Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am taking Evra birth control. I was just curious, if on my 4th week, when i remove my patch for my cycle; Am I still protected? or is it possible to become pregnant during the first few days the patch is off while I am awaiting my cycle to begin. I cannot seem to find any information regarding these few days prior to my period actually taking place. I would assume that the medication has to work its way out of my system and this is why i do not receive my period for about 3-4 after i remove the last patch, however I want to make sure I understand when I am and am not covered by the medication. Thank you! ### REPLY: Hi, Welcome to . I am . I will be answering your concerns today. Era contains estrogen and progesterone and works just like birth control pills and is more than 99% effective in preventing pregnancy. In the fourth week when you remove the patch you are still protected. During this time when you are waiting for periods to start, unprotected sex does not result in pregnancy. This week is safe period. As you have rightly said, as the hormone levels reduce in 3-6 days time, you start your period. What is extremely important is that to remain protected from pregnancy you should put the new patch of Era exactly after a week (even if you still have period bleeding). If you delay, there is a possibility of ovulation occurring exposing you to the risk of pregnancy. I hope this is helpful. If you have further concerns, contact me through . Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear doctor ,my age 28 weight 57 and if i am do blood and urine test its result is ; creatinine , urine 17.50 protein, urine 10.0mg% protein creatinine ratio 0.57 urine routine examination result redblood cells absent pus cells 25-30/ HPF epithelial cells ++ bacteria + interpretation; increased copmpliment activity may be seen in cancer, UIcerative colitis etc& decreased in bacterial infection, cirrhosis, malnutrition, kidney transplent rejection, systemic lupus erythematosus etc please tell me it is a cancer ### REPLY: Hi Seth, Welcome to  Forum. Kindly let me know what exactly are your Symptoms? Because Just the reports won't lead to any particular Diagnosis, careful physical examination is also needed. Your Urine Creatinine report is very less than the Normal range is 500 to 2000 mg/day in a 24-Hour Urine Sample. The Protein creatinine ratio in women should be less than 0.025 or 25 mg albumin to 1 gram Creatinine. The Increased Complement activity that C3 and C4 activity is seen in Cancer and Certain Infections and Cancer cannot be concluded just like that. The Abnormal Urine Creatinine is seen in conditions like Glomerulonephritis, Urinary Tract Obstruction, Kidney failure, Pyelonephritis.  Kindly get yourself examined by a Nephrologist as all these Factors have to be taken into consideration before Finalizing a Diagnosis. Wish 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! I m on birth control , Alesse . I m back for reading week and have forgotten my birth control new pack. I m supposed to start a new pack today but I didnt get the time to go to the doctors and tomorrow is Family day as well. Is it ok if I start a new pack on Tuesday? I will be 2 days late in the pack, is that ok? If I were to have unprotected sex in the next few days, is that ok as well? Or do I have to wait 7 days, so next Tuesday? ### REPLY: Hello, Thanks for your query. If you skip your OC pills for 2 days the contraceptive efficacious is not guaranteed, hence if you miss 2 days pills the recommendation is to use any additional contraception for 1 week (like barrier contraception like Condom).  I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. 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 met with an accident and had wounds on the leg.The dressing was initially done with betadine but i could not see much improvement in would healing process.The doctor then asked me to use T-bact(2% mupirocin).would like to know whether this would be useful in healing. I applied ointment thrice and I see that the ointment is accumilated (not absorbed)in the wound(in the groove) and i am finding it difficult to clean it up. Is it ok if it remains that way. Is there an efficient method of cleaning it up. Can u pls suggest any alternative ointment l ### REPLY: Hello than to contact . If I am your treating doctor I would like to tell you that Betadine is the good antiseptic. But if you find it difficult to get treated I advise you to go for culture and sensitivity of the wound. Once you got the result for culture and sensitivity you take antibiotics which is sensitive to bacteria infected to you. Till that time you continue with the Betadine, because the Betadine is the best ointment to cure the infection. I also advice you to maintain hygiene, because maintaining the hygiene will cure your half of your problem. If you have anything else to ask kindly contact us. ; Infectious Disease specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 name is Kalyan, 33 yrs old, height: 5feet 11 inches, weight: 95kg. I am feeling fatigue from morning to evening. I crack knuckles heavily and my feet paining a lot. Recently undergone thyroid test but results are doctor confirmed that I do not have any problem. I also lack concentration and feeling sleepy entire day. Can you suggest me on my health condition and recovery from here? Thanks & regards Kalyan ### REPLY: Dear Kalyan, I can understand your concern regarding your symptoms. Feeling tired, lack of concentration, excessive sleepiness can be symptoms of depression. I would suggest that you seek a psychiatric consultation for detailed evaluation and initiating treatment. Treatment with ant-depressants lie Escitalopram will help with your condition. In addition, you can start exercising daily which will make you more relaxed and help to be active. Hope that you find this information helpful. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 22 year old female, sometimes get irregular periods, but lately they have been very normal. I normally get them around the end or beggining of a new month. This month i am experiencing an incredible amount of pain in my lower abdomen and my coccyx. its a sharp burst of pain from my coccyx to lower abdomen. My muscles in my body are also very sore. Is this pre menstural discomfort or do I need to worry? ### REPLY: Dear friend, there is no need to be worry. Abdominal pain is very common during/ just before starting of menstrual period.often this time of pain went off, once your periods became over. Second, ID you are suffering from acute abdominal pain not associated with menstrual period, you should contact a radiologist to find the causes of acute abdominal pain. Sometimes this becomes very serious too. Otherwise you can take mesenteric acid (Indian brand name metal) tablets for abdominal pain. Keep smiling. Wish you a very happy new year. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my age 24 and preparing for exam at the same time i had experence sperm/semen during pee and while shit......my errection is good, health is well diet is ok... from 2 weeks i hav t masturbate but i masturbate 2/4 times in week. ? i am feeling nervous and anxiety after amuse semen during poop. ? what happen to me. ? how to cure it (home remedies) ### REPLY: Hi. This is fairly normal and there is no need to be tensed about it. It can commonly happen if your masturbation frequency has decreased recently. If you used to masturbate about 4 times a week then your body was used sperms accordingly and now that you masturbate less frequently the body is still producing sperms at the rate it was used to. And therefore when it's not getting an outlet via masturbation it is coming out with urine and during stools passage as these are times that the sphincter gets relaxed. So don't worry. Your body will get used to less masturbation and the sperm discharge will decrease. You should keep the masturbation to once a week, and it will regularize the body to that level. You are absolutely healthy and don't let anybody tell you otherwise. 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 daughter (8) have vp shunt, yesterday she told me that she have a bump (size like dime) under her neck where the shunt/tube is, I take a looks no red, just smooth bump like water inside, is that leak from tube ? or shunt multifunction ? seem like she act normal, no headache or anything. what is the possibility of this situation ? