Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had a stone of size 8mm in gall bladder.i got the pain only once till now.what all foods i should not eat to prevent furthur attack?is it compulsary to do surguy?    is the stone small or large?can drinking lot of water daily will dilute the stone?     kindly help me out ### REPLY: Hi. Noted gallbladder stone on ultrasound result. If your symptom is recurring, persistent, progressing - it is best if you consult with a doctor, preferably a general surgeon, so you can discuss with him the plan of management for your case (conservative or clinical monitoring of your gallstone vs surgical intervention). Definitive treatment is cholecystectomy (removal of your gallbladder along with the stone), which can be done laparoscopically (gold standard) or through open technique. It is not an emergent case, but there must be a sense of urgency in managing your case especially if you're already experiencing symptoms. Low fat diet is also recommended as intake of fatty meal triggers/aggravates biliary colic. Hope this helps. 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: Good evening my 7 year old is complaining of stomach pains under his belly button...He was throwing up all nite on monday had a dull pain tues and wed and thurs it just got worse with a fever but no more vomiting.  Right now he cant sleep because the pain is too bad and he cant throw up or poop because thats not why he is hurting...so im just wondering if i need to take him in ### REPLY: Hi, I had gone through your question and understand your concerns. I suggest you to consult a surgeon and get an ultrasound abdomen, blood test to rule out severe conditions-acute appendicitis etc. You can give him Charcoal 2 tablets and .  Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you child 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 ve had a large lump about 2 inches below my left ear and about an inch toward the back of my neck from my ear...i was in a car accident last year and noticed it right after...none of the doctors i ve seen have been too worried about it, but i would like to know wut it is...now i have pain that radiates throughout my body sometimes my ankles or elbows or feet or hands or knees...please help ; ; ### REPLY: HI, Thanks for the query to . Causes for painful ear lump-1 yr after car accident, is abscess in scalp hairline behind ear and -is due to the boil/ fur uncle. Treatment -would be Antibiotics / Anti-inflammatory from ER doctor. Hope this would help you to plan treatment with ER doctor. Welcome for any further query to . Hit thanks and write good review if this reply helps your health concerns, for the benefit of new and old patients at my virtual clinic at . Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir.. my husband got hit by a car jst below his knee on 26th april 2014.. doctors diagonised it as ligment fracture.. he is getting operated after 25th may 2014.. can u please tell me wat all precautions should be taken after operation.. and how much time will he take to be on his feet agagin ### REPLY: Hi, thank you for providing the brief history of your husband. A thorough musculoskeletal assessment is advised. As he has damaged the ligament, which ligament he has Damaged needs an understanding. Also, he is undergoing surgery for the same, as post surgery the total rehabilitation time will be 3-4 weeks. Undergoing physical therapy should help achieve the optimum results. In my clinical practice, patients I see with ligament injuries, physical therapy is advised, and they respond well to it. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. My dad is 78 yrs old. Basically healthy except for high blood pressure which he takes 10 mg norvask and he only has 1/3 use of his kidneys. Just recently, we believe a blood vessle popped in his head. He suddenly had headaches,dizzy and was unable to read. He was in intensive care where they did 5 catscans which showed blood on the brain(back of) near the neck i believe. He is in no pain but gets confused at times. Drs put him on 2 different blood pressure meds(one listed above) and B6 to get rid of water. He had reaction to the 2nd BP med and stopped it per MD. We are currently going to see the doctor after having an MRI. Also they said his kidneys were failing due to the medicine they gave him. My question is this.will the blood dry up? Will he get the ability to read and stop getting confused and dizzy? How long will that take? Will he be alright with this blood on the brain and what can we do to dry it up? And lastly, what of his kidneys? I belive he is going to a urologist on Monday. Thank you PS-they ruled out a stroke.. ### REPLY: Hello, As your father has a past medical history of high blood pressure and was under medication these symptoms are expected for kidneys to malfunction.  Also, there might be lacuna infarct leading to such blood vessel issue. With the blood-thinning medication, he should be fine having control of the blood pressure.  Las ix is given usually to control the high blood pressure, and it works well. But if kidneys are damaged then other measures are taken like reducing the water intake.  Coming to the difficulty in reading it happens at a certain age due to neural tissue degenerative changes. Having a neurologist opinion should provide good outcome score. At 78, we can expect unexpected changes too. I will advise visiting a neurologist and start doing regular exercise in low intensity. Recent researches have reported that doing 20-30 minutes of low-intensity exercises have helped reduce the blood pressure throughout the day.  Also taking a power Nap will help reduce further the BP for up to 5 mmHg. Monitor the medications, do regular exercise, monitor the water intake and diet plan. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yesterday, I had my left upper wisdom tooth taken out. Today I had formed a clot, but I noticed that it isnt there anymore, Im fine and dont really feel any pain, just mostly still sore from the shots I got yesterday, should I see my OS asap to treat any particular dry socket from happening? ### REPLY: Hi. Welcome to . I read your query. Clot is formed after tooth removal and helps in healing. If you don't have any bleeding, pain or discomfort, then no need to go to Oral surgeon. .  I suggest you to maintain good oral hygiene. Complete antibiotic course which you must have got from your dentist. After 24 hours, you can start doing warm saline rinses. Keep the extraction site clean by doing Betadine rinses post eating. Avoid spicy and acidic foods and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: If you have had a scan of your brain and black shadows are showing in the scan what could be wrong with this person.  She has lost ability to walk, speech affected very low speaking and most of the time with no sense can be made of what she is talking about. ### REPLY: I read your question carefully, and I understand your concern. When it comes to low density (black) area in the brain the first diagnosis whicChatDoctores to mind would be stroked. However, it is hard to judge from that info, location of those areas is necessary, manner of onset and evolution in time, age and other medical issues. Even if we were to admit that it was a stroke there are different type of strokes depending on the origin and blood vessels involved. So I am afraid more information is needed for any recommendation. I remain at your disposal for other questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I had sex on my ovulation day and the next day with the pulling it out method, no condom. How big are the chances of me being pregnant from preseminal fluid for having been exposed to it while ovulating? My period is 3 days late, felt cramping like 2 days before it was time for my period so I thought it was a sign of my period coming on time as it is most of the time, but I havent had my period so those cramping by now were 5 days ago and havent had any other pms sign except for intense headach today, but headache is never a pms sign for me, I almost never have headaches. So I repeat my question: How big are the chances of me being pregnant after having being exposed to preseminal fluid during ovulation? ### REPLY: Hi, Thanks for the