Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 14 yr old son found lumps in his neck, we went to the drs and she said that after blood test(slightly low white cell)he had a low grade fever(no higher than 100.5) tested negative for Mono. He had mild headache and not a great appetite. I actually had the very same symptoms(but didnt have blood work). Last night I got a scratchy mild sore throat. My son woke up this morning with the sore throat, any clues ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  Sore throat, mild fever, headache all symptoms are suggestive of some viral infection. Low blood count is common in viral infection.  So you should take treatment of viral infection. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My cousin, aged 39, is suffering from Parkinsons disease, for the past six years. This has restricted movement and control of his right hand and legs. Who would be the best doctor in India? He has become very depressive and also suffers pain in the limbs, neck and head. Is there a cure? What should we do? ### REPLY: Hello, Was your cousins, diagnosed from Parkinson's disease by a neurologist. What are the symptoms - because rigidity and tremors are the two significant symptoms which are notable in Parkinson's disease.  For having a diagnosis we need the help of the clinical examination under a neurologist and also some brain scan, blood test and urine test. Post which is he is diagnosed with Parkinson's disease then oral dopamine supplement will be given and the dosage will be monitored as per the clinical findings.  Exercise will help to improve the motor control, improve strength, the flexibility of the joints etc. Exercise along with dopamine supplement has a good response in patients with Parkinson's disease. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with bacterial vaginosis and I was on antibiotic for 7days 2pills a day and I took my last dose and woke up the next day with a itch swollen clit they prescribed me a stronger antibiotic is it normal for it to be itchy and swollen your clit? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No, if your vaginosis is cured you never has swollen clitoris. In my advice your infection is not cured yet. You can take metronidazole and clindamycin tablet under your doctors' guidance. If you have taken it in your current therapy, you can only substitute it. I advise you to wear cotton undergarments. Because synthetics material increase chance of resistance. Also keep hygiene because it will cure you earlier. Please wash your hands before and after hand wash. 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 have been forced to have anal sex for couple of years, Ive never like it and never enjoyed it, and was always painful to me, the problem is lateley I experienced some bleeding during bowel means when am emptying just at that moment and the blood disappear right after that, I dont feel any pain in the anus but I have a horrible right lower abdomen that doesnt let me live normally it is painful when am standing lots or sitting lots so uncomfortable, feels like burning inside my colon,I am so worry and feel so embarassed to talk about it with my PCP, I am so sfraid that I developped infection or cancer, I mention here that I used to suffer from constipation long time ago because of emotional stress and used to have a stress gastro-duodenal ulcer that I treated 15 years ago..please are these symptoms means a cancer/ ### REPLY: Hi. Thanks for your query.First the most important thing is if you do not like the anal intercourse, you have to say no to it by all means, as this is causing you psychological as well as physical trauma. The bleeding with the stool and without pain is suggestive of the Hemorrhoids or piles. This is due to the fact that due to anal intercourse the tissues supporting the veins get loosened up allowing them to swell. The pain in the right abdomen can be due to colitis or IBS which you must also be suffering already. This does not look to be cancer as there will be mass at the rectum, or the anal canal. I would advise you the following.::Talk to your PCP, Get a reference to the Surgical Gastroenterologist. Get ano-proctoscopy and colonoscopy and biopsy to see what the exact problem is like. Once the diagnosis is made further proper treatment can be very well planned. If there are large piles get operated, if small get the proper medication. Have Site bath twice daily. No anal sex at all. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...I thought I had a 24 hour gi flu starting a few days ago with nausea/vomiting, diarrhea,bloating, chills, myalgias (not sure about fever since I didnt take it).  the n/v has stopped about a day ago but I continue to have beige colored diarrhea 4-6 x/day with extreme excessive gas whenever I eat anything but my oatmeal in the morning? I eat almost nothing during the day due to the symptoms.  Other symptoms have pretty much subsided.  Any clues? ### REPLY: HI, thanks for using  It can take a few days for diarrhea to resolve completely. If you are still having symptoms, it would be best to avoid solid food till your intestines are ready to absorb food. The use of food when they are not ready would just cause abdominal cramping and cause it to be passed out. When there is a 4-hour window with no symptoms, small amounts of . You can try using probiotics, these help diarrhea to resolve because they restore the normal vaginal flora. Meds such as Pepto-Bismol or Omotic may also help you. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell in a roller skating accident and hit the left side of my chest against a steel post/railing three months ago. I heard a crunch and the wind was knocked out of me. I did go to er and they did xrays. They said nothing was broken and lungs/heart fine. It has been three months and I still have pain when I breathe deep or sleep on that side. Can internal bruising last this long? ### REPLY: Thanks for your question on . In my opinion, you are having pleural thickening at the site of injury. Blunt chest trauma can cause pleural inflammation without rib fracture or Pulmonary contusions. So this pleural inflammation after healing produce thickening pleura at the site of injury. This thickened pleura cause pain on friction while breathing, talking, coughing etc. So this is normal healing and hence no need to worry much for this pleural thickening and pain. You can apply warm water pad on affected site. Gradually over time this pain will subside. You can take painkiller occasionally, for pain relief. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was takne to hospital with breathing difficulties last week. She had water in her lungs. They also did an angiogram, and there are three blocked arteries. 98%,99%, 80%. (i think she also had a heart attack). They cannot do angioplasty stenting because of multiple blockages in places where arteries forks too. They had a meeting, and a surgeon is willing to do heart bypass surgery. Now she has had a stroke previously 12 years ago, which has left her with left sided weakness. They also say her heart is running at 27% rather than the normal 55%. Is heart bypass surgery safe for her to do? Thank you. ### REPLY: Hello thanks for posting here. I have gone through your description. She has critical heart disease involving the three arteries if the heart. And since her pumping function has .  