I would advise you not to eat from outside specially spicy and oily food, and go for a proton pump inhibitor .  In the meantime, I would advise you not to eat from outside and avoid any kind of aerated and alcoholic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father is having chronic myeloid leaukamia and he,s taking a alcoholic drug called Glivec since about 7 years. now he doesn,t eat mucha a gas oftenly comes out from his mouth with a sound .i want to know whether it is due to gastritis or as a side effect or something bad happening in his liver? ### REPLY: Hi, Thanks for writing in. Imatinib (Given) is the main treatment for most people with chronic myeloid leukemia. It is a type of biological treatment that blocks cancer cell growth. Doctors call this type of .  It blocks a protein made by CML cells. Given can keep CML under control for many years and can be taken for a long duration under medical supervision. The main side effects aquifer risk of getting an infectionBruisingTirednessA skin Rashford build muscle crampsFeeling sickDiarrhoeaHowever, if he has been taking Given for 7 years then acute side effects are ruled out. For his liver, you can get ultrasound scan done and also review liver function tests. This will measure the different liver enzymes in blood and give information on his general health condition. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor,I was suffering from bulking of fore finger (left hand), Initially i approached an MBBS doctor he did dressing for 3 days later i was getting my left hand swelling. Then i approached an MS doctor, he told infection has got more and did one operation to remove the unwanted materials. After some 10 days he did one more operation SKKIN GRAFTING. Now its fine  but he told that my finger movements will be restricted. I cant fold my finger now. I had approched him a month and half back. Please suggest is there any other method for the finger moment?height : 5.3weight : 54age : 25 ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. You must have a hand space infection. This space infection is treated by the doctors. In this surgical procedure sometimes muscles are also involved so that it also requires correction. Because of this muscle correction sometimes it may become difficult to fold the hand. I advise you to do physiotherapy of the hand muscle. This involves various exercises. Electrotherapy, heat therapy is also given sometimes for the muscle contraction. Please do as much work as possible with this hand this will gradually help improves the contraction. Please start with the milder work than gradually shift to the harder work. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in my right hip that has increased over the last six months; it is alieved somewhat by advil 3 in am and 3 in pm, but it is very limiting; stairs, forget it. grocery store, by the end of a normal shopping trip, I am hanging on my cart and limping and in agony. MRI scheduled for one more week. Assume it is arthritic. Is replacement of a hip the only remedy? ### REPLY: Dear patient hip arthritis is likely possibility. Diagnosis can be done from X-ray of the pelvis with both hips anteroposterior and frog leg views if it is advanced. Mri of the right hip may be needed for early stage disease. If X-ray is normal and MRI is showing arthritis changes it means disease is early and replacement can be delayed. If X-ray changes are obvious total joint replacement is the best option. It is very rewarding surgery with excellent results. Prosthesis shelf life is also long nowadays and long term studies are also available. Other option is joint fusion which is absolute procedure and gas poor results. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pulled my back muscle about 3-4 months age. The pain has got better, but sometimes i still have pain the morning. When i have pain i usually take co-codamol tablet (8/500 mg tablets.As i have a skin condition (Psorasis), in the past when i have taken strong tablets i get a really side affects etc so usually stick to paracetomal etc. I have also been using volterol cream, applying this to my back. Can you advise on my back problem. ### REPLY: As per your explanation I suggest you to visit a physiotherapist and take a good exercise program for your entire spine health. This will help you to improve the strength, stamina and flexibility of your spine. Here you have mentioned sometimes morning when you get up you feel pain at your back. It tells me two things. Either your back is weak or there is a problem with your bed as well sleeping posture. If your back is weak again there could be two region. Either its spinal muscular weakness or it may be related to disc problem. The only way to conform is by doing MRI and checking out your self do you feel any radiating pain from your back to legs ? If yes then it could be related to disc problem. And if there is only spinal muscular weakness Don't worry that will recover once you start following proper spinal exercise program. But I must suggest here do check your bed level (it should have even surface)and it should not be too soft or too hard. You can also use hot and cold pack at your painful area to have more of relaxing and nothing effect which will also help for relieving pain if there is any pain. At anytime if you feel the pain have increased in intensity and more frequent as well radiating to legs than do consult specialist for that. Understand one more thing pain is a symptom so Don't treat the pain treat the cause of the pain which will help you to have permanent relief. Taking some time paracetamol is ok but Don't make it your habit. 