query. The pulling out method is not a very safe method of contraception especially if exposure to pronominal fluid has occurred. Also, the episode has occurred twice during peak ovulation period so chances of getting pregnant are high. You have already missed your period. I suggest that you get a urine test done after 4-8 days to rule out pregnancy. Hope I was able to help you. Thanks for using . I would be happy to answer any further queries. Have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...i  had done X-ray of chest and i revealed that i have prominent brochovascular markings in both lungs and i get breath through only one nostril subsequently.....can u tel its treatment ### REPLY: Hey Hi, Looking to your case if you don't have any symptoms like cough or breathing difficulty, there is no problem to have prominent broncho-vascular markings. Broncho-vascular markings could have been normally also. So, not to worry at all regarding that. Regarding your nasal block it could be deviated nasal septum, get done checked by ENT specialist to rule out other causes. Deviated nasal septum is the most common condition of nose block. You can get corrected from ENT surgeon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 puja studying mbbs , i am having white scaly patches ( medium size)on starting of my forehead where hair starts ,its from 1 week only i am thinking dandruff (because i am having it) .recently i changed my shampoo 4weeks back i think that may be the reason please help me .i am fearing may i have seborrhic dermatitis so plz help me ### REPLY: Hi pupa and welcome to ChatDoctorBefore going into the diagnosis, just wanted to know if you have had similar complaints any time in the past, anywhere else on the body, on elbows, knees or on the trunk, soles and palms? Do you generally have any other skin condition or allergies/eczema?is there a family history of similar complaints? As per your description and short duration, you could have seborrhea dermatitis which is also a type of Dan .  It is nothing to worry about. It may also affect other oily areas like face, chest, upper back. Change in climate, change in shampoo or anything causing oiliness on the scalp could cause an increase. Make sure not to apply more greasy gels, styling products and to wash off conditioner well as this can also  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 doing a Patient Scenario for school. The patient was diagnosis with exacerbation of COPD. He also has an IV running already. He is difficult to arouse so I was wonder if I could give him a Corticosteroid through the iv and if so what is a common brand? ### REPLY: Thanks for your question on . In your study patient, possibility of hypercarbia (raised carbon dioxide) is high. COPD patients with acute exacerbation and unconscious state, demands ABG (arterial blood gas) analysis to diagnose hypercarbia. This is the most common cause for unconscious in COPD patient. He may need ventilator support with intravenous bronchodilators, intravenous steroids (effcorlin) and inhaled bronchodilators with inhaled corticosteroid (ICS). Since all these are prescribed medicines, you need to consult doctor for their prescription. Patient with these parameters should be managed in critical care settings. Hope I have solved your query. Wishing good health to your patient. 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, i am planning to apply for uae dubai, but my problem is i have a lung scar, and i have read a lot about medical examinations in uae and i found out that they would really deny those found with a lung scar active or not. is it really true? what if i have undergone a tests and it is not active would i still be denied. ### REPLY: Hi, Dear,Thanks for your query to . Dear I read your query and reviewed it with context to your query facts. I understood your health concerns and feel Concerned about them. Based on the facts of your query, you seem to suffer from-?TB / or Parasitic Granuloma with scar? Asbestosis with granuloma with Scar. Treatment-Consult your Chest Physician, who would rule out the various causes leading to Lung scar like you have. As you don't seem to have accompanied dyspnea or any other complaint, you need not worry, as it seems to be incidental finding and seems to be caused by old illness...mostly TB lungs.IRA and PCR tests of the scar tissue biopsy would confirm any active lung infection right now in your case. Supplementary blood ESR, CBC,would be helpful in coming to specific cause of the scar in your lung. Hope this would help you to solve your health issues in the best way possible. Welcome for any further query in this regard. Good Day!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: occasionally when I first wake in the morning as I bend my fingers or reach to grab something I get a sharp burning or stinging sensation on the backs of my hands.  After that, I dont feel it again until after my hands at rest for a good while.  Any thoughts what could cause this? ### REPLY: Hello! Welcome on  ! Your symptoms are not indicative of any neurological disorder. Arthritis can not be excluded. For this reason, I would recommend consulting with your GP and performing some blood lab tests (complete blood count, PCR, sedimentation rate, Rheumatoid factor). Further tests may be needed, depending on the above test results. Hope you will find this answer 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: Hi, My son is 1.4 yrs old, weighing 12.5 Kgs. Today, he is suffering again from chest congestion and cough, today morning when we measured his temperature it was 99.7 F, so a little fever too. History ======= In the last week (8-Aug to 17-Aug 14) he was having high fever 101-102 F (8-13 Aug) with cold and cough. One of the Pediatrician to whom we consult gave following medicine to him, after which by 14-Aug he was recovering well, in-fact there was no fever after 14-Aug, and he was all good by 18-Aug. Medicine: ========== 1. Clamp KID from Dr. Reddy s (3.5 ml twice a day for 5 days) 2. Relent + (4ml twice a day) for 3-5 days 3. Ambrodil S (6ml twice a day) for 3-5 days Now, that he is AGAIN have cold and cough with a little fever too, wondering what should be done next. Thanks, Paresh ### REPLY: Hi... I think that your kid is getting recurrent viral illness and doesn't need antibiotic at all. I will clarify certain issues regarding viral illness and if these are suiting your kid, that means, he was having only viral illness and nothing to worry as such. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. While recovering from viral illness, it is quite common to have cough and cold and that is how the phlegm comes out while vomiting or in motion. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a tooth infection. My doctor says to have Mox 500 mg. Previously he said Augmentin 625 with amoxicillin + clavulanate potassium. Are these two work the sameway?He said wth Mox 500 i shd have metronidazole 500, and not lactid acid bacillus? Please guide if fine ### REPLY: Thanks for your query, I have gone through your question, the penicillin(Amos) is effective against tooth infection, amoxicillin+Slavonic acid has extended spectrum of activity which is effective against certain organisms which are resistant to penicillin...metronidazole is effective against anaerobic infections like tooth infection resulting in swelling and gum infections...Amos with metronidazole is the gold standard . .augmenting is a bit expensive....according to me Amos with metronidazole is effective against any photogenic infection...I hope my answer 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: I think I have ADHD I am eleven, but my parents won t listen because I have high grades. Everyone thinks I have it. My dad has it and he almost got 100% on his state tests when he was a kid, so what does that have to do with anything? I guess I have just used what I know because I get numbers. I fidget almost all the time to help me focus, I am SUPER disorganized, I forget things constantly, and my grades are slipping. Believe me, there is much more. I also have synesthesia and most websites say that increases the chance of ADHD. I just moved, so I don t have a doctor to ask and I REALLY want to get into the Gifted and Talented program in my school. WHAT DO I DO?!?!?!?!?! ### REPLY: Thanks for the query dear. His level of awareness at your age is really commendable. As per your description it seems you have almost decided that you are suffering from ADHD. You have not mentioned what your doctors said regarding your condition, that is before you shifted to a new place. You may be quite simply a disorganized adolescent so to speak, then you will need support of a psychologist. But again it is best to find a good doctor in your new place, take your parents in confidence and take help from the doctor. He shall be able to guide you or prescribe medication if needed, in better way.Don't suffer unnecessarily by obsessing over something that has not been diagnosed as yet (you have not mentioned that it's a confirmed diagnosis). Take professional help, and you shall be better and improve on your grades. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi sir.. good morning.. i am very disappointed with black in armpits and between thighs. how can i get white skin bet ween these parts. please give me your precious advice and prescription.. thanking you sir.. am eagerly waiting for your reply. my email id YYYY@YYYY and i am from india.. i hope u will give prescription which is available in india ### REPLY: Hello, Thanks for writing your query to us. Shaving causes hair to grow back thicker and darker, and this dark hair is often visible under transparent, light skin - which is what makes the skin look darker. Also, waxing removes dead skin, while shaving does not do the same. If you shave underarms regularly, you may want to scrub your underarm area with a pumice stone on a daily basis. This should help combat darkness to an extent. Apply lemon juice. Don't wear polyester clothing near those areas. Wash regularly, make sure these areas are .  Try Shower to Shower. Wax these areas regularly. If your inner thighs rub together this also causes it to go dark, so you may need to lose weight on your thighs.  Stop using hair removal cream on your underarms and start waxing. Scrub your underarms daily with a pumice stone, after applying soap, while taking a shower. 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 so the past month and a half almost 2 months ive been feeling ill. it started off with just a normal flu virus that was going around wasnt a big deal but then the extreme fatigue, dizziness, increased nausea and headaches symptoms stayed. I still feel like this every day im so exhausted i feel i dont have energy to do much of anything im wanting to sleep alot more then anyone should because of this. i also have chronic back pain ive been dealing with since i was 16 and last dec i was hit as a pedestrain by a car not going fast but coming out of a plaza exit onto the sidewalk. i dont know if its my bodys stress from everything the increased pain and stress from the accident or what. my family doctor has no idea only thinks depression issue but my mood and mental health have been doing good , and because of this ive been off work because i cant function properly ### REPLY: Hello, Any viral infection will cause fatigue. Most of the viral infections are self limiting. The symptoms improve within a week or so. It the symptoms persists and associated with dizziness, nausea and headache it should be thoroughly evaluated. Psychiatric cause can only be attributed when all the organic causes are ruled out. This symptoms may be related to you backache and may be aggravated by the accident. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 infertility pblm. i have my periods 6 months wise from my 14 yrs.now i am 30.i got married 4 yrs ago.my husband is in 40.i dont what to do, so many hospitals i got treatment but still i am like this i dont know why.we r planning for baby.suggest me please i am in bangalore near marathahalli ### REPLY: Hi, Thanks for writing to . I Think you have investigated ourself thoroughly as you have shown many places. I take it that your hormone profile and ultrasound, tubal patency and hysteroscopy are normal. Furthermore, I suggest you to go for ovulation inducing .  This will increase your chances of conception. I also suggest you to go for GUI. GUI is intrauterine ingestion of sperms. Here sperms are washed and processed and placed in uterus.  You can try 3 to 4 cycles of GUI. You discuss this with your doctor. Hope I have been helpful. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my Mother has been pretty depressed off and on for the past couple of years. Nearly two years ago, she lost her job at an advertising firm due to the economy. She found a new job as a hostess for a restaurant. She clearly is unhappy with her new job and feels a sense of worthlessness from this. Unfortunately, this also comes with major mood swings and extreme agitation over the smallest of issues. The only way to get someone help is to make them understand that they do need help. How do I get my mother to understand that she needs to seek help? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Mood swings and depression are words which are supposed to be used clinically. Here the words are denoting just irritable mood / altering mood and disappointment which resulted in general irritable feeling. These common scenarios are easy to tackle. Your mother knows how to deal with those. Just tell her that her behavior is a bit weird. Also ask her friends to tell her the same. Once she realizes that her behavior is not correct, she will correct. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering hair loss for the past five years. I am just 28 and the centre part of my head has almost gone bald. This has become very stressful in life, since I am yet to get married. No medicine works on treating my hair. Can you help me with some remedy Doctor.. ### REPLY: Hi, After reading history you provided, I can conclude that most probably you may be having an .  You consult dermatologist for firm diagnosis. I would recommend as follows...- tab finasteride 1 mg daily-minoxidil 10% solution to apply twice a day on bald area-tab biotin 10 mg twice a day-shampoo with ketoconazole lotionContinue treatment till good result. I hope this would help 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: Good day. I have been feeling some sort of discomfort or pain at my lower abdomen , around the belt line for a while now. The pain is on my left which is your right. About 5 years ago, the pain was severe and I went to see a doctor thinking it was appendicitis but it was not. The pain subsided for a while but sometimes comes and goes. The pain is not sharp like appendicitis but just gives me serious discomfort that sitting down sometimes in one place is a little difficult and uncomfortable. My palms would be sweaty sometimes at that point Also I have been having this nagging back pain for a couple of months now. I dont notice in particular how i walk whether i bend a lot or not. I crack my back a lot like am cracking my fingers. Its quite disturbing. Would appreciate your feedback. ### REPLY: There are several reasons for abdominal pain. It is also possible that sometimes this pain can spread to the back. However, it is also possible that your pain could also be originating from the back. It is important that a doctor can take a detailed history and examine you to find out. Also, investigations such as an abdominal ultrasound and spine x-ray may be able to provide more information about the cause. It is advisable that you stop cracking your back as this may put unnecessary strain on the spine and if there is pain may affect it. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 get shivering and feeling uncomfortable when I am excited, angry or nervous. This happens to me very often now. I am 30 years of age. I was a good sportsman in school.But I never had this problem at that time. I play music in clubs and restaurants and sometimes when I am about to play infront of va huge audience I get this problem. At the same time I feel very stressed and sometimes feel like fainting. I am so worried about this. I was not like this before. But now I am almost like getting scared to things quickly.Please help on this. Thanks ### REPLY: Hi, I can understand your concern regarding your symptoms. From, what you have mentioned, you seem to be suffering from anxiety disorder with predominant performance anxiety. These anxiety manifests as shivering and feeling uncomfortable. I would suggest that you seek a psychiatric consultation for your symptoms. Treatment with medications like paroxetine or sertraline would be helpful. In addition, doing exercise daily will help you feel relaxed. Relaxation exercises like deep breathing and progressive muscular relaxation would be helpful. I hope that the above information was helpful. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my name is Kylie.  I have had a Blood pressure check a few weeks ago and it was 146/95 the highest reading was 143/110 and it was monitered over a 4 week period by my doctor, the last check was 142/88. im 36 non smoker, non drinker and im not overwieght. i have to have some blood tests done and to check my renal arteries for maybe a blockage, but other than that i dont feel unwell at all, always have had lots of energy and do not have any other health problems, my blood pressure was last checked 1 year before and was 120/80. any suggestions what could possibly cause it to be high?? ### REPLY: HiT hanks for query. Looking at your complaints my opinion is as follows.1. Causes of High blood pressure is multifactorial. Apart from the parameters you mentioned, there are other factors too like stress, lifestyle, type of personality, exercise and workout, nutrition, history of hypertension/diabetes in family, history of myocardial infarction in family, hypercholesterolemia which contribute to pressures. 2. Keep a checklist on the factors I have mentioned and if your answer is yes to any or few of those then chances of developing hypertension and complications arising out of hypertension is more.3. Get a lipid profile tested to rule out high cholesterol as possible cause.4. If your BP reading is consistently high on multiple occasions then it's better to start on antihypertensives, and make necessary lifestyle modifications. Hope this helps. Any questions happy to help again ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Does Zolpidem (10 mg) ever have the side effect of, upon awaking in the dark, having large spots or circles in the eyes, which will disappear upon being in the light, and never happening during the daylight hours? I did quit taking Zolpidem at this time, and have not had the problem with eyes since ### REPLY: Hi. I understand your concern. Holiday is remedy used for insomnia. Dark circle or black out is not common side effects.  Though there are few cases reported in literature.  But most of them occur due to they were taking co current other medicines. So holiday alone does not have such side effect, but combination with other medicines may lead to such side effect. Try alternative medicines for sleep disturbances. Consult psychiatrist and get help. I hope I have answered your question. Still if you have a query then feel free to ask. 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: Every few weeks, Ill wake up with a knot on the right side of my head. Its very sensitive to the touch and it usually goes away in about 2 weeks. It feels and looks like I banged my head on something, but it always appears overnight. The worse one went from a bump/knot to a bruise that scabbed up, Theyre usually no bigger than a quarter. Should I make an appointment to see a professional about this? ### REPLY: Well come to ChatDoctorThank for asking and your concern being appreciated, this could be tension headache, although migraine attack is very less likely, most of the time such headache is functional and may not be due to any cerebral pathology, still it can not be taken as granted and I would advise seeing the neurophysician it may require ct brain and other routine till then you can try Tab Carbamazepine 100 mg at bedtime some time this may help you hope this information 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: Sometimes when i eat something cold i will immediately have severe pain in my stomach. It is a pain similar to the "the brain freeze" feeling after eating ice cream. I have been diagnosed with stomach polyps in the past, but after stopping Aciphex most went away. What could cause this> ### REPLY: Hi, thank you for posting. From what you refer I think that you suffer from Peptic ulcer. Peptic ulcer is a distinct breach in the mucosal lining of the stomach.1. You should eliminate coffee, milk, alcoholic . 2. Eat 5 meals a day, small portions.3. Quit smoking cigarettes(if you smoke).However, you need the following tests to determine the diagnosis:1. Fibrogastroendoscopy.2. Liver function test.3. Glucose test.4. Complete blood count.5. Urine test. The treatment will contain proton pump inhibitor medicines like Omeprazole. Contact your gastroenterologist. I wish this information is helpful. I wish you a fast and healthy 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 am looking for Charparral (dried) to help with toenail fungus.  Have found a Toenail fungus protocol on the internet.  Use six tbsp dried chaparral to one quart of boilling whiskey..  Reduce and simmer for 20 minutes.  Remove and steep for 8 hours.  Soak your feet in this solution for 20 minutes a day,  Repeat the procedure for two weeks.Have had laser treatment on both feet and did not help. Costly $400 for one treatment.  Have used a natural mixed with Mother of Vinegar, but does not help.According to the info I have seen on the internet chapparral is dangerous to take internal, but want  tosoak my feet in this.  Would this be safe? ### REPLY: Hello, Fungal infection can only be treated with antifungal agent beside this it cannot be given try with anything else, such experiment you have mentioned here may prove dangerous or some time flair up disease. If this is the fungal infection of the nail then it best can be managed with Fluconazole ointment and oral antifungal medication like Terminating . But it is all depends upon the clinical condition, why not to consult the dermatologist for best line of treatment and proper diagnosis. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am Sujata 69 Female from India.I am DM type 2 IDDM since last 25 years. Taking Humalog TDS and Lantus in night at 11 pm.My S. urea and S. Creatine level had started to rise and with all possible control on Blood Pressure and Sugar my S.urea 88 mg/dl S. Creatinine 4.6 mg/dl on 21.6.2012 when I was hospitalised for EDEMA due to Anemia Hb 8.6%.After discharge swelling on my ankles and feet was gone,was put on Erythropotien injection 0000 iu every ten days.My Hb improved to 9.8%.But S.Urea increased to 112 mg/dl and S.creatinine 6 mg/dl. Was diagnosed with UTI.Prescribed Nitrofuraton Bd for 7 days and Amikasin inj250 mg OD for 7 days.These were found SENSITIVE in Urine culture report.I have been advised by NEPHRO to get AV fistula fitted.What to do now.Am I inching towards Dyalisis? ### REPLY: Dear friend, welcome to  ! I am concerned with your uremic trends. I think you have diabetes related chronic kidney disease which has worsened with UTI.rising urea, great, edema and overall trends suggest worsened renal function and as per your nephron advice, you may need dialysis soon. AV fistula is planned for dialysis. Pl. go by your nephron. Advice.hope you recover soon. And do not fall prey to gossip/ unauthentic advises.pl. keep me posted on your progress. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 bilateral rash that comes and goes. It mostly comes after a shower. I am on an antibiotic now for a bacterial infection I got after plastic surgery . Tomorrow is the last day of the antibiotic. At first when I started taking the antibiotic,augmenting the rash went away. Tonight after I showered it came back on both sides of my trunk. What do you think it is? ### REPLY: Hi there. I read your problem with interest, but it does seem some form of physical or heat/cold induced urticaria. Dermatology however, is a very visual line & as such, requires some clear visual digital photographs or to be seen on the ground by a dermatologist nearest you for best results! Please take a non-sedative antihistamine namely 180 mg fexofenadine taken once a day that is safe but may require a prescription in your parts. Worst case scenario is that a skin biopsy may be required to help clear the diagnosis & for further management. Cheers & Godspeed!  