Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hiii sir i am 22 yrs old and i am suffering from night fall problem since last 3 yrs please suggest me how could i stop this ..plz sir i am feeling  very sad,  i feel like i have totally lost my sex power i could not even make it for 1 minute......... do suggest me sir what i will do...... ### REPLY: Degree understand your concerns went through your details. Night fall or nocturnal emission cannot give you any health problems or sexual problems in future or present. Nocturnal emissions are natural and is a process which you have very less control over. You must understand why this happens. Let me explain. Your body produces semen whenever you are sexually excited and stores it within the body. Thus produced semen is a waste product and body will try to throw it out. If you do not masturbate or engage in sex, the waste cannot be expelled and therefore bodies option is to expel it through nocturnal emission or through urination. This is natural and due to this no health problems will happen to you. Your sex power will never get affected. Do not be anxious. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I thought I had a yeast infection so I took monistat 1 and had a horrible reaction, burning even worse and my labia swelled to the size of my finger. First it was one side, then both and now when I wake up in the morning it is only the back of one side. Should I still seek care? ### REPLY: Hi welcome to ChatDoctor1 can understand your concern yes you need to seek care. Meet your nearest gynecologist. Accorning to your history I think you are having vaginal candidiasis. Common treatment for vaginal treatment 1 it can be managed with either topical antifungal agents or a single dose of oral fluconazole.2 A single dose of oral fluconazole (150 mg) in acute episodes of vaginal candidiasis. 3 A small percentage (so monist at is not the tablet to be taken, and you are allergic to it. That is the reason for your illness. Thank you take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir, I have less sperm motility & because of this I am in depression. I have been taking Paternia Tab& Semento from 5 months. After 3 mother sperm motility increase to 5 but again it fell down to 0. Plz advice how to overcome to this problem. ### REPLY: HelloThanks for your query. Based on your statement you have what is called as Asthenospermia meaning there by that percentage of active grade one sperm is less. Truly speaking there are no medicines that can increase the percentage of motile sperms, However following general measures help to improve motility of sperm to some extent.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc 3)Take anti oxidants like Almonds 5-6 every day. 4) Avoid alcohol and smoking. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dr I am 59 n having constant stomach pain mostly on right n feel discomfert n have feeling of stomach bloating.2013 sono shows fatty liver.                                    Secondly mostly left side chest pains reason unknown gas ,acidity or wht.But of late get fever on regular basis n feel vomitng but only aensation.My friend says all this r sign of Cancer.Pl suggest ### REPLY: Hi, from history it seems that your problem might be due to fatty liver affecting liver enzymes and digestion producing pain in the right abdomen and bloating and gas problem. Go for testing of, Liver function tests, Follow up for fatty liver go for ultrasound. Avoid fatty, fried and junk food. Take some liver enzyme medicines. Stop taking Alcohol if you are taking. Consult gastroenterologist and get examined. Ok and take care. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About 10 years ago I had a chancre in my genital area which went away on its own, about a year later I was sick for a week with high fever, I lost weight and had rash in my hands now after 10 years I think I have a syphilis infection left untreated I had an RPR that came back non reactive and I am now waiting on the results of a second test called Anti-nuclear antibody, my question is will this test detect dormant syphilis? ### REPLY: Hi, Welcome to . Antinuclear antibodies are abnormal antibodies present which have the ability to bind to certain structures within the nucleus of body cells. These antibodies are more common in autoimmune disorders like SHE, Rheumatoid arthritis, Graves disease and Hashimoto Thyroiditis. These antibodies do not detect dormant syphilis. RPR is a screening test which detects regain antibodies seen in syphilis. These tests have to be confirmed by specific tests like TPA, ELISA and Fluorescent treponemal antibody test. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my friend as been given 2 wks to live stomache cancer he is in hospital, and his lungs collapsed, tonight his poop tar black how long do you think we will have him with us its heart breaking to watch he hasn t been for a poop for wks and has had 3 black tar poops since yesterday ### REPLY: Stomach cancer with metastasis to lungs resulting in collapsed lungs and advanced disease to the extent that the patient is bleeding inside passing black stools, has very poor prognosis. Survival is limited. Exact time frame is difficult to give. The treating doctors would give you a better opinion as other parameters like lab results, oxygen dependency, infections etc. also need to be taken into account. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 just been diagnosed with Adult On-set Asthma and have been on Advair for 2 months now.  The minute I step out into the sunlight I feel weak as water.  I will be seeing a Pulmonary Specialist in 10 days...But I am wondering if this is a reaction from the Advair? ### REPLY: Hello, Welcome to , Asthma is curable with proper homeopathic treatment. This inhaler can give you temporary relief but can not cure it. Long term use of inhaler also can cause many side effects. Homeopathic treatment is based on total understanding of patient on physical and mental level. And that's why detail history of patient is needed for proper homeopathic treatment. Your problem can be cured permanently with homeopathy. So consult to good classical homeopath nearby you or contact us. Have a better health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my daughter in law is 30 weeks pregnant . Its her first pregnancy. When she was at the doctors office in beginning of past May her BP was 100/65. Since Sep 25 her BP has been going up to 135/100 and edema at the ankles but her doctor said til over 140(systolic) its normal. I dont think the doctor is right biz whose BP rises by30mmHg or 15mm Hg diastolic must be considered Preeclampsia. ### REPLY: Hi, Thanks for the query. I understand your concern.  The changed range of blood pressure she has is suggestive of conceptional hypertension. She needs a second opinion for her treatment... with preferably at least 3 BP readings at different time of day to confirm need of medication.  Edema feet she has needs to be further checked with albumin in urine (which is suggestive of preeclampsia) ...she needs rest(physical psychological), treatment for urine infection if any & treatment of antihypertensives to keep blood pressure in control.  Please consult a gynecologist for proper guidance.  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 m a boy of 22 years old and an asian . My height is 5 feet and 5 inch , weight is 47 kg. I mustarbate from the age when i was 17. I do it everyday at the time of taking bath. In my mustarbate life , i was free from this only about 3 months . But now-a-days, however , i do it by watching porn movie and sometimes sexy nude girls. It is mentionable that i m suffering from various mental diseases . Sometimes i lose my memory , now i m fully unable to study deeply , i can remember nothing which i read or learn or write. It is important to inform u that i have been taking Lamitrin 50mg and sodium valproate 200mg. and lithium carbonate 400mg. for 2 years , according to a doctor . But though i m not taking it now and it is without the permission and advice of doctor . Sometimes i want to commit suicide , and sometimes die. I want to live alone , i do not have so many friends. I do not talk to the girls , though they do not talk to me also. I have lost my codifence about myself. I m in a confusion , weather i will stay in the world in a peace or abandon it as soon as possible. What should i do now , please advice me , and help me to live a happy life. Thank u . ### REPLY: Hi dear, Since when you're on treatment?what ever the treatment you describe is normally given in bipolar mood disorder patient.Currently, from your symptoms I can judge that you are having depressive phase of bipolar mood disorder.First masturbation does not cause any medical or psychiatric illness.