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 was stung on my foot and on my leg by a wasp 10 days ago. A bit of swelling and now 10 days later the site of the sting are red and warm to the touch. They also itch like crazy. I tried hydrocortizone cream this morning but it didn t help the itching. What can I try? ### REPLY: Welcome to , IF it is a wasp or bee sing, the first thing to do is to remove the sting, if the sting is inside the skin, it will take a long time to heal.  The next thing is swelling nothing to worry about that you can apply ice.  The other one is itching in the bite area which can be managed by antihistamines.I feel that because of the itching only you have this swelling for such a long period. Mild analgesics can be used for pain relief. And antibiotic lotions can be applied. Hope this finds useful with 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 Dr. Samuel,I would like to know what cause my right side lower back pain and cracking?  It has been going on for almost two years now.  Do I need to go see the doctor immediately or is there any stretching techniques I can do to fix it.  If i need to see the doctor what kind of doctors I should see.  Thank you ### REPLY: Hi, Low backache looks like a positional anomaly. The low backache is a result of muscle spasm which in itself is a protective mechanism body develops so that the back avoids abnormal posture. For pain to go, it takes not only rest (on a comfortable bed) but also avoidance of particular positions (during work, rest or recreation). Avoid sleeping on sides and stomach in case you do. While on work don't sit in one position for more than an hour and take frequent stretch breaks. Do not bend forward to lift things up, bend the knees and hips for that. Also discontinue any strenuous activity or exercises for some time. Having said that, you might want to consult your orthopaedician for a detailed physical examination and appropriate investigations. For future query, you can directly approach me through my profile http://www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Am 18 year old from delhi.My priod date was on 5th dec but this priod didnt happen till now. Moreover,p revious Month I did unprotected sex several times so will I come know am pregnant or not through urine test in lab??and if the result says am not pregnant then can I be 100% assured of it that am not pregnant??Please do reply ### REPLY: HelloThanks for writing to us with your health concern. See, the urine pregnancy test is more than 97 % reliable. If the test says you are not pregnant, then mostly you are not. To be 100 % sure, you should have a blood B  test or a pelvic ultrasound. A pelvic ultrasound will also reveal other causes such - polycystic ovarian disease, endometrial hyperplasia etc. Please have thyroid hormone measurements also. If you wish to avoid pregnancy, have protected sex in the future. Stress, anxiety, weight gain, hormonal medications, change in diet or sleep patterns - all can lead to delayed cycles. 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 Dr. Mia, I had abortion in May, 12 and not getting period after that. Now my gyne prescribed me for DUB-5, and once period will come, she advised to take Novelon (for 21 days), but I want baby now, so can I switch for Metformin instead of Novelon as I also have PCOD problem in past. I think Metformin will help me to induce ovulation. ### REPLY: Hi, You have POD. So main aim is to regularize period. DUB 5 will help you to induce period and Novel on will help you to regularize period by correcting hormonal imbalance. You can also use Metformin to induce ovulation under advise of gynecologist once your period will become regular. You can also ask for progesterone pill from day 15th to 25th: it will help in implantation and support pregnancy. Other .  Avoid stress, take healthy 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: i went to the doctor today and found out i have slightly high blood pressure (132/82). im a 20 year old college baseball player and i use hemo rage black (a pre workout supplement) to get the most out of my workouts.  is this okay or should i stop immediately? ### REPLY: Hello! Welcome and thank you for asking on ! I understand your concern and would explain that your increase in the blood pressure seems to be related to the supplements you are taking. You should know that all the pre-workout supplements have shown to increase blood pressure and cause cardiac arrhythmia. But also other secondary causes of high blood pressure should be excluded too. I would recommend consulting with a GP for a careful physical examination, a resting ECG, a chest x-ray study and some blood lab tests (complete blood count, thyroid hormone levels, cortisol plasma levels, kidney and liver function tests, blood electrolytes, etc.). Meanwhile, I would recommend stopping all the supplements that you are taking. Hope to have been helpful! Greetings,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 abnormal ECG of left posterior fascicular block.  readings are as follows and what does this mean?  Vent Rate: 62  PR 160, QRS 106, QT/QTc 106, P-R-T axes -4, 120 11.  