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 problem with meds. all together. I can t use any pain meds. OK my muscles are getting damage by cholesterol medicine. I have real bad muscles cramps. I would like to know is there anything I can take that will not make me hurt ,my hands and legs does a number on me. ### REPLY: Hi, thank you for providing the brief history of you. As you mentioned you are getting muscle cramps, and you are having problems with medicine, I can help you find some solution for this. Which is a simple process. Muscle cramps occur due to the imbalance in the electrolyte transmission which disturbed the neural impulses. Performing regular strengthening exercise will help the channels of transmission is to optimal functioning which will improve the muscle absorption and contraction by which the cramps will be avoided. I have personally experienced my patients with similar complaints and later stages stretching has helped them avoid the muscle cramps. In fact I should say no cramping as the electrolyte transmission channels are functionally well. I hope the same recovery in you. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son is 7 months old and i have been giving him Good Start from the beginning. However, his tongue is green. He has been given meds and it won t go away. I am nervous about it...we have had it checked out and came out neg. Switch formula, give him whole milk?? ### REPLY: Hello, I can understand your concern. The most common cause of green tongue in babies is presence of fungal/yeast infection on the tongue. It would have been helpful if you had mentioned what medicines are being given to him and if it includes antifungal medications. Sometimes, use of antibiotics can also cause development of fungal growth on tongue. Other causes may include presence of bacterial infection causing hairy tongue and possible upper respiratory tract infection. I would advise you to go for analysis of tongue swab in the laboratory. It can be done with the help of a dentist. Based on the analysis result, confirmed diagnosis can be reached and treatment can be started. I hope this information helps you. Thank you for choosing . Let me know if you have follow-up questions. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a small puncture wound on left side of my big toe of left foot. Iit was a result of a sting ray. It seemed completely healed after 3 days, but now is kind of red and sore. Not much swelling. I know it went into the bone, but it was fine by next day?? Any ideas ### REPLY: Hi. There is a possibility that the stinger is still embedded into the skin leading to the symptoms of allergic reaction and inflammation that you are facing. So once get it checked clinically to rule out what is the exact cause of it. For now, you can do cool compresses over it and apply steroid ointment like dexamethasone. Avoid touching or scratching it to avoid spreading. If the inflammation increase or swelling increase a steroid shot can be advised. If the stinger is embedded it should be removed. Hope I have answered your query. Please let me know if I can assist you further. 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: Hello,I have below symptons from last 2.5 years.constant runney nose ( very frequent in years),irritation in eyes (sometimes rediness), I have very short of breath last yer when i painted my house, i feeling not confirtable with smell of housepaints etc. from last six months i also feel with fast breath very frequent and not able to good sleep sometime due to short of breath. Is it allergic asthma? i need treatement from spealist? ### REPLY: HI, thanks for using  Your symptoms are in keeping with allergic rhinosinusitis and allergic conjunctivitis. Allergic rhinosinusitis are allergic symptoms in the nasal passages and sinuses. The symptoms are sneezing, congestion, post nasal . Allergic conjunctivitis presents with itching, watering, redness , swelling of the eyes. You may need to consider the use of a topical steroid nasal spray and oral antihistamines. You may also need an eye ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Dexilant for acid reflux...nothing else was really working. A friend of mine tells me that those ppi s are like poison to your system and ruin the kidneys. He said they should not be taken consistently. So what can a person do to not have the acid reflux if you don t take the meds? Zantac was ok for awhile but then quit working for me. I do not eat the foods that they say are bad for acid reflux. ### REPLY: Hi, Your symptoms are nonspecific, but these may be suggestive of gastritis, HERD or hiatal hernia, so you should do gastrostomy to evaluate it more accurately.  This is caused by irritation of stomach mucosa by certain food or medications, stress and smoking. It should be treated by changing lifestyle habits first and in severe cases medications or surgery may be required.  You need to eat smaller meals but frequently, avoid long sitting after meal and regulate your body mass. You need to avoid fried food, carbonated .  Furthermore, you should eat more milk products, vegetables and boiled food. Also, certain antacid medications may be required by diagnosis should be established first. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was bitten by a mosquito 10 days ago and have developed flu like symptoms over the last week, high temperature on and off, fatigue, coughing, sore joints and generally been feeling unwell. i just wondered if i could have been given an infection by the mosquito bite? ### REPLY: Hello, I understand your concern. I am , infectious disease specialist, answering your concern. As per your symptoms it looks like a chikunguniya infection. Chikunguniya usually spreads after a mosquito bite. It causes flu like symptoms, high temperature and joint pain. You can diagnose your self for it. There is ELISA test available to diagnose it. Though there is no treatment available for chikunguniya. In mild to moderate cases Diclofenac and other Non-steroidal anti-inflammatory .  In severe cases steroids can be added as per the requirement. Glad to answer your further concern. You can contact me on 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: Hello I am a 55 year old female who suffers from severe allergies to mold spores and dust mites.  I currently am having terrible earaches, stiff sore neck,   and sore glands on both sides of the neck.  I use decongestants and antihistimines on a regular basis but nothing seems to really help.  What can I do to break this cycle? ### REPLY: HI, thanks for using  The only way to completely eliminate the allergic response to an allergen would be to prevent or decrease exposure as much as possible. This means that you would need to eliminate any dust mites in your bedding and sofa. In addition, you should have your house and, if possible, work environment, assessed for mold and this should also be eliminated. Once you continue to be exposed, the symptoms would continue. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi..have suffered many yers with a ultrarian rapid cycling condition ..I am into a holistic approach to medicine..many years ago I took a coritsol siliva test when I was at my worse ebb ..down.. irritable and feeling dysphoric..I wanted to take this test not when was feeling myself but in this down period..my results the range was 3.5 -9.0 and my results were 1.7..I want to use bioidentical hydrocortisol prepared by a compounding pharmacist ..most doctors do not understand thuis method of treatment but it makes sense ..before I can address the thyroid I need to fix the arfenals first.. thankls for your help.. ### REPLY: Hi, 10 to 20 per cent of people with bipolar disorder may have rapid cycling, and it is probably more common in people with the form of bipolar disorder sometimes referred to as bipolar II (those that experience less severe highs).  