% of male doing it. The reason behind any psychiatric illness is neurotransmitter imbalance. If you are in my clinic I would go for Olanzapine instead of Aborigine and also continue the valproate and lithium. Also think for ECT (electroconvulsive therapy) as it has fast result. For proper treatment detail history and mental status examination is necessary. 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: After 3 years of my relationship i had a breakup with my boy friend. and now I don t know how to move on in life since last six months I ve been depressed like hell... Can t even concentrate on my work.. I can t even like anyone forget bout love.. dun knw wt to do.. ### REPLY: Hi, I am sorry to read about your breakup and resulting symptoms that you are facing. You seem to be depressed and if even after 6 months, the symptoms are persisting, you should consider starting treatment for the same. You should seek a psychiatric consultation for the same. Ant-depressants like Escitalopram or sertraline will be highly helpful in your case. In addition, you should start exercising daily. It will help you relax and feel better. Additional option of treatment with supportive psychotherapy can also be considered. It will consist of multiple sessions focusing on letting out your emotions. You can discuss with your psychiatrist regarding the same. I do hope that I was able to answer your query. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 3 months ago i had a zit on my left leg. I tried to pop it before it was ready and it became infected. Took antiobiotics and knocked it out. A month kater, same thing on my right leg. I was stupid and did the same thing got infected again, antiobiotics again. Now i have another one, havent touched it, it formed a white head, but its pretty big. Im 44 yrs old, have had leg zits for a long time, but now they seem to be getting worse. Why? ### REPLY: HelloWithin a period of three months, you had three ZITS and pop it every time, got infection and took antibiotics. The possibilities of such zits may be due to :1 Some bacterial infection like staphylococcus or streptococcus or any other bacteria. Diagnosis can be confirmed by blood culture or biopsy of affected parts.2 The next reason of such zits may be due to dermatitis or edematous dermatitis. Diagnosis can be confirmed by physical examination by a dermatologist .3 At the age of 44 years sometimes due to lowering of immunity skin got infection. So please consult a dermatologist and get his opinion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I woke up this morning with sharp stomach pains. The pain was about 2 to the right of my belly button. I started getting dizzy as if I was going to pass out.. I took some Advil and laid down. After a couple of hours, the pain has decreased but has spread all across my stomach and has since moved to my left side as well as my back. It s not hurting as bad as this morning, but is still noticeable. ### REPLY: Hi, Thanks for the query. I understand the pain you are going through. Any pain in abdomen should not be taken lightly. Painkillers may reduce the pain for some time. But they are also masking the actual problem. You have also mentioned that pain has spread all over the abdomen though reduced in intensity. It shows that the problem still persists. Are you having fever? Is there any problem while passing urine? A lot of questions needs to be answered before finding the exact problem. I would suggest you to consult a gastroenterologist at the earliest. Your condition needs to be examined properly. You might have to undergo ultrasonography of abdomen to pinpoint the cause of pain. Meanwhile, avoid spicy and oily food.  .  Hope I have been of some help to you. Let me know if I can assist you further. Thank you. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: "i had a cold sore , i pick it now its healed but the skin had ripped off ... now i have a pink spot ( under skin ) in my lips and i want to know what i can do for it to heal faster so my normal lip skin color would show , I Cant depend on time i have things to take care of & this is sort of embarrassing , Thank You . ### REPLY: Hi. Welcome to . I read your query. Cold sores are Herpes virus infections. It has a healing process of its own. But since you peeled it, the healing is delayed. Since its on moving area i.e. lips, keep the area moist with creams to avoid cracking. Apply ice over area which will help in soothing. Cooled used tea bags are also good. Most important is maintained good nutrition and HY .  Take multivitamin tablet once daily for 2 weeks. Do not peel it off. You can consult a physician and start with some antiviral medication orally or topically if required, but they are more useful in early phase. Hope the answer helps. 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: Hello, I have a crumbled jaw tooth and I have noticed it swelling recently @ the outer gum line. It has had a puss pocket that I have extabated excretions out of up to 3 times a day. My dentist will not touch me because my mouth will not deaden with novacaine. I have to have them pulled by an oral surgeon. But my medicare does not pay for the gen. Anthesia any more. Please help ### REPLY: HI your crumbled tooth seems to have .  Broken down (Crumbled teeth), often leads to pulp exposure and subsequent pupal and periapical inflammation (i.e., inflammation in the socket of the teeth around the tips/ spices of teeth). During such inflammation, Abscess formation takes place. AND IT IS THE FACT THAT LOCAL ANESTHETICS LIKE NOVOCAINE OR ANY OTHER DOESNt WORK SOMETIMES IN PUS LADEN AREA. "B" You haven't mentioned which teeth and in which jaws, as it is related to area/ technique of anesthetic injection. If you don't wish for a General Anesthesia, you can try the following, for Local Anesthesia only to become effective 1) take antibiotics like AUGMENTING 625 for two times a day for three days to ward off the infection, so they LA can be effective2) Ask for around two shots of Local anesthesia and wait for half an hour 3) ask the dentist to use other alternative techniques of anesthesia like, local infiltration/ pulpla and Periodontal blocks, Nerve Blocks etc4) Lastly if nothing works out, see a second opinion from another dentist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 these two swollen round bits under my jaw on each side, and I feel this dull pressure that is hard to describe. It feels like something is caught in my throat and at the same time its just a little achy. I can talk fine and I have no issue swallowing. Im worried this might be due to my smoking? How can I tell if its cancer? ### REPLY: Hi and welcome to . Only biopsy can show for sure what it is, but usually this is just a swollen lymph node due to respiratory infection. But if there is redness around it, or it is fixed to background or growing fast then you should visit specialist. If this is soft and movable then it can be lymph node or lipoma. To be sure you can do ultrasounds with needle biopsy and see exact case. 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 am a 34 year old female who has suffered with anxiety for about 14 years. I have recently be having panic attacks and have noticed my heart "fluttering," which concerns me. I have no pain associated with the flutters, but I obviously have concerns that there is an underlying issue. Is this normal? Obviously when I have the flutters it automatically kicks in my anxiety. Please help. ### REPLY: Hello and thank you for using . I carefully read your question and I totally understand your concern. But you should not worry. These fluttering sensation have to do with some electrical issues in the heart. Some electrical impulses that generate in a part of the heart different from normal sinus rhythm cause a premature heart contraction that you feel like a fluttering or skipped beat, because it's not a normal one. These electrical issues might be different to simple sinus tachycardia, meaning frequency above 100/beat/minute to extra-sistolic beats or other arrhythmia. The extra-sistolic beats generally are followed by a pause till the next normal heart contraction. A sinus tachycardia means regular normal rhythm with high frequency that gives you the sensation like fluttering. If the rhythm is fast and chaotic than we are dealing with an arrhythmia like fibrillation CTIF this fluttering are not frequent, in Young and normal heart, it is nothing to worry about. There are different factors that might cause this fluttering/skipped beats like emotional stress, excessive coffee consumption, coca-cola or energy .  