I also have hypertension, high cholestorol, left chest pain and shortness of breath ### REPLY: Hello, After going through the electrocardiogram (ECG) and medical details, provided by you, I understand your concern for your health. Before giving my opinion, I want you to know I've not seen your electrocardiogram (ECG) and giving my opinion only on the report you have written here. A left posterior particular block generally can be due to age-related conduction problems, structural heart disease or coronary artery disease. Your medical history of being Hypertensive and High cholesterol profile with symptoms of Chest pain and shortness of breath are indicative of Angina which needs further evaluation to prevent any damage to heart muscles. Kindly get an echocardiography and stress test done and consult a cardiologist personally for physical evaluation and proper treatment. 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: It was discovered I had a spot on my pancreas during a CT.I had HepC-ws in treatment w Pegasus for 4 mos. They wanted me to do a MRI-I didn t have health insurance and frankly I ignored theor advice aboit MRI. I have no pain or any unusual symptoms-I am now rescheduled for MRI-applying for health insurance. I am NOW VERY worried. ### REPLY: Hi, Welcome to  Forum. Since you do not have any symptoms like pain or fever it can not be an abscess. MRI has to be done to rule out any benign or malignant condition. Please do not neglect and let the doctors do their job. Since spot on pancreas is an incidental finding on CT scan and there is no clear-cut relation between HCV infection and pancreatic cancer I advise you to undergo MRI and follow the advice of your doctor.  Take care.  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: Hello doctor,Ive been having nocturnal emissions once every two or three months for the last year. Im 23 years old. Today I woke up after I had one and I feel a very very slight pain in my left kidney. Also I want to mention I just had a nocturnal emission earlier this same week. Should I masturbate or often or less? I do it once a week.Appreciate your help.Thanks in advance,Joe ### REPLY: Hello, I don't think so if it is related to nocturnal emissions. It might be due to some other reasons like stones or renal tract infections.  Nocturnal emissions are normal and masturbation is likely going to lessen the frequency of nocturnal emission.  I suggest you to visit your doctor to run some tests like urine routine examination and culture studies along with ultrasound renal tract.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 66 year old diabetic female who is in ketosis.  I have been having back pain lately and am wondering if the two are related.  I take a magnesium supplement.  My blood glucose has gone from 296 to 115 fasting since drastically lowering my carb intake.  Ive lost 15+ pounds so Im having great results but my back pain is causing me to limit my activities.  I would appreciate any advice you can give me.  Thank you. ### REPLY: For my 66-year-old diabetic female on low-carb diet having excruciating back pain, I would have the following advice; Backache may be unrelated to the diet changes. I would first consider ruling out calcium deficiency and/or osteoporosis. Secondly, would like to look at serum electrolytes as the pain may be due to muscle cramps. I hope you are taking adequate fluids. If I can rule out the above-mentioned suspicions, then would have my patient evaluated alongside with an orthopedic/ neurosurgery team to look for any organic cause. You can discuss the above options with your caregiver. I hope the above information helps you. Thanks for writing into . Have a wonderful day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 26 year old son is for past 3 weeks is complaining about tighness tingling and numbness under his left rib cage. No pain. He says it comes and goes and he doesn t feel it at all when he is lying down. He is very atletic and plays major basketball and baseball. Is this a common problem ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should first rule out heart diseases for his symptoms because left sided chest discomfort is common in heart diseases. So get done ECG and 2d echo. If both these are normal then no need to worry about heart diseases. Sometimes in young age, stress and anxiety can cause similar symptoms. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in his life and start working on its solution. He may need anxiolytic .  Don't worry, he will be alright. But first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wishing good health to your son. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hie I have recurrent candida and been using over the counter creams for almost 2 yrs now what can I do to make sure t doesn t come back again besides going to a gp because have been there several times with husband and the pills seem not to be taking this away ### REPLY: Hello, In spite of using creams/pills; still you are getting recurrent candida infections means either you are using wrong dosage or it is not candida infections. In the query you didn't mention the site of recurrent infections, (assuming in the vaginal area, is it correct). Vaginal candidiasis causes excessive milky white discharge. My suggestion is please meet gynecologist for your problem and for good treatment. 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: Hello, I am 60 and have had episodes of depression for 30 years approx.  In the past 2 years I have developed a bipolar pattern of roughly 4 good weeks to 3 very bad ones.  This pattern seemed to come about following when I started exercising every day, i.e. swimming over a mile each day.  