So once blocked arteries in the heart are diagnosed, there are two methods to open it. Angioplasty and bypass surgery. As your doctor has advice angioplasty cannot be done because of triple vessel disease and also involving the arteries where they bifurcate. So surgery is the only option in her. Surgery with a low pumping function is definitely riskier than one with a normal function. But here you have to assess the risk versus benefits. If you don't do the surgery then you are not treating the cause. Her quality of life will be poor, she will get tired easily, and she stands the probability of having further heart attacks also which will further decrease the function. Going ahead with the surgery will improve quality of life, she can do her day-to-day activities, travel etc. however despite surgery pumping function will not increase more than 35%. But the risks of heart attacks is evaded. Another thing that should be considered is how mobile she is. As you said she has left sided weakness. If she is bed bound and requires help for her day-to-day activities, then a surgery would be more of a suffering to her. A CABG surgery has a good outcome and patients usually do well for 12-15 years. Nowadays with advanced technologies and approaches, heart surgery risks have come down a lot. I personally have seen patients with 25-30% do well with CABG. So my advice is it will be worthwhile to take a call for CABG. (only if she is ambulatory, and you want to increase quality of her life)wishing her good healthRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my mother (53 yo, ex-smoker) was diagnosed with lung cancer last summer. She had surgery(left lung lobectomy). The biopsy revealed lung adenocarcinoma , without lymph node involvement and only localized damage. All post surgery ct did not reveal any problems to other organs or the brain. Yesterday she had a brain CT which revealed a 18mm tumor in the left bregmatic area of the brain and was advised to do radiaton therapy which we booked for thursday. Is there any chance for long term survival? ### REPLY: Hi, Thanks for writing in. Presence of a tumor spread. In the brain in a patient with lung cancer is stage 4 cancer. Such a case can have a survival of up to 2 years after detection. However, the tumor has been detected in early stage in the brain, and therefore it is possible that with aggressive treatment and radiation the tumor cells can be completely destroyed, and she can survive even for 5 years or more. Please discuss in detail with your doctors and if required then gamma knife treatment and chemotherapy can also be given to completely eradicate the tumor in the brain. The tumor measures 18 mm and is small and can be managed right now. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My question is, my left wrist is sore but not real painful, has been for a few days. My fingers are fine, no pain or soreness in them. Did I possibly just hurt my wrist somehow? I also have no swelling. I wonder if this is a symptom of carpel tunnel or just something else? The most is that the soreness is on the top of the wrist, not underneath! ### REPLY: Hello, I have studied your case. As per your history there is possibility of TFCC/ligament injury to wrist. It may subside with time. Pain indicates inflammatory process or nerve compression. I will advise you to do MRI and Ultrasound of wrist. Till time, you can start analgesic and crêpe bandage support. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi My daughter is 10months old and she is only 7.3kgs. her birthweight was 3.5kg. she was on nan-1 till 6months. She was 6.5kgs at that time. when we introduced the local packet milk, she passed stool 4times a day..we assumed that its due to her first tooth. that month she gained only 200gms. Later she is on Isomil. Since her weight gain was so poor, we took all sort of tests , all reports were normal and she is diagnosed with failure to thrive. Pls advise on how to improve her weight..she is also on rice/ragi..no wheat.. ### REPLY: Hi... Thank you for consulting in . I take this opportunity to tell you certain scientific facts and relieve your distress - 1. An active is a well kid even if she/ he is not eating well. 2. Development of a kid is as important as, or I would say even more important than growth alone.3. As the kids grow their interest in food decreases and interest in play activities increases so that they eat small quantity and run away to play. As parents, we need to be more patient and feed than less quantity but more liquors per day.4. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed her calorie dense by adding good amount of ghee to it.5. I suggest you not to use appetite stimulants on long run as they may cause . Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear SIr, I am suffering from continuos Cold for the last 12-13 years. I m  30yrs old now. There is a continuous flow of mucos from the back of my nose to the mouth. I didnt feel headache, cest pain, sneezing. But for the past 1 week I was feeling pain around my right eye. there is no family history of Asthama and TB. Doctor saw my  CT scan and said that there is no need of sugery and can be cured by medications. If it is not cured in 1 month he will give me steriods. The medicines he gave for 1 month are below : (1) Mucolite SR (2 dose/day) (2) Montek LC (1 dose/ day) 3) PAN-D (combination is:ENTERIC COATED PANTOPRAZOLE SODIUM AND DOMPERIDONESR CAPSULES)................ I need you help whether he has provided me correct medicnes ?? Or wht is you suggestions., you can also advise me on  YYYY@YYYY  in advance.. :) ### REPLY: Hi I did review your concern. Your condition could be due to allergic rhinitis, chronic sinus congestion, or It could be due to deviated nasal septum. I would recommend consulting a ENT doctor and get yourself evaluated. A nasal examination and if required a Paranasal sinus X-ray or CT scan may be required.Meanwhile, I would advise you to use origin spray for nasal . I hope this helps. Wish you all the best. Thank you for using . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 28 month old son has a terrible cold, hes about 31lbs. Symptoms include: 103 fever, mucus coming from his eyes and nose, vomiting, sore throat, cough and he has slight ahsma . He is not eating but is drinking. I am taking him to his pediatrician tomorrow because fever has lasted over 72hrs and every day a new symptom pops up. he is now complaining about his 4bottom teeth? What could this be, why are his teeth now hurting and why are the symptoms multiplying? ### REPLY: Hi, Welcome to , I understand your concern and 103 temp is quite high for the age. But I would like to the at this point not to worry much because it's all possible in a simple viral upper respiratory infection which needs not much of treatment other than being patient and time. All you need to do is give paracetamol round the clock, plenty of oral fluids and rest. You can use saline nasal .  Teeth pain and severe body pain can be part of symptoms of viral fever. If fever lasts for another 48 hrs more, he needs a blood test and urine test just to rule out any other infection. Hope your child gets well soon. 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 husband recently had gall bladder removed and a spot was discovered on his pancreas.  He is jaundice with following symptoms: itchy skin, yellow eye whites, dark urine & white stool.  We are waiting for a date for oncologist consultation.  How long can he wait with these jaundice conditions?  Can anything be done to alleviate the itchy skin? ### REPLY: Hi, I am so sorry for your husband situation. From what you are saying, it seems he has been suffering from mechanic inter and the reason is a spot in the pancreas. High levels of bilirubin are toxic for the brain, so I recommend you going to ER and the doctors will evaluate the situation of your husband accordingly. Please bear in mind that you can't create him in your home. I wish the best for him and you all. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: If a srgeon and a radioigist sugeest surgery for spinal stenois then the mri gets switch out,and the surgeon says oh it looks better now, and its a 50-50- deal on the recorvery, crock of shit, around l4l5 there like this lilspace my legs arnt working and cause ive got the medicare lost my blue cross when the wife bailed, but what a bunch of bullcrap , the top notch surgeon even told me it would help my legs , but my P.A. said dont do it hes not a good paitent which is not true,this dude just hates me so much he switch out the mri threw in a 8 yearold one this is maine for you they will screww you over when your down, ask what who a good lawyer then you never get treated right again, these p.a. telling real doctors lies is wrong, but they got money and lawyers lookin out for them .. The health care system in maine is a fn place you dont want to be unless your a good rich patient, bullshit,we got the worst of the worst in maine, nobody got money and if your paper work says you can pratice thats what they do, cause god knows they need the practice,These people might mean well but most of them were asleep in class, when they ask the pateint what to do and you better know cause they dont have a clue,so go on and suffer , and do know harm dont even get me started. ### REPLY: Sorry you're in such a predicament.  This is a forum for the resolution of medical questions.  Sounds like you're looking more for a place to express opinions regarding quality of healthcare.  Since there's no clinical question at hand I'm afraid there's not much response I can offer.  