It is quite known in medicine that anxiety, stress disorders might cause rhythm problems, so you have to ménage them. Pathology like anemia or hyperthyroidism might be other causes. So, if I was your treating doctor I would say that you have nothing to worry if this happens once a wile, its normal, and we will try to deal with your stress disorder. But if they begin to bother you and interfere in your live, and as you say they trigger your anxiety we can decide to do some examinations like a blood analyze, your thyroid hormones, an electrocardiogram, echocardiography and of course a holder rhythm monitoring to have a full view of your rhythm and the extra-sistolik beat frequencies if any. Only than we can decide what we should do and if it is necessary to treat them medically. Hope I was 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: I am 70 yrs old with PBC, portal hypertension and symptoms of : bloating, gassy burping, nausea, weight loss, inability to eat(I get very hungry) but am only able to take a few bites of anything. I can eat sweets which is weird! I have stumped my PCP, my gastroenterologist and my liver specialist. I ve had blood work, an MRI of my head, my stomach and a throat swallow study; all of which were normal. I am scheduled for a SIBO breath test this coming Monday. Can you help??? ### REPLY: Hi, A certain degree of bloating is normal but in case of excessive bloating, it may be a sign of food allergy, hiatal hernia, IBS or inflammatory bowel diseases.  So you should do gastroenterology work up but first try to change your dietary habits, it means: eat smaller meals but more frequently, avoid fried and spicy food, take mental tea, avoid alcohol and coffee, eat probiotics and milk products, boiled food and vegetables.  Also, there are medications such as Florian, Magnesium oxide or certain Laxatives which may relieve such symptoms of this continue.  If there is no improvement on these measures, you should consider doing diagnostic tests such as colonoscopy, anal sphincter manometry and food allergy testing. Hope I have answered your query. Let me know if I can assist you further. Take care .  Rammstein, General 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: hi Doctor, I am on my 37 t day of my cycle. I have missed my period. My regular cycle is around 25 days every month. I am married since 6 months. My Hormone levels are low so I am taking Ovasper EC and D frag for the past one month. Yesterday I went to my doctor and she suggested me for a blood best asmy uterus lining was a bit thicker. But my blood test was negative. I am worried now, Will I be pregnant still ? ### REPLY: Hi there, I have understood your concern, and I will suggest you the best possible treatment options. Delayed periods and negative pregnancy test, is mostly because of absence of ovulation. If you still have doubt about the pregnancy, blood beta  test will be of help. This test is negative for pregnancy if reports are less than 5 and positive for pregnancy if reports are above 25. If the tests are indicative of non pregnancy status, then I will suggest you the following-Please get USG done to know about the ovarian status and to rule out PCs. Also, get FSH and LH and prolactin and AMH levels done, preferably on day 2 of the cycle. This will help to know about the ovarian reserve and ovarian status. Please seek prescription help from your treating gynecologist for progesterone pills, the doctor will guide you about the dose and with . I hope this answer helps you. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ok my husband had a aortic valve replacement and a bypass he is 44. His upper lip after they took tube out is so swollen you coud not believe. All doctors ENT included have no idea. Have never seen this before. Nurses the same. he has had 9 surgeries in the last 9 years and this has never happened. He had cance when he was 18 all surgeries are a result of chemo or radiation. Any ideas? ### REPLY: You don't say how long ago his heart surgery was.  If it was within the past week, some patients will have local swelling of the lips, perhaps from mild trauma or irritation from the endotracheal tube being in the mouth or moving around a little or sometimes the patient biting on the tube and/or his lip while sedated or unconscious.  That should subside naturally over the course of a week. It is also possible he might be allergic to latex, a component of the tape glue that is usually used to secure the tube during intubation to prevent it from moving around or inadvertently coming out.  That usually subsides when the tube and tape are removed. If the tube have been out awhile without improvement, or if the lip swelling is continuing past a week or so, then his doctors should review his medication list for .  A common cause of lip swelling are  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 in law hand an angio plasty to remove two blockages from his legs... he came home after 2 days and is very much active. however he has been coughing a lot and gets frequent fever, can you pls tell me as to what could be the cause of this and what needs to be done? ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Coughing with fever indicates respiratory infection. 2. If there is sputum production, get a sputum culture, if not, a swab from posterior pharynx or bronchial wash culture will be helpful. Culture and sensitivity will be helpful.3. It's only a respiratory infection and not related to angioplasty.4. Antibiotics will control the infection. Improvement in protein and vitamins required to improve immunity. Hope it helps. Any further queries, 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: Male, 37yr old, 105kg.  AST of 56 and ALT of 122 and some liver area pain.  6 weeks ago I started feeling ill and fainted, and the Dr found I was Type 2 Diabetic.  Feel week and ill since and have no energy.  Doctor prescribed Citalopram 20mg a day 3 weeks ago and the pain started the next day.  Could Citalopram cause this pain?  Lost 2 stone 2lbs in the last 6 weeks. ### REPLY: Hello! Hope You may be well. There are four issues.1. Obesity 2. DM 3. Raised AST and ALT. 4. Pain in liver area. Visit either Gastroenterologist or Physician who may ask for few tests like USG abdomen to see for Liver echo texture (to see for Fatty liver- NAFLD, if you are not alcoholic. You also require undergoing some blood tests like lipid profile, Bag, Anti HCV ab, ANA, SMA, S.ceruloplasmin to see the cause of abnormal AST and ALT as they suggest that there is ongoing liver injury which is persist for a longer period of time will be harmful. It is further advised:1. Good glycemic control with help of Antidiabetic . Regular exercise which includes brisk walk for at least 30 min/day. 3. Very low caloric diet as per your BMI to reduce your weight which is must. 4. If your lipid profile is also deranged then lipid lowering agents also. 5. Cause of abnormal AST/ ALT as per scenario you have given appears to be more likely due to NAFLD which will require some medications like ursodeoxycholic acid, apart from measure which I have already mentioned. Pain in liver area may be due to stretching of the Lessons capsule which is over the liver due to hepatomegaly or enlarged liver.Also, if you are taking alcohol please stop that. I hope this will be sufficient and will resolve your problems. Further best of luck. Remain in touch. Goodbye ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! For the last 18 months my back pain has increased, to the point of limping. Doctors did not exactly diagnose me wity eny specific thing. My MRI shows severe recess spinal stenosis at l4-5. I have been at the hospital several times with debilitating pain. Now the pain has spread all the way to my feet, the worst pain comes at eny time I try to rest, no matter day or night. The other problem I have is the way I find my self wetting my under pants or the urgency to urinate and no sure if urine is coming out till I hear it falling. Cant get up from the sofa or chair eith out help, or with out pain. The back of my neck also started to get numb and very painful, my arms also like my legs have lost almost all strainght. Please help me understand. Iam 54 female. Thank you maria ### REPLY: Hi, Welcome to . After going through your query I think your You are suffering from lumbar spondylosis with degenerative spine with spinal stenosis. Rest in position of relief, Cartilage D once daily, NUROKIND GOLD ONCE DAILY and analgesics (DICLOFENAC 100 MG SLOW RELEASE TABLETS) give relief. Sometimes vitamin D deficiency can aggravate this so serum vitamin D test is advised if it is lower than vitamin D supplementation will be required. You have already investigated by MRI and operation may be required.  