Have you come across this before?Alan ### REPLY: Hello Alan, Regarding the association of swimming and bipolar disorder, i don't think there is any association. Now coming to your illness, recurrent depressive episodes which occur very frequently (like in your case) are suggestive of bipolar disorder. Technically the bipolar disorder should have both mania and depression. But recurrent mania is also labelled as bipolar disorder. And recurrent depression is considered to be a risk factor for bipolar disorder. As you have mentioned that you experience these episodes frequently, I would suggest you to visit your psychiatrist. Your symptoms require . The  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Doc, My semen analysis shows: Is it good, poor, or excellent? Am I goanna be a father?1- Quantity 4.00 ml     2 - 52- colour Grey-white     Viscosity Normal3- Liquefaction time 30 min 7.24- Total Count 110.00 million/ml5- Motility at 1 hr:                         Motility at 2 hrs: -actively      40  %  >50%            -actively      40  % -sluggish     10  %                       -sluggish     10  % -non motile  50  %                       -non motile  50  %6- Abnormal forms  40  %  7- Leukocytes (WBC)  0 - 2  cells/hpf  <5 ### REPLY: Hello, The given semen analysis report is perfectly normal and nothing abnormal there to worry. The sperm count and motility (proportion of active and healthy sperms) are well within the normal range. According to this report your fertility will not be affected. If your partner fails to conceive, better to consult an infertility specialist and plan for newer techniques like IVF. 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: My 18 yr old daughter just got a prescription for Junel. Her boyfriend just moved to school across the country and they ll on;y get to see eachother every other month for the next 5 yrs. i think oral contraceptive use for a low rate of intercourse may be overkill and they should switch to condom use. Wanted to know your thoughts on this before approaching her ### REPLY: Hello, Combined Oral Contraceptive (COC) like June is a good choice for birth control in a young woman who is 18 years of age because at this age fertility chances of falling pregnant from a single act of intercourse are high. If she is likely to see her boyfriend every month or more then, it might be best to continue with this method for the reasons described below. COC is >99% effective and June acts by preventing pregnancy in more than way. It stops egg release, thickens secretions from the cervix to prevent sperm from reaching the egg for fertilization and also makes the lining of the womb unfavorable for pregnancy to establish. It provides reliable birth control along with added desirable benefits for a young person such as less bleeding and pain during period, prevents the formation of cysts or fluid-filled swellings on ovaries. Furthermore, it might help with improving skin by reducing acne. Condom by itself will be a less reliable method for a young couple. However, if they are motivated enough to use it alongside pills, it may be protective against infections that can be passed between partners through sex. 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: Hello I take care of my younger brother early 40 s he is on Medicare due to broken vertebras in his back, he has blood clots forming in his legs below his knees they are really swollen and scabby lately also he is on a breathing machine night due to he is not breathing properly he is always out of breath all day long. this has been going on for a while now and the clinic he is going to is not doing anything more just telling him it will subside please help me I need a doctor to help him contact me at YYYY@YYYY ### REPLY: Broken vertebrae possibly have associated spinal cord injury, and he is not able to move his both legs (in medical terms-paraplegia). Blood clots in legs below knee with swollen legs seems Deep venous thrombosis (DVT). He needs regular use of DVT pump in legs along with anticoagulants for treating this condition. If he started to have breathing difficulty (requiring breathing machine), there is chance that he had "pulmonary embolism" due to leg clots. I advise getting 2D Echocardiography, CENT Chest with pulmonary angiogram to look for pulmonary embolism. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir i have just turned 21 and im unmarried sometime a desire comes into my mind from nowhere and i make my way to bathroom and start playing with my penis meanwhile a white substance appears to come out of my penis. in early days i didnt feel any pain but with passage of time i hurts me. is it a serious matter? if yes then plz help me to get ride of this  problem// ### REPLY: Hi, I had gone through your question and understand your concerns. Well, this white substance is probably semen which is normally ejaculated during masturbation. In rare cases as a part of STDs it may be pus, but then it would be discharged spontaneously. Certain degree of pain is expected and depends on intensity of masturbation, but if there is significant pain then it may present reinfection or prostatitis and in this case you should do urinalysis and prostate ultrasound. In every case, I don't think this is a serious problem. 