Also, keep in mind that the physicians reading these questions (comment in this case) are actually from around the world and may have no idea about the Medicare Health system in the U.S. is all about.....or even know where the state of Maine is without having to consult a map!  Hope you find the care you need. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 bronchitis months ago and still had breathing problems, and a cough that would come more at night time. The Dr. I went to twice said it was pleurisy and prescribed me an inhaler, which has worked some, but I am still coughing some at night and feel like there is something I have to cough up but there is not. There is also the stabbing pain on my left side of my chest. Is the inhaler and nebulizer going to clear this up? ### REPLY: Hello dear, The inhaler and nebulizer will provide symptomatic relief by causing bronchodilator (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs)and reduces the inflammation. But as long as the underlying cause is not treated, the symptoms will recur. Investigations like complete blood count & X-ray chest will be helpful. If any infection is detected, then you need to take a course of antibiotics. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister feels some pain on her left side right now, to the left of her stomach.  She says that it feels like the same pain that she feels after running for long periods of time, long ago.  Lately, she has not ran for a long time (2 yrs or so), and she suddenly feels that same time.  Moreover, she has felt it for 4-5 hours now.  What should we do? ### REPLY: Hi. Thanks for your query. Since your sister says the pains she is feeling now are the same way when she used to have long runs, suggests this to be more of a muscular origin. It is possibly a spasm of the muscle which can be instigated even by a trivial trauma or sudden movement from rest to get something. What should you do ? > I would suggest you the following for your sister. -First ask her to lay in the bed without any movements to get a full rest. Give her any analgesic if you have. Shift her to ER or a Hospital for :Actual physical examination by a Surgeon so that a proper clinical evaluation can be done to get a clinical diagnosis, to get a proper order for which investigations to be done and proper treatment. Investigations needed may be high resolution ultrasonography of the abdomen and abdominal wall. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mam has just being told that she has 3valves blocked 100percent, doctors said can t do any surgery as she has gotten them all and her case would be to risky , as her heart is damaged to much from a recent heart attack.he also said to us to be prepared,I was just wondering in your experience would it be days etc. just need to know a time frame. ### REPLY: Thanks for your question on . I can understand your concern. See, exact time frame for survival of these patients can not be determined. But by your history and description, she is definitely have very poor prognosis. She is having failing heart due to valves blockage. And surgery is also very risky due to over all health. Without surgery, in her case, life expectancy is less than 1 month. She may succumb at any moment due to cardiac arrest. So be prepared for this. Hope I have solved your query. I will be happy to help you further. Wishing good health to your madam. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor,My daughter is 1 year 3 months old.She is having cold and cough.She is prescribed with mucolite,allegra and azithral.Azithral has been prescribed for 3 days-5ml once in a day,allegra and mucolite 2ml both thrice a day for 5 days.Please advice ### REPLY: Hi... Thank you for consulting in . Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15 mg/kg/dose (max ceiling dose 500 mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetirizine at 0.25 mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was wondering what a possible elevated alk phos 183 and slightly elevated alt numbers might mean? I have a history of thyroid cancer and I recently had a rt knee medial meniscectomy. Would any of these have something to do with the test results? I had an abdominal sonogram on friday and am awaiting the results. Thank you. ### REPLY: Hi thanks for asking question. These both can be elevated in bone disorder or bone disease or bony trauma. You have done knee meniscectomy that can lead to elevation of these enzymes. Liver problem can lead to elevations of these enzymes.USG will reveal if fatty liver, hepatitis or other liver pathology if present. Osteomalacia, vitamin D deficiency or renal disease can lead to elevated alkaline phosphatase. Wish you good health. Monitor both this enzyme level for next few months. Take care... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 43 years of  age. I had suffered from Bronchial Asthma since the age of 10 years. I used to have severe attacks and during that period I was dependent on steroid and antibiotics ( or made dependent should I say) for around six- seven years of intense asthmatic attacks. Slowly and gradually the frequency of attacks became less and dependence on steroids also became less. These days I have to take salbutamol inhaler and a medicine called Telekast L. After procrastinating for quite some time and after consulting doctors I married at the age of 38. Unfortunately after two years of short marraige my wife also expired.My questions pertain to my sex life and the problems I am facing. For the most part I had suppressed my sexual needs and often resorted to masturbation.I noticed that I suffered and continue to suffer from premature ejaculation and after ejaculation there is pain in my testicle sac and at the root of the penis. The erection is also not strong enough.Moreover I also feel absolute lethargy and get exhausted very quickly. Most of the time I feel sleepy. With increasing age and a small child to look after I am getting increasingly apprehensive about myself. Many in the family are asking me to go for second marriage so that my child who is only three and a half years can be adequately looked after. But I have my concerns about my sexual potency. Is there any medicine so that the symptoms of overall lethargy and weak libido is taken care of. My future looks absolutely bleak and I seek your urgent advice  to come out of the present predicament. ### REPLY: Hello, and welcome to ! You mention a few separate issues in your question.  The premature ejaculation is typically psychological in nature, so it is likely that a sex therapist may be helpful.  As far as the pain in your penis and scrotum, I would recommend being examined by a doctor, as this could represent an infection or an anatomic abnormality requiring surgery to correct.  Your fatigue and poor libido could be caused by a number of things, including low testosterone, poor physical condition, sedentary lifestyle, other medical problems (such as high blood pressure, high cholesterol, diabetes, and others), just to name a few.  This should be evaluated by a doctor as well. I wish you good health, and thank you for posting on ! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Ronnie. I have a very confusing question but in order to ask i feel i need to include some of my personal information. Im 24 and i was diagnosed in 2012 with Schizoaffective disorder as a result of my attempted suicide. I had problems for years(since around 6 years of age) with it but it was very few and far between. Though 2011-2012 it began effecting me more often. The confusing part of it is prior to having any of these issues i was having issues with my gender. I was born in a males body but i feel and have always felt as i was a female. The feeling of being trapped led to anxiety and depression. I tried medication for the depression but never told anyone how i felt inside. So the meds didn t have any effect, and the doctors were left confused. i found my own solution when i hit high school age and began wearing women s clothes under mine. It was a small thing but it gave me happiness and hope. I then got my ears pierced and this too was a booster to my outlook, and emotions. But it was short lived as it made me realize i was still having to hide myself. I struggled to fit in with others in school but i wasn t able to fully be myself. I couldn t add to conversation with other girls, but i wasn t able to talk with guys as most of the conversation was about sex. I am ready to come clean and be open with everyone, and i ve had success with telling my family and a few friends and they support