I think your query answered. Welcome to any follow-up query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 86 yo mother has PAD & therefore had a angiogram & angioplasty (2-3 100% blockage & stents). 2 hour surgery / recovery for 2 hours then removed line . Right away bleeding profusely &nurse called for help with a ER doctor, ICU nurse, & another nurse. Nurse had strattle her & put direct pressure on the groin area with her hands approximately 25-30min. After this a waiting period again of 2 1/2 hours then she stayed overnight discharged next day. One week later groin area & left leg extremely black & blue & swollen 3x times it s size. Took to ER ultrasound discovered she now has a pseudo aneurysm. I m now suspecting this was caused when nurse took line out .... or was done with angioplasty ..... what caused this????? After this time she spent 6 days in hospital now sent home & has appointment for another ultrasound in 6 weeks & possibly another procedure of some kind. So what is going on Dr s are pretty tight lipped & are not explaining much which I find really unusual. ### REPLY: Hi, this is the complication of the procedure. Pseudoaneurysm is basically bulging of the wall of the artery where the puncture it to enter into the artery, most of the case it seals within a day or two. However, sometimes artery bulges out at the site leading to pseudoaneurysm. The treatment for this is tight pressure or compression at the site. From your site restrict her activities to minimal for few weeks. Sometimes if its big then surgery is needed to repair 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: Hello. I just had a renal biopsy last Friday, I m unsure if it is related. But on the left side of my abdomen I have been having pain. It started Tuesday and has been increasing in severity. When I take a deep breath, walk, or sneeze the pain is stronger. I m also having back pain but it s not as severe.Sometimes I also feel pressure in the pelvic area. ### REPLY: Hi. Thanks for your query and an elucidated history. With the history of a renal biopsy, the cause is obvious. The hematoma or an infection or a lemonade in the retro-peritoneal space can cause all the problems you have of pain, which is increasing in severity, and increases on deep breathing, walking and sneezing along with back pain. The pressure in the pelvic area suggests that the hematoma might have spread to the pelvic area too. I would advise you to report back to the center / Doctor who performed the renal biopsy, get an ultrasonography or a CT scan of the abdomen and get the proper diagnosis. The treatment will be according to the findings, till then have complete bed rest, take plenty of oral fluids, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pin holes and old scars from my bad teeth that 10 dentist would not take care of for  20 years my bottom big tooth caped in gold kept absessing  for over 20 years. I became very sick  I also have tmj now.any way life long story.I know a lot and learned a lot and I am still alive I am 54 the gold tooth is gone now. Only because the dentist was getting ready to retire.After I returned for the 3rd. time  I did not take any antibiotics my choice.I am getting help with my teeth finally by wonerful doctor dentist.Is there any thing I can do to heal old uneven skin tissue and pin hole scars? ### REPLY: Hello, thank you for consulting with . As you are mentioning, it looks that your tooth was infected and an abscess was formed below the tooth. And when an abscess becomes chronic, it forms a sinus opening, which . In your case, as now the tooth is removed, the abscess will heal as well as sinus opening will get closed. If not then you should visit an oral surgeon to get diagnosed with the condition and even get stitches done. Hope it 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 was hit in the forehead along my hairline on Monday ( i was playing in the pool with my son who is 2 and he threw a heavy plastic penquin water toy and hit me by accident)it did bleed some and a knot immediately came up.  today is Friday and the knot is still there and it seems to be a little more sore than it was in the beginning.  If it were a severe injury, would symptoms have shown up by now? ### REPLY: Hello and welcome to , Trauma is the cause of the injury. The knot caused by the trauma could is probably due to hematoma formation. Hematoma is caused by collection of blood at the site of injury. Hot compresses will help to resolve the hematoma. You can wait for a couple of days and take hot compresses and painkillers if required. The hematoma will resolve within few days. If it does not, you can consult your primary health care provider. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey Docs. I ve been fighting a bad back for 20 years and it appears I m going to have to get a decompression operation (L4-L5). I ve put this off for a long as I can, but getting around this pain is getting really old. My question is; do I have reasonable chance to get some long term relief? I m in reasonably good health but I do smoke a pack a day. Thanks for your consideration. ### REPLY: Hi, From your information it seems you have a condition where there is a nerve compression for a prolapsed disc or a stenosis (narrowing of the canal caused by either the disc or extra bone formations or even a shift in the vertebral position). All these causes a bad back but essentially leads to pains shooting down the limb and disturbances in sensation. So to answer your question, if the MRI does show a nerve affection or an unstable vertebral bone, and it correlates with your symptoms and signs, then there is a good chance that you will get pain relief.However, this is along standing condition and your back muscles will be weak and contracted which means intensive physiotherapy will be required.Furthermore, you are a moderately heavy smoker and this will in no way help pain relief or a quick recovery so think about quitting! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m only 43 been having sever chestpain that starts throat area ,can t cache my breath,pain moves to shoulders and arms .numbness follows,also dizziness,sweating,feeling like I m going to pass out,I have panic disorder and feels nothing like oanic attack.very scary ### REPLY: Hello, I have gone through your query. Thanks for using . All your symptoms are due to panic attack. You should take Tab. Clonazepam 0.5 mg mouth dissolving preparation at time of your symptom. Mostly if you will be immediately relived, and it will confirm that your problem is nothing but anxiety. In case you are not relieved, you should get ECG and Echo done to rule out any heart disease. My best wishes .