Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir,My mother has developed some ulcers in her mouth for the past five years. She is not able to eat anything because of this. We have tried lot of docotrs and thier medicines. But there is no use. We have even scanned her throught , but there is nothing to worry. These ulcers have developed because of the heat caused by the various types of tablets daily for the past 20-25 years for her diebetic & other ailments. This is Doctors findings. Kindly advice me a medicine wchich can cure her mouth ulcers, so that she can at least eat. ### REPLY: Thanks for your query, I have gone through your query. The recurrent ulcers could be a recurrent authors or recurrent herpetic ulcers or other autoimmune disease. Consult an oral physician to rule out these things and get the ulcer site biopsied to confirm the diagnosis. You can use topical steroid like triamcinolone acetone(0.1%). Apply 4-5times daily for 1 week. Do saline gargling. I hope my answer will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was exposed to radon where I worked for 8 yrs. I have had skin rashes under my arms and on my legs for yrs. The only thing that gets rid of them is the use of prediscone. I don t want to keep taking prediscone for the rest of my life. Is there any way that I can get rid of the rashes by getting a blood transfusion or by some other way ? Thanks! ### REPLY: Possibly, you may not have these rashes because of radon because the pattern you are quoting does not match. If possible, send me the pictures of your rashes. What is your age and do you have hypertension, diabetes, and does this rasChatDoctore and go, or it persists? Which medications are you using ? Also let me know your professional history since beginning. Besides inform me about your other colleagues, who were working with you at a place where you have suspicion of radon exposure, suffering from same sort of rashes ? If yes, send their pictures too or let me know I can contact them. If you have ever visited dermatologist, and he did your biopsy for histopathological evaluation, please share that report too. You can call me also on my given number. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, girlfriend has been waiting to have her period for 3 days now after coming off the Ginet 84 pill. We have had sex a few times all time whilst she was on the pill and with a condom. Just wondering if there is a chance that she is pregnant. Also she has been feeling sick and currently has a fever. Thanks ### REPLY: Hi, If your friend has taken Gannet 84, regularly (there is no missed pill), & also used condom- I don't see any chance of conception for her. As she has already a gap of 3 days, let her wait for periods to come. If pill was missed, & there was no bleeding during inactive pills, consider pregnancy.  Gannet 84 pills have 7 inactive pills at the end of the strip. So you are not supposed to wait for with .  Actually Gannet 84 is not given only for contraception. It is given for certain accompanying conditions like pimples.  If your friend does not have any such problem, let her consult her Sync & start some simpler contraceptive after she gets her period.  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, my 18 y.o. old son has moderate carpal tunnel in both hands which he has had for about 18 mths - had both wrists injected with steroids last week. The left hand hurt during needle and felt like his hand was having an electric shock and the right hand he felt nothing - now both hands are annoying him quite badly and he regrets even having the needles. Will the cortisone take a while to have any effect? He is very reluctant to have surgery as there as so many side effects but his surgeon won t give him more than one set of steroid injections where I have heard some people have to have a second round.... I would very much appreciate any feedback.... thanking you kindly ### REPLY: Hi, thank you for providing the brief history of your son. As mentioned, a thorough neuromuscular assessment is advised. As for carpal tunnel syn .  During this condition there is a tightness and the flexor retinaculum which leads to compression in the underlying structures leading to pain, numbness and hand dysfunction. Since your Surgeon provided the cortisone over the flexor retinaculum, it is to relax the tissues there. Which may depend upon the physiology to accept or reject. That is where you have heard or on net that people had to undergo the next dose of cortisone or may be surgery in the future. But there is a non-invasive way of dealing With carpal tunnel syn ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Are you a board certified ENT Specialist? Hi Dr. Bhatti, Please bear with me, rather slow typing on IPad. Rather long history in attempt to resolve my problem with no avail. Root canal performed by dentist in 2007. Will have to refer to record for exact date. After root canal performed had to travel out of town to attend funeral. During lengthy vehicle travel, experienced fluid drainage from upper right side if mouth. Repeatedly having to spit, bad taste. While staying at hotel noticed small blue particles in fluid. Also experienced severe headaches, burning of mouth, redness of tissue on face (I have photos) extending to bridge over nose. During this time, Rheumatologist had perscribed Cellcept (Feb 2007-Feb 2008). Had tonsillectomy w/ adenoids removed Feb 2008). Tonsils positive for actinomycetes. Extreme pain, swelling redness resulted in 16 root canals within 6 months. No periodontal disease , always healthy, never smoked, no alcohol, not over weight and dental check ups, cleaning ex rays every 6 months through out life time. All root canals failed, and extracted one by one. Tooth number 5 was tooth that abscessed initially. Deep tissue biopsy of area in April of 2012 positive for anerobic bacteria. Oral Surgeon did not request identification on order, therefore, anerobic bacteria not identified or treated. Constant pain, with immediate flare, redness and swelling upon eating aand drinking. Numerous CT Scans, MRI s, have identified activity. Have been sent from specialist to specialist for past 4 years, all the while suffering pain, drainage to the point of nearly giving up. Constant draining from mouth, difficulty sleeping, mucus thick, chocking. Physically, lethargy, unable to work and have any life whatsoever. Presently, seeking to travel to large metro area for assessment at teaching hospital. Very ill, weak, etc. condition debilatating. Questions or suggestions? ### REPLY: Your signs and symptoms described reveal that you have some chronic infections in your mouth which are bothering.  First forget about individual teeth having problem but just concentrate on improving your oral hygiene.  If there are active infections with symptoms like pain, fever, visible pus discharge, start one course of antibiotics under the guidance of some doctor.  I cannot prescribe antibiotics here because I cannot decide you one will suit you better.  Next, if you don't have these active signs but just constant irritation or mild pain, start improving your oral hygiene with the help of mouthwashes or just warm salt water gargling 3 times a day (provided you are not hypertensive).  The oral rinses containing HY .  