Diagnosis of rapid cycling bipolar disorder can be difficult. In adolescents, it can be mistaken for conditions such as ADHD. Treated with Lithium or Aborigine according to the body weight and episodes. Please consult your psychiatrist he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is taking Aldactone right now and the doctor told us that he should take livolin forte. My father had been medicated for liver cirrhosis which the doctors said his condition will only give him a max of 6 months life. Right now his ascites is causing his abdomen to bloat. Can you tell me what medicine could be more effective to discharge the fluids faster than aldactone? ### REPLY: Hi, Welcome to , Your father is having Liver Cirrhosis due to this he is having ASCIIs in this disease accumulation of fluid in peritoneal cavity, just reducing fluid in abdomen may not be enough, if it is causing discomfort paracentesis may be done which is removal of fluid by needle aspiration. Please consult Gastroenterologist and there are many medicines which can be given. You need to check his serum protein level and if it is low blood or salt free Albumin may be useful. If this disease is due to Alcohol please make sure he is not taking alcohol. If he is compensated and takes care he should continue to do well, see no one can predict the eventuality. Please take care. Good Luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 11yr old daughter has white bumps on the front part of her tongue and since Saturday it has been extremely sore and feels like its on fire, she has not eaten anything different, Motrin will only help for a little bit , even lidocaine is not helping, any ideas? ### REPLY: Hi. Thanks for the query. White bumps on the tongue that are sore can be due to inflamed tongue papillae or can be canker sores. So my suggestion is to make her do warm saline gargles. Gargling with a solution of soda bicarb in water can help. You can also consult an Emergency room and get her checked so that they can advise her vitamin B complex. You can also give her soft and non-irritant foods. Sucking ice lollies can help in reducing inflammation and pain. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a rash of some kind  i thought it was shingles but now dont think so it itchs so bad i cant stand it and it is for the most part spread out not in a bunch more like smaller seperated  some in a bunch but single spots the more i scratch the more pops up ### REPLY: Hello, Thank you for posting on . I can understand your concern regarding the skin lesions but It's difficult to point specific diagnosis in absence of clinical examination. Therefore, I insist you to post good clinical pictures to me so that I can help you in a better way. You can reach me directly through the below-mentioned link.https://urldefense.com/v3/__http://doctor. ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 year old daughter has had a dry, short, raspy cough for months now. She has been perfectly healthly otherwise. it sounds like when one has a hair tickling their throat. or a cat with a fur ball. It doesnt seem to bother her or slow her down, but it is always there. should I be concerned? ### REPLY: Hi, Thank you for asking question on . Seasonal coughs will clear with cough syrups containing Dextromethorphan and an anti histamine like cetirizine. When persisting for months one has to exclude whooping cough and even asthma. Better consult pediatrician. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,My son is 3.6years old and he is having loose motions (once or twice) a day.Stool test was done and found that there is bacteria.We have doen several medications but still its the same.Can you let me know is there any good docs whom I can consut on this? ### REPLY: Hi... Greeting from Chennai. Thank you for consulting in . It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was in a car accident 3 years ago. I was only treated for my fracture in right hand. I believe I had whiplash and now suffering from chronic pain. I didn t notice anything was wrong at the time. I am being treated for my neck but right collar bone isn t the same as it is on the left. It has a dent close to shoulder and I have shoulder pain. If I get an xray or mri is it possible to show fracture or if something happened? I know something is wrong. Also what are the possibilities of the dent in collar bone. Could I have dislocated shoulder? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have chronic shoulder pain and hand pain. Well there can be many reasons for symptoms you mention in query like muscle spasm, nerve compression or heart problem like angina. I would suggest you to consult orthopedic surgeon for proper examination and treatment. Doctor may order CT scan, MRI along with nerve conduction test and physical examination to confirm the diagnosis. Doctor may prescribe muscle relaxant, anti-inflammatory, nerve supplement along with physical therapy . For now stay calm, take ibuprofen, apply warm compresses to shoulder and arm, do light stretching exercises under expert or acetaminophen for pain and take proper rest. 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: i am kvreddy aged 44 yrs. My left kidney measuring 104x53mm with mild hydrouretoronephrosis. Cortico medullary differentiation is maintained. No solid or Cystic lessons. Small calculi measuring 8 mm noted in mid pole and 5 mm in the upper pole, Few small calculi measuring 4 mm noted in the lower pole. Till date no pain. pl advice me. this report was of 06 Mar 2013. ### REPLY: Hi, Thanks for writing in.Dos for kidney stones(i) . 5 to 2.5 liters) a day may help flush out your urinary system. This will also allow small stones to pass through.(ii) Visit washrooms regularly and empty your bladder when you feel like doing urination.(iii) Please take fruits like apple, papaya, watermelon, pineapple, Mesabi, bananas and orange, vegetables like, white gourd, ladyfinger, pumpkin, pulses like too DAL, moon DAL, Bengal gram(iv) If you are having pain and burning during passing urine then you can take ALSO syrup 15-30 ml twice or thrice daily, dissolved in water for one week. This will prevent acidic urine and stone formation.(v) If you have sharp pain then you can take tablet containing hosting (e.g. HBO Max 10 mg or HYSSOP 10 mg) twice a day for 2 to 3 days, till you have pain. Though side effects are rare, please consult your doctor and take these medications under strict supervision.Dots for kidney stones(i) Please avoid holding urine for long intervals.(ii) Please reduce foods containing oxalate like non veg, vegetables like spinach, tomato, cauliflower, brinjals, nuts like AJU, pasta and almonds.(iii) Decrease extra salt in foods.(iv) Avoid spicy pickles.(v) Do not neglect any pain and consult your doctors immediately. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 injected cloud 9 over a 3 month period and i have been off of it for about 6months but still having at night more racing heart nerve spasms in arm and chest and sometimes feels like i have damaged my nerves or blood vessels in my heart .i went to the cardiology dr and they done a full check even a heart cath and said my heart was real healthy .i am just scared i can only sleep on my right side.im 36, 6ft, 210lbs and no bad medical history at all. ### REPLY: His your cardiac cat his normal I would advise you to go for a 24 hour holder monitoring, it will keep a record of your heart beats and nature of your palpitations. Your beats would be recorded for a period of 24 hours hence any problem with electrical currents of heart would be ruled out.cardiac path tells us only about myocardial ischemia, while electrical current disturbances can also cause the problems. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im having SGOT 44 and SGPT 67 and trigliceride at 400. Im on 10 mg Atorvastatin. I used to take 160 mg of Lipitor also along with Atorvastatin. Ive stopped Lipitor for last 2 months. I have been on these drugs for last 5 years. The SGPT and SGOT have been steadily over the last 5 year. Please advise. ### REPLY: Hello! Thanks for putting your query in . I am a Gastroenterologist. Increase in GOT and SGPT has many cause like Hepatitis B, C, Metabolic disorders, NAFLD, alcohol intake etc. So I will suggest you to visit a Hepatologist for evaluation who will advise tests and then manage accordingly. Meanwhile, there are few medicines which I found very useful in my patients are ursodeoxycholic acid and vitamin E. Do regular exercise and reduce your weight if you are overweight, avoid alcohol if you . I hope I have answered your query and this will help you. Wish you a good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi good morning im mayflor montes im 22 years old from philippines i would like to ask why is it in my stool there is a blood im pregnant right now 2 months i dont know doc what happening to me because i feel normal but if i go to bath room there is a blood evry stool i give out can you please advice me..thanks this is my email adress YYYY@YYYY i hope to hear from u soon ... respectfully mayflor ### REPLY: Hallow Dear, During pregnancy a hormone called Progesterone increases many times in the body. This hormone relaxes the smooth muscles, blood vessels and causes constipation. Dilated blood vessels in the rectum and straining due to constipation is known to cause piles or aggravate already existing piles in the rectum. These pile further start bleeding if hard stools have to be pushed by straining. Therefore, during pregnancy, bleeding piles is a known complication. You seem to have bleeding piles. Please get the diagnosis confirmed from a doctor by per rectal examination. To get relief from this:1. Have soft diet with roughage.2. Eat plenty of fruits; in particular Banana, Citrus fruits like oranges, sweet lime, etc. 3.  .  4. For few days you may take Liquid paraffin for softening the stools. 5. Locally apply Practosedyl cream. Please do not use its applicator for application, apply with fingers deep inside the rectum. With these you should feel somewhat better. If still the bleeding continues, you may have to undergo ligation of the piles. Please report this to your Obstetrician. I hope this should help you for the immediate relief.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: we had sex on 15th of march.. well, during the period of intercourse, he removed the penis before the sperms came out. i am a bit worried even then if it is safe not to take an IPILL as he is sure that he removed it before the sperms were out. please reply at the earliest.... thank you. ### REPLY: Hello dear, I understand your concern. In my opinion as the semen was not ejaculated inside the vagina there might be no chance for pregnancy. But if you don't want to take chance even for 1% then the Pill can be taken. To be effective Pill needs to be taken within 72 hours of unprotected intercourse. So relax. Avoid stress.Don't worry. The chances of pregnancy are rare as your partner is confident about with . Hope this helps. Best regards.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just checked my blood pressure. I normally take it on my left arm and it normally is around 104 to 110 over 68 to 76. However tonight my left arm pressure was very low at 82/62 but I don t feel bad. I took it again and it was approximately the same. So I decided to take my pressure in my right arm and it was normal -104/70. I have now taken my pressure 3 timess in both arms with the same results. Should I be extremely worried about this difference? ### REPLY: Hello, I understand your concern and would explain that this difference between both arms is quite normal, due to the anatomical changes of the blood vessels in the arm.  So, there is no reason to worry about it! Anyway, your blood pressure values are low. For this reason, I recommend having some rest and taking plenty of fluids. If you are taking any antihypertensive .  Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have been having a bad smelly fluid/gooey substance in my belly button. it usually occurs before menustal cycle and usually once throughout the month randomly. when i clean it with a cutip, it kind of looks like ear wax. it smells really awful and im embarrassed by it. please help me. this has been going on for years but now getting worse. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have umbilical discharge. You may have some umbilical sinus or fistula. So there may infection in that tract. You should go for examination to check your condition. If needed to take antibiotics and other 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: Hi My name is Daniel! I am 30 years old! I live in Brazil! I have been diagnozed with Dengue on Thursday (just based symptoms and very low platelets ) and yesterday they discovered I have chickenpox. (no joke) I had a horrible chicken eruption yesterday, I also felt some big lumps under my skin in the neck area. Should I expect the worst? (I can provide more details). It s not clear whether it is only chickenpox or a combination of both. Thank you! ### REPLY: HIT hanks for posting your query.  Neither Dengue nor Chicken pox causes big lumps under the skin over neck area.  Sometimes associated with chicken pox (which is a viral infection), there occurs additional bacterial infection of either the skin lesions or the throat.  This bacterial infection of the throat can cause enlargement of glands in the throat region. These glands are called Lymph nodes, and it is these enlarged Lymph nodes that you are noticing as big lumps.  There is no need to worry, but you need to meet your doctor and get a prescription for Antibiotics for the enlarged lymph nodes. Hope this information was useful to you. Any clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 61, Few years ago I had breast cancer , one breast removed went thru all chemotherapy , radiation etc Am on femara n heart pills, sugar reduction pills, have cholesterol and sugar levels fluctuate mostly on high side ! Sometimes feel nose blocks then when I blow my nose I see blood on my tissue It isn t much but noticed it on different occasions, My Question is how do I control sugar ? Getting blurry eyes can t even watch Tv as I can t see faces clearly Also want to drive my car as I feel happy when I drive ### REPLY: For control of sugars first thing to do is to go for regular exercise, diet control and medications. Medications prescribed by your doctor need to be strictly adhered to. If there is no control with oral medicines if your doctor things it is necessary. Then he will put you on insulin. Your blood pressure also needs to be checked regularly. High blood pressure is a common cause of nose bleed, but other local causes can be ruled out by an ENT specialist only. Your blurring of vision is also likely due to high sugars ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor advice me to take Susten 300 sr 1 Tab daily after Dinner, i want know that have any problem to take susten 300. please advice and i am 7weeks pregnant and also doctor said in my blood test they find thyroid 7.78. If it is anything affect my baby. ### REPLY: Hallow Dear, Susten 300 is a Progestational medicine. Throughout the pregnancy, Progesterone is required to maintain the pregnancy. It prevents the uterine contractions and stabilizes the pregnancy. Probably your doctor might have noticed some factors which might have indicated the possibility of instability of the pregnancy. Therefore, he/she must have started Austen 300 to stabilize the pregnancy. So Austen 300 is very safe during pregnancy and necessary in Progesterone deficiency or Pregnancy at risk. One such factor which may affect your pregnancy is your Thyroid levels. In fact in Thyroid function test, T3, T4 and TSH are evaluated. I believe you have mentioned the level of 7.78 as TSH level. Yes, 7.78 TSH is high indicating that your Thyroid is functioning low. This may affect the pregnancy and/or baby adversely. Hence, you need to take Levothyroxine throughout the pregnancy. Please get the prescription from your Obstetrician. I hope this helps you today. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: we had oral sex and my pre cum has touch on the tip of the vagina i i didnt ejaculate inside too and the pre cum too as i was using condom but during the oral sex i was rubbing with my penis the vagina and condom remove and my pre cum has touch on the vagina and after that i have given ipill in just a hour of it after having oral sex. is it possible if she gets pregnant. Her last period was on 21/5/15 and we did oral sex 6/6/15 ### REPLY: Hello dairy understand your concerned pre-cum goes close tot the vaginal introits then there may be chance of the pregnancy. But you have given I pill with in one hour of sex. It is highly effective in preventing the pregnancy. It has 95-97% success rate to prevent the pregnancy. So very less chance of the pregnancy (0-5%). But I pill cause change in the menstrual cycle as it cause hormonal imbalance. It may cause early period, delayed period by 1-2 week, excessive bleeding and intermenstural bleeding. If period will delay by the more than 2 weeks then go for urine pregnancy test and or blood  to confirm the pregnancy. If pregnancy will be there then still you can terminate the intrauterine pregnancy by the abortion pill under the supervision of the gynecologist.Meanwhile, avoid stress, take healthy diet, . Use condom in future to prevent unwanted pregnancy. Hope this may help noncontact  for further health query Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: In the last few weeks I have been experiencing an average BP of 140/90, my heart rate varies between 85-107, other symptoms are painful burning-tingling in my forearms and hands, dizziness, ringing in my ears, nausea, inability to concentrate, chills, and occasional brief unconsciousness. What kind of doctor do I need to see? ### REPLY: Hello! Welcome and thank you for asking on ! I read carefully your question and understand your concern. Your symptoms may be related to different disorders: - Thyroid dysfunction (Hyperthyroidism can mimic this clinical scenario)- Anxiety - A chronic infection affecting different systems (like Lyme disease)- Cardiac arrhythmia-Seizures (seizures can be closely related to cardiac arrhythmia)I recommend consulting with the GP for a careful physical examination, a resting ECG, a chest x-ray and some lab tests: - complete blood count-fasting glucose-kidney and liver function tests-blood electrolytes- thyroid hormone levels- inflammation tests (PCR, fibrinogen, sedimentation rate). Further tests may be needed to establish the cause (like an ambulatory 24-hour ECG monitoring, an EEG, infection disease screening tests). Regarding your blood pressure, it is a borderline high blood pressure, and some modifications to your lifestyle would be helpful to reduce it: - diet modifications (less caffeine, less salt intake and carboy .  Hope to have been helpful! Best regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: During the night i feel difficulties in breathing and when i breath a sound comes from my chest.I feel some congestion in my lungs and also cough badly.I also feel sneezing and irritation in my nose most of the time here in bangalore.I am from rajasthan ,when i am there i do not see any problem at all.but when i come to Bangalore all the problems start.i came bangalore 4 years before,but previously i naver had breathing difficulties but now it is getting worse.Please provide suggestion to cure this problem. ### REPLY: Hi, thanks for your question. I read carefully your question and in my opinion runny nose, breathlessness,chest sound(probably wheezing), cough and the fact that all this respiratory symptoms are worse during the night and when you change city suggest for allergic bronchial asthma. I recommend going to your physician so he/she can order some necessary test like chest x-ray(to exclude a pulmonary infection), pulmonary function test and skin prick test(to find if there is something to which you are allergic) to confirm Bronchial asthma and start treatment. Hope I answered your question. 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 had seizures in past but noone could diagnose my seizues I am fine now but from that time I have memory problems I never have a desire to remember the past nothing comes naturally I really care for my condition. Is this a memory problem or another disorder ### REPLY: Hi, Thanks for writing in. Memory is the function of a group of brain centers and this is known as a higher mental function. Seizures happen due to bursts of electric current within the brain. Any seizure patient must be investigated in detail. This includes full neurological clinical examination and psychological assessment. You need to take tests to evaluate your recent, short term and long term memories. Since you have said that the past cannot be recalled easily, it might be due to long term memory problems. You also need electroencephalography and functional MRI scan to know exactly which part of your brain is involved when asking questions on memory. These studies should be done in a research institute where facilities are available. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Res Doctors I am feeling breath trouble since two months on 30th Oct. I got 101 fever and cold and cough. Consult with general physician he has given routine medicines Acufix, Doxyril, Omnacortil, PCM etc. but breathing trouble continued till 13th Oct. On 14th Oct I admit in Jaipur Golden for breathing trouble. They diagnose as anxiety neurosis with sinusitiis and given me Respule Levolin, Budecort ,Torpan, Aziwok,DOM DT, Deriphylin, Lonazep, Prothiadin, Brozedex,Steam Inehalation, Duonase nasal Spray. All the test fasting pp cbc tsh trop T kit PA view are normal except Neutrophiles wich is 82 above the range 40-75, and Left maxillary antrum shows moderate degree of opacity with loss of definition and irregularity of sinus wall. Please advice me whether the treatement is correct or should I consult to any other doctor if yes then where and which department to consult. Virender Gupta 0000 YYYY@YYYY ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Neurosis is functional mental disorders. In a way anxiety neurosis is anxiety disorder. Therefore, don't confuse. You should know that these problems are not mental diseases, but are mental disorders. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Lifestyle changes, change in thinking pattern, relaxation etc. are as essential as medicines. Psychotherapy can help you to change your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently had a ultrasound on my heart due to palpitations and feeling very fatigued, extremely sluggish, chest pressure, numbness down my arms at times, and feeling like i could not go for days on end. Hard to breathe, etc. The results of my ultrasound came back saying this: Report Pulmonic Valve: Trace pulmonic valve insufficiency is noted. Pericardium: No evidence of hemodynamically significant pericardial effusion is noted. Venous: The IVC is normal in diameter. Conclusion: Otherwise normal echocardiogram. At the time of interpretation, no previous studies were available for comparison. Summary 1. Estimated Ejection Fraction of 55 to 60%. 2. No tricuspid stenosis. 3. Trace mitral regurgitation. 4. Trace pulmonic valve insufficiency. 5. Trace tricuspid valve regurgitation. I would like to know if all this is normal or something I need to be watching or monitoring? ### REPLY: Hi, Mild tricuspid regurgitation or pulmonary regurgitation or mitral regurgitation may be seen in hematological heart disease or pulmonary hypertension or ischemic heart disease with dilated cardiomyopathy etc. If it is mild no problem but if it is moderate to severe lead to pulmonary edema, palpitations, dyspnea or cardiac failure. So you have to control your blood pressure and diabetes. Regular exercise and eating green leafy vegetables are useful. Please consult your cardiologist, he will examine and treat you with medication to prevent further progression. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am taking now metoprolol er 50mg. I am an active and play soccer. Sometime just to warm up, I do jogging for 3 miles and it has become difficult. I get short breath and whizzing. Why is that? Is there any remedies? is there any one who can help me? I am dont have money? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you should consult pulmonologist because possibility of either asthma or bronchitis is more. Both of these can cause wheezing and breathlessness. So consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PUT (pulmonary function test). PFT will not only diagnose them, but it will also tell you about severity of the disease and treatment is based on severity only. You will need inhaled bronchodilator (formoterol or albuterol) and inhaled corticosteroids (ICS) (budesonide or fluticasone). Don't worry, you will be alright. First diagnose yourself and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END