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m on the combined pill microgynon and today six days into my new pack after the pill free week and a normal period which normally lasts around 3 days into my new pack I forgot to take my pill this morning. When I went to the toilet I wiped away some red blood . Just a small amount and nothing else since. What could be causing this breakthrough bleeding? Could it be because I forgot to take my pill that morning? ### REPLY: Hi, Thanks for the query. Yes, the spotting you noticed could be break through bleeding due to missing the pillAnyhow as 24 hours not yet over, you take the pill now. And continue remaining pills as usual. Possibly your spotting will subside soon. If the spotting continues, consult gynecologist once and take tablets to control it. For more details you can ask me directly through the premium forum. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a 5 mo old.he s had a congestion for than a week.His symptoms are: watery eyes,congested chest,persistant coughing, loss of appetite. I ve diluted his breast milk,given steam bath for ten minutes,use humidifier but no fever i dont know what else to do please help ### REPLY: Brief answer:Could be bronchitis, needs examination by pediatrician and nebulization. Detailed answer:Hi, welcome to . I see similar cases in my clinic every day. A 5-month baby with congested chest, cough and cold might be suffering from bronchiolitis. In bronchiolitis, nebulization needs to be given and a complete chest examination by a pediatrician is mandatory. I advise you to meet the pediatrician and get the child examined. I hope this will help you. Wishing your child good health. Take care. 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 doctor ....have a very itchy rash under arms under breast, lower back , doctor has given me clarithromycin and prednisolone for five days . Dont seam to be working . He did say I think if this is not working will try .candida. As it so itchy he didnt give me any soothing cream . Can I buy over the counter candida . Im a woman I do a lot of sport , and get very hot . Thank you ### REPLY: Hello, I had gone through your query and understand your concern. Short answer: Looks like candidiasis, Candid will help. Detailed answer: Thanks for asking on . Itchy rash under breast and arm pit is may be due to Candidiasis which is a fungal infection. These areas are prone to fungal infection because of constant wetness due to sweat. Candid cream contains broad spectrum antifungal .  Yes, you can go for over the counter Candid. Hope this helps. If you have any other queries, 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 in Stage IV of Cirrhosis of the Liver/Autoimmune Hepatitis. My blood work came back positive a couple of weeks ago. My Dr is in Raleigh, NC and I just moved to Atlanta, GA a couple of weeks ago. My Dr in Raleigh said it was imperative that I seek a Dr here in Atlanta or neaby. Can you recommend a Dr to me. I am also on Medicaid. Thank you. ### REPLY: Hi and thanks for the query, It is important to know what came back positive in the blood work up.  Was it an infection or was it the presence of absence of viral ;particles? It is important to know what was positive exactly in order to institute an appropriate treatment. Antibiotics are needed in case of infection and antiviral agents, and at times liver transplants in some cases could be offered. More information is required and seek the opinion of your gastroenterologist. Kind regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife is continually snezeing from last 2 days. Rate is 20 to 22 sneezing per min. From last 2 days consulted with many doctors they say it s an alergic reaction. And need to wait for 2~3 days more. It s a very horrible codition. Pl suggest Is it normal. Or pl suggest what to do next ### REPLY: Cellophane You for contacting . Yes it is because of allergic response and takes some time to relieve. I would suggest you following things:> Take levocetirizine one at night for 5 days.> Take montelukast one daily for one month. Research has shown that it decreases the allergic symptoms considerably. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. Wishing her 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: Q I was diagnosed with breast cancer and had alumpectumt Nov,13.My surgeon said I would need radiation,set up an appt with radiologist,he suggest herceptin, radiation,and hormone therapy, set up an appt with oncologist to discuss herceptin and he feel I should have chemo, I know my herr2 gene came back pros and so did estrogen, and progesterone, I am very confused on what treatment I should receive, I should add that I am 71 years old with no major health issues ### REPLY: Hi, thank you for providing the brief history of you. As you mentioned the difference in the thoughts of the Radiologist and the oncologist that is making you confuse. It is not a case of worry, as you can request both of your oncologist and Radiologist to have a discussion on your case and then plan to a proper rehabilitation process. I am sure they won't have problem talking and discussing on their ideas and come to a proper treatment. As both may have different thinking in mind taking to your case after assessing you. Both are not wrong, but the variation of the thoughts are making you confuse. So patients comfort is the first line of action which they can do by meeting up and discussing your case. I am sure you will be at comfort once they both have a discussion as the principle of medical to keep the patient at optimum comfort. 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: hii my name is famaan i am a boy 22 years old.... i am straight guy....i had protected sex with a gay but when i was fuckung the condom breaks and i didnt came to know that it s broken inside....i didnt cum inside his ass max to max Fucking lasts for 45 secs or 1 minute he say s he is clean he wanted me to trust him... but i am scared what should i do now to prevent from aids ... ???.. i am really very scared and parents dont know about this...... : ( ### REPLY: Hi, if you have a strong suspicion you can have a course of Antiretroviral medicines for Post-exposure prophylaxis(PEP). It is a regimen of a week or so and can prevent the infection in many cases if started soon after exposure to the infecting agent. You should consult your doctor for the same and start it if he advises. Please be careful in the future, you have a long life ahead. Make it healthy. Feel free to contact me directly on Ask a Specialist section of the website. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 3 year old has been getting red itchy painful pimples on her buttocks that scar as they heal. They are now spreading to her upper thigh and back, and her 5 year old sister is getting them as well. Very random places and isolated, not groups. The pimples seem to dry up and heal within a couple of days, but then others appear in unrelated places. I,ve taken the toddler to the GP, he thought diaper related, but I dont think so now, as they seem to spread. ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband had surgery for stage 1b lung cancer removed right upper lobe right lung. also had a spot on his brain gamma knifed. Oncologist want to do chemo once every three weeks. Why if all the cancer was removed and lymph nodes were clean. What drugs should be used IV or oral. ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. Surgical removal is the treatment of choice for stage 1b lung cancer. Post-operative chemotherapy should be given in all patients. During surgery, handling of tumor mass cause spillage of tumor cells in the operative site. So there is risk of tumor recurrence. To avoid this complication, post-operative chemotherapy is advised. So my suggestion is to give him chemotherapy cycles. Usually chemotherapy is given intravenously, and most commonly used agents are cisplatin and topside. So no harm in post-operative chemotherapy. This will reduce the chances of recurrence. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir,I am a male of 48 yrs old. I get asthama problem during onset of cold and out set of cold.  I have consulted a doctor he gave me antibiotics for five days and ventolin to continue bu aafter ten days though i am doing my norml work, still I get coughing and breathing problem in the morning and evening. ### REPLY: Thanks for your question on . I can understand your concern. You are not improving because of you are not taking correct treatment for asthma. Ventorlin is short-acting bronchodilator. Its action lasts for only 4 hours. It is advisable to take long acting beta 2 agonist (LAB) (formoterol or albuterol) with inhaled corticosteroid (ICS) (budesonide or fluticasone). Oral combination of antihistamine (levocetrizine or fexofenadine) and anti-allergic (montelukast) once a day at night is also beneficial in asthma. So better to consult pulmonologist and discuss starting these medications. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a painful lump inside my vagina, on the posterior wall for past week. It feels rubbery and is in the area where I would have had stitches after the birth of my son 9 years ago. I am wondering if I may have developed a keloid scar here? Is this possible after so much time has elapsed? I have had no trouble with that area until now? What else could it be if not related to scarring from childbirth? I am a midwife, so understand the physiology! ### REPLY: Hi, thanks for sharing your recent health problem with us! Well, I've gone through your description and can perceive the tension building within you; but truly speaking, if I were your treating consultant for this case of painful vaginal lump I would like to say you, not to worry! Yes, this is fairly a common occurrence in women of childbearing age! This is nothing but a Catholics cyst recently infected due to some region. It is a congenital cyst related to lateral vaginal wall and prone to get inflamed and cause lump and pain! This is not keloid!Therefore, please get a physical examination by your local gynecologist for confirmation and necessary treatments like antibiotics along with . Hope you got your answer; please revert to us if any more queries on this/Wishing you good health! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hai,i m 25 years old.I m married..trying to get pregnant.I have been having my gray hairs from 20.it started spreading more now almost 20% of my head is gray..I m having blood clots in my periods..I thought i was anemic and took iron tablets for 2 months..then i went for a blood test my blood level was in mid range normal ( Hemoglobin , folic acid )& my vitamin B12 is also normal,but my MCV is 77 and my MCH is 25.3 which is slightly low than normal. Does this mean i m Thalassemia carrier..Can i hav a healthy baby...If i conceive...plz suggest me how to increase my health to prevent anemia? ### REPLY: Hello, I would be happy to help you with your question. Premature grain of your hair is genetic and not associated with any problems related to conception.  Second, if you have heavy periods, this needs to be evaluated by your doctor with an exam, ultrasound, and additional labs to workup your anemia.  If you have heavy bleeding, this is more likely an explanation for the bleeding than thalassemia.  If you correct your bleeding, and you are still anemic, then this testing would be indicated.  I hope that this helps and good luck - Please ask me if you have specific 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: I am 21 years old I had bell s palsy 3 years ago, I used to take diprofos injections ( around 8 injection starting from daily to twice weekly). I face recovered 90% from the paralysis yet I had other problems. I never had acne but after taking the medication I had all type of acne covering different parts of my face( first it stated with small pimples and white heads to cyctic acne) and now after 3 years I still suffer from acne which is deep in the skin( cyctic acne I suppose) I tried a lot of over the counter wash but none worked. Is that a side effect of diprofos? I also had a lot of stretch marks ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern looking to the history given here I could say that the history of Bells palsy and having acne are two different conditions and nothing to do with each other, in my opinion you need to see the Dermatologist for acne because this is lengthy treatment and one has to see the dermatologist periodically, hope this information helps you, take care and 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 my name is kristy and im 27 i been diagnose with klippel feil about a year in a half ago they said i had it since i was 18 but now it got severely bad im in stage two for nerves in my spine and body and also my neck bone and spine bone im at a lost all i have is therapie and pain killers is there any other way to have releaf from evryday pain and i know its gonna end up killing me as i was born a sick child and allways been sick my whole life please help me with knowldge about klippel feil what to expect how worse is it gonna get and what can i do ### REPLY: Hi, Sorry that you've been diagnosed with KFS, however, you should know that KFS as its own entity rarely causes early death and people can and do lead relatively normal lives albeit with restrictions due to their musculoskeletal abnormalities and sometimes other organ system involvement. In terms of the pain I'm going to give you this link to look into because I've sent this information now to several of my patients who are in chronic pain for other reasons, and it is an interesting concept that may develop into something you could benefit from since you're so young. It's called the Orphaned/Anesthesia global project.  Also, KFS can be approached surgically in such cases if pain and immobility of the neck or if scoliosis became so painful or obstructive to daily activities that other measures simply don't function. Scoliosis can be corrected if you have that problem and again, you're young, so I believe your healing capacity is going to be excellent assuming you don't have any significant comorbid metabolic conditions such as diabetes, hypertension, etc. I think that with the right therapy program and support groups by your side you stand actually a much better chance at a very good quality of life that may not be completely full of chronic pain as you might think.  And just so don't think I'm trying to make things sound better than they are... HA!....check this link out on KFS (perhaps you've already seen it...but read way down where it is PROGNOSIS....and let me know what you think). 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, im 15 I have a couple of things that I need to ask you1. I hate going to school I think it because im not social? can you suggest some things that I can do to change it? and if it isnt that what would it be?2. I have bad anxiety and it is really putting me down can I do something to help cure it and may it be related to the school thing?3. I have bad anger problems and have got adhd what can I do to cure these 2 problems? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. You are 15. You are naturally having adolescent growth and adjustment conflict as well as role conflict. I think you are confusing these things with ADHD and anxiety disorder. For an adolescent, getting angry with normal circumstances is normal. If you are that sure about your symptoms, do consult a clinical psychologist who assess you with some anxiety and ADHD scales. Only after confirming to these, you can be sure. For the time being, you might need counseling. I am happy to provide you telephonic counseling. Contact me through customer care at www.ChatDoctor .com. 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: Hello my wife was stung by we beleave a fire ant. She said it burnt and the foot swelled up quite a bit there are 2 little blisters in her toe but the foot has turned purple a day later and hurts to walk on. Also she now has a rash all over her body and it appears to be a red line going up her leg. We have no health insurance but of corse her health is the most important thing right now. Any advice? We did also do benedril and cortisone cream ### REPLY: Hi, Thanks for writing to us. It seems your wife developed insect bite induced cellulitis along with lymphangitis(red streak going up her leg). To treat the same she should take a course of oral antibiotic along with anti-inflammatory analgesic and a topical antibacterial cream. She should give rest to affected leg too. I would advise that you visit a doctor nearby to get the prescription for above medicines. Hope that helps. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have contracted citrobacter koseri after tkr.i am on ciprofloxin,rimicyn fucidin for 12 months.my crp has been below 10 for the last 5 blood tests the lowest was 2.1 two weeks ago the tablets were started on 7 july 2012    Q.how much longer before the citrobacter is considered dormant or stable in the body and can stop the antibiotics ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Citrobacter kosher is always pathogenic in the body. So you should test yourself for the culture and sensitivity. Once the report is available you can take the treatment accordingly. Completed treatment should be taken. Hygiene maintenance is important tool and should be adopted. It will help us equally in the treatment as antibiotic do. Please adopt good handwashing practice. This will also help us in treatment. In alternative to taking a will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Hi, I have a burning sensation on my penis after masterbation or sex, my penis goes red burns for about about half hour after cracks on the skin and flakes iv tried thrush cream, sodercrem it clears after a couple of days but as soon as I try sex or masterbation it comes back again can you help please? ### REPLY: Hello, Sometimes vigorous masturbation lead to local release of histamine lead to redness and cracks. It may be latex allergy or soap allergy or spermicide allergy. So use tablet levocetrizine before sexual activity. If symptoms not improved please consult with your sexologist he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After a CT 2 wks ago, was just informed that I have an L-1 transverse process fracture. Pain Mgment Dr. & orthopedic surgeon (who did Minimally Invasive SI Joint Fusion 1-1/2 yrs ago) are consulting and haven t heard back from them yet. I did fall on garage floor 1 mo ago because neighbor s dogs ran through my legs. What questions should I be asking? ### REPLY: Hello, I have studied your case. I will advise you MRI spine and if there is any cord compression with lower limb weakness. If there is no neurological involvement then conservative brace or rest is sufficientLater on follow rehabilitation and physiotherapy. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my 1 year 2 month baby had severe vomiting in the night and was throwing up whatever spoons of ORS i gave also. woke up in the morning and passed smelly diarrhoea stools. but he drank one bottle full of ORS. What dosage of metrogyl ped. suspension should i give him? or any other medicine you suggest. not able to travel, so may not be able to reach a doctor now... ### REPLY: Thanks for consulting at . Diarrhea and vomiting suggest your baby is suffering from Gastroenteritis. Gastroenteritis may be caused due to bacterial, viral or protozoal infection. For vomiting give Ondansetron (0.10 mg/kg BID)Give ORS solution to prevent deny . Give probiotics like Eco norm Sachet 1 BID. As the stools are smelly, it may suggest some bacterial or protozoal infection. You may start antibiotics after consulting your doctor. Metronidazole can be given in the dose of 10 mg/kg 8 hourly. If your baby is getting deny ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 regular continuous sweet pain in upper abdomen left side , just below the chest or u can say just below the rib cage , i have already gone through the ECH , Echo test , Endoscopy all are normal , presently taking some medicine for gasetrology  , but still not comfortable feeling same problem of having too much gas , any one can help me plz ### REPLY: HiT hanks for writing in ChatDoctorI need further information regarding 1.)your age 2.)how long you are suffering with this problem 3.)do you have symptoms of nausea /vomiting 4.) any complaints difficulty in passing stool 4.) factors aggravating your symptom5.)any chronic analgesic intake history/alcoholic 6.)are u under any cardiac or antihypertensive medications 7.)recent trauma history, As you mentioned your ECG, Echo test, Endoscopy all are normal, cardiac and gastric diseases unlikely .can you mention that some medication prescribed by your gastroenterologist.my advice is to . I would be glad to provide answers to any further queries. Thanks for using  Have a good day! 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: Hey. My mom was diagnosed with liver cancer it has spread to most parts of her body like lungs. The doctors could not do anything but asked us for a home based care.. Now she has swollen legs vomiting yellow stuffs and she can eat anything. Is this the end what is happening? Also can she fly back home from OR tambo to harare? Regards Feli. ### REPLY: HelloThanks for writing to ChatDoctorShe has liver cancer with metastasis, so she is advised for palliative care only. Definitive treatment is not possible in this stage. Yellow vomiting may be due to metastasis to lung. Swollen legs may be due to many factors like anemia, cardiovascular compromise etc. You should consult your doctor. Symptomatic treatment should be given to her. Hope I have answered your query. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: On my brothers DRE a hard nodule was felt. His PSA was 3.1 which was up from his previous reading of 2.8. The urologist thought it might be a calcium  encapsulated but after the biopsy he said it wasnt. He said it had a 50 - 50 chance of not being cancer. If it is not cancer what could it be.? My brother is 58 yrs old. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. His PSA level is slightly high. PSA more than 4 gives chances of prostate cancer. There are other causes also. Benign prostatic hyperplasia and chronic prostatitis can also give increased PSA. Moreover, Hard nodule can be due to cancer, or it can be calcification in BPH. In BPH corpora amylase also turn in to calcification, so it may not be cancer. He should monitor his PSA level and if needed go for repeat biopsy. Consult your doctor and take treatment accordingly.  Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is experiencing a sharp pinching pain in the centre of his chest. He feels it could be gas but is not sure. I am concerned and feel he should go to the hospital. he is 53 years old. It is approximately the 3rd rib down from the collar bone. There is no sweating, dizziness, other pains, or symptoms of any kind. ### REPLY: Thanks for your question on . I can understand your concern. Possibility of HERD(Castro esophageal reflux disease) is more for his pain. But better to rule out cardiac cause first. So get done ECG and 2d echo. If both are normal then HERD is the likely cause. It causes central chest burning type of pain with gaseous feeling of stomach. Ask him to follow these steps for better symptomatic relief. 1. Avoid stress and tension. Avoid hot and spicy food.  Avoid large meals, instead take frequent small meals. 2. Start Proton pump inhibitors. 3. Go for walk after meals. 4. Keep 2-3 pillows under head in bed to prevent reflux. 5. Ask him to avoid smoking and alcohol if he haven't these habits. Hope I have solved your query. Wishing him good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My left arm went numb while I was n the shower and the pain traveled into the back of my head. I got out of the shower and laid putting pressure right on the back of my ear/neck. The pain lasted about 15 minutes. I m 63, weight 212, height 5ft 3 1/2. I have had the numbness in my arm before but not with the severe pain in my neck/head. ### REPLY: Hi... The pain and numbness could be due to some nerve entrapment of the nerve while exiting out of the small hole of the vertebrae. I recommend you not to neglect the symptoms at least now.kindly fix up an appointment with an orthopedic to rule out radiculopathy and neural irritation..... if there is any disc prolapse involved then we need to start of treatment at the earliest for a good outcome... I suggest you to kindly icing in the neck and shoulder to reduce spasm in-turn reducing the symptoms. Keep your neck supported while sleeping...with a good pillow or a rolled towel supporting the curvature of the spine . Maintain posture while in work...so that you spend most of the time in neutral neck posture rather than bend neck as this worsens the issue... You can start isometrics for your neck extensor muscles and stretch front neck muscles by looking up and giving slight over pressure under your chin... Hope this is helpful for you. Kindly revert in case you need any further clarification... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 14 year old daughter is taking 1350 mg of lithium a day. It s been two full weeks. Three of her lymph nodes are now swollen causing her pain when she turns her nech. She had the same kind of reaction when she was on lumictal and also had mono at the name time. Is the medicine causing this Could she be anticonvulsant to lithium . ### REPLY: Hello Patti.welcome to Health Care Magic Usually lithium is not reported to cause side effects of lymphadenopathy, so don't worry about lithium dosing. Capital is known to causes serious skin side effects and serious hypersensitivity in susceptible individuals and lymphadenopathy may be seen with it. So lymphadenopathy may be probably due to some other cause. Kindly visit a doctor for proper investigation. ThanksTake Care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am tithii am suffering with some stomach infection where i am having gastric , as well as loose stool , and while going for stool my stomach aches in wierd way as well as feeling nosea. What medcine to take ? i have suffred with the same earlier too as my stomach is too sensitive ### REPLY: Welcome to . I am . I have read your query in detail. Furthermore, I understand your concern. If this has occurred only acutely, it might be due to stomach infection requiring antibiotics like Tinidazole, Metronidazole. But if you have such loose stools and pain abdomen very frequently, you might require workup for Malabsorption Syn . So, if this is chronic, write to us in detail. This is my best advice for you with the available details, if you have any further query, please ask me. Stay HealthyChatDoctor, MD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For about a month now Ive had irritation behind my front teeth. When I examined the area, I noticed vein-like raised ridges on my gums that I had not been aware of until then. The irritation seems to be exclusive to those ridges and flares up after eating. I think the ridges are normal, but its almost like the irritation is spreading and medication only seems to work for a short time. Im on my mid-20s, about 190 lbs, and have had braces, oral surgery, and a gum infection in the past. Can this be something common like gingivitis or could should I see a specialist? I really just need some peace of mind right now. ### REPLY: Hello, Thanks for consulting , Read your query, as you have irritation in gums this can be gingival inflammation due to oral hygiene is not good, or trauma during brushing due to hard bristle brush, or due to infection in gums may be localized Periodontitis. I will suggest you to consult Dentist or Periodontist and go for visual examination of front teeth to rule of the cause of inflammation, in meantime you can do Luke warm saline rinses, you can apply ointment Mugel or McCoppin gel on gums. Hope it will help you. Wishing you good health.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Since late September I have had painful, burning, and frequent urination.  Have also had pain during ejaculation and have also had difficulty maintaining an erection.  I have been on an antibiotic(Bactrim) for around 21 days and symptoms did get somewhat better but after about a week being off the antiobiotic the symptoms came back. ### REPLY: Thanks for contacting  with your health care questions. You are concerned about having painful urination and pain on ejaculation. Your symptoms sound like you have prostatitis and your doctor has been treating you as such with a 21-day course of Bactrim. Unfortunately prostate infections are sometimes very difficult to cure and may require an additional 4-6 weeks of a more powerful antibiotic. In my practice I will use Cipro or Joaquin for 4-6 weeks to treat difficult cases of prostatitis.  In summary, you may have chronic prostatitis and need additional antibiotics for 4-6 weeks. Please contact you medical provider to proceed with treatment hope this answers your question. Please contact  again with any of your health care concerns ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell on my lower back folded from doing straight leg crunches with my iron gym used for pull-ups . I hit my right lower back bone I m assuming it might be a sprain or a bruise of some kind . What should I go about doing to quickly alleviate the pain ### REPLY: First you have not mentioned your age which is very important in case of back pain. For treatment of severe lower back pain you can take some painkiller like biozobid-plus or osteopath only when the pain is worse or disturbing your daily work along with some calcium supplements like shackled or toscal-gem once daily. Do some physiotherapy exercises after an expert opinion of physiotherapist. I will also advise you to sleep on plain surface. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 26 year old male.I feel pain in middle of my chest.The pain increases if i stretch my arms or if i try to pull my head down.Any type of physical activity increases the pain.I Go to gym regularly and do heavy work out.If i do work out in pain then it increases. Sometime when i stretch my arms then i get a sound like cracking something from my chest and i feel relaxed. Please suggest me what to do ? ### REPLY: Thanks for your question on . I can understand your situation and problem. By your history and description, possibility of musculoskeletal pain is more in your case. So better to follow these steps for symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid movements causing pain. Avoid bad postures in sleep. 3. Start painkiller and muscle relaxant .  4. Apply warm water pad on affected areas. Follow these for 1-2 weeks, you well definitely improve. If not improving than consult doctor and get done chest x-ray to rule out internal damage. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 2 years 4 months old daughter had 2-3 loose motions for last 2 days. She also vomited once today. She was also feeling slight pain in stomach. We got a stool test done today. The stool test shows Mucus present and RBC (1-2) present in stool. Rest things are within range. Though we will consult our doctor tomorrow, kindly suggest what could be the problem. We hope there is nothing major to worry. Kindly suggest. ### REPLY: Hello, 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 am having trouble with my front teeth hitting first. I can clench slightly to make my back teeth touch. I have worn two different appliances for over 20 yrs. I am a bruxer and prior to appliance therapy, had numerous headaches. I wore a full splint for about 11 yrs. and an NTI since. Both worked well. Recently I have been clenching a lot during the day as well as during sleep. I am "religious " about wearing my NTI. What do you think is going on in my joints to cause this ? Thanks. ### REPLY: Hello, Thanks for writing to us. Clenching anterior teeth primarily may be due to-crossbite, posterior open bite, TMJ dislocation. I would advise you to get a thorough clinical as well as OPG investigation done for the jaws. Based on the radiographs, position as well as alignment of each tooth and treatment plan can be evaluated. To prevent the habit of bruise, habit breaking appliances has to be placed. Meanwhile, maintain oral care. Hope these suffices. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am 8 weeks pregnant I have had the Mifepristone Pill yesterday at my hospital, I have been asked to go back today and have next tablets inserted inside me My question is what are my chances of having a normal healthy pregnancy if I don t want to go ahead with the next tablets will the embryo be affected with the pill at this stage.. Is there anything I can do? Sara ### REPLY: Dear Sara, Continuing pregnancy after consuming Tab. Mifepristone will be hazardous decision. Mifepristone and Bisoprolol, both the medicines are known to cause developmental abnormalities in the baby. Hence, once the medicine(s) are consumed, decision should not be reverted to continuation of pregnancy. After Tab. Mifepristone, Tab. Bisoprolol have to be taken after about 24-48 hours. So if you have not delayed it for more than 48 hours, you may still go to the hospital and get Tab. Bisoprolol inserted. If you have crossed this time, you may have to repeat Tab. Mifepristone which should subsequently be followed by Bisoprolol. Even if these medicines fail to terminate the pregnancy, please do not continue the pregnancy; opt for surgical evacuation of the uterus, may be by MVA aspiration. I hope this helps you.  ### END