Next step is consulting again your dentist and starting some treatments to add ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, I am a 23 yrs. old girl. I have wide gaps in my 4 front teeth of the upper jaw and small gaps in the teeth of the lower jaw. Kindly suggest me if I can opt for invisible braces to close my gaps and what s the estimated duration and cost for the same. Also let me know if teeth bands are safe enough to close the teeth gaps. ### REPLY: HelloWelcome to ChatDoctorI would like to tell you that duration of orthodontic treatment depends on the case & the age of patient. The correct time of treatment is teenage period because that time we get good results as that time bone is growing & tooth alignment is easy. Still it takes around 6 months to 2 years depending on the case. For further treatment you need to consult your orthodontist for proper diagnosis & treatment planing. Take Disregards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 31 years old, yesterday I took my blood pressure and the reading was 147/93. I have previously had high blood pressure but am not on any medication. How dangerous is a reading that high, and what are simple ways to help control high blood pressure. ### REPLY: Hi Thereafter going through your query I understand your concern. I would like to tell you that high blood pressure in young age should be managed with lifestyle modification initially that includes -low dietary salt intake-stop junk food-stop smoking/alcohol (if you do)- brisk walk of 40 min daily - decrease your weight if you are obese Make these changes in your routine for 3-month period. If even after this you BP stays more than 140/90 then you will require medicine to control your blood pressure. Hopefully this has answered your query. Kind Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi for over a month i ve been feeling numbness in both sides of my face and half my forehead with some pressure in both sides like somebody been pulling my hair but no headaches or pain at all and two days ago I have been waking up with a red eye in my left side the only time that numbness and pressure goes away is when I get off the shower and laydown for a while but then they come back after a few minutes ### REPLY: Hello dear, I can sense that you are a bit anxious about these things. Precisely, your symptoms of numbness on the whole face and feeling pressure on one side of forehead does not have any localizing value for any organic disease. Also, the way it goes on taking a shower and lying for some time and then again returns, also points towards a non-organic disorder. This seems to be psychosomatic in nature. You should see a psychiatrist. I hope this could be of help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 CERTIFIED MEDICAL ASSISTANT. I HAVE A FRIEND WHO BEEN HAVE THIS LARGE KNOT ON HIS BACK THAT BEEN CAYSING HIM ALOT OF PAIN. HE REFUSE TO LET THIM PUT A NEEDLE TO DRAW FLUID OUT. NOW COULD YOU GIVE HE THE BEST OPIONING ADVICE TO GIVE MY FRIEND. I SAY THEY MAY DO LASER SURGERY. ### REPLY: A knot can be due to some benign reason, also it can be of sinister reason. Here in this case a histopathological examination is needed to know the exact pathology of this. For that needle aspiration of fluid is necessary. Because knowing the cause is not only necessary to decide exact mode of necessary(like what u said laser surgery or others) but also the prognosis that is whether it will recur in that place. So try to motivate your good friend to go for needle aspiration. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sitting here watching tv and i felt my heart beating irregular i felt my pulse and it was as if my heart would beat twice then pause then twice and pause. It has since then returned to normal I just recently saw my doctor for palpatations that have been lasting for weeks the attempted to put me on beta blockers and told me my heart was fine after the ekg i am 24 years old quit smoking and drinking overweight am i going to have a heart attack? ### REPLY: Hello, Likely, these are PCs (Ventricular Premature Complexes). Most the times, these are benign and not dangerous. However, you should get one Holder to confirm the diagnosis. You should also get echo done to rule out the possibility of cardiac illness. You are unlikely to get heart attack. These are increased by smoking, excessive alcohol intake, excessive thyroid hormone levels, caffeine et cetera. So, overall, likelihood of serious issues is less but needs to be evaluated. The treatment for this is beta blockers like tablet Metoprolol XR once a day, dose to be increased gradually. So, you should get this prescribed. 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: Semen analysis report Quantity 1.5 ml ,colour grey whitish,transperancy opaque ,viscosity.viscous ,time ov liquifictn 30 min pH 7.5,fructose positive ,total count 21 mill/ml, live count. 6 mil/ml,sperm per ejculate 31 mil ....p ercentage ov mtlty 30 % rapid linear progression 0%,,slow linear/non linear progression 35%..non  progressive 65%,, sperm normal morphology 20%,,wbc 2 % rbc 1 % what does this report means ? Am i able to impregnate my wife ? Am so woried am just 27 yrz old.how to treat rapid linear progression its zero :( ### REPLY: Hi, thanks for using  Semen analysis provides general information on fertility. Some men with abnormal results are still able to conceive and some men with normal results may experience difficulty.(1)Semen volume is normally 2 to 5 ml, your value is slightly below this at 1.5 ml(2)sperm count of 21 mill/ml- this is normal, it is supposed to be greater than 20 mil/ml(3)in terms of motility or progression of movement, normally at least 50% should show normal progression.65% of your sperm were not progressive, this would imply that at 35 % were moving(4)in terms of their shape and structure (morphology)- at least 50% are supposed to be normal, in your result only 20% were normality is possible that with the abnormalities in shape and movement that pregnancy may still occur naturally though it may be more difficult. If it is not possible to achieve conception via natural means that artificial methods are available that may be able to help you and your wife. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir i am rishu, 24years old and i used to perform handpractice but i left it at the age of 21 years. now my pennis became small and am regular victim of nightfalls. my semen seems watery. now manytimes when i get excitement my semen comes out,even i am awaken or i am talking to a girl. sir i want relief from it. ### REPLY: Hello, Semen seeping through penis after urination or while having sexual thoughts or while with an attractive girl or woman or while waking up in the morning etc. is common, and it is not a problem at all.  This is a natural body procedure whereby your body tries to evacuate the stored semen.  Semen is produced within your body whenever you are sexually (even slightly) excited and is stored within your body. Now this stored semen is a waste product that your body wants to throw out.  This is a natural process and you don't have any control over it. I also assure you that this is never unhealthy. Therefore, I suggest consulting a psychologist for physical examination, diagnosis and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father has colon cancer , prostate cancer , there is fluid builing up around his lungs which is being drained , the valve in his heart is closing causing a swishing sound he is not a canidate for surgery and has now aquired c diff in the hospital. We are getting different time frames for him . He is not feeling pain and is still eating ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He has colon and prostate cancer.  Treatment depends on type and stage of cancer.  As you, he is not a good candidate for surgery, so treatment options are chemotherapy and radiotherapy. Despite treatment prognosis remains poor. Life expectancy is not good. 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: Can u explain my CTA chest w/ intravenous contrast results? The central airways are patent. There is minimal dependent atelectasis within the lung bases. no focal airspace consolidation, pleural effusion or pneumothorax. There is scarring within the right middle lobe no suspicious pulmonary nodule or mass. ### REPLY: Thanks for your question on . In my opinion you should not worry about this report. As your CT report is normal. Minimal atelectasis in lung bases is a normal variant. No active treatment is required for this. And no need to worry about scarring. As scarring suggest old lesion only. You may have previous pneumonia which healed and produce scarring. So no need to worry with this CT report. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 25 years old, Height 6.2 feet & weight 81kg. I have lower back pain for 10 years ago. The pain return back after 4 years back. Every time take medicine & hot bag treatment after pain cure, but again after many year the pain regains and trouble me very much. What is the problem & what measures should I take? ### REPLY: Hi Welcome to ChatDoctorAfter going through your query I concluded that you may be having recurrent attacks on back pain. It may be related to muscular pain and vitamin and trace elements deficiencies. You are advised to do regular exercise and take regularly vitamin and trace elements to prevent its occurrence. You can discuss with your Doctor about it. Hope your query get answered. If you have any clarification then please don't hesitate to write to us. I will be happy to help you. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ll be as brief as possible. Basically I m wondering if my rapidly decaying teeth I was informed of 30+ yrs ago would have any connection to the myxoma (benign) that was discovered growing (and removed in 2014) in my left atrium. When it was confirmed I d had a minor stroke , ER Dr. said there was evidence of older ones as well but couldn t tell from how far back. I had absolutely no idea. It ts still doesn t seem real. ### REPLY: Hi.... Welcome to . You have problem of decay tooth that may be because of poor oral hygiene... more prone to infection. Lack of saliva also lead to more decay tooth. Food lodgment or more sweet consumption also lead to this type of symptoms. Consult a dentist for oral examination and treatment plan. If tooth decay not treat than it progress and involve full tooth sometimes access or bony infection. Better to treat a decay tooth in initial stage. In decay tooth filling or act or extraction that one treatment plan...all treatment depend on tooth situation... I hope this will help you. Get well soon. 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: M y wife had tooth ach before . dentist cleaned and filled her tooth now there is not much pain she has sharp sensation arising out of her chin and face dentist says this is no more teeth problem this is nerve problem today I observed some of the nerves from inside chin are visible and sullen. Kindly advise and your phone no. is not given in internet thanks albert gomes ### REPLY: Hello and welcome to  forum, according to the history presented by you, I would like to inform you that your wife is experiencing pain or even sharp sensation due to a faulty restoration, sometimes the filling is too high that when the patient tries to close his /her mouth, sharp shooting pain occurs. But as you said that your dentist as already examined, then I would recommend you to get a second opinion also, because until I check the tooth clinically, i won't be able to give you an accurate diagnosis. Sometimes, even the infection within the tooth if not removed properly prior to the filling can cause pain n swelling, therefore kindly visit a specialist soon, i wish your wife good health, thank you for writing to . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 wife two months back and we had opted for contraceptive pill. At the time of her first periods the bleeding started on the normal timings but now the second period is getting delayed. She is already 2days late.. Is there anything to worry about. Till when can i expect the second month period?? ### REPLY: Hi Hope this message finds u in good health. I have gone through your msg and understand your concern.it may be due to some sort of hormonal imbalances or variations in the body, though there may be other reasons as reclothing to worry about, You should eventually get back to normal. Take multi vitamin and calcium supplements Do consult a gynecologist if symptoms worsened back to me for any FOLLOW-UP QUERIES anytime. . .(MBBS, MS,MCH) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 27 weeks pregnant and i have loose motion from this morning and went to the toilet for five times followed by  pregnancy vomit.i feel guidy.is there anything serious? will my baby be affected? am extremely worried. please answer my question. ### REPLY: Hello, I have gone through your query and understood the concern. There are several possibilities in the current scenario. The vomiting and the diarrhea could mean an infection. The giddiness could be due to the electrolyte imbalance caused by the diarrhea and also possible due to fall in the blood pressure. Alternatively, a threatened preterm labor can often present with diarrhea and raised hypertension could be another possible factor that should be thought of. So long as there is no gross disturbance and the fetal movements are well-preserved, there is no need to worry about the fetal well-being. Yet, please report the matter to your health care provider and get proper help. 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 a grey spot on my scrotum at the base of my penis. It is not raised and does not itch, I noticed it after using nystatin and triamcinolone acetonide cream. I was directed to use the cream for 4 weeks due to a bacterial infection after going to a water park. These lines are similar to the stretch marks on my penis but these seem to extend onto the scrotum. Could these have been caused by the Nystatin as I read it thins the skin and can cause stretch marks. Also my wife has been told several years ago she has HPV this was what concerned me after seeing these grey marks. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. The cream you prescribed is for the fungal infection and not for the bacterial infection. Yes an antifungal cream with steroid can cause you skin thinning, but such incident occurs after only a long time usage. Yes there is chance of HPV in you as your wife is having the same. I advise you to direct your treatment towards the HPV. Both the partner should be treated simultaneously. Please start using condom at the time of intercourse. It will prevent cross infection. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I had a radioisotope bone scan for suspected scaphoid fracture. I unexpectedly became pregnant then around that time. I had s successful pregnsncy and now am glad to say have a happy baby but with delayed speech. . What is the risk to the baby for radiation exposure at conception ? ### REPLY: Dear patient In early weeks of pregnancy if baby is exposed to radiation it has major effects because 1st trimester is critical period of developing embryo.  During this period cells are dividing at rapid rate and all body systems are developing. Also, radioisotope scanning exposes you and your baby to significant radiations. So your baby has chances of fetal anomalies and development. Take her to expert pediatrician and get thoroughly examined. 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 had a total hysterectomy two years ago and was put on Premarin 1.25mg. I also take venlafaxine, (anti dpepressant) . I have been under a lot of stress recently and have suffered with nodular acne which is very painful. I am using Differin medication at night and have tried lots of products, including oxytetracycline anti biotics. Can the Hrt be adding to this vey painful chin and nose scene? Any ideas would be very much appreciated . Thank you x. ### REPLY: Hi. Thanks for the query. May I know what dose of venlafaxine you are receiving & how much of beneficial effects you are perceiving at present? You are taking Remain as HRT as you mentioned. One of the side effects of taking synthetic estrogen (remain) is flaring up of acne due to hormonal imbalance & also there is a risk of developing ovarian, breast cancers with unchecked use of HRT. Considering that you have already exhausted many options for painful acne; you should recheck with your doctor about continuing remain as gradual with .  Also check with your doctor about use of isotretinoin cream to alleviate acne especially in back ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 woke up this morning and found that I could not laugh, cough, or breath deeply without feeling pain down the right side of my rib cage.  I didnt take much notice and dismissed it as sleeping awkward, throughout the day walking, sitting and sometimes talking has been a bit of an effort.  I have also discovered that I cannot lie on my right side.  Do I need to be concerned? ### REPLY: Thanks for your question on . I can understand your concern. Possibility of pleuritic chest pain is more in your case. Chest pain with coughing, laughing, deep breathing etc. is characteristic of pleuritic pain. It can due to inflammation of pleura. And lung infection is the most common cause for this. So better to get done chest x-ray. If chest x-ray is normal than no need to worry about major lung disease. Musculoskeletal pain can be the cause. So avoid movements causing pain. Start painkiller and muscle relaxant .  