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: Hi, I have a lot of pain in my upper spine . I noticed that I have black and purple spots on my upper back and lower back. It is very painful and sometimes I can not bare the pain. I m 49 years old and I have a history of falling on my back. When I first noticed the purple/blackish mark there was only one of them, but now that same spot has grown bigger and in different places. I need to know what this is. Please get back to me as soon as you can, I d appreciate it. ### REPLY: Hi, Thank you for posting your query. The exact diagnosis is possible only after a careful clinical examination. The black/purple spots on your back may be related to the injury due to fall, which could result in a hematoma. They could be unrelated to the fall too, such as skin lesions (Melanesia, etc.). Please get them checked by your GP. Please get back if you require any additional information. Best wishes, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor my son is 2yrs 5 months. ..since 10 days he has stopped eating food completely....he use to have 4 meals a day but now nothing at all...we consulted our peadtrician he gave meds to clean his stomach nd suppositories to cure constipation. .but no improvement till now...he does not eat his favorite food either...he is playful nd active..no lethargic actions...but just refuses to eat pls advice wat shud I do. Thanks ### REPLY: Hi... Thank you for consulting in . I take this opportunity to tell you certain scientific facts and relieve your distress - 1. An active is a well kid even if he is not eating well. 2. Development of a kid is as important as, or I would say even more important than growth alone.3. As the kids grow their interest in food decreases and interest in play activities increases so that they eat small quantity and run away to play. As parents, we need to be more patient and feed than less quantity but more liquors per day.4. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed his calorie dense by adding good amount of ghee to it.5. I suggest you not to use appetite stimulants on long run as they may cause . PLEASE DO NOT GIVE ANY SO-CALLED APPETITE STIMULANTS AS THEY ARE NOT VERY SCIENTIFICALLY PROVEN AND THEY HAVE THE SIDE EFFECT OF EXCESSIVE  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I m 20weeks pregnent I ve had discharge for a while but its now got a slight green tinge colour to it I had a 20 week scan yesterday an was told my cervix was fine I ve had 4 children an never carried to term also been told ive got high amniotic fluid ### REPLY: Hello, and I hope I can help you today. Vaginal discharge gets heavier during pregnancy, and it normally has a yellow creamy color. It should not have a strong odor or itch. Greenish discharge may indicate either the presence of mucus (which can be normal) or either a bacterial or yeast infection. Yeast infections tend to produce chunky discharge with solid portions and no odor, while with a bacterial infection, odor when urinating or after sex is usually present. The way one could tell the difference is by an examination by your prenatal care provider, who could take a look at our discharge and let you know if it is normal. Your high amniotic fluid will need to be continued to be followed during your pregnancy by ultrasound but it most frequently goes away by itself. You likely will need monthly ultrasounds until it does. I hope I was able to adequately answer your question today and that this information was helpful. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i m 25/f 46kg nd i have a T.B. in spine and it is in initial stage(recent infection) i start my medication of antitubercular drug 4 days back. i m facing nousia and vometing can i withdraw medication for 15 days. i want to restart it after my medical pg exam. ### REPLY: Hi I can understand your concern... Noted you have tuberculosis spine.... Here rest has to be done .... We want immobilization of spine so rest needed.... You can consult orthopedic surgeon for further examination and advise... Functional bracing or cast immobilization Might be needed... And yes anti tuberculosis therapy taken without break to avoid resistance of bacteria and proper management..... . ... Follow up regularly done as to avoid any deformity and response to therapy.... If neurological deficit, fracture, deformity occurs surgical management needed. So continue with  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was wondering why Its so hard for me to get comfortable?/ why am I so restless?I often feel the urge to either sway one or both of my legs or bounce one up and down while sitting.I have briefly looked at Restless Leg Syndrome and Im doubtful that I have ADHD because at a young age our family doctor said I didnt have that. Any insight is greatly appreciated. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Shaking of legs simply does not point towards restless leg syn .  I advise you not to notice the restless legs yourself. Ask somebody to monitor you without you knowing it. Let him monitor you when you are at work, at school, at games etc. Then ask him how serious it is. If he says it needs to be corrected, then you start researching about it. Definitely not now. Worrying about a possibly non-existing problem can be the basic cause of the problem itself. Be wise. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i am a 21 year old male who is suffering from attacks of irregular and a pounding heart and also it may sound a bit strange, but my brain is telling me that my legs are going break. It has been concurrent and i cannott sleep. Please can you help? ### REPLY: Hello, After going through your medical query I understand your concern and I would like to tell you that pounding heart rate with all other symptoms of yours looks like anxiety but to exclude any heart disease get a basic cardiac evaluation is done which includes ECG and echocardiography done and consult a physician with reports for further treatment. 