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She may have leakage from shunt tube or some benign cystic lesion or some other mass. She should go for examination and if needed go for ultrasound study. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my back upper right tooth pulled on Friday. Now I can feel some sort of lump near the sight that is painful, I have clusters of canker sores around the area, mostly on my cheek. I also just noticed cluster of small white bumps spreading across my gum away from the extraction site, towards the front of my mouth. I really hope they dont turn into canker sores since Im already in agony but I have no idea what they are. ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have undergone extraction now you have lump near extraction site don't worry about this you can do is you can apply ointment Gum paint twice daily on painful Gums.  Do warm saline gargle two - three times a day.  Do Betadine gargle twice daily for one week. If you won't get relief then consult dentist for oral examination. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my friend is 86 years old with a defective heart valve.  they cannot operate as she would not survive the surgery.  her lungs fill up every month and she is in the hospital for this condition.  she goes to rehab and then goes home and back again with filled up lungs and shortness of breath.  your feeback please.  linda ### REPLY: Hello, thanks for using . I had gone through all the data posted. Lungs get filled up means that because of decrease in pumping action of heart blood gets pooled up in the lungs. When blood gets pooled up the water content of blood moves from blood vessels into lungs which causes shortness of breath. To tackle this we can do two things 1) improve heart function so that blood doesn't get pooled in lungs. 2) diuretic to decrease the water content of blood. So unless the heart function improves this cycle continues. 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: Ive had double by pass open heart surgery and two stent implants.  Now Im told I have a bad artery in front of my heart that they cant do anything for I have unstable angina pain..medication dont help me with pain.  Im worrying about how ling I will live, Im only 52 yrs old ### REPLY: Hello, I have gone through your query. Thanks for using . I understand that you have undergone CABG and stenting, inspite of that you still have angina. I am sure your treating doctor has given fully optimized medication. In this case there is procedure called external enhanced counter pulsations I.e.EEC. This will help your heart to develop micro collaterals beyond the blocks of larger arteries. You may please consider My best wishes .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have an over active thyroid and am on carbimazole my thyroid levels are in the normal range although if the dose is reduced I end up having a thyroid crisis. I am currently on 5mg twice a day. I am 5 stone over weight and keep being told to lose weight. Believe me I am really trying i watch what I eat, walk the dogs when I can (I have osteoarthritis, asthma and a fractured spine so activities are a bit limited). One week i could lose a couple of pound then the next week i weigh myself I have put that back on and more besides. How can I lose weight? I have heard that carbimazole can make it harder to lose weight. ### REPLY: Hi dear I read your problem of overactive thyroid and u taking Carbimazole (5 mg) and have in normal range. You are also a pt of osteoarthritis, asthma and fractured spine because of this u have limited activities.First u do some investigation for u recent problem.1-THYROID PROFILE2-Hb3-SERUM FE4-SERUM Ca5-CXR PA VIEW6-XRAY OF KNEE AP AND LAT IN MY VIEW FIRST OF ALL1- U MAINTAIN UR THYROID LEVEL AND COMES IN THYROID LEVEL.2-HYPERTYROID CONDITION CAUSES OSTEOPOROSIS WHICH MAKES UR CONDITION WORST SO MAINTAIN THYROID LEVEL.3U MAINTAIN UR THYROID LEVEL AND THEN U CAN ALSO LOSE THERE WT EASILY.1-TAKE 1GLASS MILK EVERYDAY IN UR DIET.2-USE BOIL WATER IN UR DIET.3-DONOT USE VIGOROUS EXERCISE IT MAY PALPITATE BRONCHIAL ASTHMA.4-TO LOOSE WT AVOID FATTY AND HOLY FOOD ITEMS.THANKS FOR QUERY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 to the doctors and hospital several times..I am in a lot of pain and discomfort. I have been experiencing pains in my lower belly and back and have sympyoms of a utine infection but I dont have one as the doctor dip tested it the other day. Ive been given cocodamol and an antibiotic but ive finished the course now andni feel its getting worse. I cant sleep becausr of the pain down below and constantly feel the urge to urinate. Im waiting to get biopsies taken from my bladder on the 10th of next month..but I dont think I can handle this for another day! Help!! Ive had everything done from swabs to scans etc..al clear ### REPLY: Hi. Thanks for your query. The pain caused from the bladder nut with normal urine and scan tests may be due to Destructor muscle instability. Only geometry and endoscopy of the urethra and urinary bladder can diagnose such a problem. It is better to consult a Urologist and see what exactly the problem is. Continue antibiotics for 3 weeks.Nowadays there are medicines available for such conditions too. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a foot problem since 2004, which a doctor quickly diagnosed as Foot Drop, and he said it would go away eventually, The foot doesn t perform very well, and it obviously hasn t gone away. That Dr. said there wasn t a treatment for it so I didn t follow up. But I ve moved from North Carolina to Charlottesville, VA and have recently visited the UVA neurology clinic and had the nerve tests, which gave me the startling news that I did not have foot drop --- wrong nerves involved. I m seeing the Neurologist at UVA soon and have been Googling just now, which makes me think I might have Morton s Neuroma, and I m struck dumb as it were. I have lived with a crippled foot (and talked about it ) for 11 years and now feel foolish, but does it sound as if that s the problem? If so, do you think I ll have any luck with physical therapy to wean myself off my walker? I m 84 and have waited too long, but would love to hear about your experience in this area. Sorry to go on so long. Best regards, Carol Cook Neurology specialty ### REPLY: Hi, thank you for providing the brief history of you. Yes, you can have an opportunity with physical therapy to regain the movement back which will be completely the nerve acceptance to the electrical stimulation provided as a part of the therapy. Also, most nerve injury or major neurological issues require physical therapy in this or the other way to get the musculoskeletal movements back. And research also supports the electrical stimulation to get the movements back with electrical stimulation, exercises and medicine combination. Since your age is 84 there will be a little delay but still there is a possibility to get back on feet without a walker. Keep a strong mental attitude and I am sure you will be helped. In my clinical experience I have seen cases with foot . Regards 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: My daughter woke up in the middle of the night uncomfortable . He head was to hot her back ,feet ,and stomach as well I checked her temperature and it seem normal. Her breath is hot and I was concern she could have internal body fever shes 9months old ### REPLY: Welcome to the ChatDoctorI completely understand your concerns. But don't worry. Most fevers are harmless and are caused by mild infections. Over . Fever is an important part of the bodies defense against infection. Many older infants develop high fevers with even minor illnesses. If you feel that you are not getting a proper temperature by peripheral devices, I would recommend you to take her rectal temperature. Taking your babies temperature rectally will give you the most accurate result, and the best tools for this are rectal thermometers, which are designed specifically for this purpose. Look for one with a flexible tip and a wide handle that won't let you insert the thermometer more than an inch. You can use a multipurpose digital thermometer as well but be careful and don't insert it more than 1 inch. If the rectal temperature is more than 100.4degrees Fahrenheit, you can give her acetaminophen or ibuprofen for it. Also, sponging is useful to bring down the temperature. If fever continues for more than days or if It's associated with any other symptoms, then do contact us or your pediatrician. For further questions, do contact us. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Recently I have been having a lot of discomfort after eating in my upper middle abdomen.  I have also been having bouts of crayola crayon green diarrhea pretty often now.  I have a history of IBS but never anything like this before.  Should I be concerned? ### REPLY: Hi. Thanks for your query. Read the history and understood the problems. History of Crayola Crayon green stools is indicative of an active and atypical infection as usually seen in infants. This is casing you the pain in the upper middle abdomen along with Gastritis. Anyways, the known history of IBS complicates the problem more. I would advise you the following :First of all the tests before the antibiotics are started to get the correct results.- Stool: culture and sensitivity; routine and microscopy, occult blood.- Blood : CBC, Sugar, thyroid, liver and kidney functions - Urine test -Ultrasonography-Colonoscopy. Your Doctor will start a course of an antibiotic which is active against the bacteria that produce green stools; metronidazole, probiotic are a must to restore the gastric flora, symptomatic and supportive. I am sure this is going to help you a lot. Once the Problems come under control, go for further tests if required. Continue probiotic for a long tine. Have control over stress and anxiety ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HELO SIR I M 46 YR FEMALE   I HVE COUGHING PROBLM AFTER TKING PRONLED MADICATION OF STRONG ANTIBIOTIC CLAVUM IN  AND HAVE  CONTINOUS FEVER  IN BETWEEN IT GETS ALRIGHT BT AGAIN IT REAPPAERS I HAD BALLONING AS I WAS SUFFERING FROM HEART  DISEASE IN 2000 AND MOST OF THE TIME MY ESR  IS RAISED A LOT ### REPLY: Hello I read your question and i would like to help you. High values of ESR indicate an inflammatory situation of your body. Antibiotic use usually after the treatment the ESR low down till in the normal values. If it does not normalize despite the right medication it is necessary to do some other blood tests to see if there is an autoimmune disease or other cause that not allow the ESR to normalize. For example:ANA, ANCA, RF, CEA, Hole blood count, CRP,Ca 125. So my opinion is better to consult a GP after all. Thank you I 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 cry everyday .i have the best parents . the best family .still i dont know the reason why i cryi am in 12 standard . i am very stressed . because my exams are near and because of crying i am loosing my concentration please help . i feel like dying ### REPLY: Hi, You seem to be under lot of stress. You might be suffering from depression which are causing the symptoms mentioned by you. Depression leads to low mood, crying spells, decreased concentration, negative thoughts, tiredness, sleep and appetite disturbances. I would advise you to talk to your parents about your current status and seek a psychiatric consultation. You might need to be treated with anti-depressants like Escitalopram. Regular counseling sessions together with medications will help a lot. Hope you recover soon. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My child has recently started sticking his tounge out and blowing spit bubbles all the time. I think this is very normal behavior for a 3 year old boy but my sister in law seems to think this means he has been molested. He shows no other signs of molestation but I was wondering if sticking out his tounge is an indicator ### REPLY: Hello, I can understand your concern. Sticking out tongue and blowing spit bubbles in a 3-year-old is not a sign that he has been molested. It is a myth. It has probably originated in old times because at this age, kids are not usually aware of molestation, and they cannot know if they are or have been molested. So when they stick tongue out and make spit bubbles, the myth makes parents to be aware regarding the surroundings of their kids and stay conscious regarding the molestation. Age 3 is the age when mouth and teeth grow actively and this produces excessive saliva in kids. The kids tend to make bubbles out of this excess saliva as a game. You can explain the child that these are not good manners and should be stopped. There is really nothing to worry about. I hope this information helps you. Thank you for choosing . Take care. 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: from past few days about 10 days,,if i sit in office chair for a long time and getting up, my tailor bone pains a lot At home if i sit in bed or car seat or couch i dont have any pain i am a female 36 years old, i had c section 5 years back with epidural ### REPLY: Hi, Thanks for your query. The pain in the coccyx that you have described can be related to coccydynia. You need to do hot site bath to decrease the inflammation in those joints. Do hot fomentation over sacrum. It will take weeks to months to subside. Use ring cushion and take site bath [sitting in lukewarm water for 10 min]Take analgesic like Nicosia 90 once daily along with tab methylcobalamine 1500 mcg once daily. If not relieved with all these methods then local injection may be required. You can take this consulting your doctor. Clinically spinal origin of pain needs to be ruled out, if required MRI spine can be done. I do hope that you have found something helpful, and I will be glad to answer any further query. 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 want to ask tht can I be pregnant if I got my periods. Usually I get into periods 4 days early bt this time I got into periods 4 days late. Before 15 days of my periods I was having breast pain nd it still pains bt nt so much now. Even I was having headache, feeling sleepy nd had to go to toilet more often. Even I cn see some swelling below my abdomen. Today is my 3rd day of periods ### REPLY: Hi there, I have understood your concern. I will suggest you the best possible treatment options. Basically, missing period is the most important sign of pregnancy.  If you have got your periods, even if they are 4 days late, you can very well assume that you are not pregnant. In case you still have doubts, please get mornings first sample of urine tested for pregnancy. In case of doubt blood beta  test and USG will be of help. I hope this answer helps you. Thanks.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my son suffered from scarlet fever a month ago since then he has been falling sick and always given antibiotic.currently he is having cold. I am afraid he should not get fever and be on antibiotic. Please tell me why this is happening to him.Worried mum ### REPLY: After complete treatment with antibiotics the chance of complications are reduced. Complications now occur very rarely. However, if they do occur, they can be serious. Complications due to the spread of the infection can occur early in the infection and may include the following:Ear infection (Otis media)Throat infection and collection of pus (abscess)Sinus infectionPneumoniaMeningitis and brain abscessLater complications can (rarely) occur a few weeks after the infection has cleared. These occur as a result of immune reactions in the tissues. These may include:Rheumatic fever (which can damage the heart)Kidney damage (glomerulonephritis)If your child has only cold and no other symptoms, you may give him chlorpheniramine. But in case he develops high fever or any other symptoms, do contact your physician. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a week ago today landing on my left buttock very hard. i had a bump for the week noticing it was getting smaller. last night getting out of my car i hit the bump. this morning i now have a blood looking bruise. it is still painful when i walk and have a sharp pain in one spot. was this a hematoma of some sort? is there something that can be done or does it need to run its course? ### REPLY: Hi, Thanks for your query. After going through your query I came to know that you injured your left buttock a week ago, and you got hematoma. If you have no fever, then no need to worry much. Hematoma gradually resolved by itself. Thrombophob gel local application three times a day over it(no rubbing) can help in resolving it. Sometimes hematoma does not resolve by themselves. In these cases aspiration with wide bore needle is done to suck the collected blood under aseptic condition for which you need to visit doctor. You can discuss with your treating Doctor about it. I do hope that you have found something helpful. 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. . You can discuss with your treating Doctor about it. I do hope that you have found something helpful. 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: my baby ( 6 days old) is not getting his mother milk hence doctor suggested Lactogen 1 but baby is suffering with liquid loilet and probably stomac pain every time we feed him with lactogen. should we change to NAN 1 or Biomil? need your urgent openion earliest. I am from bangladesh. ### REPLY: Hi, Welcome to , There is no urgent need to do that. Lactose is good enough as long as baby is liking it. Loose stools can happen if hygiene method used to prepare feed. That needs to be avoided. Be as hygiene as possible while preparing and feeding him. Stomach pain which you think is happening is actually gaseous distension and can be prevented by burping adequately after feed. May your child gave great 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: hello sir,i often get wet dreams at night,i kindly request u to give some sollution and stop this problem...plz i am more scard and i think my height is not growing equally to my age because of this wet dream problem..plzz somebody help me ,waiting for ur reply.... ### REPLY: HIT hanks for using  A nocturnal emission or wet .  It is part of sleep and there is nothing wrong in it. It is usually seen in male at adolescent age. Furthermore, it does not affect on height or leads to any physical side effects. In case, you want to stop it, you can do masturbation or can try some antidepressant like paroxetine. In case, you need further help, you can ask. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , my dauther is 13 months and she has a not scratchin whiter spot in her knee. What do you think it could be?Should worry? Because I am worry? Yes, my daughthe has a white spot in her knee? And I have been thinkin and worry of day becasue of this spot. ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  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: Dear Sir, My age is 31 years. I am suffring in back pain (upper side of back near neck).The pain starts at midnight and after this I cannot sleep easily.I am regularly using Diclofenace Sodium 100mg two times daily and Mecobalamine 500mcg three time daily. Please help me I am in Pain. ### REPLY: Hello, THX to contact us. I understand your concern. If I am your doctor I advise you to do physiotherapy exercise to strengthen your back muscle. Analgesics you can take as and when required, but it is not he definitive treatment. You should also think of getting X-ray chest and neck for vertebral abnormality. You can also think for heat therapy to reduce pain. In long duration of treatment exercise is the only way of reducing your back pain. Please do Serum Vitamin B12 and vitamin D level to check for any abnormality. I will be happy to answer more of your concerns, kindly know me, Wish you a very good health at . . Infectious Disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, about 6 months ago Ive had a lump on my neck near my collarbone.   I never thought much of it..  How ever I now have sharps pains on my left side of my face and head and ear. It comes and goes.  Sometime I feel a tingle sensation around my face and my left arm....  I am booked for an autrasound on Monday, and am very worried.  What could this be? ### REPLY: HI. Thanks for your query. Both the problems look not related as the lump at the collarbone can not cause facial pain and vise versa. The lump at the collar bone can be a lymph node and should go for FNAC and biopsy to determine the cause of enlargement and treat accordingly. The pains on left side of face. Head and ear can be due to trigeminal neuralgia / sinusitis/ Consult a neurologist, get MRI of the Brain, trigeminal nerves and sinuses to determine the cause and get treated accordingly. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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. Sometimes my husband wakes up scared and stands up hyperventilating. It s usually triggered by a light touch, such as my hair landing on his arm, etc. Once he realizes he is safe, he goes right back to sleep. Could this be a sign of ptsd? He s never had an anxiety attack, that I m aware of. ### REPLY: Degree understand your concerns went through your details. First I wish to know why are you Asking "Could the sudden wake up from sleep be a sign of PTSD?" without any other additional symptoms in itself proves the problem is not PTSD. PTSD comes after a traumatic experience or event. It could gild, moderate or severe. Just startling is not a significant symptom in the case of PTSD. The significant symptoms include Feelings of intense distress when reminded of the trauma, Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating), Avoiding activities, places, thoughts, or feelings that remind you of the trauma, Increased anxiety and emotional arousal etc. Does your husband experienced any traumatic events in the past? If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. 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: This morning while dropping my child off at daycare I was coming out of my truck and slipped on ice and fell flat on y back, when I managed to get up my lower back and neck hurt. I didn t think I hit my head at the time, but when i got to work the back of my head hurt and was completely wet, assuming from the ice and water on the floor. I feel extremly sore but what is worrying me is the extreme headache I have. What do i do? Is this cause for concern? ### REPLY: Dear-thanks for using  and I read your question with care. The back and neck pain is secondary to the fall and can last few days. Due to the fact that you did not hit the head, we don't have to worry about a subdural or brain hematoma. However, the headache is because the acute body trauma, you can take analgesic as acetaminophen or ibuprofen for that. If your headache persists for more than 48 hrs or if you start having neurological changes as memory deficit, blurred vision or changes in the strength or numbness of your extremities, you should go to ER for a CT scan of the head. Otherwise, this is part of the result of a fall and should see the improvements in 72hrs. I hope that my advice has been helpful .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I woke up Saturday morning with my right upper tooth hurting. I assumed it was a toothache during day on Saturday and Sunday it has got worse. Now I can not touch 3 of my teeth with finger or food and it hurts up in to my cheat. Do I go to ER or call emergency number for dentist ### REPLY: Hi Dear, Understanding your concern. As per your query you have symptoms of pain in right upper teeth which seems to be due to exposure to nerve root endings due to severe attrition, stress, malocclusion and underlying systemic pathology. Need not worry. I would suggest you to visit oral and maxillofacial surgeon once and get complete examination done. You should go for clinical evaluation and intraoperative periapical radiograph and start treatment accordingly. You should go for root canal treatment and composite resin restoration. Avoid intake of cold substances and hot liquids as well. Maintain hygiene of oral cavity and avoid sticky food. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What does it mean when a doctor finds a hole in a premature baby s stomachthey took my baby that was born premature to children hospital to day.said they tryed to feed her and she throw up. They said the found a hole in her stomach . What does this nean ### REPLY: Hi, hole in the stomach means that your child has got an intestinal perforation. It's a very serious condition. Since your child is preterm, he is very prone to infections and perforation of stomach or intestine. This condition is closely related to Necrotizing Enterocolitis(NEC). As of now, child will have to be put on very high antibiotics and a surgery might have to be done to repair the perforation. He will have to put nil per orally and on full intravenous antibiotics. He will require continuous monitoring and admission for few weeks. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, I am 34 years old and suffering from serious anixity disorder that is ocd for so many years and now i have been taking medicine for atleast one and half years. In fact i have been cured up to 80% not completely. My main problem is unwanted thoughts whicChatDoctores in my mind regularly and there is no break not for a single moment whenever I try to think something same and distrubing thought comes in mind and have been ruing my life toltly sick life. I have been feeling every condion which are possible in ocd such as door checking, gas checking, sexul thughts, stress, doubts, suspicians, insomnia, heart beats, sweating, unwanted thoughts and I had enclosed myself in to darkness of a room and just watching tv for hours continously ### REPLY: Hello, Thanks for choosing  for posting your query. From the description that you have mentioned, it appears very clear that you have an Obsessive Compulsive Disorder. I should mention that OCD is a difficult to cure illness and as you have said that there is 80% relief, it's a big relief. For OCD, you have to be under the treatment of a good psychiatrist. The treatment options are:1) SSRI Fluoxetine, fluoxetine.2) TCA- Clomipramine3) Antipsychotic: risperidone4) Behavioral therapy: Exposure and response prevention5) Cognitive behavioral therapy. Try all of them together and that will give you relief. Also start doing exercise and good diet. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 49 and I found a hard lump a couple of months ago about 3-4 inches above my ankle on the back of my leg that started out red and sore to the touch.  The redness went away and it now looks like an old faded lt brown bruise and I have to really look to find it.  However, it is still sore to touch - much like a bruise is and it still is hard.  It is about the size of a penny.  I also now have heel pain on the same leg when I get up to walk but then it fades. Its worse some days than others. Sometimes it hurts every time I get up and other days it hardly hurts at all.  I do have Dupuytrens disease.  Could this be a lesion similar to that? ### REPLY: Hi! Good evening. I am  answering your query. Although it needs to be clinically assessed, with your history it seems that you might be right in your presumption of this being a manifestation of Dupuytrens disease of the tendo-achilis, though not very usual. I would advise you to get it assessed by your family physician for a proper diagnosis. Till then, you could go for an anti-inflammatory . I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having pain on the right side of my head and have been treated for a sinus infection. The antibiotics did not help so I went to an ENT who said it could be related to a migraine and stress and that he did not see any infection, he prescribed a medrol pack for 6 days. Still no relief so now I am going to get a MRI of the brain tomorrow. I recently had a root canal and the pain is in different areas of my right side of my head. It hurts sometimes on top, up thru my nose and upper jaw and mostly the area behind my right ear. I sometimes feel a little light headed and my head like when I get a sinus infection.Do you have any suggestions ### REPLY: Hello, I can understand your concern. The type of pain you are experiencing is also felt if oral cavity or temporomandibular joint (TMJ) has focus of infection. As you have recently been through root canal treatment, I suppose that the dentist must have checked your other teeth and may have informed you if any of them is infected. So we are ruling out infected tooth as a cause for pain you are having now. The other possibility is TMJ problem. This joint is associated with opening and closing of jaws along with side to side movements of the lower jaw. The problems with this joint are often felt in ear and can be felt up to temple and behind the ear. The upper jaw and nose might feel referred pain. Thus, before going for diagnosis of brain problems and MRI, I would advise you to visit a dentist or oral & maxillofacial surgeon for examination of the TMJ. If they rule out any problem with the joint or oral cavity, you should go for MRI of brain. I hope this information helps you. Thank you for choosing . I wish you feel better soon. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have a deep lump on the edge of my right scapular near my spine. the shoulder has been painful for some time and the pain is felt in the ribs and under the arm. I have pain also in the upper arm and my thumb mostly but sometimes all of my fingers are numb. ### REPLY: HI. All the symptoms you have mentioned may be due to the Cervical spine problem, it may be cervical Spondylitis or Spondylolisthesis with Neurological manifestations. The lump on the edge of the right scapula can be a muscle in spasm or a lipoma or a sebaceous cyst. MRI of the cervical spine and of the Brachial Plexus can give the reason for the pain in the ribs, under the arm, upper arm and the thumb. You may have to go for surgery of the spine if the compression Inter-vertebral discs are more prominent and causing symptoms of compression; if not Physiotherapy will help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. i had a baby in turkey 1 year ago and have been suffering with low iron anemia. so i was on tablets. i dont eat alot as never got time with having a baby and dont eat good food, and now i am getting pulpertations, my heart keeps racing and i ache all over? YYYY@YYYY ### REPLY: Hello, I have gone through your query. Thanks for using . Your symptoms are due to Anemia. You must recheck your hemoglobin again.first if you want to take good care of your baby, you must take care of yourself first. You must east well. Take lots of green vegetables and Jagger, rich source of Iron. If still your hemoglobin is low check your Iron level, and you should take total dose of iron in injectable form. This will help you a lot. As last resort if your hemoglobin is too low you may need blood transfusion, which mostly you will not née. My best wishes .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have Psoriaz more then 6 years already. It became worse after born of my 2 children one after another with difference 1.5 years. Ive tried many ways to ged rid of this, even took a courses of UV lights but nothing helped. Now my Doctor prescribed me Neotigasone, 60 drugs which I should dring for 2 months...I wanted to ask if this could help me or make some harm? Thanks ### REPLY: Hello, Welcome to , Neotigasone is accretion, and it is an approved medicine for Psoriasis. This will help you. If you are taking the medicine under supervision of your doctor and if you continue monitoring your blood parameters as advised it should ideally do no harm. When you are on the tablet you should not get pregnant, and I am sure your doctor would have counselled you in this regard. Your skin and lips can become . Hope this helped, 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: Dr, I am 30 yrs old and i am pregnant for the first time. since my pregnancy i am affe cted with lichen plasm. i have been prescribed with halovate ointment. now iam 5 monts pregnant and this infection is spreading all over my body. can u suggest what do i take for the cure now ### REPLY: Warm welcome! Thanks for visiting world's best online health forum. I was assigned to assist you today for the health query you have. Lichen plans is self limiting usually (means it goes at its own) but sometimes the symptoms may go worse and become bothersome. In that case I usually use to prescribe Cetirizine oral, Fluocinonide And Tacrolimus topical ointments for application to affected areas of skin. For oral Lichen lesions you need to keep good oral hygiene and diet improvements to have a good power to fight against infections. You may consult a Dermatologist too for better insight. I hope this was all you needed an answer for. I am at your disposal for extended explanation and medical help if you need more. Healthiest 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 aunt is 40 years old and is suffering from hyper tension and USG report shows small kidney and pathological report creatinine, blood urea potassium found raised and acc. to Dr. it is a case of CRF and patient is anemaic. PLz suggest the proper treatement for this disease.. ### REPLY: Hi and welcome to .  