Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My baby is just 5 months old. Whenever he was fed he vomitted a substantial amount of milk after feeding. He also is having very poor appetite. His doctor prescribed Dormstal for that day. Currrently he is only having 2oz of milk in every 2 hours. He even is not feeling hungry at all, it seems. What to do? ### REPLY: Hi...by what you quote I feel that the infant is having severe form of GER (gastroesophageal reflux). Your son will need - 1. Antireflux therapy - Proton pump inhibitors + antiemetics2. Always make him lie down in a propped up position - as in the care seat. He should not be sleeping completely flatly.3. Avoid heavy feeding and feeding more times and in small liquors.4. This type of GER is the root cause for the constipation she is having. He needs expert gastroenterology consultation. 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: A few weeks ago, I had a cold or similar virus which triggered my asthma. I was given a 5 day course or prednisolone which killed it, along with a 7 day course of amoxycillin for the bronchitis that followed. i had to return to my GP for more antibiotics after a week as the infection did not fully clear up, and was given a week s course of co-amoxyclav. I was fine until last week, when my asthma symptoms started to appear again. It is very mild, usually one puff of the inhaler kills it, but it is even happening at night now, waking me up. I am not ill again, do not feel ill again, so would like to know what could be the possible reasons for this happening, please? ### REPLY: Hi, Whether the diagnosis of asthma is self diagnosed or diagnosed by a physician. Are you a smoker? Infection may be a precipitating factor for precipitation of asthma or chronic bronchitis. Prednisolone may help during acute exacerbation of asthma. Oral antibiotics also help to control infection during a period of exacerbation. They have no role in controlling inflammation in asthma. Short-acting bronchodilators will also give you temporary relief. You have to use MDI formoterol-budesonide BD through spacer or salmeterol-fluticasone BD. Inhaled corticosteroids are cornerstone of management in asthma without having many side effects. You should also use a diary to record the symptoms or peak flow meter for objective monitoring. Frequent nocturnal awakening means your asthma is uncontrolled. I can not give you a definite management without physical examination and laboratory tests. You should consult a pulmonologist. Hope, I answered your queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 2 & 1/2 weeks ago I was treated for a facial trauma I had sustained tripping on a brick and landing on a gas main. I was given antibiotic and pain reliever, and a follow up in three days. At the follow up visit, I had a fever, elevated blood pressure ( which I have never had; I m only 34) , and elevated heart rate. I was given an injection of antibiotics, as well as an additional antibiotic to start along with the original. I finished the course last week, swelling went down, and was only left with some slight bruising under the eye, bridge of nose, and upper lip. I felt almost back to normal. My question is: I now have SEVERE body aches, pain in my jaw and my eyes, and extreme sleepiness. I wake up with a headache every morning. Could this be a sign that the infection is still present, and possibly getting worse? I can barely stand to touch my arms or legs. Additionally, I am also on long term Prednisone treatment (well over a year now) and I also take Cellcept; both for Behcet s disease. These symptoms are nothing like I ve ever experienced with Behcet s, but I thought the immunosuppressants might be playing a role as well. Thank you in advance for any advice you can provide me with. ### REPLY: Hi, Noted that you are taking long term course with steroid for Behçet disease, suffered facial trauma and now have headache and other symptoms as you have mentioned. Since you have facial trauma head injury that is brain and its covering injury has to be seen for by clinical evaluation, MRI of the head and other necessary investigations. If there is any finding then you will need a guided management for the headache. If infection is still present then you will need a proper antibiotic cover along with proper anti-inflammatory medication. Other reasons also should be looked for, investigated and treated if found. 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: what is best for me to do to improve my liver count? I quit drinking 11 months ago after many tears of alcohol abuse. a friend told me to drink cranberry juice. I have been drinking 1 gallon of water every day. What more can I do to improve the liver count results from my blood test? The nurse told me it was still quite a high count according to the blood test results. Thank yo! ### REPLY: Hi, I had gone through your question and understand your concerns. By liver count, I guess you are speaking of liver enzymes like GOT, SEPT. Cranberry juice will not do much good. I would suggest you to - Continue to . If you develop pain abdomen or fatigue or yellowish discoloration of eyes and urine, visit a clinician. He/she can examine you and correlate clinically. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have cirhosis of the liver due to hepatits C.  about five days ago i started with a itchy body rash. it started on stomach and inner thighs. today i notice it underneath my forearm. according to my doctor i am i liver failure. is this rash part of my liver problem and if so how can i treat it. ### REPLY: Hi I can understand your concern.... See your rashes in hepatitis C can be from following causes.........1.allergic rashes 2.hepatitis c chronic illness induce rash 3. As a result of side effect from HCV treatment etc.... You can take antihistamines . ... If severe rashes topical steroid application might be useful.... Avoid sun exposure .... Use moisturizing soap .... Loose cloths....Meanwhile, if rashes related to  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a rash that started under my arms. now is down my arm, under breast, stomch, thighs and inside top part of calf . it itches and gets worse with heat . can you help? no puss. just red bumps that get bigger after itching. ### REPLY: His completely understand your concern and I hope I am able to help you for the same. You seem to be having extensive fungal infection. First some general precautions: Wear cotton clothes and undergarments in order to reduce the sweating. Do not apply any kind of oils / moisturizing lotion over the affected area. Just give warm saline compresses over the affected area twice a day and then apply an antifungal cream. Something like clotrimazole cream helps in most cases. Also, you will need to take oral antifungals 2 weeks. In case of severe itching, take some antihistamine once a day. If inspire of the above measures, the lesions continue to persist or increase, then you might have to see a dermatologist for proper assessment and management. Hope it helps Best wishes for a speedy recovery .