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: Hey. I m 34 years old who had an abortion at age age 27. I now need a baby an have been trying for years and can t get pregnant why is tha. Also fo two weeks now I have been feeling slight movement in my belly the uppersection. Could you say why. My birthday is the 11 of this month I will be 35 ### REPLY: Hello mam, thnx for trusting  doctors for your health related queries.I guess your concern is about getting pregnant....right...I got the picture.well lets ANFR to your question with small discussion below with d info u have shared with us.1.age, apprx 34 yrs....women of age group 18-40yrs r called reproductive age group, here the chances of pregnancy are more,,,after 50yrs chances nil...42-45yr transition zone, chances of pregnancy are NT as high as 18-40yr nor as low as 50yrs.I hope y am I stressing the importance of your age....understood NASA????means to say u have high chances of getting pregnant....so don't put ourself into unnecessary tension.now I would like u to focus on interfertile PERIOD,it starts from 10th-16th day of menses....here ovulation occurs,this ovum meets sperm n women gets pregnant....in this period if u do more episodes of intercourse the chances of pregnancy are more....usually women don't get pregnant either there is problem in wife or husband sometimes both....with the information u have shared about u, i guess nothing wrong from upside.still u haven't shared info about your menses....so I cant say 100% no problem on your side...u haven't shared info about your husband.how old is he??WTA is exact age??was it a late marriage for him???so I can't comment are there any mean from husband side...but, even any problem is there, dont worry,CZ here comes the advantage of 21st century technology. The name of technology is ART-assisted reproductive technology.ex.IVF the bloating sensation you are experiencing may be BCZ of gastric problem.it has nothing to do with pregnancy...well with this small discussion u can try out my suggestions:-1.have patience....don't put unnecessarily ourself into tension.2.I insist u n your husband to have more episodes of intercourse during fertile period(scientific mean told already ABV)try this for next 4-5months,this solves 90% of your problem3.if you're in very hurry or no results after 4-5months then visit a nearby gynecologist/infertility specialist for further help hope this WZ informative enough, helpful n useful for your query.regards: . .(had abortion at 27yrs...now about to com 35yrs still not getting pregnant....I can understand your psychology,don't worry all women goes through this phase....have patience.I pray god that u get blessed with baby as fast as possible, hopefully, TWINS!!!!!!) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 13 years , she had abdominal pain around the umbilicus for 15 days now , she has low grade fever 37.4-37.6 , since about 10 days she started to complain back pain that extend from thoracic to lumbar region , she has hihg WBC count with neutrophilia , but normal other CBC parameters , urine & stool are free , abdominal ultrasound shows nothing , since about a week she started to complain also ankle pain but no signs of inflamations , she already receaved ceftriaxone 1gm injection for 5 days & paractamol 500 mg twice daily , but she improve temporarly then complain again , now i am confiused , what is the cause & why she is not improving ? ### REPLY: Hi. Thanks for your query. Read and understood the problems you 13-year-old daughter is having. It is good that the Ceftriaxone course if already given. High WBC indicate that she may have hidden abscess somewhere, and since she has pain in the spinal region I would advise the following:-Repeat CBC-MRI of the spine to see for an abscess or so.-CT scan for the abdomen to see any inflammatory process going on like inflamed lymph nodes or so.-Clinical evaluation and physical examination by a Surgeon can clinch the diagnosis and give a better plan 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 was just prescribed Ondansetron for nausea caused by gastro intestinal issues, but I got concerned when I saw it has an effect on brain chemistry like serotonin HT5 something. Does this effect brain chemistry? If so, are these temporary and resume to normal when stopping the medication? ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. Question : Does this effect brain chemistry? Answer : Yes. It prevents vomiting by affecting brain chemistry. Without affecting brain chemistry, vomiting cannot be stoppedQuestion : If so, are these temporary and resume to normal when stopping the medication? Answer : When the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Underneath my tongue the veins are red and sore. Prior to me writing this I wiped off like some type of mucus or puss that were formed on the the glands underneath my tongue in little ball shapes . Its painful when I move my tongue around or it brushes against my teeth . What is the cause to this? A few days ago I woke up with this irritation underneath my tongue. What do I need to do? Please help. ### REPLY: Hello and welcome, this is due to heavy calculus and plaque deposition on the lingual side of lower front teeth. This occurs due to increased mucous content in saliva. There is gingivitis and abscess formation resulting in inflammation of gums. Visit your dentist and get it checked clinically. Get deep scaling and root planning done by your dentist. The assess has to be . Use soft-interdental toothbrush and dental floss to clean your teeth. Rinse your mouth after every meal. Use chlorhexidine mouth rinse twice daily. Always brush in all aspects of teeth.ie, buccally, lingually, occlusally, incisally, massage your gums using gum tone gel. Take tab.doxycycline-100 mg once daily for 7 days to make your gums intact, firm and resilient. 