Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 neck and back pain sice last 2 yaers and I am taking anxiety disorde medicine but my pain is not going. Actually what is the prblem of my neck and back on left.Is it the physical effect of Anxiety or not.But my other effect of anxiey is improving well except of back pain and neck pain . ### REPLY: Hello, I had gone through the case and found that it might not be due to anxiety. It can be due to any vertebral problem. So I will advise going for X-ray of spine to know the spondylosis or spondylitis of cervical and lumbar vertebrae. Also go for calcium and Vitamin D3 level in blood.Meanwhile, take mild painkiller and avoid pillow for sleeping and do exercise. Hope my answer will be effective for you. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello,im 19yrsold,from past few months my hairfall is uncontrollable i hv curly hairs as im a student may be because of studies tension or improper diet is the main cause for my hairfall can u please suggest me some vitamin tablets so that i can gat my hairs back. ### REPLY: Howell come to ChatDoctorIf you are a male person then this could be due to "Male-Patron-Baldness" although this is very uncommon in this age, but this can not be ruled out unless it is being proved some hair root disease, till then this can be prevented with "Minoxidil 5% lotion" apply this on your scalp, you are too young so better to see the dermatologist for proper diagnosis, you have not mentioned your gender here else something better advise could be possible, 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 m felling to much pain in my leg every day at morning ........ after few hours it gone .... i can walk.. but next day it again start ..... i m suffering this kind pain last few year .... no any kind pain killer works during pain ......... what i do now ...... pl. help me...... ### REPLY: Hello, I read carefully your query and understand your concern. The pain in the legs in the morning can be related to rheumatoid arthritis. It can also be related to muscle tightness. I suggest doing a rheumatoid factor level for further evaluation. Meanwhile, I suggest using a muscle relaxant such as Baclofen three times a day. I also suggest using magnesium supplements. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards!  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my problem started with swelling on top left side of mouth around wisdom tooth, had the right side removed couple of years ago they said the left didnt need to be removed now of noticed my gums lighting and have big hard bumps in the bottom of mouth behind tongue please help ### REPLY: Hello, You should not worry. The wisdom tooth may have moved, and you see changes. Go to the dentist for an x-ray and re-evaluation for extraction. You can rinse with warm salt water and monitor for changes. Your jaw continues to grow and respond to pressure. It is common to have lower Tori which are bone bumps usually positioned more forward near your canines and premolars. If you feel inflamed or swollen, take anti-inflammatory medication and consult your dentist. Swollen glands, which are usually softer, indicate an active infection. Infection from a tooth can .  Expansion may be related to a cyst or other growth. Thank you for your inquiry. I am happy to assist you further with any additional questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 daughter is only 1 month old and she is having generalized seizure disorder. Doctor has prescribed Valparin 200 10 drops twice a day. Till when I should continue this medicine and sometimes she starts crying heavily. At that moment what should I do? ### REPLY: HelloValparin contains Valerie acid, and it should not be given below 2 years of age. Below 2 years there are high chances of hepatotoxicity. Most of the pediatrician used to give phenytoin or phenobarbital in this age. Nowadays levetiracetam is a better antiepileptic . Most common cause of seizure at this age is birth asphyxia, some metabolic disorder or brain malformation. Cause should be identified first. Most of the time in case of seizure disorder medication is needed to be continued at least for 3 years of seizure free period. Here I would suggest you to consult a pediatrician for evaluation and for change of medication. 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: use of mupirocin ointment nasally I am having I spinal fusion in the morning and was instructed to use mupirocin nasally prior to arrival. the mupirocin I received from the pharmacy is 2% ointment when I read the internal literature it said not to use in the nose but that there are nasal forms of the medicine. I think I tecieved the wrong stuff from the pharmacy that being said. should I still use it or wait and see what the doctor would like to do in the morning? ### REPLY: I would recommend waiting to see the doctor if the package insert and/or the pharmacist has verified that what you were given was not for use in the nasal mucosa.  They will have the medication in the hospital in all likelihood and should be able to get that applied prior to surgery.  Please rate this as a 5-STAR response if I've provided useful information and write me at: www.bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes, can you tell me if lisinopril hctz , omeprazole , and simvastain effect my husbands sperm or fertility ? we are trying to get pregnant and have been for 9yrs and we have been to dr after dr test after test ... and no answers. so im doing some findings and wanting to know about his meds. thanks ### REPLY: Hi, Thanks for writing to . Let me explain you one by one. Surprisingly there are fewer studies or researches on this topic. Omeprazole is not know to cause any adverse effect on sperm count or fertility. Lisinopril is not having direct effect on sperm count, but it effects fertility by following side effects---Decreased interest in sexual intercourse-inability to have or keep an erection-lack or loss of strength-loss in sexual ability, desire, . But these are rare side effects. Simvastin rarely cause erectile dysfunction. It is also shown in some studies that it reduce testosterone levels which is required for sperm production. This may be the cause of reduced sperm count. You can discuss with your doctor to switch to alternative  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffereing from UC..and i have been using medicines from the last year..recent past i have observed blood in my motion so my doctor prescribed azaron 50mg along with mesacol800 which i have been using from last year..is that safe medicine to use? ### REPLY: Hi, Azathioprine or mercaptopurine usually takes between 6 weeks and 3 months to become fully effective. During that time, you may need to take corticosteroids to maintain control of your disease. Azathioprine has been used for about 30 years for the treatment of IBD. Common side effects include:* upset stomach* nausea* vomiting* diarrhea* loss of appetite* hair loss, or* skin rash 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: Every so often when Ive stretched out or just run up the stairs my chest starts to feel really tight and I experience trouble breathing. It doesnt happen all the time and Im fine doing normal activities and dont usually experience this when doing anything active like running or exercising. ### REPLY: Thanks for your question on . I can understand your concern. You are having chest tightness and breathing difficulty on exertion. So we should definitely rule out heart diseases for your symptoms. So get done ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry about heart diseases. Sometimes stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relaxed and calm. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. i am having severe abdominal pain. it is mainly around my naval and hurts when i touch the skin, or push on my belly button area... also it hurts to walk, move and situp. sometimes when i am walking  i literally double over in pain.. almost falling to the ground. I have been to the emergency room friday night.. and the doctor informed that it was just muscle pain... becuase the urine sample came back negative. i also just got over a yeast infection. Can you help me ?Katie ### REPLY: Hi. Thanks for your query. The cause of the pain as you described around the naval on touching the skin, on walking, on bending, moving, sit-up and so on can be an infection in the umbilical region due to an infected umbilical granuloma or infection in the area which has spread around. With severe abdominal pain you can always consult a Surgeon and a Neurologist to see if the sensory system is at fault. Get examined by a General Surgeon, get ultrasonography done, a 5-day course of an antibiotic and anti-inflammatory medicines and take full rest. You may be fine . Take Proper treatment for Yeast infection. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 grad daughter, 25 mo, has the following symptoms: - yellow, past poop - not eating much yesterday, only milk - ate a little better today, some berries - sometimes eats dirt, also like cardboard - last several nights, VERY restless sleep, last night and tonight, awake and fussy crying every 15 minutes or so. ### REPLY: Hi...she has a viral diarrhea and also has the habit of eating dirt and biting cardboard so in all probabilities this is PICA.as described in medicine. She needs some iron supplementation and I suggest you consult your pediatrician for the same. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a rash/hive--who knows? It literally looks like I ve been burnt and the skin is lifted. It started out in my torso, then my breasts, Underarms, lower inner thigh (close to vagina) and now ALL over my back. It s been coming and going for months but now it s spreading. Should I be worried? ### REPLY: Hi, You seem to suffer from urticaria. If it occurs more than 6 weeks, then it is chronic urticaria. Consult the dermatologist for the perfect diagnosis and proper treatment.  After thorough investigations, your dermatologist might prescribe proper .  If any triggering factor is found, that should be avoided. Antihistamines, steroids, etc., may be considered. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I m a 42 year old female and for about a month and a half, i ve had sever back pains on my left side started lower back and has now moved to upper back and shoulders. Now the pain seems to have spread to the front of my chest and I sometimes have a burning sensation under my right brest and into my chest. Someone said costrochondritis (spelling) fits with my symptomps? ### REPLY: Hello. Thank you for posting your query with us. Well the pain that moves from the low back and to the upper back and shoulders can be mechanical in nature. If you have a lot of stress at home or at work then you need to take some days off.  Go to a good physical therapist who would assess the strength of your lower back and your shoulder muscles. A good exercise regimen to strengthen the muscles will help ease off the pain. Take a muscle relaxant for a week or so and do hot water fomentation on the painful area. Also at times, such pains are due to deficiency of Vitamin D3 or calcium so get these levels checked in your blood and if a deficiency comes out then visit an orthopedic who would prescribe you some supplements to make up for the loss. Till then, maintain a good posture, start exercising, decrease the level of stresses and eat a healthy diet to stay fit. Get well soon!!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi. me and my partner have been trying for a baby for 8 months now. well, not exactly trying but we don t use protection as were happy if it does happen. I had a miscarriage middle 2 years ago - baby was my ex partners. anywho, we re both really wanting to bring a little one into the world but I m starting to think there s something wrong with me, because of the miscarriage or him. his sperm is quiet watery And clear and I m worried he may be infertile. I m too nervous to ask him to go get it checked as he d be so upset at the thought of not being able to have kids. is there any tips and tricks to fall pregnant faster and why could it be that he s sperm is the way it is? am I worrying for no reason ? ### REPLY: HalloThanks for your query. You had conceived 2 years back from your ex partner, so it is unlikely that anything is wrong with you. Both of you have to be frank enough to discuss this among st yourselves and consult Infertility Clinic. If you are scared to suggest to your husband to get his semen Analysis done then you can take help of elders in your family or some trusted friends. If some abnormality is detected in your husbands' semen analysis It can be treated with medicines. So do not worry and have a 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: Had gallbladder surgery 11 days ago. Three days ago, yellow pinkish puss is leaking from my belly button. Have been changing my bandages several times a day to keep it clean. I an not in any pain, the redness around the bellybutton is not getting any bigger. How concerned and worried should I be as will this pass with time. My most concerned situation is infection. I am seeing my surgeon on May 7th for my followup. ### REPLY: Hello! Thank you for the query. This leakage is most likely caused by wound infection indeed. It may be caused by bacteria presence, irritation due to stitches presence, lost stone in the wound. The fluid can also appear due to incomplete abdominal cavity closure, or presence a part of perineum in the wound region. I suggest you to visit your surgeon sooner. It is because infection may spread to the surrounding tissues, the infection can cause poor tissues healing and result with hernia in this area. The wound needs to be checked by surgeon, .  Antibiotics might be necessary as well. Hope this will help. 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 a lump on the outside of my left knee, it almost feels like the head of fibula but it s been like it to different extents for years, I did break the fibula playing rugby 8 years ago an inch lower down, there is no real pain but recently it seems worse ( doing more training) and has started to hurt in the night. Do u think I may have a partial dislocation or would I be in constant pain? ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Cause for painful lump on left knee-In my opinion your lump could be a mismatched fibula post-healed fracture of fibula 8 yrs back. Due to increased training strain, it is hurting you and indicates arthritic changes at the fibulo-tibular joint of the left knee. But it could be a fibular lump ? Locally-malignant and hence needs ER Ortho-Surgeon check up and needful treatment. If not treated it could increase your leg pains constantly. So do check it up from ER Or tho- Surgeon. For Final Diagnosis and treatment needs clinical data from a Doctor. And Hence for further treatment I would advise you to Consult ER Ortho-Surgeon, who would treat it accordingly. This advice is based on the facts from the history you give and needs further clinical check.Hence, I would advise you to check with ER Or tho- Surgeon. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you. Hope this would relieve your problem. Welcome for any more query in this regard to . Write good resume and Click thanks if you feel satisfied with my advice. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a very painful lump in front of my ear. It feel like a lymph node. It is even causing ear pain. I have another under my jaw on the opposite side. I thought it was because of an acne cyst on that side until the one on the opposite side appeared. Any thoughts on what it could be? ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You may have some reactive lymph node enlargement.  Or one acne like lesion.  You should take a course of antibiotics.  If lump doesn't respond to treatment then biopsy diagnosis is advisable. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir I have a query. Can these birth control pills or pregnancy control pills (like MALA-D) hold pregnancy for 1 or 2 years? means if any lady being pregnant can avoid pregnancy for how much time through these pills. Can it be more than1 year???? ### REPLY: Dear member, Thanks for using . Birth control pills also known as contraceptive pills if used regularly are very effective in preventing pregnancy. If the lady who is consuming the pills is a young lady (To answer your second query regarding lady being pregnant and wants to avoid further pregnancies I assume your query is regarding the use of birth control pill after the lady has delivered her child and doesn't want another baby now. MALE d cannot be used in lactating or mothers who are breastfeeding. In such a scenario I would usually recommend other methods. Kindly get back if you have more doubts on this issue. Thanks. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a large upside down crescent shaped bruise on the side of my abdomen. There is a hard white lump in the middle, and the bruised part looks like blood pooling beneath the suspiciously white, hard spot. I have not injured myself, certainly not bad enough to get such a bruise. What else could it be? ### REPLY: Hi, Good Evening. This is . -I studied your query in depth and Understood your health concerns.-Accordingly on the facts given by you-Causes I would suggest is as follows-a-I think you are a case of-Hamartoma ? Dermoid ? Sebacious Cyst? Dermatofibroma? Lipo-fibroma? Epidermoid Cyst-with rupture of the riding veins around it causing blood suffusion beneath it. Hope this would help you with the relief you needed. Wishing you healthy living and early recovery of this query. Wellcome for more queries till you get the satisfied. Thanks for your query to  Clinic. Have a Good Day...!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 32 years old, using Mintop Forte (5% Foam type solution) for the last 6 months, But its not effective. But am continuing...So if any other effective medicine or solution, where i can see the result in few month...It will be very useful for me.Please suggest me.. ### REPLY: Hello. Thanks for writing to us at  You seem to have An . It is genetically determined patterned hair loss. Usually there is a family history in other male members of the family. Hair loss and thinning is predominantly from the frontal scalp; it may also be associated with anterior hair line recession as well as hair loss/thinning from the angles of the anterior hair line thus causing them to widen and deepen. Only, Minoxidil and Finasteride have approval for use in An ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 need to consult someone who can help me overcome this feeling of loneliness and Dejection that i constantly feel ever since i got the shock from my boyfriend...I need answers to some questions as in what did i do wrong...why did he suddenly change? there are many complications...I understand this was not a usual relationship...I had two kids and he was unmarried and all that stuff i understand. But for 6 years we were madly in love...I worshiped him and could do anything for him. Nothing has helped me...my kids are devastated. i am good for nothing. i am a complete failure. i always stood by him when he needed me and he left me alone and dejected. I am not a teenager. I barely found love of my life. I was happy and suddenly he decided to break free...cant get over the shock...cant get over the shock....someone help me....i am so depressed...now that he is settled, he told me he cant be with me anymore...simple bcoz now he doesn t like the same things that he used to like once. help meeeeeeeeeeee!!!!!! I need answers. ### REPLY: Hello.......... The sudden loss of a loved one-what we call as bereavement is a common enough phenomenon in most peoples life. It usually results in an adjustment disorder though on occasions it can be severe, what we refer to as acute stress reaction. You would have to get over this initial phase of anger or depression over the next couple of months following which is required (is these symptoms persist), we would recommend appropriate medication or psychotherapy measures. At this juncture supportive psychotherapy by a (clinical) psychological counselor might be appropriate for you. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am taking crestor 10 mg and once a day with hydroxychlor 200 mg two times a day and have muscle weakness in knees and and legs with charleyhorses where my legs are sore. I also take etodolac 400 mg two times day with azor 10-40 mg any good ideas thank you Thomas Walter ### REPLY: You must see treating doctor. Muscle weakness and pain may be related to medicines you are on. Sometimes, other causes may be there too like Vitamin B1,B6,B12 deficiency, calcium and vitamin D deficiency etc. which can be evaluated by blood test if your doctor considers. If you smoke or have excess alcohol, that may also need to cut on gradually. Next is blood sugar, obesity, overweight cause if any, to be screened for. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello I am a 41 yr. old woman, just diagnosed with mctd. a problem that I am having is occasional sharp pain at the base of my head atop my neck. im now starting to have trouble sleeping because it hurts when I turn my head. I was first of all trying to find out what this could be and if it has anything to do with the mctd. sometimes it feels as though my upper spine is going to just pop out especially with any sudden movement. ### REPLY: HIT hank for asking to ChatDoctorI can understand your problem, you have not stated here the treatment which are taking, your problem is related with your immune system, If I would be your Doctor then I would definitely put you on steroids this gives excellent result in such cases for long term basis, if you do not have diabetes or renal disease then you can have word with your doctor for this, have great day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi.....Im a 43 year old male thats 290 lbs and I just had my bp checked and it was 186/83...... Ive been working on my weight and hitting the gym for the last 6 weeks. Ive lost 27 lbs and getting arms like a  body builder.....I just wanted to get your thought on the BP? ### REPLY: Hello! Thank you for asking on ! Your blood pressure values are above the normal ranges. This could be related to overweight or straining physical activity. Nevertheless, I would recommend consulting with your attending physician for a physical exam and some tests to investigate for other possible secondary causes of high blood pressure: - a resting ECG- a chest X-ray study-some blood lab tests (complete blood count, blood lipid profile, fasting glucose, kidney and liver function tests, blood electrolytes, PCR, sedimentation rate)- a urine analysis all the above tests result normal, you should discuss with your doctor on the possibility of starting antihypertensive therapy, in order to have a better control of high blood pressure. I would also recommend some tips to help you maintain a normal blood pressure: - diet modifications (reduce salt and caffeine intake, avoid energetic .  Hope to have been helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have prostate cancer. Had Radical surgery that removed prostate and seminal vessicals. Some cancer remains. None in bones or lymph nodes. Met someone that said EZ-Act helped cure his daughters cancer. I m looking at radiation therapy next. Is taking EZ-Act an alternative option that will slow the cancer or put it in remission? Also, what is your opinion about the new Proton Radiation therapy? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have radical surgery and still you have some cancer cells.  It suggests that you have cancer is later stage.  Now radiotherapy and chemotherapy is helpful in four prostate cancer.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 33 year old woman with low back pain for two weeks. I have been experiencing numbness in my legs. I had an MRI confirming degenerative disc disease (L4 and L5) and spinal stenosis . Today the numbness is worse in my legs, extending the full length of both legs and not mainly in the feet. I have started leaking small amounts of urine with a constant urge to urinate. Should I go to the ED or wait ti get in to see a Nuerosurgeon? ### REPLY: Hello, You are young and are having problems which are progressing rather rapidly. Minor degenerative changes may not be sufficient to explain the symptoms which you are having. I would advise you to visit emergency department rather than waiting for to see a neurosurgeon. Some progressive conditions, if identified early, can be treated in time to prevent any major damages. You could be having urinary tract infection, which also needs emergency attention. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been experiencing pain in the area directly below where my rib cage ends on the left side for the past week. I am very active and initially thought that I had pulled a muscle. The pain is severe at times resulting in me actually yelling out when I cough ,breath in deeply, turn over in bed, and ever bend over to tie my shoes. I can pinpoint the pain by pressing on the soft tissue area following along the curvature of my rib cage. Is it possible that something is going on with my spleen? According to my research that is the organ that is located in that area. ### REPLY: Hi ad welcome to ChatDoctorYes, spleen is situated there but also stomach, left colon and lower part of lungs. First thing to think about is muscle pulling, and it is treated by rest and painkillers. Some more serious are pneumothorax and spleen contusion, and small diaphragmatic rupture, but these would have more intensive symptoms. Also, any kind of pneumonia and pleuritic can cause such pain. I suggest to wait 3-5 days to see progression of pain. If you have difficulty breathing or any other serious symptom or pain progress go to hospitals soon as you can. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have lower body temperature and sweating , went to doctor he checked my urine, my blood pressure, heart beat, and lungs said all were fine, I think I have a tooth infected from smell in mouth, dr said I was fine and said to come back if problems arise example: blue lips ### REPLY: Hi Welcome to  . I have gone through your query and can understand your concern. Decreased body temperature is common after sweating & this might be symptom of excessive sweating & doesn't denote any problem. Tooth decay doesn't cause decreased body temperature and sweating. You should visit a dentist for treatment of dental decay, if you have them to prevent any dental complications.  Decreased body temperature and sweating is commonly due to systemic conditions like low blood sugar, excessive sweating, low blood pressure, etc. so you should visit physician, if problem persists & blood tests may be required for diagnosis. In meantime, you could take acetaminophen & . Don't worry you would be finessing your query is solved. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 age is 36 years.since,my  sprem count 40 Million and my sprem motility was 42%(rapid  4%, Slow Sluggish 27%, Non progression 11%). i have taken Hi-Q plus for  tablets 30 days & doxy for 14 days. in result my sprem count has come down to 25 million,WBC/PUS CELLS has been increased to 8-10/hpf and rapid motility is increased to 15%. Impression given in the report is: asthenospermia with infection, could please advice us in further course of action ### REPLY: Hello, For further workup, you have to investigate with semen culture report to find causative organism and antibiotic accordingly. The cause for low sperm motility should be searched like vitamin and mineral deficiency, smoking, alcohol, excess stress, Hormonal problem, infection in genital tract etc. According to cause specific treatment given.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had C diff recently. It was treated with Flagle and I improved but continued to have symptoms. I then was diagnosed with a kidney infection . I took an antibiotic for 3 days and the kidney infection cleared up. I have an appointment with a gastroenterologist on Feb 20th. Today I have had diarrhea and the last couple of times going it has been fleshy/bloody. Not a great deal of blood but definitely blood. Should I make an appointment with my family physician to reassess for the c diff or wait to see the GI on the 20th. Just a note that prior to having the C diff I had not been on an antibiotic for 2 years and had not been in the hospital or exposed to c diff that I know of. Thanks ### REPLY: Community acquired Cliff is becoming more commonly seen in practice in the United States.  Since you recently had Cliff and now have recurrent gastrointestinal symptoms after short course antibiotics for urinary infection, the primary concern would be for recurrent cliff.  Untreated cliff can result in complications more serious than diarrhea and cramps such as megacolon.  I would suggest that you see your primary care doctor as soon as possible, repeat stool studies and consider another course of treatment for cliff.  Certain labs also offer cliff strain analysis therefore being able to determine if you have a resistant strain that may benefit from treatment with other agents such as oral vancomycin. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Prickly pins and needle feeling in the palms of hands and soles of feet.  Rash appears on and off on the tops of hands and palms of hands that almost looks just like circulation with tiny red spots (they arent raised).  Rash is now on my thighs too. Its been 4 days since the symptoms started. ### REPLY: Thanks for asking this question. You mention In your chief complain that pin and needle feeling in Palm and sole area. This is typical sign of nerve disorder or nerve inflammation. Presence of nerve compression lead to typical pin and needle feeling sensation. Relief in nerve compression produce drinking sensation. You have to check your B12 level also it can lead to nerve degeneration. On and off skin rash rule out carpal tunnel syn . More amount of alcohol also lead neurotic. If problem is long-standing than take one your MRI. Take rest. In case of neuritis start anti-inflammatory  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Implanon birth control in my left arm . Two days ago i started having a pain in my left arm and when I extended my arm i had pain from my shoulder to my elbow . The next day the pain had moved to my armpit where it now looks slightly swollen and I can feel a small lump and now when I try to left my arm at the shoulder i have a strong pain. could it be caused by my implanon? ### REPLY: Hi, Thanks for the query. Rarely side effect like fibrosis around the implant or development of infection etc. can occur. The lump you are feeling could be swollen lymph node. So you once consult gynecologist, get examined. If the presence of infection is confirmed you may need antibiotic course and anti-inflammatory and analgesic .  Possibly with this the symptoms will decrease. For more details you can ask me through: 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: my boyfriend has toth pain poften, a visctim of not having his teeth taken care of growing up.  they often prescribe him an antibiotic for the "infections"in his teeth and apain pill.  He has gone through a recent 10 day of penicillin, the usual antibiotic, ending about 10 days ago.  However, now, in addition to pain starting up on his lower teeth area, the area underneath his tongue is also swollen.  I have recommended probiotic to help but what else can he do, prior to him obtaining health insurance next March? ### REPLY: In case of infection in his teeth its advisable not to wait for insurance.  These episodes of pain won't stop unless and until the infection is taken care of by dental treatment. Infection in the teeth can be treated by Root Canal Procedure which I am sure your concerned Dentist must have advised you. And infection of gums needs to be treated by scaling and if needed flap surgeries which also I assume must have been mentioned by your Dentist. In short, getting treated is only the ultimate option before the infection results in loss of tooth. There are no medicines which can cure the infection of teeth as called as decayed tooth. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 cycle is a normal 28-29 days cycle. Which probably was 3-4 days after ovulation. Ive had protected sex on 23rd Oct and took an ipill within 50 hours just to be safe. I got my periods on 1st Nov which was exactly 28 days from my previous cycle. But my second month has been delayed now, counting from 1st Nov I should have got my periods on 28-29th Nov. But still havent gotten it. Is it the ipill or could I be pregnant? ### REPLY: HelloThanks for writing to us with your health concern.The I pill is known for altering the normal pattern of your menstrual cycle. It can advance or postpone your expected cycles by up to a week. But this affect generally does not persist beyond a month. What you are experiencing this month is probably not related to the pill. Make sure that pregnancy is conclusively ruled out.Also, stress, anxiety, emotional turbulence, weight gain, hypothyroidism, polycystic ovarian disease, change in sleep or diet habits - all these can cause a skipped period, apart from pregnancy. If you do not menstruate within a week more, and pregnancy is ruled out, then you would require a gynecological evaluation to know the cause. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,doc,my liver size is 55mm.my age is 30 years. and hight 4.9 with75 kg weight.is it reaily inlarged.iam miled dibatic too.taking glucophage tab 500mg alternate day.i did my liver enzyme tests it was normal .my doc did not advise me any thing.how can you help me. i need advise.thanks and regards, ### REPLY: Hello. Thanks for putting your query in . I can understand your concerns. This size of liver suggest it is enlarged. And it is fatty Livermore are many causes of fatty liver disease like hepatitis B/ C, metabolic disorders, autoimmune disorder, alcohol or .  So for this you require evaluation and then appropriate management. So I will suggest you to visit a gastroenterologist for evaluation.However, with the information provided by you, it is due to overweight. So you need to reduce your weight by diet and exercise. Among the medicines take tablet Adílio 300 mg TDS and cap Evian 400 mg OD. Both are available OTC. They are to be taken till liver size returns to normal. I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I have been feeling pretty unwell for about 2 weeks. For about 3 days I felt I had a very bad flu but after my fever has subsided and I m no longer very conjested. Now I have a really persistent cough , but this is weird too. I don t constantly cough, I am virtually fine for periods of time (3min-1hr) and then will cough really hard and not be able to breathe. I also have a bit of a burning itchy sensation when I inhale deeply, but not in my throat . I m a bit confused what this could be? ### REPLY: Hello. U were initially having upper respiratory tract infection with symptoms of throat congestion and flu. Now u probably developed lower respiratory tract infection and sinusitis with involvement of lung parenchymal. It probably is Pneumonia. U had to perform Chest X-ray and labs such as Blood CP for elevated TLC count to check for infection in blood and X-ray PNS to rule out Sinusitis. U should visit hospital and go through the following tests and examination by your physician for appropriate antibiotics and anti histamines that can be levofoxacin and Loratadine and Pseudocode .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Gud Morning Sir,Sir i am suffering from stomach ache from last 2 years. i had ultrasound , endoscopy and all blood check up. All reports are within normal ... i am taking pentaprazol (For gastric) from last  2 years but no used at all. it is not working to me. My ailment started after drinking hot spring water. I have lot of burning sensation in my abdomen and back pain...also my urine... is yellow... wht to do sir,,, please give me your suggestion. ### REPLY: Hi, you have not mentioned whether liver function tests are done or not.  Yellow urine indicate excess bilirubin in the blood, and hence jaundice needs to be ruled out.  You also require upper gastrointestinal endoscopy for ruling out more serious diseases as you do not seem to respond to pantoprazole. Change your food habits, avoid coffee, tea and spices and try bottled water rather than supplied water.  If there seems to be no response, a gastroenterology consultation will be required. 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: I am suffering Ankylosing Spondilytis for around 10 years. It has started to affect my neck and become Cervical Spondilytis. Kindly tell me the medication for the pain management. I surely know that the disease is incurable, the only soultion being surgery which is beyond my bearance. ### REPLY: Hello, I am sorry to hear that you have AS. medication are many to look for but that has to take on the basis of availability. Different countries have different .  Taking under the guidance of the orthopedist should be of good choice. But this is symptomatic and will be only for short duration course.  For the longer run, you need to do exercise for the muscles which are getting involved and also hot water fermentation to improve vascular supply. In my clinical experience, most cases perform well with a combination of  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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/Madam,I am 38 years old, and am undergoing treatment fo conceive. Now I have chosen IUI, and taking tablets puregest (morning and evening) and folvite (only in the night)i feel dizziness for about half an hour every day. I dont know what could be the reason?Also I want to know is this a positive or a negative sign of pregnancy. ### REPLY: Hello and welcome to , Feeling dizziness is not a feature of pregnancy. Dizziness can occur due to many reasons. It could be due to hypotension (fall in blood pressure), vasovagal syncope, or ear problem. Inner ear is associated with maintenance of posture. Any infection or inflammation of the inner ear causes imbalance. Hypotension refers to decreased blood flow to brain. Vasovagal attack is caused by loss of tone of blood vessels and hence leads to hypotension. If the dizziness is very frequent and troublesome, you need to consult your doctor for clinical examination and relevant investigations. The condition can be manage med after investigations. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I am 33 year old woman having a son 7 and half year.Just few days before I had experience a sudden pain and discomfort in my both side stomach.Rushed  to the doctor and  she advice cyclopam,O2H (ofloxacin&Ornidazole tablets),PAN-D,Digeplex Ready Mix saying you have intestine infection and you will have to complete the 5 day course of these medicines. After having these medicines from the 3rd onwards I am suffering from  frequently Acidity , burning  and stomoch pain.I revisited 4th day and  went for full abdomen soonography too but he report is normal.they suggested continue with the prescribe medicines.but I am afraid of taking those medicines now .Kindly suggest ### REPLY: Hello.it seems like you had an episode of diffuse gastritis, and it takes time to get healed properly. Many a time it resurfaces again, which will make you feel that the medicines are not working. Whatever medicines that doctor gave to you were good and will NOT cause any burning sensation and pain. Having said that and keeping few more differentials in mind I am prescribing you following .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 well i am having allergic bronchitis and asthma. Doctor has prescribed to take Simply One 400 ( Rotacap) from Cipla  once every 24 hrs. Now this medicine is not available in market. Is there any substitute or should i change the doctor because as per doctor this is the most advanced molecule available for asthma at my stage.Is there any permanaent cure for asthma with some natural therapy?Mr AMr A ### REPLY: Hello Mr A, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. Simply One is Ciclesonide (inhaled corticosteroid) + Formoterol. As it is not available, ciclesonide can be replaced with other inhaled corticosteroid like budesonide. Combinations of budesonide + formoterol are available in market. So kindly consult your physician to prescribe the alternative inhaler.2. I would like to mention here that inhaled corticosteroids are preventer type of inhalers which reduce frequency of attacks. So you need to take them regularly.3. As an Allergist, I would suggest you allergy testing for common air-borne allergens such as pollen, house dust mites, molds, insect proteins, animal dander, etc. This will help you to identify the substances causing allergist to you and also to know the measures to avoid them.4. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms over a long period.5. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.6. Regular breathing exercises including Yoga & Panama and a healthy diet rich in vitamins & minerals will also help you in a long run by improving your lung capacity and immunity respectively.7. Regarding other natural treatments, I would suggest you to consult a qualified Ayurveda or Naturopathy doctor who might help better. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a pain in my lower stomach in the right side and constant feeling of sickness nothing seems to relieve the pain or nausea and suggestions of what i can buy over the counter. Im a male and 46.Had my gallbladder out 6 months ago could it be to do with that? ### REPLY: Hi, Welcome to . I have read your query and understand your concern. Pain in right lower abdomen with nausea is suggestive of right ureteric stone or (to lesser degree) appendicitis. To differentiate between the two an ultrasound of your abdomen will be needed along with a complete blood count and a routine urine test. For your symptomatic relief, you may take any painkiller, an antiemetic and a PPI tablet from over the counter. Tell the chemist that you need these, and he should give you. But do get these tests done and show to a doctor for definitive management. Hope I have been 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 was swing dancing a week ago, with alot of spinning, pulling and quick movement. That night, a large pea size lump and swelling showed up in forearm in muscle about 3 inches from elbow joint (towards wrist ). Bruising developed in next few days along with an ache towards hand after weeding yard. Today, a week later, greenish bruising is showing on both sides of the elbow joint, and an ache not going away, and tingling in the hand, palm, pinky and ring fingers. Bump is painful and throbbing. Shooting pain towards hand when leaning on elbow while getting up from laying down. What did I do? Should I get it checked? ### REPLY: Hi, this appears to be a muscle tear of the flexor group caused by your dancing activities. The swelling is from a blood collection. A stretched nerve running down to the hand along the side of the injury can cause tingling and pain.] You need to rest the limb in a sling with a pressure bandage for the elbow down to the hand. Apply ice and take Ibuprofen or diclofenac for pain. Once pain free start stretching exercises ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a lady of 24 years old, 1.65m tall and have been having a recurring set of infections in the past 10 months, firstly it was heavy growth of staph aureus and after months of medication and relapse, a 10 dose IV injection of rocephin seems to have sealed it,only to find out a month later that i am diagnosed of infection due to proteus merabilis,i have only one sexual partner and its the same with my husband, how do I stop them permanently ### REPLY: Hello there, I am . Dose and schedule is varied according to site of infection. I need to know Proteus infection is from which of your body site.Though Rocephin also covers this Proteus infection as well as staph aureus. But if it is Staph. Aureus which is MRSA than this Rocephin is not found useful. So, check your report is it mention there it is MRSA negative or something like that. If it is MRSA negative, and you have taken Rocephin that have cleared staph infection. And now you have been encountered Proteus infection from somewhere, so you need to treat that only. Simultaneous your husband also need to be treated according to sensitivity pattern. Hope I have given appropriate guidance to you. If you have any query you can consult me anytime. Give me star rating according to your satisfactory level. Thanking 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: Sir,I was suffering from jaundice last year. Then I recovered completely by taking medicines. But lately I have started feeling so weak that I cool in my legs in winter and I have Shortness of breath after some hard work,please tell me solution.ThanksNaresh Jain ### REPLY: Hi thanks for asking question. Noted you have breathlessness after exertion. So here first possibility could be early cardiac failure if edema and hypertension like condition present. ECG can be useful. If cardiac failure beginning with hypertension diuretic started. Here asthma or bronchitis like respiratory condition also ruled out. Pulmonary functionless helpful in differentiating between restrictive and obstructive pulmonary condition. Check your hemoglobin level also. Anemia can also lead to dyspnea on exertion. If present treated with iron tablet or by vitamin b12. I hope my suggestion will be helpful to you. Take care.... .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i am male 61 years , i have ben diagnosed with prostatomegaly grade 1 , with prostate mmmmis mild enlarged in size  and course echotexture. prostate measures 36 x 34 x 35mm , volume: 23cc..is there any thing that i need to worry and is there any medication that i may have to go for ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have graded one enlarged Prostate which is common at this age and nothing to be worried about it. If you have obstructed voiding symptoms like increase frequency for urination, Nocturia,weak urinary stream, urgency etc., take medication like Tamsulosin once daily. This will help to relieve obstructive urinary symptoms and improve urine flow. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 i had unprotected sex with my gf on 9th november and after 3hr i took her unwanted72.she took a lot of pain.Her period date was 13th octomber.we dont want to baby so she is safe?Have i got her new dose of second unwanted72 or i-pill?Replay me fast as soon as fast. ### REPLY: HelloThanks for writing to us with your health concern. When taken within 24 hours of unprotected intercourse, the emergency contraceptive pill is more than 95 % effective in preventing a pregnancy. So your girlfriend is protected against pregnancy, with only a 5 % chance of failure. There is no point in getting a new dose of emergency contraception. That will only increase the side effects. If she misses her period, take a pregnancy test. In general, the risk of falling pregnant is very low. So do not worrywart care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been hit by stick on my right side of my head just above my right ear, some years back. I get severe pain twice or trice a month on both side of my brain, have consulted many neuro doctors, without any result have gone through CT Scan and MRI, I MRESSION AS FOLLOWS: Evidence of encephalomalacia in both frontal lobe is seen. possibility of formation of porencephalic cyst in left frontal region could not be ruled out. IMPRESSION OF MRI : Changes of encephalomalacia are seen in frontal regions on both sides. please suggest ### REPLY: Hi, Thank you for posting your query. First, I would like to reassure you that the MRI brain findings do not represent any serious brain disease. MRI findings of your brain suggest an area of damage due to injury to your head, which has healed. It is like a scar that we get on our skin once a wound has healed.  No specific treatment (including any surgery) is required for your MRI abnormality. The cause of your headache is most likely migraine. It needs preventive medications such as flunarizine, beta blockers, etc. Please consult a neurologist. 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: My brother has an ostomy and recently has noticed kidney bean like objects in stool but hasn t eaten them. He has had colorectal cancer and it passed to liver and has had two additional liver tumors and currently having chemo. What could those kidney bean objects be? ### REPLY: Hello and welcome to . As a specialist. I can fully understand your concern. Operated colorectal cancer with stoma and liver metastasis, is stage 4 cancer.