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI , I am 30years old lady .Black patches are there below eyes cheek, and on eye brows. Consulted doctor and they refereed medicine Glycovira cream . I used it for a day and it s effects are : light red colour on used area . It seems it acts like acid . Can you guide It s normal or it s not proper medicine . Thanks & Regard Rekha Email Address: YYYY@YYYY ### REPLY: Hi Rehab, It sounds like you have pigmentation, possibly plasma. Glycovira cream contains a substance called Glycolic acid, which is given for the treatment of pigmentation. However, you need to be careful while using it. Here are some of the precautions you need to take:1. Do not use any kind of scrub on the face while you are on glycol treatment2. Avoid sun exposure, and use high SPF sunblock if you have to go out in the sun3. Do not bleach, wax or use any aromatic oils on the area4. Do not massage the glycol cream. It just has to be applied gently.5. Use the glycol cream only at night, never during daytime. Since you have erythema (light red color) on the area where you have used the cream, discontinue it for a couple of days. Once skin returns to normal, use the glycol cream mixed with a gentle moisturizer or petroleum jelly. Gradually reduce the quantity of moisturizer over a period of few days, as your skin gets used to the glycolic acid. Remember that rubbing the glycol cream on your skin, or applying it in excessive quantities is not going to give you faster results, and, in fact, might damage your skin. So use it as advised by your dermatologist. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor,, i am sherif , 26 years old ,, from egypt married from 2 years i have a problem in the motility of sperms , its too slow doctors said that the problem in smoking ,, but really i cant stop smoking. so please doctor ,, is there is a medicine or its hopeless case i will be thankfull if u tell me thanks a lot ### REPLY: Hi, Asalamo album your sperms slow motion is not due to smoking it is due to less production of an . Relaxation of mind can help in product ion of hormones. But this smoking is not good for heart ,treatment 1 .you should take PROVISION tab 25 mg morning and evening for 3 month(90 days) then break for 7 days get semen test and motility of sperms. You have avoided inter course for 5 days before semen test.  2.-Evian 500 it is for strength of genital system ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 240 lbs 62 64 years old was trying to break up a fight between our two dogs and was accidently bitten on the hand. The wounds were puncture wounds and bled slightly. He wash the wounds and put bactine on the wounds. This was a week ago, the wounds have healed and look okay however his hand is swollen. We are now treating with heat and cold in half hour intervals Is this correct. I am having him call the doctor in the AM but was just wondering if we should do something immediately? He is a VET and on vet disability so our ER options are limited. ### REPLY: Thanks for posting you query to .first I would like to suggest you weather dog were vaccinated or not if not those you are satisfied with my answer.  Feel free to communicate if any query .en first step is to take rabies vaccination. If your dogs were vaccinated then no need for it. Now coming to current problem as dog bite causes penetration in crude form so damage to tissue and blood vessels laceration takes place which require long time to heal.  But no need to worry as you should take precaution to avoid secondary bacterial infection by maintain proper cleaning and . For pain take :Tablet of Diclofenac potassium 50 mg with Serratiopeptidase 5 mg two times a day .it will help in receiving pain and decreasing swelling. Tablet Pantoprazole 40 mg once in morning to prevent  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 my name is ajay my age 20and height 5,8 and weight 68 & and my billirubin was 8.44 and i take only liver 52 and some natural medicine and my diet is very light and i did not use oily , spices but last 1 week i feel very poor so what can i do right now tell me ### REPLY: Hi, thanks for posting query at .I read your query and understood your concern. High bilirubin level should be properly investigated if you have associated yellow sclera/skin. Are liver enzymes elevated too? Are the major causes ruled out, from liver pathology to hemolytic anemia?therefore, you're advised to visit a hepatologist to find a cause of bilirubin and further course of action maybe advised accordingly. Blood tests, and radiological examination maybe done to find out a cause (if any).hope to answer your concern. Wish you good and sound health regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My wife is suffering with skin allergy( too much itching). This has started during her 5th month of pregnancy. Recently she has been diagnoised with asthama . Doctor has informed that asthama and skin allergy are linked with each other. He also suggested there is no permanent solution for this. Will there be any solution for skin allergy? ### REPLY: Hi, thanks for using  There are different rashes that can occur in pregnancy and some of these are associated with an itching. Some of these rashes are called : purity of pregnancy, pruritic urticaria pa pules and plaques of pregnancy, pruritic folliculitis of pregnancy. None of these are associated with any problems with the baby and are generally treated with oral antihistamines and topical steroids. Intrahepatic homeostasis is another cause for itching in pregnancy. This is associated with increase in liver function tests. It is treated with antihistamines, some women may require additional medication. In most cases there are no complications though in some rare cases complications may occur. You may want to consider visiting your doctor to determine if she is experiencing one of these pregnancy specific rashes. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter has pain in her upper abdomen thru to her back. It is moderate to sharp. right in the middle not on a side. She doesn t want to eat because it makes it worse. Have tried antacids, laxitives, acid reducers, no greasy foods. Also get head aches a lot. ### REPLY: Hi and Welcome to , What is age of your daughter.  First please rule out menstrual pain.  Are taking timely diet? This conditions may be due to abdominal migraine, which can be treated well with medicines.  There is also possibilities of gastric ulcer, please do barium swallow and meal series.  If necessary do endoscopy and ultrasound to rule out gastric ulcer or mass lesions.  Please consult internal medicine specialist.  Wish you speedy recoveryThank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have 3-4 Marble shaped/sized lumps under my right Jaw Bone. Just under the skin, moveable, tender to the touch, nothing is presenting on the left Jaw Bone. I have never had these symptoms before. What could it be? And what kind of Doctor do I go to to check it out.Many Thanks,Kirsti ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You may have submandibular lymph node or salivary gland swelling.  You should take a course of antibiotics according to your doctors advise. If it doesn't respond to treatment then go for fine needle aspiration cytology. Then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has cholesterol and has been on statins for almost 10 years now. He does enjoy his whiskeys on weekends and wine on some days.. His liver function tests have shown high GGT values.. The doctor has advised udiliv 300 mg, 1 tablet at night for 3 months. Does this medication have any side effects? Is this medication safe to have along with statins? Thank you ### REPLY: HelloSign GGTP is due to the increased intake of alcohol. Although ADÍLIO has many side effects like nausea, vomiting,diarrhea, joint pains etc. and should not be taken along with statins, its role in reduction of GGTP is very doubtful.ADÍLIO is basically used in treatment of gall stones. The best treatment for reduction of over enzymes caused by alcohol intake is1... Complete abstinence from alcohol2... Regular exercises3... Consumption of fresh fruits and green vegetables4. Avoidance of junk food and controlling of sugar levels if you have diabetes. 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 had done a tatoo on my upper arm and now t there is a red rashes and bubbles and hot bubbles on the tatoo area its same shape as the tatoo . and this happened after 15 days of the tatoo was done . It was a Ink tatoo and no machine was used in it.  A simple stick was used . Can i use CANDIDERMA cream ...? ### REPLY: Hello. Thank you for writing to us at  You have most likely developed Allergic Contact Dermatitis/ ACD to Tattoo ink, as suggested by red rashes, and fluid filled lesions at the exact site of a tattoo.ACD can be delayed because you body was probably getting sensitized to the allergen i.e. tattoo ink before mounting an allergic response. I guess it must be itchy too. The cream that you have inquired about in this query is a topical antifungal, and I would not advocate it for your skin problem. If I was the treating doctor I would have suggested you to us a topical potent steroid+antibiotic combination cream, twice daily at this site for 5-7 days. An example of such a combination is a cream containing clobetasol propionate 0.05% & mupirocin 2% Or juridic acid. An OTC oral antihistamine e.g. cetirizine 10 mg once daily will provide you symptomatic relief from itching. 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: sir my PTCA was done in Dec.2010.since then I am taken monit 20 at 8am& 3pm,seloken xl25,clopigrel75 at 9am,nikoran5 and ecosprin150 after lunch, rosuvas20at 6pm and nicoran5 after dinner.Should i continue these medicines ? I dont feel any cheast pain,splz advise me. ### REPLY: Sir, Thank you for the question. But unfortunately It is difficult to make a decision about all this medication without knowing your Anglo report and PTC report, your age, risk factors status, past hospitalization history. If I were treating a situation like this I would consider stopping Nikolai and moderate if chest pain has totally ceased.  I would certainly continue results and esprit. These medicines are great in preventing further heart attacks. Spoken and clopidogrel may be required depending on your reports. I am afraid I am unable to say beyond this with the little information I have received from you. Discuss with your treating physician in your next visit. Good day! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i am suffering with tooth pain from last three days.....i tried clove oil it did work but not for a very long time. there are holes in my two back teeth on both sides (right and left) whenever i try to eat something i sticks between that holes which begins the pain again........can you please help me by giving a good device........i cant bear the pain and want to eradicate for forever..... many thanks harjinder ### REPLY: Hi, Thank you for the query. Harijender you are suffering from pain because of acute pulpits, it means there is decay in the teeth leading to infection. This condition can be best diagnosed by an x-ray. So get an x-ray done for both the teeth. Your dentist will decide whether to do a root canal treatment or just a restoration if in case the pain which you are feeling may be sensitivity sometimes. This will be followed by a course of antibiotic and analgesics. Hope this will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: We have a friend whose son is hospitalized with a variety of illnesses. What landed him in the hospital in the first place was a gran-mal seizure. He has had further seizures & stroke. The latest diagnosis is very severe since it is MERSA of the lungs. We fear for him and his family. Does this young man s family have any hope for him to recover from such severe health problems? ### REPLY: Hello, Yes, if given proper treatment MRSA can be eradicated. Based on the history your friend seems to be suffering from hospital-acquired MRSA infection which can be life-threatening if not treated. MRSA (methicillin-resistant Staphylococcus aureus) is a specific bacterium that is often resistant to (is not killed by) several types of antibiotic treatments which can be harder to treat or become worse if the appropriate treatment is delayed. He should be examined by a lung specialist (pulmonologist) to evaluate his condition properly. Since MRSA is resistant to many antibiotics, the treatment will depend on the culture and sensitivity of the blood/sputum. The doctor will choose antibiotics that the laboratory reports as susceptible on the resistance test they perform in each culture. The antibiotics like Vancomycin or Ninefold or fifth generation cephalosporins are found to be effective in susceptible infections. Further, since MRSA is a highly contagious disease every effort should be made to avoid making direct contact with skin, clothing, and any items that come in contact with your friend. 