As a Urologist, I can understand your anxiety. Your aunt is suffering from CKD/ CRF with H.T. and anemia. You should've written her He, creatinine,urea, uric acid, and electrolytes level.She'll need to have a kidney biopsy to know cause of CRF. In the long term, shell need to undergo a kidney transplant. Anemia is corrected by giving plasma infusions and erythropoietin. The earlier she has a transplant, the better for her. If you've any other doubts, send her reports to me, as a direct question. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 28 yrs old Female. I have no major health problem.I got married 3 yrs back. I have had 2 abortions, one after 6 months(in Nov 2007) and another one after another 10 more months(in Sept 2008).I do not take any contraceptive pills. We are only going for external contraception.Now we are planning to have a baby, and we have been off contraception since last 4 months and still we havent got positive results.Do you think that previous 2 abortions could have affected my fertility?What measures do you suggest to take before getting pregnant?Also, what all should I have to have a healthy baby whenever I become pregnant? ### REPLY: Hi, Thanks for the query. I understand your concern.  Were you using contraception for all of these 8-9 years? If not you should go for investigations like- - Excluding any infection of genital tract.& get serological tests for STDs - Ovulation study to confirm normal ovulating cycles.  - Semen analysis to confirm normality, - Tubal patency test.  * In case of any problem detected-take complete treatment to get rid of it.  * both of you need to be free from any illness for at least 3 months before conception. Take folic acid 5 mg daily/ vitamin E 200 mg daily(both of you)for three months.  * try unprotected sex on your most fertile days (around ovulation day) * consult a gynecologist earliest after confirming pregnancy (inform about 2 incidences)- for hormone supplement & cervical suturing as per need.  ** If no conception within 1 year. Go for assisted pregnancy with help of infertility doctor, Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a dark line over nose from past 2/3 yearsTried many medicines but still its there.Initially i had one line but nowadays i could find another line getting broadened in the top portion of the nose along with a line in the bottom above the tip of the nose.Kindly provide me a solution for this as am just 23years with dark complexion ### REPLY: Hi, You seem to have condition called transverse line. There is a black transverse line caused by hyperkeratosis. Mostly it occurs in patient having chronic rhinitis(cold). Due to running nose, patient clean the nose rubbing the nose upper side with his hand (salute). I have seen many patients having transverse line of the nose. I usually recommend retinoid gel 0.012% like retop A gel or tree gel 0.012% to apply on the line. Percentage of street of the gel may be raised if needed. Comic acid and vitamin C containing cream may be applied till good result. Vitamin C tab. And glutathione may be taken for long time. Habit of handling the nose may be stopped. You might feel better after few weeks. Still, you consult dermatologist. I hope you got my answer. 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 bay boy is four and a half months old and off late probably a week or so he has been straining while peeing and when he is bf also he strains and cries and passes urine like it is an interlinked urge...i dont lactate enough so i giv him top up feed and i hav relocated to uae, i used to feed him lactogen in india and here it is unavailable so i fee him similac since he refused nan but his intake has considerably reduced...plz need help ### REPLY: Howell come to ChatDoctorIf the baby has problem in passing the urine, then most likely cause would be fibrosis (is the condition where the foreskin of penis can not open properly during passing the urine "Retraction problem) and this need to be ruled out first, second this could be due to crystal formation in urine this also need urine examination, hope this information helps, take care. (These both the conditions need to be treated accordingly if found positive) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 blood pressure is raised 128 over 90 my doctor said one of my liver enzymes is high, for the last 18 months i have had trouble with my hip and need hip replacement and my doctor has been prescribing me celebex and declefenic and i have read these can raise blood pressure how long do they last in your system ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You highly blood pressure and pain with hip replacement. Celebrex and Diclofenac both are non-steroidal anti-inflammatory .  They don't have significant effect on your blood pressure so don't worry about that. Just be relaxed. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a cyst under my skull behind my right ear. Its almost in my neck, but still the hair area. Its there for about 14 years. It makes my neck very stiff and hurts alot from time to time. The pain usually goes up to my head and down to my right shoulder. Its not visible to the eyes, but if you touch it you can feel its hardness. Ive mentioned it to many doctor and all they do is give me mucle relaxing and exercise. I even went to an cirugian to get it removed and he said he couldnt see it, so he couldnt renove it (I couldnt help to laugh). Can you tell me anything about it, please? ### REPLY: Hi, Dear,Good evening. Thanks for your query to my virtual  Clinic. I studied your query in-depth. In My opinion-diagnosis is-? Dermoid Cyst ? Sebaceous Cyst?or it could be a chronic mastoiditis-as the pain and tenderness is felt.? Or it could be -Normal -Mastoid tuberosity with tenderness due to the deep pressure on it-misunderstood by you as-hard cystic lump behind the right ear. AS the Surgeon could not see and detect it-you would need-X-ray Skull, USG of the Cystic Swelling, and or-CAT scan or MRI to confirm the diagnostic probabilities. Treatment-Would be-a-Surgical Excision- if it's proved to by lump-? Desmond or ? Sebaceous Cyst, b-Chronic mastoiditis-would be cared by Tb-NSAIDs, Antibiotics with Surgical debridement of the mastitis by a ENT Surgeon-Hope this would resolve your worrying query. Wellcome for more query from you. Good day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: how do i reduce my sgpt & sgot levels and what medicine should i take to reduce the those level sgpt is reached 126 (biological reference range is 13-69)& sgot is 65 (biological reference range is 15-46) please suggest some medicine back to the normal. ### REPLY: HelloIncreased SGPT may indicate liver injury. It may be due to many reasons like hepatitis, alcohol intake, altered lipid profile,autoimmune causes etc.GOT is non-specific, and it increases in many conditions. You may need few more investigations like routine hologram, random blood sugar, lipid profile, ANA estimation, viral markers, urine RE/ME, ultrasound of abdomen. I suggest tablet ursodeoxycholic acid 300 mg twice daily for three months to my patients. It helps in regeneration of liver cells. Further requirement of medicines depends upon findings. Avoid alcohol if you take it. Get 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 neighbor is older (not yet elderly) & has fibromyalgia , & currently being treated with lyrica & savella she has been on both for a few years now & she feels that the lyrica is causing her to be forgetful & once in a while has been in a blackout state after the lyrica was upped for the pain , what other medicine can she ask the doc about that could help her instead of the lyrica , I love her like family & hate to see her like this ,she doesent want to be on anything too strong either any suggestions?? ### REPLY: Hi, thanks