(advanced cancer). He shouldn't be worried about the undigested food, coming in the form of bean shaped particles. He should complete the chemotherapy as advised, to improve the QOL.(quality of life). If he sees blood, has jaundice, has nausea or omitting, he should report to doctor at once. Also repeat blood tests as advised. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hr. Dr. CHandra, I have observed ulcers on the foreskin of my penis since last one week. I wanted to treat this problem asap. Please note that i have never had any extra relationship with anyone other than my wife. request you to suggest medicine for the treatment ### REPLY: HelloThanks for query. You have not mentioned your age in your query. The ulcers on foreskin can be mostly due to fungal infection due to Diabetes (Genital Candidiasis)You need to consult qualified Physician or Urologist for clinical examination and get blood sugar levels done to rule out Diabetes. You need to take broad spectrum antibiotic like Definite along with antifungal . Along with topical antibiotic ointment like Newsprint twice daily. Ensure to wash your genitals with warm water twice daily. Ensure to avoid sexual encounters till it heals up completely. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 my gallbladder out 4 years ago and can eat fine but sometimes i get pain under the rib cage under the right breast and ripples to the side  i have been doing stepping exesises  have i hurt muscles and what can be the pain i have had ultra sounds and blood tests and all come back normal ### REPLY: Hi, Presentation of post cholecystectomy pain. Differential: surgical incision pain, fat intolerance or stone remnants in common bile duct. Ultrasound abdomen maybe done to rule out stones in common bile duct and to see the tissue underlying incision. Advice:- take pantoprazole before breakfast (for the rest of your life)- also get a complete blood cell count(CBC) test-avoid OILY food and FAT diet altogether-avoid eating stomach full and mouth full-avoid spicy food Hope I have answered your query. Further queries are welcomed. 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: around 7 days ago, i noticed this suddenly developed rubbery lump/disc under my left nipple. There is no swelling, its a little sore. I think it is due to my protein supplement named Body Fuel. This was a changed supplement than my regular one and i start taking it 8-10 days back. Prior to this supplement, my dosage was 2 scoops on training day and 1 scoop on non training day. But I changed the dosage for this new Body Fuel supplement and i start taking 3 scoops (providing 45 g protein) on work out day and 1 scoop otherwise. Also i was went to the gym for workout just 2 days in a week. I this lump formation due to inferior quality supplement or its sudden dosage change (with insufficient workout) or is there something else happening in my body???I am a pure vegetarian. And today I saw abrupt and very high hair fall it was like 40-50 hair falling and this was very very abrupt for me. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your breast lump has no relation with your food supplement.  It may be due to some benign breast lesion like fibrotic disease or may be malignant.  You should go for fine needle aspiration cytology and demography.  It will give you exact idea regarding cause. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then you can contact me at Bitly .  Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having a pain on my left side (seems like under my rib cage for several months, it s not all the time but any time i lay on that side or bend in a way that seems to stretch that side. How can i tell if it is more of a strain of some sort or something more serious? ### REPLY: Thanks for contacting . You have problem of pain at rib cage area that may be because of muscle strain also. Plueral fluid accumulation in lung may cause sharp pain at chest region. Pluericy may diagnose. Take chest x-ray for diagnosis. Costco . If it is because of muscle strain than it has low intensity pain. Physiotherapy can helpful. Consent a physician for further diagnosis. I hope my guidance is helpful to. Take care. Thank you very much. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sons mother in law has cancer in the spine.  The doctors put a stint into her brain to be able to take out 15 ccs of spinal fluid and in turn immediately return the chemo medication back into her spine.  She cannot walk whatsoever.  She has a catheter but has alot of blood in it.  The catheter was just changed today, but is still bleeding.  I know that she has been taking heparin and coumadin.  Her white cell count is very low and is taking medication to enhance this.  What I want to know is what can my son do to be able to work.  Her insurance will not pay for a caregiver every day.  This is what she needs!  The relationship between my son and his wife is getting hard.  They are arguing, etc.  They also have a 2 year old son.  Wow, i just dont know what to do or where to turn to help them.  Do you have any suggestions? ### REPLY: Thanks for the question. So your sons mother-in-law has three main issues. She is unable to walk due to tumors has bleeding catheter. She has low WBC count. Whether she will be able to walk in future can only be told by a scan of the spine. If it has shown no major fracture, she might walk after treatment. Bleeding from the catheter needs to be investigated whether it is due to low platelet counts or due to heparin therapy, Low platelet counts will require platelet transfusion and if it is due to heparin then heparin needs to be stopped for few days and plasma transfusion and vitamin K has to be given. For low WBC growth factors will be required. Antibiotics are also required to prevent any infection in between. Hope this solves all your queries. 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: him 20 year old.i hd sex on 13 of last month.my partner used condoms and in the next morning i took unwanted 72.my due dates are 30-31or many times 1st.bt dis tym i missed my dates.is there any chance of me getting pregnant?.if no then y my periods not started yet?? ### REPLY: Hi, Thanks for the query. As your partner used condom and as you have taken emergency contraceptive pill, the possibility of pregnancy is less in your case. Emergency contraceptive pill can alter the menstrual periods depending on the time of the menstrual cycle when that was taken. For more details : http://srsree.blogspot.in/2012/08/emergency-contraceptive-pill-short-term.htmlSo, emergency pill can be one cause for your problem. Repeated intake of emergency contraceptive pills can make the cycles more irregular. So, consult gynecologist once, get evaluated and take tablets for with .  Better to use some regular contraceptive method. 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: The gap between the paracetamol and meftal 250 ...my daughter is 10 yrs old and having high fever up to 104...my doc advised us to give paracetamol....if fever is still high we should give meftal 250... She has fever even after giving meftal 250....can I give paracetamol.... ### REPLY: Dear user thank you for your question about that as high grade fever 104 considered very dangerous and may have severe effects and the solution is very simple.....paracetamol and metal are good antipyretic, and you need not increase dose of antipyretic . .....but very important step required before all of this.....this step is doing cold compresses...making cold compresses and put him under mild cold running water fora time if 10-15 minutes until grade of fever reach 101-102 then give him antipyretic....antipyretic have excellent effect in lowering moderate fever ...but if fever is high antipyretic have limited effect and fever may remain high even if you increased the dose .simple cold compresses should not ignored...it will help you a lot...lastly treatment of the cause of infection is the main........hope that helps 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 there I would like to know, ive done the dettol test a few times now, and it shows positive than i went for a blood test but that shows negative.  