me. Which was very surprising to me as i had lost a lot of my friends after being diagnosed as Schizoaffective. As i opened up to my family I ve haven t had any issues at all regarding mental he all besides the ever-present depression of not looking how i feel on the inside. Its been 2 years since I ve fully opened up and had no problems. Which brings me to my question, because of the fact I m already diagnosed with Schizoaffective disorder; am i able to get my letter from a psychiatrist for Hormone Replacement Therapy, and Sex Reassignment Surgery? And if so, what steps do i need to take in doing so and finding a psychiatrist who can help me with the process? I do apologize for the length of this but i felt it would help to have some background so i could get an answer that would apply to me. Thank you for your time. I really do appreciate it. ### REPLY: Hithanks for using  If I was your treating psychiatrist u would have diagnosed u as a case of gender identity disorder. In gender identity disorder, people think they are trapped in wrong body as you are feeling. In that case u have u consult your treating psychiatrist for taking u permission for sex reassignment therapy. There are certain guidelines for GID like u have to first wear female outfit for one year, if u feel comfortable with that, then your psychiatrist will give u certificate for surgery. Rest discuss with 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: himy daughter is 17 yrs old and she just had blood tested.  We found that she has as of 104 and alt of 49.  She doesnt drink, eat much fatty food, etc.  Does some physical work and she is not fat.  she is on the petite sideso we are a bit confused to why her levels are so high.  Any suggestions?  We have an appointment but that is another 3 or 4 weeks out. ### REPLY: He and welcome to .You shouldn't be concerned. These are only mildly elevated AST. It can because by excessive exercise or smoking. Also, some temporary liver damage can cause it as well, but you don't need to be concerned. He should continue with healthy diet and life. Also, he should do ultrasound to see is there any liver damage or gallbladder disorder. If something is found such as fatty liver or fibrosis then he should do Villa markers and take certain medicines. 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 started sulfamethoxazole 800 -160 tabs Sunday evening for a infection on my leg. Prescribed by a Dr in a medical clinic. He also told me if the infection starts to spread I should go to the emergency room for a antibiotic drip. I don t see much improvement today. There is a few more spots off the main infection. Should I wait for this antibiotic or seek help again. ### REPLY: Hello, Thank you for your contact to . I understand your health concern, if I am your doctor I suggest you that you should think of culture and sensitivity from the infected leg. Take treatment according to report. Till that time continue with the . I will be happy to answer all your future concern. Thank you, ChatDoctorInfectious disease specialist. Wish you the best health at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 need a medical assistance.I am 30 years old and i have a problem in my fingerswhich gets swollen and turns into black color specially at the joint area near the nail of my hand fingers. i got acute pain and i need an assistance online and ready to make visit to mumbai if required. ### REPLY: Hello and thank you for your question. It does sound like you need to see a doctor. You could have a form of arthritis causing your joints to swell. The swelling could cause the discoloration of the skin. It is important to find out the cause of this swelling since it could be serious and there may be a treatment available to you. Please try to see a doctor as soon as possible for exam and blood tests. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The skin on the side of my breast / under armpit feels numb. If I press down I don t feel any lumps but it feels like a sore muscle and there is also 4 small bumps on my skin that look like mosquito bites (there not mosquito bites it s February in Chicago) Do you know what is causing this? ### REPLY: HI, Welcome with your query to . Based on the facts of your query, the cause seems to be Fibroadenomas which is a benign condition with Hormonal imbalance. Check if your menses are nearing. Increased vascularity might explain small bumps on your skin. In my opinion you seem to be having -Fibroadenomas, with sore tender breast tissue and the armpit-due to axillary tail tender breast. Mammography and FNAC Biopsy would fix the cause from your Surgeon. Hope you got the answer for your query. Hope this would help you. Welcome for any further query in this regard Will appreciate writing your feedback review comments, to help the needy patients like you at . Good Day!! . S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, may I answer your health queries right now ? Please type your query here... I had sex wit my boyfrien in march I got my lmp around the 20 and tn had sex wit a new friend in april bit I didn t get a cycle that mnth and I m currently 16 weeks pregnant can you help me figure out who s the dad?? ### REPLY: Hallow Dear, It seems from your history that you had menstrual cycle in March after the intercourse with first partner, and you have missed your period after the intercourse with the second partner in the month of April. If this interpretation is right, then your second partner has to be the probable father of your baby. However, if this interpretation is not correct and if you never had menses after the intercourse with the first partner, then you have to conclude about the probable father of your baby by some scientific tests. The age of the fetus can suggest you about the day when the conception has taken place; thus you can infer which intercourse is responsible for conception. If you do ultrasonography, you will be informed about the age of the baby. Ultrasonography calculates the age of the baby from its size; hence the age is calculated from the day of conception. This will give you the indication of probable father of the baby. Else, you may wait till the delivery and then get DNA test done which will definitely conclude the information about the father of the child. I hope this helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have dark circle around my mouth .... I can see uneven color in my face....Tried so many treatments right from Home remedies, Beauty parlor, & been to best dermatologist in chennai. After all I can see bit differene, but NO CURE. Is it possible to get the SAME COLOR in all over my face? Please reply...Gayathri ### REPLY: Hello, Thank you for posting on . Complexion of any person is having two components; constitutive, one which is predetermined by genetics and racial factors and usually cannot be changed with any treatment. The other component is due to external agents like environmental exposure, sunlight, use of any cosmetics etc. and is amenable to treatment. You can get a series of chemical peels, which actually remove the upper dead layers of skin and stimulate regeneration of collagen and thus newer layers of skin. Many options are available in chemical peels depending on the requirement and skin type. (Glycol peel, retinol peel, cocktail peel etc.)Also, chemical peeling can be preceded by a simple procedure called microdermabrasion or commonly known as skin polishing to augment the results. Also, at home you can try using cream containing comic acid, betray . Always use broad spectrum sunscreen before going out in sun. Use a plain moisturizer like detail DAM on daily basis for healthy and HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son was vomiting and had a slight fever.we gave him Tylenol and it helped the fever but he had diarrhea for 2 days. At first it was green then yellow and at times gray colored. My son is acting better and normal and staying to get hoods appetite back but still having light colored stool.is that something i should be worried about ### REPLY: Hello, Welcome to . I read carefully your query and I understand your concern. You do not have to worry about, as long as your child is acting normally and .  The condition you are describing is benign. Normally, the brown color of the stool is made by a substance called bilirubin. When stool passes through the intestines rapidly as is your sons case, diarrhea, there may be little time for bilirubin to undergo its usual chemical changes. Thus, stool can appear green in appearance due to rapid transit. Mild diarrhea usually passes within a few days and kids recover completely with care at home, rest, and plenty of fluids. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you and your son 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: ive  just had a urinalysis and It indicates the ff:protein; trace/ WBC 5-8hpfrbc: 0-1hpf / E cells : manyA. Urates: few / M. Threads: manybacteria: many Ph is 7.0 and Specific gravity is 1.020i know i have problems with my urinary tract and ive had a history of kidney stones.. Could my kidney be malfunctioning? i am worried about my pregnancy and i am scheduled for the doctor next week... ### REPLY: Hi, You have a simple urinary tract infection. As such urinary tract infections are more common in females because of a short urethra or urinary tract. Infection is increased more in pregnancy because of decreased hygiene and immunity. So, all you need is a good dose of antibiotics. Do not take any antibiotics on your own because you need to consult a doctor to get antibiotics which are safe for your baby. I hope this will help you. All the best. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sharp stabbing pain in lower left side of stomach , happened very suddenly and felt like I might pass out, also hurt to breathe, stomach and chest felt tight, like i could not take a deep breathe, it lasted about 20 mins, I had to sit down because of the pain but then it just went away as quickly as it came, still don t feel well but the extreme sharp pain is gone, very confused about what this is, what caused it and why it came and left so suddenly ### REPLY: Hi, Thanks for posting your query. Do you have fever/ watery diarrhea/ constipation/ spasmodic abdominal pain/ nausea or vomiting/ weight loss/ mucus discharge in stools? Do you have any mass palpable in abdomen? Is there any aggravating or relieving factor for abdominal pain? With the available described symptoms, there could b possibility of peritonitis or muscular ache. You should consult with internal medicine specialist/ gastroenterologist and should go for thorough check up. You should go for complete blood count, urine routine microscopy, renal function test, serum amylase and lipase, colonoscopy, UGI endoscopy for better clarification. You should take low fat, spicy soft diet. Meanwhile, you should take antispasmodics along with proton pump inhibitors. Treatment depends on exact diagnosis. Take care, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having fatigue and pain in my joints, mostly my hands and hips. About eight months ago I had a bout of facial muscle twitching, a severe headache behind my right eye and double vision. I did have an MRI that showed some lesions that were questionable for MS. Follow up MRI was recommended I just havent went back to neurology as they really dont do anything as I am asymptomatic at this point but I think this joint pain stuff is separate and different that the previous problems. What are your thoughts. I just hate going to see someone because the few times I have sought medical attention nothing conclusive is ever found and it ends up being a waste of my time. ### REPLY: Hi, thank you for providing the brief history of you. A thorough clinical neuromuscular and musculoskeletal assessment is advised. As you had a previous MRI, we need to understand the report and also the clinical signs and symptoms too. As you age also should give us some input. To be practical, that 90% of MRI taken will not be having a normal results. So worrying about having an MS should be first removed from the mind. Also, the fatigue can be due to another factor and needs an understanding. It may be due to reduced physical activity of may be due to not a proper diet. A neurologist should assess you initially and go through all the physical examination, chief complaint and diagnostic reports. Understanding that MRI can not be a perfect diagnosis as well. Also, many of the Neurological condition will have similar symptoms and to make a differential diagnosis is needed, without whicChatDoctoring to a straight conclusion is not ethical. As you had double vision, fatigue, headache etc. we need to perform a proper clinical examination and also the chief complains or the past medical history, family history etc. Much More understanding happens if listened to you initially about you.Also, for fatigue you need a proper diet and proper physical exercise to improve the metabolism and immune system as well. Pain and aches in the joints can be Due to lactic acid which is formed at the end of each glycolysis cycle which is the base for the activation of muscle. Also, I will recommend you to perform breathing exercises, meditation and physical exercise which will make all the possible things turn down. In my clinical practice I have seen many cases which have a combination of complaints and also after proper assessment and understanding of the case we recommend physical therapy, and They respond wellRegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir, My daughter twisha age 5 was suffering from acute nephritis at age of 3. she was on steroids then. she recovered from the same in 6 months. she went in to relapse after 6 months but recovered in 3 weeks. later there were no issues and she was normal. now for past 4 months she is regularly getting few symptoms as seen at age of 3 like swollan eyes, aulbumin varys from plus one to plus four. I have shown here to child specialist as well as nephrologist. she has under gone various test for kidney such as sonography, dsma scan, urine creatin ratio, blood tests etc. she showns symptoms and then goes back to normal. this is being happening for last 3 months. Doctors are not able to judge the cause. all reports show that kidney is normal, but cause is not yet traceable. Request to guide us on the issue as we are very much concern about her. ### REPLY: Hi, If I were your treating Doctor for this case, I would come up with three possibilities, these include:1. The first possibility is B-hemolytic Streptococcus of group A. Diagnosis can be confirmed by test for Antistreptolysin-O, then she also will be required throat culture and sensitivity to antibiotics and consulting of ENT .2. The second possibility is herpes persistent infection. IGM, G to HHV 6 type, CMV, EBV should be measured to rule out any herpes.3. Hereditary, consult genetic doctor. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a medium size lump on my inner thigh in my groin area at first I thought it was an ingrown hair but now I m starting to question it feels like a hard lump inside it s red and it s kind of cracked in the skin not sure if I should go to my family doctor and have them look at it or if it could be something to not worry about ### REPLY: Hi, Lump on inner thigh with red and cracked skin should be seen by your Doctor for clinical evaluation, examination and investigations as and if needed. If there is any evidence of infection you need a course of an antibiotic, anti-inflammatory and supportive medications. If clinically it is not sure then added tests of blood and ultrasonography will help to get a correct diagnosis. The possibilities can be lymph nodes, any infected cyst, can be a hernia too. Hence, the necessity of proper diagnosis and management. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi..i m a student pharmacist from pakistan...i got presyncopal episodes 2 years ago...my cardiologist told me dat it was due to weakening of a heart muscle...which occurs in 33% of girls...he diagnosed it by having done my echo...he prescribed me cap.tricardin and tab.inderal..i wanna know da name of my disease plzzzzzzz... ### REPLY: The sensation of losing consciousness has a number of causes. The discovery made by your physician raises questions that require more information for a definite answer. Most medical societies recommend that the discovery of a weakened heart muscle be followed by pursuit of the cause of that weakness. With the symptoms that you have felt, some investigation of your heart rhythm may also be warranted. Briefly,1. There is not yet enough information to properly "name" the problem affecting your heart.2. Further, testing with your Cardiologist is needed to gain that information and screen for heart rhythm disturbance.3. The medicines recommended are in lines with current society recommendations. Follow up with your doctor is necessary to ensure that they are working (effects usually measurable beyond about three months). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife has a chronic cough which according to the varios doctors that we have visited, is allergy and they generally give her Motaire and some cough syrup. These give marginal relief but the cough persists. Someone recommended SEACOD tablets which could boost her immunity and give permanant relief after sometime.Is this true and if so what should be the dosage of SEACOD. She is 53 yrs old. ### REPLY: Dear Friend. Chronic cough has multiple etiologies ranging from just allergy, asthma, COPD, Acidosis. Montair and other anti- histamines can control the situation acutely. But the question is to be sure about the etiology of Cough. Please review with us with her X-Ray of Chest and Mammogram. Till than she can take levocetzine 5 mg once daily at night. Seacod capsules contains cod liver oil, which is an immune modulator, it helps in building the immunity. So, It's not a problem if she takes it. But it will not help in acute conditions.  Stay Healthy .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have an abdominal pain on my lower right side. If I press down on the area it doesnt hurt but it can give me a sharp pain every now and again. I had the pain yesterday when exercising but as soon as I stopped it eased off. I can feel it at the moment whilst sitting down but it is not painful.  I have had the pain since returning from holiday and have suffered from diahorria which has now cleared up. ### REPLY: Hi ! Based on the history of diarrhea in the recent past, you may be having simply a colitis (infection of the colon, specially on the right side in this case). You may have to go for a stool test and depending on the reports your family physician may advise you for some antibiotics for intestinal infection. However, one should keep in mind about a sub acute appendicitis, and the diagnosis can be done only by clinical examination by your family physician/surgeon assisted possibly by an ultrasound abdomen if need be. Wishing you an early recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I stepped on a piece of glass and it went in about a little more than half an inch and when I pulled it out blood started gushing for about 3 minutes and then stopped. Now I m having some pain when I walk and swelling and numbness on that area and on my toes. Is this normal? Please help! ### REPLY: Hello, It is due to local inflammation. There is a chance for infection and antibiotics have to be stated preferably amoxiclav. Daily clean with soap and water and apply topical antibiotics like mupirocin. If there is pain, over the counter available analgesics like paracetamol or diclofenac can be taken. 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: sir, i am haveing twins which are born on 02/10/2014 who are premature babies of 27 weaks and boy : 1.2kg and girl 1.3 kg and till now their are haveing repetaed infections for Boy: mainly mouth infections where are using vitamin c and for girl : repeted cold and cough and fever , this cold and cough are coming for boy at a frequncy of every 30 days and for girl for every 20 days its being very defficalt for us to look after can u give me better solution to get rid after this ### REPLY: Preterm low birth weight babies are very much prone to infections as there immune system is very poor. They are also very prone of getting cold as they cannot maintain their body temperature... First thing you have to do is always monitor their body temperature. An easy technique is to see whether the temp of hands, feet are same as over abdomen. If not your babies eye suffering from cold stress. Keep them well wrapped and feed them frequently. Once weight of the babies crosses 2.5 kg all these problems will come down. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, may I answer your health queries right now ?  Please type your query here...hi,my kid is 18months old and is not well past few days.he has cough,cold and also lack of Hemoglobin(8.7). what should be normal count if Hemoglobin for a kid of 18months.. ### REPLY: The Normal hemoglobin in 18-month-old child should be around 12 milligrams per liter. The hemoglobin level is 8.7 in your child which is less for his age. To know the cause of low hemoglobin you should to some blood test like complete blood count with peripheral smear, iron studies, hemoglobin electrophoresis. An examination by doctor is also necessary so that we may not miss any important finding. Review with report. 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 husband wears steel toe boots, when he does he gets a sore between one of his toes. Its gotten deep, and puse is comming out. The toe has turned red and Im sure its infected. If we soak it in warm water and take some antibiotics, think we came fix this? Its about a Half inch circle thats pretty deep. I put gauze between it to soak up the puse. ### REPLY: Hello, Welcome to , With the history and the symptoms it looks like your husband is having infected toenails. As the pus is coming out of the wound it suggests that your husband is having bacterial infection. It requires a course of broad spectrum antibiotics and to maintain proper wound hygiene by daily . Your husband should protect the wound by avoiding friction caused by the steel shoe and injuries by other means. The wound will take some time to heal as there is a loss of tissues because of infection, with proper  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ve felt breathless on and off for a few months, it seems to be worse if I ve drunk alcohol (even a small amount like one or two beers). Last year I had some blood tests taken for a different reason and everything was absolutely fine apart from a very low folate level. ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would explain that your symptoms could be related to low blood pressure or a lung disorder. I recommend consulting with your attending physician for a physical exam and some tests: - a cardiac ultrasound to examine your heart structure and function and exclude possible heart failure- a chest X-ray study and respiratory function tests to exclude a lung disorder-vitamin B12 plasma levels. A close monitoring of your blood pressure is also helpful to exclude possible hypotension. You should discuss with your doctor on the above issues. Hope to have been helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I believe my brother inlaw ,his 25 He won t bath, has very bad ocd, will not leave the house. Could have Schizophrenia where do we start to get him help. He will not sign or go for help, the world is crazy in his eyes. this has been going on for 6 years and just getting worse, My mother inlaw has know idea what to do.. ### REPLY: DearWelcome to  understand your concerns went through your details. I suggest you not to worry much. The given details are not enough to have a proper diagnosis. But the condition you are describing surely is a psychological disorder. You should consult a psychiatrist and get proper diagnosis and treatment. Medicine alone cannot cure psychological disorders. Need psychotherapy based practices. Consult a trained psychologist for the same. If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to overcome your problems. 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: My 7 month old baby since starting solids seems to have an excessive amount of wind. She is breastfed and never had any other issues such as reflux etc, and was not colicky as a younger baby. She now wakes with stomach aches and passes a great deal of wind. Her bowel motions are also very smelly. Have used simethicone (infacol) drops which don t appear to make a great deal of difference. Eliminating certain foods (dairy etc) has made little difference thus far. Any suggestions would be appreciated!1 ### REPLY: Hi... Thank you for consulting in . This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to .  Unless the air comes out like burping or flatus this discomfort will be there and next time check if the baby is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief. The two best ways to relieve this distress is - 1. Do not put the baby in lying position after feeding till the baby burps out the swallowed air.2. If still crying - put the baby in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here... hello sir/mam I am dhiraj kumar goyal from India. I have a problem of mental sickness and fear of death. thats y i have no confidence. please help me. i will be highly obliged to you ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Across the world, Every one has fear of death. Nobody wants to die. Nobody wants diseases. Still people are normal. Why?. Because they have so many other things to do or to think. You are a young person, I hope, though you have not given your age. Fear about death and health is called health anxiety. Counseling should cure you. Just consult a counselor. 