for providing a history on the case. I will take recommend doing some exercises. Sometimes taking excess of medicines will damage the body. I truly understand that fibromyalgia pain is really a tough to deal but taking too many medications will not help in longer run. Well with my fibromyalgia cases I keep all these things in my mind and the prolonged side effects. I focus on the rehabilitation planning and then help best with meditation, yoga, breathing exercises, fitness training, strength conditioning etc. I hope you will be helped too. All the best. Sometimes thinking out of the box helps a lot ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 severe lower back pain for the last of couple of months. The main is more when I wake up in the morning. i consulted an ortho doctor. He said the tissue in L5 joint has squeezed. Temporirly he has given me ocid 20 , aceclofenac and Nucoxia 60. How to solve this problem permenantly ### REPLY: HAI.this is lumbar disc compression or prolapse, a chronic pain problem, u had to follow good spine relaxation physiotherapy exercises. By avoiding strain on the back.pls go ahead with a MRI lumbar spine for localization of the problem. For pain control u can start with gabapentin or pregabalin added with methylcobal daily, these . U can visit good pain clinic for local nerve blocks or intrathecal magnesium for relieving the pain and spasm.good luck take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a male 71 years old.I have developed sever medium sized cyst type knots under my scalp on the back of my head in my hair line.  they are somewhat painful and are seeming to get large.  This started about a week ago and is getting worse by the day? ### REPLY: Hello, Welcome to , A cyst is a sac that is filled with a fluid or semi-fluid material. Cysts develop in various places in the body, and it also arises from scalp. The most common types of cyst that occur under the skin surface of the scalp are epidermis and polar cysts. These cysts used to be called sebaceous cysts. An epidermis cyst is a cyst where the cyst sac forms from cells that normally occur on the top layer of the skin. A polar cyst is a cyst where the cyst sac forms from cells similar to those that are in the bottom of hair follicles. The cyst can be easily removed by a simple operation under local anesthetic. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am suffering with bipolar disorder and mild deppresion since 7 years, because of this i have taken very fastest decisions and lost entire my money.Right now I amd taking Pramiprex-1mg and depakote 500mg and for good sleep taking one Ativan tablet at bed time.Myu memory has comedown drastically.Recently stasrted yoga ,meditation and started personal journal. ### REPLY: Hi.depression is word with lots of negativity along with these. So try to be optimistic and have positive altitude on every situation. Do exercise and yoga daily routine which may increase your inner power. Try to go to alternative medicine like homeopathy which may treat not only disease but from inside to outside .for these you need counseling on psychological bases and homeopathy is best option .you stop all this psychotic medicine because it decreases your thought process on starting you feel difficulties but after some time you feel good. Thanks . shah84@yahoo.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: How long does it take for Strep Throat to go away. I have been taking Biaxin since Thursday.  I still have the white patches of infection, fever, body aches, muscle and body fatigue.  I also have an ear infection and sinus infection to go along with it.  Normally when I take antibiotics for strep I feel pretty good at least by the 1st or second day. ### REPLY: Hi thanks for contacting ... Here you could have streptococci like bacterial infection, or it can be viral influenza respiratory infection....CBC can be done for it... If shows neutrophils then bacterial and if show lymphocytes then viral cause can be there.... Take cefuroxime protein like antibiotic for it . More water taken.... Hot water useful.... Avoid excess spicy and fried food excess for few days.... Fruit juice more.... If blocked nose present you can take .05% oxymetazoline nasal Spray can be taken... Antihistaminic . ... If still condition increasing then throat swab can be taken and send for culture... Consult physician discuss these with him... 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 took a HPT that came out faint positive and i havent had a period this month but i have started spotting today. I have taken other HPT tht came out negative but the one I took was early pregnancy test. Ive been getting sick and feeling nauscoeus. Lower back pain. Im bleeding but not bad and not really hurting with cramps. Hats goin on ### REPLY: Hello,First, you undergo one blood test for beta-ChatDoctor to rule out conception. It is more reliable than home pregnancy test. TVS scan gives additional information. Other reasons are stress, hormonal imbalance, pelvic infection, irregular diet habit, over wt etc. Following initial test result, you consult with gynecologist to proceed other investigation. Take suggestive measures accordingly. Maintain genital hygiene properly. Avoid stress and control body wt. Take some muscle relaxant gel to reduce back pain. Hope it helps for 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: My husband was told yesterday when I  took him to the hospital that he has mania, just what is that? I took him to th hospital  because he was out of control and had not slept for thee days and nights and  he was doing all sots of crazy things and was most irratable. I could not stand it any more. He is also in stage four liver disease. ### REPLY: Hello, welcome to . From the information it appears that your husband is suffering from bipolar disorder (Mood disorder). In Bipolar disorder patient has both manic and depression episode. In Manic episode common symptoms are: over cheerfulness, anger, irritability, increase energy and decrease need for sleep. It is a chronic and severe illness and treated by psychiatrist on urgent basis. Medicines like mood stabilizers are primary mode of treatment for this illness. Wish you good health and all the best. . 99doctor.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good day: my question is my dad is 63 years old. I am registreted nurse and i was concerned about his question. He asked me that what could be the problem if he is presenting tong burn and pain, vission irritation and muscle pain. Im not sure what could be the problem but i tought about the sjogren syndrome. Any advice or Dx you can give me i will apreciate. ### REPLY: Hi there. Welcome to . I have read your query. It appears that your father may be suffering from possible Vitamin deficiency like Riboflavin and other B vitamins and possibly vitamin A. It is advisable to eat plenty of fresh fruits and green leafy vegetables. The colors fruits and vegetables have more vitamin content than the non-coloured ones. Also in old age, the person tends to not take enough water so high chance of deny .  Kindly make sure he is well HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had back surgery at 28, I am now 54. I had a hip replacement last year. In addition I have fibromyalgia and osteoarthritis. I am taking Cymbalta 60 mg, does not help pain but has other benefits for me. Lydrica ws tries as well as tramadol. I am getting my 2nd injection of viscosupplemantation to biilateral knees for the second time next week. First time was in May lasted 2 months. Also was prescribed 800mg Motrin, helps a little. Also made an appointment for an accupuncturitst next wee. Just cant take the pain any more from hands to feet, why can I not receive stronger pain medication? I feel embarrassed bc I walk funny from all the pain ### REPLY: Hello, Welcome to the magical world of health care, I went through your query, and I can understand that you are in pain, BUT let me tell you getting a stronger pain medicine is not a safe idea, the majority of them have other adverse effects, and cannot be used for long. Now coming to your point of pain, appreciation of pain occurs in the brain, and our tolerance controls how much pain we feel, this is the reason that similar impulse cause different level of pain in different individual, so first learn to be active and bear some pain. Second get treated those joints which are maximum painful first, either replacement or Rhodesia, what ever suites your needs. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. I hope a 5-star rating if you feel guided in your treatment, Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having severe diarrhea for for over a month now and have noticed a hard lump or bump in my abdomen area lower on my left side. no blood in stolools but frequency is all day and sometinmes in the middle of the night, I am afraid it could be cancer is this possible ### REPLY: Hi, Dear,Thanks for the query to My  Clinic. I studied your query in details and understood your health concerns.-Treatment Advise and Cause of your hard -lump on lower left side of abdomen-a-In -my opinion-from the facts given by your query -it mostly suggests as-due to Strangulated old hernia with -severe intermittent-diarrhoea.-Other possibility is chronic TB enteritis with hard lumpy-node in the groin Area.b-I would advise -USG, which would fix the diagnosis amongst many probabilities as suggested above.c-After confirmation of diagnosis, Urgent-Repair of Hernia with Release of strangulated chronic hernial adhesions is advisable. This advice would help you to plan treatment with your doctor. Hope this resolves your query. Wellcome for further query in this regard. Have a Good Day...!! With Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i take adderral xr but can t go to sleep till 5 in the morning then i can t get up till 3 or five in the morning plus i take cymbalta for deppresion for i had a back fusion so i take perocet for pain is that ok or does it affect the adderral xr ? why cant i sleep at night because i am under doctors care dor deppression and i take lamictal desyrl klonapin and ambien at night also i don t know what to do also taking adderral give you demdemenyia or brain damage.thank you kathy ### REPLY: HiT hanks for using  Adderall is a stimulant and if you take it daily, it would affect on your sleep, Better to avoid it for few days. Cymbal ta is good antidepressant, but it has good response on somatic symptoms rather than depression. Better to shift on antidepressant like trazodone for mirtazapine to get sound sleep. You can take Klonopin and ambient at night. Take parcel on sos' basis for pain. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My girlfriend is on Loestrin 24 Fe birth control pill and has been for probably 8 months. She takes it religously. We recently had sexual intercourse and I was not wearing a condom but I pulled out before ejaculation. She had her period a week before sexual intercourse, and now, 1 week later, when she is taking the placebo pills and supposed to have her period she isnt. Whats the deal? ### REPLY: Hi, I have read your query & understand your concern.  Your girlfriend is taking contraceptive pills Holstein 24 Fe regularly, at the time of sex you had taken precaution in form of with . . All This thins suggest sufficient of protection & there seems to be no chance of conception.  You are concerned as she did not start her menses while on placebo pills. This can be due to psychological stress leading to hormonal disturbance. / with ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am totally fine and my height is 5feet 3inchs and my problem is masturbation i am 13 years old and masturbate daily cant control it and the doctors says that you do it aging and again your height will not grow is there any way to control your mind stop masturbating? male ### REPLY: Hello dear,First, I wish to tell you that Masturbation is common among young males in their teenage, and it does not have any bad effects on health. Since you are feeling that masturbation is interfering with your normal functioning, you can try out the following measures:1. Improve your social life by spending more time with friends and relatives.2. Keep your mind active and busy at all times either through curricular or extracurricular activities.3. Have a diet rich in fruits, vegetables, fish, nuts & honey.4. Avoid fast foods & lipid containing diet.5. Avoid smoking & alcohol.6. Keep away stress, think positive.7. Exercise regularly & practice meditationThese measures will be helpful in improving concentration & builds up the confidence level. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had stuffy nose and sneezing for past couple days. In the morning I had green but it gets clear after I clear sinus. I was taking mucus relief day and night sinus congestion medicine since 1st. Today I went to pharmacy and got Wal-itin D (loratadine 10mg pseudophedrine 240 mg) and its 1 dose per 24hr. I took it at 3pm. It did not help the sneezing/itchy sinus or runny nose. Can I take the night time( acetaminophen, guafensin 200 mg and phenylephrine5mg) or day time (acetaminophen, diphenhydramine chi 25 mg , phenylephrine hci 5mg) medicine? It seemed to stop the itchy and runny nose. ### REPLY: Hi, You might have sinusitis or allergic rhinitis or upper respiratory tract infection with congestion which actually causes all these symptoms. You can do some routine blood tests with sputum examination and chest X-ray to have confirmed diagnosis. Anyway, you should be given oral antibiotics (quinolones or accolades) in full course for about 4 to 5 days with antihistamines syrup or mast cell stabilizers and nebulizers with steam inhalation to get rid of complete infection from sinus or nose.Don't for self-medication despite they are OTC . So, better to consult ENT specialist for further treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently lifted a 60 lb. object, then spent 4 hours standing at my father s wake. A couple of days later I noticed a sharp pain, almost spasm-like on the right hand side of my lower-middle back. The spasms have subsided but it s been 5 days and I keep getting what I can only describe as sudden back cramps when I move a certain way. My father died of renal cell carcinoma and I am afraid this is what I have ### REPLY: Hi and welcome to ChatDoctorDo not afraid, this is not renal cell carcinoma. The fact that your pain is occurring with movements indicates a muscle strain. Any strained muscle when stretched gives severe pain. To get relief from the pain and for quick healing:1. Do hot fomentation at the site.2. Apply local anti-inflammatory gel 2-3 times a day.3. Take anti-inflammatory . 4. Do not lift weight or try to do exercise that involve painful muscles. Give proper time for the injury to heal. 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: hi good day. my puppy was accidentally licked my tiny wound in my skin in my legs, but my wound is almost healed and its so very small. its like a scratch only and i get this in mosquito bites i think. but last month i got anti rabies vaccine because of scratch of my cat. what do you think? i am safe or not? thank you and god bless you.. ### REPLY: Hello, Thank you for your contact to . I understand your health concern, if I am your doctor I suggest you that as the wound got healed. There is no chance of any infections including rabies. So do not worry. Maintain local cleanliness and apply antibiotic ointment. 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: I m 44 years old and recently hurt a muscle training my shoulders. The muscle pain is in my upper back between my spine and shoulder blade. I have iced it many times and the pain is almost gone but now my right triceb is lame and weak is that a nerve thats damaged aswell ### REPLY: Hi, When a patient complains about muscle weakness and sensory changes in this case upper limb (triceps) the doctor first looks at this part where you have the pain (UPPER BACK) to see if a patient have a pain in the nerve roots.  If pain is in upper back doubt is in the roots of the nerves but if the pain is not there, doctor with looks for the other muscles that have same innervation with the muscle that feels weakness in this case n. radialis to look for weaknesses: extensors of the wrist and fingers and looks for sensory changes in the parts that n. radial gives sensation. I suggest you consult a physician. Hope I have answered your query. Let me know if I can assist you further. Take care Leonard, Physical Therapist or Physiotherapist ### END