Apply warm water pad on affected areas. Don't worry, you will be alright. First rule out lung infection. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 61 years old, in good health. Avid bicycle rider...since 3 days ago has been having feelings of pressure in the temple area. It is not there upon arising, goes away with exercise. BP 138/79. Had a bad fall a month ago while vacationing in France. Severely bruised upper back and ribs. Also has intermittent pain in groin area, especially upon sitting for period of time. Could there be any internal injuries. Xrays showed no fractures. ### REPLY: Hello, Thanks for writing to us, I have studied your case with diligence. Internal injury may not manifest after long one month after injury . You need to take muscle relaxant and analgesics. Physiotherapy like USG, TENS will help in early recovery. Till time take rest, avoid lifting weight. Hot fomentation will help. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been feeling depressed now for the past few months at least, I have an appointment with a doctor this Thursday but feel like I need some advise and help as soon as possible. Its really affecting my life, my boyfriend and the way I look at things. ### REPLY: Hi, I went through your query and can understand your distress. Depression is a disorder which affects the way we think and makes it difficult to manage out day-to-day functions. It's nice that you have already fixed appointment with your doctor. After complete evaluation, if you are diagnosed with depressive disorder, treatment with anti-depressant medications like Escitalopram would be helpful. You will have to be patient about the response to the medications, as most of the anti-depressant are slow to act and will need at least 2 weeks to start showing response. In addition, you must start exercising daily, as it will help you feel better and relax. I do hope that I was able to answer your query. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m experiencing pain in the lower back and hurts to walk and stand. I had an appointment this morning with an orthopedic dr and he took x-rays. The disc between thr 4th and 5th lumbar is pretty much just a think line now. I was diagnosed with degenerative disease in the lower back about 10 years ago after an MRI. I will be doing another MRI after pre-authorization with insurance company. Dr. talked today about a possible epidural injection. Is this painful? Will this take care of the pain or will I need other injections down the road? ### REPLY: Hi, Thank you for posting your query. Lower back pain due to degenerative lumbar disc disease and prolapse of disc is a common problem. It is not a serious disease.  MRI of the lumbar spine would clarify the diagnosis further. Epidural injections are standard treatment for severe lumbar pain. It is a very safe procedure. In addition, you would require good physiotherapy. Epidural injections may have to be repeated after three months.  Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey Doc, I have multiple cysts on my testicles which I have always had.  I have asked doctors before and they say they are not dangerous and removal would be a painful process.  I try popping them myself because they are embarressing but they always grow back.  How can I get rid of them? Secondly when I pop them, white stuff comes out (both liquid and string)  are they contagious if that white stuff(I assume puss) touches other parts of my skin is it more likely a cyst will grow?  thanks doc ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have multiple Sebaceous Cysts on scrotum. The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac)Sebaceous cyst is not contagious. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I had some lab work done. My glutamyltransferase came back high. What is glutamyltransferase. What problems can this cause? ### REPLY: Welcome to  Good Day or Gamma Gautama Transferase is an enzyme present inside the liver cell and is usually released following damage to the cells. It is known to rise in a variety of conditions, the commonest one being after a bout of alcohol/chronic alcohol intake. You need to quit .  Have you done your other Liver enzyme tests? You will need to consult with your Doctor regarding various other possible causes if you haven't  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son, who is nine months old and has had auto-immune thrombocytopenia (low platelets) since birth, fell three days ago by pushing his toy box around and hitting his mouth on the corner of it. He injured his top lip on the inside. The bleeding lasted about 7 minutes and then we got it to stop. Now he has something like a blood clot on the inside of his top lip where that thing is that connects your gums to your lip. He sucks on his hands to self soothe, and doing that makes it bleed a tiny bit. He doesn t have a fever and the clot doesn t seem to hurt him. He just gets irritable if I try to look at it. What should I do to make sure it heals correctly? ### REPLY: Thanks for your query, I have gone through your query. The lip injury might have resulted in the formation of the hematoma. This can happen secondary to thrombocytopenia. Nothing to be panic, you can apply cold over the hematoma(ice cubes). Do not disturb the area by touching it or moving it. It subsides in a week time. If it is not subsiding then consult an oral physician and get it evaluated. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 9 year old son had a persistent cough for three weeks, went to doctor who heard crackles in lung, given azithromycin, still have cough X-ray of chest shows clear lungs but trachea deviated to left, cannot exclude mediastinal mass or adenopathy. Double aortic arch not excluded. Appointment next week, very worried ### REPLY: Hi, Thank you for asking question on . Normally trachea is either central or slightly to the right. Deviation of the trachea suggests some pathology.Something is pressing on the trachea from right side. As x-ray did not show much information, better go for CT chest. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 46 year old male, had lithotripsy on left kidney to break up 4mm stone. Every went fine and urinated fragments out. Two months later had 5mm stone in right kidney lithotripsy didn t break up. Had it lithotripsy done again a month later, again didn t break up. What next? ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have a stone of 5 mm size in your Rt kidney, and it did not get fragmented even with two attempts of lithography. The stone of a size of 5 mm is likely to be passed down through ureter in to bladder and urethra. You have to ensure that you . Taking alpha blockers like Tamsulosin will help to pass it down through ureter smoothly. In case if it gets impacted into ureter and gives severe pain it can be fragmented endoscopic procedure called UreteroRenoscopy(URS). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ve been coughing up streaks of blood since February. It comes and goes nothing major maybe once a week that s it. My tongue is discolored a little and has white patches on both sides. And my throat constantly feels like something is stuck. I ve been extremely week and fatigued. I ve had bleeding for 3 yrs now through bowl movements and vomiting but both have just disappeared since I started coughing it up. Two and a half yrs ago I was diagnosed with anemia but found nothing through upper and lower GI. I went to a doc 2 weeks ago and he didn t check much but said now I don t have anemia but he thinks its insomnia. Can anyone help me and give me an idea if there s something I can take to get rid of all of these or what test I should have done to figure out what is going on? ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. You are having bleeding tendency. And for this we need to first rule out platelet function abnormalities. Platelets are blood cells, help in prevention of bleeding. So better to consult hematologist and rule out platelet related disorders. Another possibility is lung related diseases. Hemoptysis (coughing out blood) is seen in following lung conditions.1. Tuberculosis2. Pneumonia3. Bronchitis4. Cancer. So consult pulmonologist and get done chest x-ray and CT thorax to rule out all these causes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffaring from Stress Tensions Anxiety Related Problems, Excessive Thinking Aggressive Behavior, Learing Disablities Poor Concentration, Inferiority Complex Loneliness Sleeplessness, Fear Phobias Ocd Suicidal Tendency Addictions, Depression  Re, Inner Personality Development please answer me. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I am not sure about your age, living conditions and vocation. You have so many symptoms associated with most of the common mental disorders like anxiety disorder, OCD, depression, ADHD, personality disorders etc. Are you trying to exaggerate? In any case, no self diagnosis. Correct and timely diagnosis should help you cure your problems. Please consult a psychologist for psychometric tests to determine your problems. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For sever cough, i was given a course of antibiotics, Mozec 500 mg (2 times a day) for 5 days. cough reduced partially. This was followed by MONTEK-LC 1 tablet has been recommended for 20 days post lunch. after the first tablet got a very good relief, but now its the 4th day i.e 4 tablets consumed, the cough has started again... keep getting severe bouts of cough. I was taking ambrolite D.. now doc has said to take Mits Lincts DX. Pl advise...why did the cougChatDoctore back, when I had good relief with 1 tablet, and now after 4 tablets the cough is still bad. I am worried. please revert ### REPLY: Hi, I understand your concern.  Your cough seems to be allergic in origin, secondarily infected by bacteria.  - To get rid of the cough I feel the extent of infection, / bacterial sensitivity to antibiotics should be known ( physical examination by a physician, Blood counts-TLC/ DLC, X-ray chest, sputum culture & sensitivity test) & then a full course of antibiotic to remove bacterial infection(indicated by excessive cough/yellow sputum)/ Tab. Diethylcarbamazine (according to blood cahnges0 cough syrup, Monte LC should be given for sufficient days.  - Allergens recognized & avoided/ desensitized. For prevention in the future.  - avoid cold/ sour things/ exposure to allergens - hot saline gargles / vapor inhalation.  - .  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife had been seeing doctors about her body pain, she has diabetic 2, taking numerous pain prescriptions but relief has not been felt. Just like this morning. She had long troubled sleep, she went toned at 9:00pm and got up at 7:00 am with body pain. We had attended mass at 8:00 and went back home to bed with bodily paid. What do you think is wrong with her and suggestion best possible treatment? How about Professional body massage clinics. ### REPLY: Hello, There can be several causes for body pain. For pain, you can take tablet acetaminophen. For further assessment, you may require complete hologram, nerve conduction studies after physician consultation. You may require physical therapy after physiotherapist consultation. Further treatment mainly depends upon the underlying condition. Avoid over exertion. 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 had my period 2 weeks ago and a few days ago I had sex and my boyfriend didnt pull out like he normally does. Normally he pulls out a few seconds before he ejaculates, but this time as soon as he pulled out he ejaculated. What are my chances of becomming pregnant? I had sex on Monday, which is one of the days I was at peak fertility ### REPLY: Hallow Dear, Before opining on your case, I would like to give you some scientific information about the Fertile Period. Egg release (ovulation) takes place 14 days prior to the next expected menses. Egg has a life of 24 hours while the sperms are active for 72 hours. Hence, a period of a week around the ovulation is fertile period. So, if your menstrual cycle is of 30 days, day 16 is the ovulation day. Thus, intercourse two weeks after the menstruation is very likely to be in the fertile period. Before ejaculation, there is ejaculation secretion which also contains some sperms which are capable of fertilizing the egg. Therefore, pull out technique is not a reliable method of birth control. You may please go for more reliable methods like birth control pills, condom or intrauterine device. Your history suggests that there are good chances that you could be pregnant. Now wait expectantly for the menses. If you miss them, for confirmation of diagnosis of pregnancy, you have the following options:1. Pregnancy test on the overnight first morning urine sample 8-10 days after missed period. Earlier these tests may give false negative results. 2. Beta  tests are very sensitive and specific tests and give reliable results even few days before missing a period.3. Ultrasonography 10 days after missing period.4. Clinical examination 10 days after missing a period. If you are pregnant, and it is unwanted pregnancy, you may opt for medical termination of pregnancy up to 9 weeks of gestation after which you may need surgical procedure. I hope you have got the guidance. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 fibroids that do not have symptoms right now. I am really very tired of having a big belly and I have high blood pressure. I exercise, eat right , and I am starting yoga is there anything else I can do that will not raise my pressure. Even on. Eds, my pressure elevates from the slightest thing. I am 54 and 52 and I weight 150 lbs ### REPLY: **1. Total salt intake should not exceed 2 grams per day.2. No extra salt should be taken during meals.3. Use Los alt where salt is essential.4. Avoid salt rich food: pickles, papal, sauce, cheese,salted butter-biscuits-peanuts cashews-butter milk, wafers, popcorns5. Take potassium rich foods like grapes, Columbia.6. Avoid saturated oils and use monosaturated or polyunsaturated oils.7. Avoid all deep-fried foods, unskilled milk, meat.8. Increase fiber intake i.e. leafy vegetables, salads, fruits, pulses and legumes.9.use skimmed or double toned low fat milk.10. Check with a Cardiologist regarding Lipid profile, E.C.G. for any I.H.D. changes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am a 32 year old woman 120 lbs, mother of two little girls, dedicated to excercise and healthy eating.  I run 3 to 4 miles a day, never feeling any discomfort, or shortness of breath during exercising, but this last few weeks, I feel slight discomfort in my chest off to the left and sometimes in the shoulders.  Went to the doctor (internal med.) he said he felt there was nothing wrong with me, maybe stress and anxiety.  So do you think I have something physically wrong with me or am I just too in tune with my body and am telling myself there is something wrong when there is not? ### REPLY: Thanks for your question on . I can understand your concern. Since you have Calcified already consulted doctor and everything washed normal, no need to worry about this pain. Stress and anxiety can also cause similar kind of chest pain. So avoid stress and tension, be relaxed and calm. Avoid movements causing pain. Take sound sleep of 6-8 hours.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 im a female age 41 i all the sudden got back pain kept getting worse till i couldnt walk been to hos ptial and chiropractor. got treatment at chiropractor can walk but he said my spine moved 14mm to left it didnt fix spine but did fix where i could walk he said was probly pinching nerve i dont know what could be causing my spine to shift and i have no health insurance to figure it out. i also get burning in back i really need help im afraid i wont be able to walk again please help me ### REPLY: Hello. Thanks for writing to us. The pain in the back with the burning in the back is likely to be due to a prolapsed disc with a nerve root compression. Going to a chiropractor will not help you much. You need prescription muscle relaxants and methylcobalamin supplements. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 18 month granddaughter has an enlarged heart. the dr. s say she has bronchitus, she also has a very bad sore throat, soars all in her little mouth, & has a fever of 104.9 for a week now. she is in the hospital at this moment, i worry she will not get the proper medical care because her mother has her on medicaid, & lets face it, i know as well you know that thats not the greatest insurance to have & that your choice of dr. s is so very limited. they just discovered the enlarged heart today. i am worried about her like crazy!!! she was hospitalized about 9 months ago for rsv. & she has been on a nebulizer having to do breathing treatments since she exited the hospital for the rsv. no=one smokes that she lives with nor that she is ever around. what can you tell me about this? ### REPLY: Hi, The condition you described seems to post viral myocarditis may be associated with heart failure. She requires anti heart failure treatment with ace inhibitors like April, beatboxer carvedilol and diuretic furosemide and Anderton along with lanolin. Restrict fluid intake as per 24 hrs urine output. Better is consult with a cardiologist and have regular followup with adequate management most cases of enlarged heart have good response and becomes normal. 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 fibromyalgia and am looking for an exercise regimen to get me moving and build my core. Because of my pain, I ve become sedentary and need to move more. Can you recommend some exercises to start me out slow and then progress to a moderate plan? Due to weather, I prefer to stay indoors. ### REPLY: Hi, thanks for giving a brief idea about your history. Well for fibromyalgia there is very limited access for each and every thing. But a continuous variation and modification of exercise will always be of help for making core look with doing Pilates. Along with it please look forward with breathing exercises. As breathing is the first one to focus. Try doing strengthening of the antigravity muscles. I mean to say, the muscles of your back. Them look for upper limb strengthening and lower limb as well. Focus on strengthening but without weights. That might not sound sensible. But yes I mean to say same thing. And I spoke exactly what I meant to. Strengthen while using no weights. Well, a guidance from a professional physical therapist always words to an extent a better. For my personal experience with fibromyalgia patients I prefer to divide the whole program into different variations like meditation, yoga, breathing exercises, fitness training, strengthening conditioning, etc. There will be a lot of fora about the fibromyalgia and lot of patients are benefitted with various things. What I mentioned was a rehabilitation package which can be fluctuation on a basis of demand and supply. I wish you a speedy recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a single inflamed bump on the shaft of my penis. I popped it thinking it might just be a pimple and some solid stuff came out and then it bled alot for something so small. What could this be, i have never popped a pimple with such solid stuff in it before? ### REPLY: HelloThanks for query. Based on the facts that you have posted I would say that you have infected Sebaceous Cyst on the shaft of the penis. The penile skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Take broad spectrum antibiotic like Augmenting along with anti-inflammatory . Along with topical antibiotic ointment like Newsprint twice daily. If it persists even after taking medications for a week you will need to consult qualified General Surgeon for clinical evaluation and further treatment. You may need to get it excised in Toto (Completely along with the sac). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For the last 2 weeks I have been having unknown origin seizures. They are on the verge of being grand mal seiures but also are what the doctors are considering tonic-clonic seizures. I do not remember anything about the seizure itself but can often times tell what is going on around me but just cannot respond to anything. My body is basically paralyzed to where I cannot move. I am so frustrated right now that I don t believe that anyone cares what is happening to me. I have been taken to the emergency room 4 times now in the last 2 weeks with these episodes. I was placed on Keppra, Klonopin and Dilantin along with taking Lyrica for my severe fibromyalgia . I have been seeing a doctor, whom I thought was a neurologist only to find out that he had only studied neurology , and they only thing he ever wants to give me is Percocet for the degenerative disc disease that I have. I am to the point now where nothing matters anymore. I understand that depression and stress can be factors in all of these symptoms but when I have been fighting them for over 2 years, it gets to the point where nothing matters!! Can you please make any suggestions to me on which other way to look as far as a diagnosis? They have ran cat scans and MRI which all show negative results. PLEASE, I am desperate at this point! ### REPLY: Welcome to ! I have read your question carefully, and somehow I feel that you either have mixed seizures ( GTCS plus Dissociative) or only dissociative (due to stress) ones. The points which make me feel that you have dissociative seizures are---- that you are having them so frequently, ---you feel depressed from past two years, ----there is no history suggestive of injury, fall, tongue bite, cheek bite, tooth breaking, in - continence during any of them (at least not mentioned in query) ----and all scans are within normal limits. Even if now you want to confirm that whether you have GTCS, then get an EEG or serum prolactin levels, they rise in a true seizure and come to normal limits within next 24hrs, an EEG will come abnormal when you have true seizure. In mixed seizures, patient is given antiepileptics and medicines for stress, which take care of both the things. I think that you must see a psychiatrist, even if you have true seizures, as, you have significant depression, hopelessness and worthlessness, which is harmful for you. Your condition is difficult right now but let me tell you, I have seen cases worse than yours getting completely well. So, there is still Hope, but you need to gather some strength for yourself and move ahead! Please fix an appointment with a psychiatrist and do see him at least once. Till then please continue with the medicines. Hope this answer gives you some help in getting well please feel free to ask more 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 ...my mother feels very week now days. She wakes up at 3:00 Am daily and feel her heart is going to weak. She cries sometimes and feels like no one is for her in this world.She does not eat as she should. She is looking do weak. Pls suggest what is this and what we should do. Thanks ### REPLY: Hello. Thank you for asking on . I hope I can help you. Weakness of cardiac origin can be elicited by low blood pressure or slowed heartbeat/conduction disturbances. If you can, please tell me, has she had any episodes of fainting with or without loss of consciousness? Does she take ?  Also, an echocardiogram should be performed, to assess heart muscle and valve functioning. After these tests are done, we can judge if this problem is of cardiac origin and, if it is, proper measures of treatment must be undertaken. I hope I answered your question. Feel free to contact me again. 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: dear Dr, Dr i am 57 year old person and 5 feet in height,my weight is 65. i have a pain in my hip joint till 4 years in time. I got a x ray report and doctors said that i have ostiopyrus.i got treatments to that but still not cured. so can you please tell me what are the best traetments to cure my pain. thank you, ### REPLY: HiT hank you for asking . I have gone through your query. Osteoporosis has effective treatment nowadays. Calcium should be taken as dietary supplement. Your vitamin D level in blood should be measured and should take vitamin D supplements if it is low. If this is not working bisphosphonates like Olen .  Costly treatment like monoclonal antibodies (Donesumab) is also available. This treatment should be taken under the supervision of your orthopedic surgeon or physician. Hope this may help you. Let me know if anything is not clear. 