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, my name is natasha. i have always had cyst on my ovaries for as long as i can remember my menstrual starting. In oct.2009 i had a torsion surgery , i had my right ovary and fallopian tube removed. The dr. said the fallopian tube was basically crushed. Years go on and about 6 months after that surgery i had noticed that i had the pain once again, i started getting 3 months ultrasounds and everything was fine. just cyst that came and went monthly. however. 5 months later i fell to the floor in pain and ended up at the er. They had told me i had a huge cyst the size of a grapefruit on my left ovary. I was scheduled in for a laproscopy . during the surgery the surgeons had removed the cyst, also scar tissue on the right side and that was on my live. a month after surgery i noticed some pain. I went into the er, and had fluid. during the next three months i noticed the pain of a cyst , last month in aug. I went in the er have a cyst it is complex a month later i go in and its a follic cyst 2cm. I am in great pain, i saw the dr and the dr said nothing to worry about- i am in pain to the point jeans hurt my cyst. i can t lay on my left side or anything. I have a scheduled ultrasound in 6 weeeks. I don t know why i keep getting cyst. 6 months ago i had the surgery. could it be cancer? endo? psoc? should i ask for metiform (sw?) ### REPLY: Pain is very rare in cancer unless there is torsion of ovaries or severe adhesions causing intestinal obstruction. Usually cancer presents as an abdominal mass or distention with free fluid in the abdomen. On ultrasound cancer presents as a complex cyst. As u already had surgery twice, it looks to me more like a adhesion during surgery which can only be corrected with presurgery with adhesionolysis. If you have completed the family? Then removal of ovaries is also an option ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 left church for a wedding, standing outside waiting for the bridal party to come through, went to move and my legs were asleep. Several people thought I was drinking. I have not. I came home and legs still very weak. tingling in my fingers. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have weakness of fingers and tingling of fingers. Well there can be many reasons for symptoms you mention in query like nerve entrapped like ulnar nerve, vitamin B12 deficiency or inadequate blood supply. I would suggest you apply warm compresses on finger and arm, start taking vitamin supplement for few days and do light stretching exercises. You can also keep your hand in hot water tub with Epsom salt. If condition doesn't get well then consult orthopedic surgeon for proper examination. Doctor may order CT scan or MRI along with take history and nerve conduction test. Doctor may recommend physical therapy, prescribe anti-inflammatory along with nerve supplement. Doctor may also refer you to neurologist for nerve dysfunction. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been having chest congestion during cold season and dry cough both and night. i had dificulty in breathing. i was prescibed l.montus tablets when necessary. its past two weeks and since i took one tablet of l. montus tablet i h ave not had any attack. h ow should i take the tablets ### REPLY: Thanks for your question on . Months tablet is having montelukast.  It is leukotrine receptor blocker, so anti-allergic in nature. And you are mostly suffering from allergic bronchitis.  So it is good .  Ideally it should be taken at bedtime after dinner. And you can continue this especially during winters to avoid allergic symptoms. So no harm in taking it for long time. As it is safe for long term use. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 female, 51, never been pregnant and not pregnant now. I have a dull, achy feeling in my lower right stomach which I have had for a very long time, that comes and goes, but now it s more persistent and feels kind of inflamed. I also have pain in my sciatic nerve on the right side and pain in my right knee. ### REPLY: Hi. Thanks for your query and an elucidated history. The possible cause of pain in the right lower abdomen with right knee and right sciatic nerve area is definitely due to a prolapsed intervertebral disc. Get an MRI to see for the discs and an ultrasonography to rule out other possible causes of lower abdominal pain at your age of 51 without the history of any pregnancy like:Appendicitis, ovarian Cyst, tumor, cancer or so. Cancer is thought about due to your age and pain related to the sciatic nerve which can be due to secondaries in the spine causing compression of the cord, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: trulimax was antibiotic and it was given still as the cough did not subside and the med was substituted with others .  shld we go for antibiotics again? now she is having exams.. too much medi. is it good? she never had wheezing etc b4 but only after this severe cough the doc gave asthalin inhaler. advise pl. will she be alright ? ### REPLY: Hello dear, welcome to .come have gone through your concern in depth.* The doctor decides need of antibiotic depending upon the clinical presentation and co relation with the signs elicited.* It is not to be considered as too many medicines good or bad, what ever is mandatory, has to be given then only she will be alright. Hope this clears your query. Wishing your angel fine recovery. 