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 doctor my son has just turned 4yrs old and for the past few months he has got very thin. His stools are always soft and sink to the bottom of the toilet, on occasion they are diahorea. He recently has complained of his bum being itchy and it is red. He is at nursery school and I know he is active and growing but has always had a good appetite and we would eat healthy home cooked meals, however the food in school is somewhat processed and I think at times he does not eat a lot of his dinner in school and this may be a contributing factor in the weight loss. Also about 2 weeks ago he seemed to be having bad nightmares, sweating/fever and his body was twitching a bit. He was like that for 3 nights running and then it stopped. he has night sweats regularly but this was more like a fever. I am concerned about his weight, and was wondering if you would have any advice, or would this give you an idication of any possible diagnosis? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I hope you consulted a child specialist regarding the symptoms you mentioned here. Furthermore, I could see the problems are a bit more complicated. Realistically, these symptoms could more physical than psychological.  Please consult a child specialist before approaching any psychologist or psychiatrist. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Good Evening.  My dad who is in his 70s is a diabetic and is hospitalized with liver and kidney failure and also had amputation of 4 lower limbs.Can anyone pls update is there point in shifting him to a bigger hospital, though the current doctors taking care of him have said chances are just 5%. ### REPLY: Having simultaneous kidney and liver failure probably suggests infection or any other acute event. I would suggest you to shift to higher center as we should not give up because its life. If he needs lifelong dialysis then ethical emotional and moral values will come in to the picture. But at present better to shift and if he needs dialysis then peritoneal dialysis is best option. All the best. If you have any questions feel free to contact me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My brother in-laws was told by a doctor that he has a blood clot on the left side of his brain and needs to have surgery.. He also was told there s a 50% chance of him passing away during surgery Also that he has a 50% chance If he doesn t have surgery if it gets the size a quarter dollar ...So can u tell me how much is this information is a fact ### REPLY: Hi, I am .  I have read your question and understand your concerns. Let me try to help you Question : So can u tell me how much is this information is a factAnswer : The Information Given seems correct Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Let me know if I can assist you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have had abdominal pain for 2 years now the pain never goes away, painkillers only dull the pain but do not take it away, i have had a colonoscopy, gastroscopy, lapaoscopy, ultrasound, transvaginal ultrasound, ct scan and x rays done they x ray showed inflammation on the ileum, i had my appendix removed when i was 20 so it is not that, but i have tried everything and had all the tests imaginable done i feel like im going insane and the doctors are strating to talk that way too what can it be please help? ### REPLY: Hi ! Good evening. I am  answering your query. As you have got almost all the tests done for your problem, I would advise you for the following few:1)In case you eat from outside, I feel that you may be sensitive/allergic to gluten, which is found in many fast foods containing wheat, pasta, etc. This is not easy to diagnose, and the best way is to exclude all kinds of fast food you consume in outside eating joints (if this is the case with you). It is best to have home cooked food with more of roughage or carry the same with you if you are busy. Gluten sensitivity can give rise to all the symptoms you have described. Some modification in your diet like more of roughage, enough liquids, avoidance of oily, fried, and fast food, and avoidance of alcoholic beverages and smoking if you do. I suggest you to consult a gastroenterologist along with a dietician on this aspect of the diagnosis, which possibly might not have been considered until now. The gastroenterologist will be able to diagnose with few biochemical tests along with a possible repeat endoscopy with biopsy of the intestinal mucosal wall, while the dietician can guide you on your food that you can consume pleasantly. Also, there is a need to exclude co-existing amoebas which is very common globally and treat it if positive by a stool test for ova and cyst. 