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 am taking montair lc one tab , livolin 2 puff twice, combihale ff 250 2 puff twice daily from last one year. After diagnosis of asthma. Is it safe to take that much medicine so long. Is there any alternative. What are the side effects of these medicine. Feel very tired all the time. ### REPLY: Hello, Welcome to , Is is not safe to take this medicine for long time. In case of emergency use it is ok otherwise not. This medicine have many side effects after consuming for long time. Homeopathy has a sure solution for asthma. You can be free from this medication too without any side effect. Homeopathic treatment is based on total understanding of patient on physical and mental level. And that's why detail history of patient is needed for proper homeopathic treatment. Your problem can be cured permanently with homeopathy. So consult to good classical homeopath nearby you or contact us. Have a better 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, about 10 years ago i fell off a horse and shocked my lower back and hips. i was unable to move for a few hours and it took about a week for me to be able to walk properly. I have suffered with bad hips every since. i have previously been to the doctor who told me to loose weight, this i did and returned a year later. I was then told that this was a kind of pain i was going to have to put up with! my hips click as i walk and crack every few minutes (loud enough for other people to hear), they also feel like they come out of the joint or are not sitting in the joint properly. recently the pain has also spread to the back of the joints aswel, making walking very difficult and even standing painful!! please help! ### REPLY: Dear patient Considering your case possibility of hip arthritis with loose bodies inside hip is more likely.  Are you having difficulty in squatting and cross-legged position?  If yes then this diagnosis is more likely. I would advise X-ray of pelvis with both hips anteroposterior and frog leg view to confirm diagnosis.  Visit radiology center nearby you and get it done.  If report shoes arthritis need to consult expert orthopedic surgeon nearby you and get yourself examined. If report is normal start physiotherapy with hip range of motion exercises from physiotherapist.  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: hello i have a question i had unprotected intercourse a few weeks ago im not on birth control and my partner was not wearing a condom he used the pull out method, i have irregular periods and i got my perod on the 26th of may it only lasted 4 days it usually lasts a week, ive been having some cramping , i took a pregnancy test today and it came out negative should i take a blood test? ### REPLY: Hello dairy understand your concernThere is always chance of the pregnancy as you had unprotected sex, and you are not on birth control pill. I would suggest again go for urine pregnancy test and or blood  if period will not come in next 7 days. If you will be pregnant and do not want pregnancy then still you can terminate the pregnancy by abortion pill under the advice of gynecologist. Hope this may help noncontact  for further health query Best regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is it safe to take Flucloxacilin antibiotics when I actually in day 10 of my cycle and I am probably expecting my ovulation on day 14. doctor has given me the antibiotics for a week. I am very reluctant to take it now since I am really planning for my pregnancy? Kindly advice ### REPLY: Hi, Welcome to . I am . I will be answering your concerns. Flucloxacillin belongs to Penicillin group of .  Animal studies have not shown any teratogenic effects due to flucloxacillin when used during pregnancy.  The limited evidence in human pregnancies has also not shown any ill effects. So you may use this medicine while trying for pregnancy if your condition demands. Even infection is not good when you are trying for pregnancy. If your doctor can change it to other penicillin like Ampicillin, amoxicillin, oxacillin, it would be great. There is more evidence available regarding the safety of these medicines in pregnancy. I hope this is 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: My husband is 52.  He has had diabetes since the age of 12.  In April, 2010 he had a stroke leaving him with right side paraparesis.  He  started dialysis in May, 2010.  He has a lot of pain in his lower back and woke up last night with chest hurting and the night before with stomach and lower back hurting.  What do we need to look for? ### REPLY: Welcome to  .1. There are few reasons for back pain in this case, due to the underlying paraphrases if the patient is less mobile.2. Underling Diabetes - If it is uncontrolled.3. Age related degenerative changes do may cause the back pain.4. I would recommend an MRI spine to find out the status of the disc and cord involvement, at the same time a plain radiogram (X-ray) spine for bony changes. Hope it helps you. 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 have had excruciating back pain for 2-1/2 weeks. I have had sciatic surgery in 2004, epidurals series 3 times, and 2 radio frequency leisionings. Nothing for about years except vicodin (I m down to 1/2 a day until this past episode) My family Dr. only recommended a steroid shot and a cream now, no MRI or X-ray. Can t hardly get out of a chair without horrible spasms (or whatever they are). Walking, barely, with a cane . Was doing water aerobics 3X/week before this happened. Any suggestions? What kind of Dr., what is laser surgery, not that I m looking for back surgery. Any help or suggestions would be appreciated. ### REPLY: Hello, I have studied your case. You may need to do MRI spine again with contrast to see for nerve compression If your new MRI shows disc bulge with nerve compression then re surgery may help. Due to compression of this nerve root there is tingling numbness in your leg and pain associated with it. For these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and TENS therapy will help Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Does a hida scan or endoscopy look at liver or pancreas? I had both done for chronic severe upper abdominal pain . Feels like I am constantly being stabbed in put of stomach , sometimes gears a little to upper right. I am belching and burping constantly also. Both tests were negative. Endoscopy showed my stomach was fine and hida scan showed nothing wrong. I have had no blood work done. I am a 30 year old female, 100 pounds. Eating causes the pain to be excruciating. It lasts for days. I just found out I am pregnant and am scared that something is wrong in my liver or pancreas. I take Zantac twice a day. GI suggested I try Questran for bile reflux. I don t know what to do anymore, ### REPLY: Hi and welcome to , thank you for your query. No, these 2 procedures cant verify some liver or pancreatic diseases. You need to do ct scan or some certain laboratory findings to evaluate this. Your symptoms suggest stomach issue, but also it can be caused by bowel disorder or pregnancy. So you may need colonoscopy too. Since you are pregnant, you should not do ct scan and MRI would be better option so consult your doctor about it. Wish you good health. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My three yr old daughter has pea sized lumps under her chin, I can literally grab them with my fingers and move them around. Also I have noticed that she has lumps on her lower jaw bone. Her right side id quite larger than her left and I am starting to worrry. I took her to see her peditrician last month and she ran a bunch of tests and they were all negative. Should I be worried? ### REPLY: Welcome to  .1. Generally lumps in the sub mandibular regions are arising from sub mandibular gland.2. Or it could be just dilated salivary ducts due to obstruction congenital abnormality.3. Initially I would suggest getting an ultrasound neck to find out the cause / where it is arising from / what consistency it has / and how it is with adjacent structures. 4. Only after that - I can further tell for some treatment.5. If it's done it's ok or else ask your doc to help you with that, hope it helps. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is Hillrie I just found out I have HVC. When my daughter passed away 7/25/10 on a Sunday morning, I lost it. I would continue to Blackout most of the 1st year, I felt like a zombie. The second year 2011 I started coming out of my shell little by little, I knew I had my eldest daughter, a grandson she gave me, a son who is now 16yrs.old & a my youngest daughter, who will be 12 Aril,20,2013. By 2012 I started to realize how much my family needed me. Even my grown daughter and sickly mother, so in 2012 I broke that shell & fought my way bake. I lived a very self destructive life style after the death of my daughter. I felt  I should have been the one to go, not my beautiful daughter. I wont lie I even tried twice back in 2010, now I live for my family who I love so very much! I wake every day & remind myself God needed Jessica, my daughter for something so important that she had to return home & we will all be together again when the time is right. Now I am in the fight for my life & need any & all information on Hepatitis C. I NO THIS DESEASE IN MY PONISHMENT, for the way I lived my life after my daughter. It is now 2013 my life is all about taking care of my sickly mother & all my children & my grandson for as long as God allows me to. I would appreciate any new info sent to my e-mail address also treatment new or close to being FDA approved.  Thank you for reading  my e-mail that I sent to you this is my e-mail  ( YYYY@YYYY )9 ### REPLY: You should talk to a hepatologist to see if you are a candidate for treatment with the current available .  There are many factors to be taken into account before starting on therapy. The current therapy has a lot of side effects, and these are mainly to the Interferon injection that needs to be given with the rest of pills, however soon there will be a new therapy approved which will be only with pills, no injections, less side effects. You can see the progress of all the medications undergoing clinical trials at www.hcv ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am on the pill and have been prescribed fucidin cream to treat a skin infection. my doctor told me it was an antibiotic but did not mention my pill and it doesnt say anything about it in the leaflet that came with the cream. is it just oral antibiotics that affect the pill? ### REPLY: Hi, Fucidin (juridic acid) is a topical antibiotic commonly used to treat skin infections caused by susceptible bacteria. It is only the oral antibiotics which may reduce the contraceptive effects of the pills. When applied locally on the affected area of the skin while on contraceptive pills, funding does not affect the pill. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father n law had a surgery about 10 years ago, replacing all veins from top of leg to foot. Although that surgery has done well the doctors have had him on blood thinner ever since. Just recently he has gone to hospital with severe headache and they found a subarachnoid hemorrhage in the brain. They took him off the blood thinner, kept in icu a week, and now say just go to regular doctor. We asked what would happen now to the original vein surgery (since stopping Coumadin) and basically was told its a catch 22 . So by that advice it will either be the aneurysm or something else that kills him. I understand that none of us will escape death, I would just appreciate knowing the options. I will gladly appreciate your professional ADVICE and experience with this matter. ### REPLY: Hi, I am .  I have read your question with care and understand your concerns. Let me try to help you Question : I would just appreciate knowing the options. Answer : The way forward is to maintain his blood in such a level that it has enough anti coagulants to prevent thrombosis in the veins, but not enough anti coagulants to cause a bleeding in the brain There are few tests that will help us find about Blood Clotting These are called PT, apt, Into have to do Consult your doctor, do these tests, and titrate (increase or decrease the dose of his anti coagulant medications (blood thinner) so that the medications are enough to prevent his veins from clotting, but do not increase in the blood to such a level as to lead to bleeding in a brain This looks tricky, but there are lots of people who are in the same situation, and they are maintaining good quality of life by meticulous testing and adjustments of the doses Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Let me know if I can assist you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been seeing my dentist about sores in my mouth. They started on my gums but they now also go down my throat.  He thinks I may have an autoimmune disease.  He sent me to the UW oral medicine clinic and they want me to have my eyes checked since I also have a history of blisters on the insides of my eyes.  I have a history of lots of sensitivities and allergies.  I think these are possibly the result of just another sensitivity that I havent yet figured out what it is.  I really dont want to spend hundreds of dollars and hours of time to do lots of tests to get zero answers.  Ive done that too many times before.  Eventually I always find out that its some food or substance that I dont tolerate.  Oral medicine said they want me to continue checking it out anyway.  I dont want to.  How important is it to have this checked out. ### REPLY: Hello, Well sores in mouth can be due to allergies and if they have extended down the throat then can be probably a severe reaction. Yes, it is correct that you should get evaluated and investigated further so that exact cause can be ruled out and treated appropriately to avoid further recurrences. Also, if you already know any allergens that can cause similar symptoms then avoid eating such foods and taking certain medications. You should also avoid spicy and acidic foods. Take vitamin B complex supplement daily. You can also gargle with 1:1 solution for Milk of Magnesia and Ben . Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend had internal bleeding and has been in the hospital for 4 days and now they said they found a tumor on his pancreas. My mom died of pancreatic cancer. They gave her 6-8 weeks and she lived 8 months, but i honestly feel that my friends is worse than my moms becuz she never had internal bleeding..my moms friend went in the hospital with a similar situation as my friend and died in 11 days am i assuming wrong? Can it be something else besides cancer? ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  You may have pancreatic cancer or some pseudopancreatic cyst.  Whatever it may be, you need surgery if there is internal bleeding.  Consult your doctor and go for surgery 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: what would the likely diagnosis be for a 40 year old male who has severe pain on his left side and back below the ribs. He describes the pain as spreading to the lower abdomen and groin and comes in waves that fluctuate in intensity. He has painful urination and brownish foul smelling urine. He reports a persistent urge to urinate and urinating more often than usual along with nausea and vomiting ### REPLY: Brief Answer:This symptoms may be due to urinary tract infection. Detailed Answer:Hello, Thank you for using . This symptoms may be due to urinary tract infection such as cystitis (bladder), urethritis (urethra), or pyelonephritis (kidneys). The only way to diagnose an infection is checking a urine sample and after that performing a urine culture. The urine culture is the most accurate test to determine for sure whether an infection is present. The lab puts the urine sample in an incubator. If any bacteria are in the sample, they will multiply and show up. However, it takes 24 to 48 hours for the bacteria to grow enough to be detected.  The monoculture should be followed by Antibiotic susceptibility testing (AST). Based on the result of the last one, you may take a specific antibiotic treatment. I suggest you to undergo an abdominal ultrasound too, in way to exclude any possible structural cause of the UTI. Meanwhile, you should . You can take diclofenac (Dan) tablet with an initial dose of 100 mg orally followed by 50 mg oral doses every 8 hours, maximum 150 mg per day. Herbs such as golden seal, UVA RSI, blackberry root, and wintergreen have the ability to soothe, relieve irritation and reduce infection in the urinary tract. Load up on foods packed with vitamin C or take vitamin C supplements may help you fight UTI. You should take of your diet the bladder irritants such as: caffeine, alcohol, spicy food, nicotine, carbonated  ### END