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: We had our almost 16 year old daughters blood just done as she is a high performance track athlete training daily and we were worried about iron deficiency. Her results showed a slightly low MCHC count; 325 (reference range g/L).   Her hemoglobin count was 130 (g/L) and ferritin was 88 (ug/L).  How might the lower MCHC effect her performance in sport, she is a middle distance runner.  The doctor at the clinic suggested a B12 supplement.  How will this help?  Is a very low dose of ferrous gluconate (300mg) a good addition to her diet as well? ### REPLY: Hi, Thank you for your query. Both the hemoglobin and ferritin levels of your daughter are absolutely normal, and you need not worry on that count. Low level of MCHC per se does not have any significance if the other parameters are normal. There is no harm in giving B12 supplement, but I would suggest that you supplement her with all the vitamins rather than only one. This shall not have any effect on her athletic performance. I hope I have answered your query to your satisfaction. Wishing your daughter all the best. Rajiv K Khandelwalhttp://goo.gl/SuCjl ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: had heart stent put in 4 months ago due to heart attack that was brought on by severe pnemonia that put me on life support.a week ago my feet and ankles started to swell, getting less swelling,but still there.called my doctor,wont prescibe water pill,till he sees me sometime next week,any over the counter suggestions ### REPLY: Hello and thank you for your question. There are no over the counter pills that you can take, but there are some things you can do to decrease the swelling. Cutting out all salt in your diet is very important. This means not adding salt to your food but also avoiding prepared foods such as processed meats, canned foods and eating out at locations that do not use salt restrictions. Propping your feet up so that they are above the level of your heart can help also using support hose or compression stockings can decrease the swelling. Walking or just moving your legs around while you are sitting around get help get the fluid moving out of your legs as well. If you develop shortness of breath or chest pain you need to go to Emergency Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has high blood pressure, is on Coversyl 10mg, has had erratic readings at home today207/174     164/107  right arm  and 122/83   151/98  left arm.  this is the first time I have taken both arms forhim.  How dangerous is this ?  his kidneys are already affected. ### REPLY: Hi Thanks for posting your query.  See there is a significant difference in his blood pressure readings between his left and right arms. This indicates that there might be some problems in aorta (major blood vessel of the body) or some obstruction in blood supply to the right arm.  He requires 2D Echo and MR angiogram scan of his right arm to check for the problem.  Yes if Blood pressure is not under control for long time it can harm the kidneys. Kindly get Serum creatinine and urine albumin to check if kidneys are affected.  If kidneys are already affected then more aggressive control of blood pressure is required. Hope this information was useful to you. Any clarification feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a Leep procedure done a year ago because my pap smears kept testing abnormal. I have since had a normal pap. However, I believe my boyfriend of 3 years has the HPV1 virus. Prior to being with him I never had an abnormal pap. I m wondering if my abnormal pap was a result of him giving me the virus. He continues to get cold sores on the outside of his mouth. They look like the images on google for HPV1 herpes virus. I want to ask him if he has it or knew that he had it, but that s a sensitive topic. My concern is I most likely have it now and does this mean he will keep giving the virus to me and I will have abnormal paps again? Will I have to keep getting the leep procedure down the road because he can keep giving it to me? Can my kids get it if they drink from our drinks and etc.? ### REPLY: Hi, I am so sorry to hear about this abnormal pap smear that you have reported. Herpes has no relationship with abnormal pap smear. What causes abnormal pap smear is HPV(human papillomavirus) This causes warts and not cold sores. You may be concerned about the sores and herpes, but this has no relationship with abnormal paps. Also, remember to take great care of yourself especially protection during intercourse. I hope this helps. I wish you well. Thank you so much for using our services and feel free to ask for more information and clarifications if need be. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 6 week old fell off the couch. After a few seconds of crying he started falling back asleep. I started feeling parts of him to see if he d react like he was injured but he didn t. He just went back to sleep. What else can I do to make sure he s ok? Is it ok for him to be sleeping now? ### REPLY: Hi, in cases of head trauma there is high chances of brain injury. There are some symptoms which are found When brain injury occurs like persistent crying, seizures, persistent vomiting, bleeding from mouth or nose. If above symptoms are not present, then most of the time child does not have brain injury. However, it is better to get the child examined by a Euro surgeon, and if required a CT scan of head should be done. I hope this 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: Ive had a numbness in the left side of my jaw for 3days now and currently now have a sore throat that feels like my throat is closing up when i eat or drink anything the only thing i am able to drink is water, i am 20yrs old im 51 and weight is 314lbs ### REPLY: Dear Sir/ Mam, Numbness in left side of jaw might be because of eruption of your third molar or wisdom teeth. Since important nerves and blood vessels passes near the erupting wisdom teeth, you may feel the numbness and throat pain. If your wisdom teeth are already seen in the oral cavity, check for any decay or infection. Take an X-ray (OPG). Since the wisdom teeth is last one to erupt in the oral cavity there might not be enough space. If there is no sufficient space in the jaws or if the wisdom tooth is not in proper angulation it cannot come out completely. If there is no problem with your wisdom teeth, then suspect jaw joint (TMJ) problem. Hope your query is answered. Please don't hesitate to contact me back for further doubts. Happy to answer 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: 63yr old male patient, vertigo both BPPV and Vestibular, cervical pain w/headaches The signal in the cord and partially imaged posterior fossa is unremarkable. Spinal canal stenosis and kinking of the cord is again noted at the C5 and C6 levels. Disc space narrowing and degenerative endplate signal changes are most apparent at the C5-6 level. No abnormal STIR signal is seen. The vertebral body heights are otherwise well maintained. No evidence of a marrow replacing process to suggest neoplasm or acute trauma is seen. The paraspinal soft tissues are unremarkable. At the C2-3 level, mild narrowing of the right neural foramen is seen. At the C3-4 level, mild narrowing of the neural foramina bilaterally is seen. At the C4-5 level, a left paracentral disc osteophyte complex or protrusion mildly effaces the anterior thecal sac. Narrowing of the neural foramina bilaterally is seen. At the C5-6 level, a mild diffuse disc osteophyte complex with protrusion of the inferior C5 and superior C6 end plates posteriorly is seen. Mild compression of the cord at this level is seen. No cord edema is seen. Narrowing of the neural foramina bilaterally is seen. At the C6-7 level, mild to moderate diffuse disc osteophyte complex effaces the anterior thecal sac and mildly narrows the neural foramina bilaterally. At the C7, T1 level, no significant disc osteophyte pathology is demonstrated. At the T1, T2 level, no significant disc osteophyte pathology is demonstrated. The partially imaged parotid and submandibular glands are unremarkable. The parapharyngeal spaces are fairly symmetric. The thyroid gland is not well visualized. No definite enlarged lymph nodes are seen. Facet hypertrophy is noted at multiple levels. Impression: Degenerative endplate signal changes with spinal canal stenosis at the C5-6 level. Associated mild disc osteophyte complex. See above discussion of each vertebral level. No cord edema. Suggestive possible treatments. ### REPLY: Hello, The main treatment for chronic degenerative cervical changes such as in your case is with physical therapy and painkillers. Painkillers consist first in over the counter anti-inflammatory medication such as Ibuprofen and if not enough medication for chronic pain such as Gabapentin or Duloxetine.  