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: Dear Sir My son is around 6 yrs old. He do not want to take food usually. He is becoming emaciated. For few days, we found some blood around his leap at morning time. Teeth seems to be okay. Why it comes ? We are worried of any systemic infection. Please suggest us some possibilities. ### REPLY: Thanks for your query, I have gone through your query. The blood around the lips could be because of the gum infection, or any cuts in the oral cavity or pulp polyp or any bleeding disorders like idiopathic thrombocytopenic purpura. Consult an oral physician and get these things ruled out. Get a complete blood investigation along with INR to rule out the bleeding disorders. If any gum infection then get your teeth cleaned and use topical gum astringents like stolen gum paint. If pulp polyp is there then get the tooth treated. If bleeding disorder is there then consult a general physician. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir, This is Prashant Chaturvedi from Lucknow, i would like to ask the best treatment for my Grand Mother that she is suffring from Gallballder Cancer and the treatment is undergoing to Mr. Rakesh in Asian Hospitol Faridabad in Delhi. They suggest us instent wire put in the body and then decide to operate the gallbledder tumer.we hope you will give me best.  Thanking You. Prashant Chaturvedi.0000 ### REPLY: Hi, Thanks for writing in. I suppose your grandmother has cancer of gall bladder that is causing biliary obstruction. The lever generates bile which is required for digestion of food. The bile is stored in gall bladder. Cancer in the gall bladder can cause problem in bile clearance and this leads to bile getting collected in the liver and there is jaundice. In your grandmother the biliary obstruction due to gall bladder cancer is causing problems. The doctors want to insert a stent to restore bile flow and reduce jaundice. This is done to bring relief to patient by allowing the liver enzymes to become normal. Complete surgery for gall bladder cancer is possible only in early stages. Please discuss if your grandmother has early cancer and if surgery is planned to remove toe gall bladder. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am 32 yrs. i have a daughter of 5 yrs. I got copper T when she was 6 months old. My family members are asking me to get it removed but I dont want that. I am not ready for another baby. Is it safe to keep it for some more time? If yes, then for how much more time? And if no, then what should be another way to not getting pregnant? Pills and condom are not the right answers for me. Please suggest. ### REPLY: Hi, From your notes it appears that you are using Copper T which has efficacy for 5 years. You cannot continue to use it after 5 years duration as its efficacy is reduced, and you are at risk of getting pregnant. If you wish to postpone pregnancy, you may visit your doctor, remove this and get a new copper T inserted. If you do not wish to use pills and condom then discuss with your doctor regarding using hormone patches, subdermal implants or three monthly/monthly hormone injections.I hope I have answered to your satisfaction. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I really in need of best advices. A friend of mine is suffering from PCOD. Otherwise she is completely fine. She is trying for baby from last 3 yrs but no luck yet. She been to laparoscopy. It was decided that she will go through IUI during her first cycle. but now, in her first follicular study report after surgery, its been observed that the follicle/egg size is not increasing. I wonder if any one of you have heard/experienced similar situation? Doc said that at this stage he will have to cancel IUI. She is quite upset with more n more waiting period. She is already 33yrs. Pls help!! Why this happens? Any particular reason? Is she need to do any specific blood test or report at this stage? There is nothing thru which egg can grow? ### REPLY: Hello,thanks for the query appreciate your concern for your friend.let me know does she have any hormonal problems*(estrogen, progesterone,prolactin levels), thyroid problems, were her periods regular, ;does laparoscopy report show PCs.size of eggs and number vary in various conditions first consult and discuss with gynecologist regarding the problem and treatment modalities and options.do not worry as infertility treatment options have developed a lot and treatment is possible.wish your friend will conceive soon.bye ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 started feeling this sharp toothpain a few months ago and went to see my dentist who checked thoroughly also with an xray and couldn t find anything - I have been to see her several times after that and still she cannot see any damage to any tooth at all. The sharp nerve pain, i would call it but, is felt in a particular tooth, it comes occasionally and the first lot was very very painful. and i used a pain killer and over about 3-4hrs it stopped. I was just thinking today that though I don t feel any pain in my ear, I do occassionally feeling like i want to clean it, as though i feel a bit irritated in it and also occasionally, I feel a very minute bit faintish. Do you think there might be a relationhip of any kind? What can be done as i have felt this tooth-nerve pain several times today and its becoming really annoying. ### REPLY: Hellooo...read through your query...and I suggest since u told u had met dentist many times with X-ray and couldn't find reason u can meet a neurosurgeon as it can be due to some neurological origin pain.....(since after taking painkiller also it's not reducing Na) some pains in the oral cavity in absence of cavities can be neurological origin...be cool and meet a neurosurgeon or neurophysician.hope your benefitted something from this reply.have a healthy day!!! ### END