My friend also did the dettol test and her result did have the same look as mine and she was pregnant, is it that my hormone counting is to low on the blood test thats why its not showing.  Ani ### REPLY: Hi, Thanks for the query. I understand your concern.  Fetal test does not have any scientific basis. You should always rely on home pregnancy test of urine done after 8 fays delay in pregnancy. OR blood  test around expected date of menses. You are true in guessing about low hormone count when blood yest is -ve. But even HTP is going to be -ve with low hormone counts.  Do rely on scientific methods please.  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: im having pain in a gland when i turn my head a certain way n tender to touch on the left side of my neck just under the jaw and feelin a lil bit like a possible ear ach will be coming .but mostly feels like a lump in the neck n tender to touch or move neck while driving n turning head . ### REPLY: Welcome to . 1. Lump below the jaw area - possible causes could be sail-adenitis (dilated salivary glands due to distal obstruction) or inflammatory cause.2. Next possible thing is sub mandibular gland, and finally lymph nodal enlargement.3. And other possible cause could be infected abscess or lesion.4. Ultrasound neck will help to assess the cause - that will tell the nature of the lesion its source and extension.5. An FNAC - fine needle aspiration cytology could be taken if it's a mass lesion for identification of the cells.6. As a remedy muscle relaxant cream can be applied. Rest treatment will be better after evaluating the cause. Good luck. Hope I have answered your query.Anything to ask do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I broke my left hip 2 1/2 years ago. I never was prescribed physical therapy. Since my surgery, I do not have the same flexibility (which should probably be expected); but, I have lost the ability to squat or raise my left leg keeping the knee facing forward. As I raise my leg, my knee turns to the left as does my foot. When walking it takes concentrated effort to not walk in a slew-footed manner. Is this normal? ### REPLY: Hi, as you described your concern, physical therapy is necessary after joint surgeries. But not to worry about walking, yes it is slightly abnormal if you are making efforts in normal walking. U can correct it, but it will take a bit long time, you can start from general stretching of your hip muscle and can consult for gait training with physical therapist. I hope you will get benefits from this. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am an 18 year old male. For the past 5-6 months I have noticed a dramatic decrease in my muscle mass and the amount of sleep I am able to get. Even with my normal eating and excersise habits, I keep losing weight. About 2 weeks ago, my left tonsil swelled quite alot and still has not returned to normal. This swelling was accompanied by muscle spasms in my hands, fingers, biceps and calfs. I have also been experiencing morning sickness and moderate to extreme periods of anxiety and nervousness. ### REPLY: Hello, I have studied your case. There is possibility of infection leading to wt loss And also check your it B12 and it D3 level.HLA B 27 blood test with RA test may rule out inflammatory disease. Routine blood test like CBC, ESR, HIV,bag, RBS will also help in diagnoses. You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case. If you find this answer helpful do not hesitate to rate this answer at end of discussion. Hope this helps. Wish you a speedy recovery.  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: Fell getting out of tub and hit my left breast/rib area on the edge of the tub.  If I put my left hand on the bottom area of my left breast and top of my ribcage, I have a 6 out of 10 on a pain scale.  Can it be serious, or will the pain go away on its own?  Coughing is out of the question :)) ### REPLY: Hi. Since you have a lot of pain and tenderness. I suggest you to kindly go get an x-ray done for your chest go rule out any rib fracture... This is done to rule out any complications that might arise later...Don't worry until it is confirmed. I also suggest you to do icing frequently on the tender area.keep it supported with a sports tape.if possible. You can have Anti-inflammatory medicines to keep your Pain under control with GP advise. Hope this information is helpful.Revert in case if you need any further clarifications. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Well I am a forty eight years old female that began to have rapid heart and pluse rates accompanied with some burping.  I was give a series of test blood and cardio. The results did not point to a cause my cardiaologist prescribed cardia xt 120. The systems subsided but have returned what is happening? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you're all symptoms are related to stress and anxiety. At your age of 48 years, chances of menopause is more. During this period, females tend to have hormonal changes like low estrogen, progesterone etc. And these hormonal changes can cause mood swings, stress, anxiety etc. And all these can cause rapid heart rate, burping etc. So better to consult gynecologist and get done hormone levels. You may need hormone replacement therapy (HRT) and anxiolytic .  Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi sir I have problem in stomec,my age is 27 year frequently I feel that push type coming in my latrine and sometimes its OK at ur own it is going on for last one year if I take medicines I feel its OK but as I left medicine situation comes back as it is. ### REPLY: Though m not sure what u mean by "push" but I think u mean to say u have to apply force to pass stools and your stools are quite hard. In that case you are suffering from constipation there can be many reasons for constipation, u need to increase the fiber content in your diet and should eat salads, vegetables like cabbage cucumber carrot zucchini fruits like apple oranges berry to increase the roughage content. Occasionaly in case of severe problem you can take syrup lactulose 20ml but should not make this a habit. Show your surgeon to find the root cause of your problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mothers s.creatinine is 3.7 & her blood urea is 158. kindly advice if such a kind of kidney patient can be treated . and also kindly advice that how much time will it take to get the parameters normalize. and also what all she should avoid to save her kidneys; aneet ### REPLY: Hello Anent and welcome to . As a Urologist, i can understand your anxiety. You should've written her age. She has got kidney failure. Next step is to find out the cause for failure. Usually, the nephrologist will do a kidney biopsy. According to report, specific treatment, will be advised by the nephrologist. Your mother should have a 5g salt,40g protein, diet. Her B.P.must be normal. She must do blood routine, creatinine,RBS, LFT,electrolytes and uric acid. Then an ultrasound scandium, is also needed to check her progress. If you've any doubts, you can send the reports to me, as a direct question. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my total serum bilirubin is 1.0 which is normal but my serum sgpt(alt) is 84 and serum sgot(alt) is 42 both of which are above normal.I need some suggestion regarding this, is the condition of my liver is dangerous or i have any form of jaundice or any medicine have increased this sgpt and sgot level because for last 3 months i was taking penicillin tablets ### REPLY: Hi thanks for contacting . You are taking penicillin since 3 months. So . Second it could be by fatty liver. So rule it out by USG abdomen. Sometimes viral hepatitis or Bag carrier might because. Do viral marker for that. Do you have history of any heart problem or muscle injury or myositis like condition?? As they can raise liver enzymes. If you have history of outside food then also hepatitis A or Hepatitis E can cause. Viral marker useful for it. I have given you few possibilities but  ### END