Mind you that medication is only to alleviate symptoms, it is an only physical therapy which has a benefit in the long term. If symptoms persist in local shots of steroids and analgesics may be tried. If there are symptoms indicating cord compression and neurological deficits on physical examination then surgery might be considered. 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: on the 2nd of last moth i was diagnosed & treated for e coli.the day i finished the meds i began haveing suvere groin lower back &abdominal pain.i waited a couple days before returning to the hospital only for them to treat me as though i was a drug seeker.i do have a history with cancer.i had a complete histerectomy 13 years ago??????pls help regina.f ### REPLY: Hi Regina. Thanks for your query. I can understand the plight you must be going through. E cold infection can be just a small part of the major problem as you are rightly suspecting. Since you have undergone the full course for E cold, you yet have severe pain in the groin, low back and pain in abdomen. I would advise you the following:investigations: Stool - routine, microscopy, culture and sensitivity, urine and blood. Colonoscopy.CT scan of the abdomen. The investigations will guide us for further treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Will a person with brain atrophy end up in a comma? My 80 year old mother was diagnosed last year with brain atrophy. She was just seen by another neurologist who has determined that the disease has progressed at a rapid pace. We are trying to understand where this could go. Worst case. ### REPLY: Hello and welcome to . The short answer is that brain atrophy does not end up in coma. Brain atrophy is a finding on a CT scan or MRI of the brain - it is a radiological finding and not a clinical diagnosis. Brain atrophy on a scan may suggest that a patient is having cognitive deficit or dementia. When you say that "the neurologist has determined that the disease has progressed at a rapid pace" you probably mean that the neurologist has diagnosed your mother with dementia and is referring to dementia as progressing rapidly. Dementia does not end up in coma, but in "end stage dementia" - the worst case which you are asking about - patients brains deteriorate so badly that patients do loose all contact with the outside world and their condition may be compared to patients in a real coma. I hope you find my answer helpful. Regards and all the best while you care for your mother. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently went to the hospital for a GSH test I think thats the name of it, and it showed up That my Fallopian tube is leaking bad, what procedure happens next and is this why me and my partner are still to conceive a baby, If u could get back to me I would be grateful ### REPLY: Hello....thanks for trusting the  doctors for your health related queries. I guess your concern is about.treatment for leaking fallopian tubes...right. Firstly I want to inform you that.the procedure, u had gone through is HSG(hysteroslapingography) not the GSH. It is done to know the patency of the both fallopian tubes. The infertility patient usually goes through the procedure.in this procedure the dye injected inside the womb and x-ray films are taken. If there is dye leaking through the fallopian tubes inside the abdomen, proves that both fallopian tubes r patent, that means there is no blockage. I think u had HSG, n your both fallopian tubes r leaking, that means u have no blockage. That means your both fallopian tubes r patent. Secondly I want to tell u that u r not required any type treatment for this, because your fallopian tubes r normal. Lastly want to say that...RELAX, DON'T WORRY. I have high chances of getting pregnancy. KEEP PATIENCE. With the above discussion u can try out my suggestions-1. RELAX, NOTHING TO WORRY. Just confirm the procedure. If u had HSG then nothing to worry.2. Try to do coitus during fertile period(it is from 10th to 16th day of cycle during this period chances of getting pregnancy is high). So do coitus as much than possible during this period.3. If you are still worried or in hurry then visit nearby infertility specialist. He/she can help u. I hope the above information is useful, informative and helpful for u.regards- .  I pray the God that u will be blessed with a cute n healthy baby.hopefully TWINS) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m 18 yrs old i have taken i pill after intercourse after 4 days i got heavy bleeding for 2 days on which my periods ar due. Now after 9 days of taking i pill have severe abdominal and leg pain what does this indicate ??? I m pregnant ????? I dnt want to see doctor please advise i m vry tensed. ### REPLY: HI, Leg and abdominal pain after I pill is rare especially since you already got your periods. The pain could be due to other reason like local injury or rarely blood clot in your leg. Does the pain increase on walking and associated swelling is present? Chances of pregnancy is less but still to confirm it I want you to do a pregnancy test with a UPT kit. It costs cheap and is available in all pharmacy. The instructions on how to use it & how to read the test is given on the Kit Box. Contact us with the test 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 have severe mid lower back pain that is worse when standing 8/10 and 2/10 when sitting . I did have prostate cancer and received radiation and implantable seeds for treatment in 2015. I also had bilateral hip replacements in 2014,for severe arthritis.Any thoughts? ### REPLY: Hi I am . .  In my opinion that might be sciatica due to nerve compression which is common for post-operative hip replacement patients. You may begin with relaxation, Advil tab when needed, hot massages with topical gels, some cases may need steroid injections, physiotherapy will be effective. Please consider a 5-star rating with some positive feedback if the information was helpful. Wish you good health, Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was masturbating a few moments ago and when I rolled over I managed to jab the center of my penis on the pin on my belt buckle (that goes into the holes). Though it didn t pierce the skin (blunt trauma) it certainly hurt like hell, blood started coming out of my penis. The bleeding and pain has stopped, but I m really freaked out. What exactly happened down there? ### REPLY: Thanks for asking in  forum In Short: You might have injured your frenulum(fold of skin which holds foreskin when retracted. Explanation: Frenulum tear might have caused this as you injured yourself with belts part. If bleeding, pain has stopped, no wound and if you are able to retract foreskin normally during sex then no need to do anything.  If not visit a doctor for further treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir!!, Good Afternoon!! I would like to say that, my Mother has nephrology problem..Her name is Suparna Gupta. Her age is 46 years.. She has Diabetic since 2o years.. & she has high blood pressure also.. Now , till one year, she has kidney problem.Her Serium Creatinine is always high.. its range is (3.00 to 3.50 ). & Dr. also informed that,her Right kidney is small in size. So she wants to come to Chennai Appllo hospital for her treatment.. Could you pls tell me , the Expense of this treatment & is it properly cured or not? . Could you Pls, sned all the details in my email.Your early response is highly appreciated.Thanks & Regards, Dipannita Gupta ### REPLY: Your mother is suffering from diabetic nephropathy. She will require dialysis in the future. Current treatment should focus to retard the initiation of dialysis. For that, you have to do the following strict restriction of dietary phosphate protein intake should be 0.6 gym per kg body wt control of BP to less than 130/85avoid pain killers avoid Ayurvedic or homeopatChatDoctoredicationscontrol of blood sugar ### END