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 a men 48 years old,75kgs weight, in my stool was detected giardia gamblia;before that analysis, a doctor recomended my Furoxona, after, when the giardia is detected I take for 5 days Metronidazol..past 4 days I had a rash in the body  and the symptons for giarda persist :::now I am taking Tinidazol........my question is....The rash is related whith the giardia?:::::::: ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No, Guardian won't cause rash directly. Giardia remains limited to the intestine only. It will remain stuck to the intestine where it sucks the essential nutrients particularly fat. Fat soluble vitamins are so not going to be absorbed easily. The rash which had appears is because of the deficiency of the essential nutrient. So in my advice you should take the medication you are taking previously. But there is also a need to take the multivitamin tablet. This will replenish the nutrient deficient. Please adopt good handwashing practice this will make a barrier and prevent further transmission of the parasite. Please eat healthy food like food should not be dirty. This parasite also transmits with water. So . I will be happy to answer your further concern on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My back feels like it s tingly and asleep for a couple months now. Even before this my feet feel swollen but look fine. I just had blood tests done and haven t received the results. This feeling is annoying me and I am worried...I have a one year old baby and don t want anything to happen to me as I m 43yrs old, 5ft 7 and 153lbs. My blood pressure is normal. Thanks! ### REPLY: Dear friend thank you for your consultation.it seems that you are having a back pain. Generally back pain is caused due to back muscle spasm.to decrease the pain you should start back muscle strengthening exercise like vertebral flexion exercise. Also never lift any heavy weight or bend forward.it is good to know that your blood pressure is normal. Then still if you have any disease then there is every possibility that it will be reflected in your blood report. So get the report and if you want, you can directly send me your query .and I will be glad if I can help you in the future. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering from heel heel and ankle pains with swelling for the last one month. For the last ten days multiple joint pains developed, without any swelling, but swelling at ankle continuing and suffering from fever and chillness in the evenings. For the last one month, I have been using Dolokind & Pentakind tablets. For fever I am taking Lenol as prescribed by Doctor. Now, on 29 th I have consulted Rheumotologist in one of the famous Hospitals in Mumbai. They have prescribed HLA B27 test(reort yet to come) and medicines of :T.Etoshine90,T.Omnacortil5,T.Saaz,T.Folvite,T.Pan. I need ur sincere opinion. I was diagnosed for Reactive Artheritis ( without HLA B27 test). ### REPLY: Hi, thank you for providing the brief history of you thorough musculoskeletal assessment is advised. As you have been diagnosed with reactive arthritis a little knowledge about it is required .  It occurs in reaction to an infection by certain bacteria. Most often, these bacteria are in the genitals (Chlamydia trachomas) or the bowel (Campylobacter, Salmonella, Shell and Yersinia). Now, as you have multiple join pain and aches along with swelling at the ankle, I will advise you further to visit a physiotherapist who can help you with your pain and aches. Since the pain and aches are possibly due to the infection I am sure the physician will guide you with antibiotics for the same. Undergoing a thorough urine examination is advised as to check the possible bacterial infection present also. For the pain and swelling management the physiotherapy will help you with therapeutic ultrasound therapy and TENS therapy by which the inflammation and pain will subside. Also, performing regular exercises are guided here to understand that the bodies metabolism and immune system are slowed down which lead the bacterial infection to go higher and lead to reactivate arthritis. Exercise will help improve the metabolism, immune system and strength in the muscles as in the reactive arthritis the bacterial infection directly attacks the soft tissues of the joint. So exercises will play an important role. Also while performing the Strengthening of the core and pelvic floor along with special exercise will help improve the bladder to empty completely and avoid any bacterial infection to persist due to Union my clinical practice I recommend patients with similar complaints to physical therapy as it will help them to recover better and avoid future complications. RegardsJay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son who is 15 years old got pain in back and we went to an orthopedic surgon for the check up. He asked us to have MRI, and the reports says that he has mild scoliosis towards left on his spine.  Since he is so young can that be cured forever? He is a tennis player and can he play the game in his near future? ### REPLY: Dear patient Treatment of scoliosis depends upon the degree of curvature of spine. Since he is 15 usual treatment is with brace and physiotherapy.  Also, we have to search for the cause of scoliosis like wedge vertebra or hemivertebra. If there is pathology which is leading to scoliosis and curvature more than 30 degree it should be treated surgically. Visit expert spine surgeon nearby you and get it done.  Scoliosis is totally curable with proper treatment and he can continue all hid sports activities even after surgery.  All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, my name is Bukky I accidentally gave my 7month old baby an overdose of piriton instead of 1ml morning and night I gave him 2.5ml morning and night for 2 days I stopped immediately I realised and now today being the 3day night he is very hot his temperature is high and he has been cranky and not comfortable but I have given him paracetamol 2.5ml just now. ### REPLY: Hello Thanks for asking us. You should not worry at all, this much dosage is not over dosage. Your baby will be little sedated and sleepy. Just give him your feed if he is sleeping too much. Hope this answers your question. If you have additional questions then please do not hesitate in writing to us and do a follow-up.*Always check for history of allergy before taking any medicine. Wishing your child good health with regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 18 month old has swollen gums upper & lower and upper lip is a little swollen as well. His mouth hurts and he tries to eat but only takes one bite and says ow and won t eat anymore. We took him to the dentist and he s on a rx for amoxicillin but he wasn t sure what was causing the swelling. He has a mild fever and we re giving him advil for pain & inflammation. I also noticed tonight he has a few small redder than usual spots on his tongue, almost like he ate something sour that irritated his taste buds. His hands and feet are not red, I checked in case it was hand, foot & mouth disease. Oh and he s not sleeping well at night, he wakes up every couple hours but he s still very active during the day. Any idea what s wrong with my little man? Thank you!! ### REPLY: Thanks for your query, I have gone through your query. The pain, swollen gums and fever could be because of the herpes virus infection, you can just give him symptomatic treatment like paracetamol for fever and topical anesthetic and analgesic like Anabel for the painful tongue. The other possible cause of the pain, swelling and fever could be from the erupting deciduous tooth causing infection of the overlying gums. If the infection is from the gums you can take amoxicillin and Cronin for 3 days after consulting the oral pediatric dental surgeon. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yesterday I started getting Sharp pains in the right side of my chest. I assumed anxiety and treated according with xanax  and sleep. Today the my chest hurts on both sides when I move or stretch. Deep breaths and sneezing hurt as well... Not so much a Sharp pain now a constant pain in my upper chest only. Any thoughts? Thank you! ### REPLY: DearWelcome to ChatDoctorWe understand your concerns went through your details. You were talking about anxiety and took medicines for it. In that case, you must have undergone tests in regard to your heart and its proper functioning. I hope your heart and lungs are in good condition, and you knew it. Anxiety is usually fight or flight syn .  In that course, stomach produces more acid and body muscles are stretched to make it ready for any eventuality. Stretched muscles may be sore for over two or three days. In your case, the chest muscles were stretched, and you are feeling the pain next day. If you have never visited any doctor to assess your heart condition, please do it now, and then you can have a sigh of relief and peace of mind for next two years. 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 am having difficulty walking up and down stairs, my legs are shaky and when I get to the top or bottom of the stairs I have to stop due to dizziness. This has been happening for a few days now and I have no energy, I currently have a head cold but not sure if that is related to the shaky legs. ### REPLY: Dear Patient with your type of symptoms I would first like to know your cardiac status, for that ECG and treadmill tests are essential and ECG during treadmill is more informative, second thing I would order blood investigations to see your Hemoglobin status and any infective or inflammatory condition, so getting CBC, ESR and CRP will suffice. So first and foremost see your doctor, discuss this discussion and get examined and investigated. Hope you heal soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I think I may have taken too much Albuterol. My throat is extreemly itchy, im weazing, im having difficulty breathing, and am afraid to take anymore albuterol. I have asthma and havent had sufficient health care to take care of it properly. What should I do? ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. If your wheezing is not improved by taking albuterol, my first suggestion would be to get examined by your doctor, as it suggests a possibility of severe exacerbation/severe symptoms of asthma. Your doctor would examine your chest with stethoscope and will determine how much severe your asthma symptoms are.2. In that case, he may prescribe you corticosteroids for a few days in addition to your inhalers.3. After improvement, your doctor will decide whether you need regular inhalers, depending upon how frequent and how severe your asthma is.4. Please avoid cold .  Please take light diet, and plenty of warm fluids if possible. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you a very good recovery and the best of the health ahead. Thank you &  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 38 year old lady, healthy and been having night sweats for the last one year. I don t have a fever, cough and have not lost any weight. I exercise often, eat well but I am naturally slim, I was found to have latent TB 4 years ago but was advised that I do not need treatment for it. I have a sister with type 1 diabetes mellitus. I am concerned about the night sweats and I do not believe they are due to environment. What is your advise? ### REPLY: Hello. I have gone through your question. As I see you are worried about Tuberculosis. Latent TB does not require treatment as it is the active TB that requires treatment. It is very rare that you have developed Type 1 diabetes mellitus as 95% of people develop type 1 diabetes before the age of 25 years. Now for your night sweats I need more information from you:-1. Are you taking some depression medications?2. Are you taking ?  Are you taking any diabetic medications?4. Are your menses normal? Please provide me with the answers to above-mentioned questions so that I can help you. Please feel free to contact me. Thanks and wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have currently survived breast cancer and possibly have skin cancer on my right earlobe...so now I think everything is cancer. A really large egg shaped lump came up on my right butt cheek. It seem like an abcess to me. Could it be possible cancer? ### REPLY: Thanks for your question on . I can understand your fear. But every skin lump is not always malignancy in your case. Yes, chances are high, but skin lump can be due to other causes like infection or allergy. In your case at present I think you should first get done clinical examination of your lump. Then ultrasound examination and biopsy from the lump. Biopsy is needed in any lump for confirmation of diagnosis. In my opinion it seems abscess mostly. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello1.- I had my gallbladder removed a few years ago (DOB 6-15-1970).  Ive been told my body does not process fats as effectively as it once did so I try to not eat to many fatty foods, but I know that certain fats are necessary and beneficial (fish, olive, nuts for example).  Should I limit those as well?2.- I also notice if I eat cheese or a steak (its a treat I may have a few times a week), I get little pouches above my eye, but below my eyebrow the following day.  I was told it could be fatty deposits and a sign my body is having a hard time processing the fat.  Is that true?Ana ### REPLY: Mostly your questions have answers in them. You should limit intake of food that is not getting digested. It includes fatty food, oils, complex proteins (in beans), etc. Fish oils have side effects. The white pouches usually develop due to fatty deposits. Decreasing high calorie foods like milk products (cheese, butter, ghee, ice-creams, etc.), non-vegetarian food are best avoided. Regular exercise at least 20 min a day is a must. Get your blood tested for lipid profile. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 tick bit about 6 weeks ago...i have a slight rash around the area, but my blood tests show up negative for lymes....i had lymes several years ago, but the blood test came out negative then....but when treated my symptoms of tiredness, fogginess and muscle aches went away. I am so concerned that it is happening again. Yesterday i started on one side of my mouth (outside lip) is getting wet and the other is not....ugh...any thoughts? ### REPLY: Hi, It's not Lyme disease if your tests are negative. It can be due to the lip or some food allergy, personal dermatitis causing rashes around the mouth or lips, charities and oral herpes. Get examined by a PCP, get all STD screening tests done, You may need antivirals. In the meantime take antibiotics, Doxycycline, non-sedating antihistamines and vitamin B6, B12 supplements. Stay away from addictions if any.  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: 34yrs. Cerebral palsy . Epilepsy . 24hr care required. Been on tegretol cr and phenobarbitone for years to help control seizures. Neurologist prescribed keppra for 2yrs. No side effects but experienced 1-3 seizures daily. Weened off keppra and started sodium valproate . Within the first week she had experienced sedation, vomitting. Then bloods showed valpro levels low, dose increased. She experienced hypothermia , sedation, vomitting. She lost the ability to swallow food and drink. Bloods showed her phenobarb levels were toxic. Is this common or unheard of for these medications to interacte this way? ### REPLY: Hi, Thank you for posting your query. The side effects as experienced by the patient are known with the medications she has been given, however, they are fortunately uncommon.  The only method of treatment would be to titrate the dose of medications till the desired efficacy is reached, as per the tolerance by the patient, and the .  I am sure she would recover from the side effects of medicines with proper care and there is no need to worry.  Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have had a chest xray that showed opaque calcific opacites, but ji had a chest xray in march 2011, prior to emmigratingthat was fine. if i have contracted it in the past few months how will i know if it flares up again i am worried that my lungs will continue to have these deposits and kill me ### REPLY: Hi, Dear,Thanks for your query to . Dear I read facts of your query and reviewed it in context to your health issues submitted. I understood your health concerns and feel Concerned about them. You seem to have old Pulmonary lesion-which was non-opaque in March 2011. But got calcified in few myths time. Possibility of such lesion flaring up in your case, is very high, as that lesion is still active in non-opaque area. Most commonly Pulmonary TB get reactivated in such a lesion. Such lesion could be in making in acidosis / lupus lesions / or Cancerous lesions.IRA blood test and T-spot tests give activated old calcified lesions, which could be confirmed if Sputum AFB testing is accompanied by IRA blood test. Review of the other causes is needed for proper treatment in your case. Remedy-IN the given scenario, I would suggest you to investigate with AFB/ESR/Chest X-ray / and IRA Blood tests-in correlation with malaise and body ache and fever with weight loss-could fix the flare up of calcified lung lesions in your case. Proper TB- DOT regimen under observation with proper follow up check would prevent recurrence in your case. Second opinion from other Chest Specialist/ Physician would be needed. Get Second opinion with Chest Specialist/ Physician to rule out other causes as discussed above. Just don't worry and be patient and co-operate with your doctors, till you verify with your attending doctors. Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard to following link-http://doctor. .com/Funnel?page=askDoctorDirectly&docId=70229Wishing Good Healthy Life!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been in agony, which I thought was a tooth ache, but its not. It seems to be in my jaw as it affects all the way up to my ear down to my jawline and then some up in my cheek. It is swollen. I cannot eat regular food as it hurts my jaw. I can t talk a lot, make faces, laugh, etc as it hurts soo bad. I ve been on Clindamyacin since last Wednesday. 2 tabs TID So I don t know whats going on. I just feel like whatever it is spreading and I don t like it. If you could help me, I would be so grateful. Thank you. ### REPLY: Thanks for your query, I have gone through your query. The kind of pain and swelling you are describing looks like it is arising from wisdom tooth infection(peritonitis or periodontal abscess leading to cellulitis). Consult an oral physician and get yourself examined completely and take a radiograph like OPG to rule out the tooth infection or any pathology.Meanwhile, you can continue the same course of antibiotics take only 600 mg in a day means 300 mg two times daily. Do saline gargling. Consult the oral physician as soon as possible. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 2 year old daughter was diagnosed with e.coli UTI ( 100000 colonies-plastic bag)on 6/17 and she was treated with antibiotics for 10 days-Rocephin for 6 days and Omnicef for 4 days. She had a repeat urine cultue on 6/18-catheterized , 12 h after starting the antibiotic and it was negative. She became afebrile 60 h after starting the antibiotic. She has been afebrile ever since. She is doing well, back to baseline. She had a repeat urine culture (plastic bag)7 days after the last antibiotic and it grew 10.000-20.000 colonies of Pseudomonas, sensitive to all the antibiotics tested. The pediatrician said that it is most likely a contaminant and we are planning to repeat the test. What do you think? ### REPLY: Hi, thank you for posting your question. All laboratory reports should be correlated clinically and treatment should be directed to the patient and not just the reports. These are two of the basic principles of medical practice. In this case as you mentioned, your daughter seems to have responded to the treatment and has shown clinical signs of improvement. In such a scenario if the reports show something that is not correlated clinically, it is better to repeat and confirm the result rather than blindly treating. Pseudocodes is a common pathogen found in hospital acquired infections. Hence, in this case it is likely that it could be a contaminant of the collected bag or container, or the collecting method could have been faulty. Also, the colony count mentioned is not high enough to cause concern at this point of time. Thus, the next logical step would be to confirm the test and decide accordingly. If you have any more doubts regarding the case, do reply. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir i am suffering from fever since 5 months and all blood test reports are clear even they checked for tb its also clear and still i am suffering light fever and i lost my body weight also . mostly at morning and after taking meals i fell like feverish can u plz help me. ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern looking to the history given here I would like to tell you something as long as the human body temperature is concern to rule out the possibility of fever (Body temperature above 37 C) the reading of body temperature should be taken under the axillary region, tympanic membrane temperature, intro rectum, here one can get the core temperature and this is important to decide whether this is fever or not, in against of this surface temperature is there and usually by putting hand on body surface one can get the idea of increase temperature, but this would not be fever no matter how this is worm or hot, hope this information helps you bye. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 27 years old,just married in about a year,no baby yet.i have a history of high blood pressure and 7 months ago i discoverd i have hypothyrodism,i am currently taking thyroxine 25 mg,last month i had my uterus examined on ultra sound. it said i have bulky ovaries with small peripherally located follicles, what is that and can i have babies? ### REPLY: Hai, thyroxine plays major role in all our body function (body temperature regulation, metabolism,menstrual cycle etc.). In which lack of thyroxine (hypothyroidism) will cause irregular periods (mensuration cycle). When irregular period is persisted that leads to infertility. And as from your quote it seems to be you got a poly cystic ovarian disease(POD). This is also not allow the ovaries to function properly. Ovulation will be disturbed. This will also lead to infertility. High Blood pressure also should be considered. Consult your gynecologist to treat your bulky ovaries with Follicle. Once you start treatment for bulky ovaries with follicle your periods will get normal, along with maintaining thyroxine level in normal limit will solve your infertility problem, and you can have a baby. Thank you hope I answered your 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: Hello, I have a throbbing like pain in my left chest area, just under the left nipple or breast, I am a 22 years old male. Is it possible to be the colon that is making this pain ? I was at hospital today and ECGs and Bp with blood tests are normal. Thanks ### REPLY: Thanks for your question on . I can understand your concern. Colon pathology is unlikely to cause throbbing pain in left sided chest. So no need to worry about colon related problems. Your cardiac work up is also normal, so possibility of anxiety related symptoms are more. Anxiety and stress causes tachycardia and this can give you symptoms of throbbing pulsation in left chest area. So better to consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. 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: I have had a red mole on my left breast for years. It has always bleed and over time become bigger. Two months ago it bleed and now it s as if the inside of the mole is hanging out. I have seen a consultant dermatologist and I am having it removed next week. Can you explain the procedure and should I be concerned about cancer . Also will it be painful after its been removed? ### REPLY: Hi thanks for your question. This mole is malignant (cancerous)or not can only be determined by histopathology, once it is removed. The procedure for its removal depends upon its size, if mole is of small six it can be removed under local anesthesia.However, if mole is of large size it has to be removed under general anesthesia. You will have mild pain after its removal which can be easily taken care by painkiller. Hope this answers your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 heart beat has been jumping or doing a hicup ever two beats for the last couple of days off and on went to the emergency room and they said id be fine it was from stress, i made it quite aware to them that i had wpw syndrome and had surgery for it and its been ten years since i had problems like this. I feel like this is dangerous but they said id be fine unfortunately my heart leveled out at the top or bottome of the ekg every two heart beats instead of making a point after every beat. This is very uncomfortable and i dont have inusurance no family doctor and i feel like this is unhealthy. ### REPLY: Thanks for your question on . I can understand your concern. Yes, stress can cause rapid heart rate. But since you had WPW (wolf Parkinson while) syn .  So get done ECG, 2d echo and Holder monitoring (24 hours continuous recording of ECG). If all these are normal then no need to worry about major heart related diseases. Your rapid heart rate is mostly due to stress. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: last night I woke up with upset stomach & felt awful. Took BP 168/91 pulse 91 which is not normal for me. I have been having lower extremity pains & walking is very hard for more than a few mins without having to stop rest- stop rest. Am I having a heart issue ?? ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would explain that your symptoms may be related to different disorders and a differential diagnosis should be performed. The pain in your lower extremities may be related to a peripheral arthropathy or to a lumbar spine compression. I recommend consulting with the GP for a careful physical examination, a Doppler ultrasound of the leg vessels and a lumbar spine x-ray, to establish the diagnosis. Regarding your blood pressure, some tests like a resting ECG, a routine blood test, kidney and liver function tests, thyroid hormone levels and blood electrolytes to find out the possible cause. Hope to have been helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 49 today, i have been feeling a jittery feeling in the left side of my chest area, kind of like anxiety or something. I have been checking my blood pressure, blood sugar etc. and it has all been fine, what can i do to ease me of this? i also have been having a lot of leg and feet cramps. ### REPLY: Thanks for your question on . As a rule in left sided chest discomfort, we have to rule out cardiac cause first. So please get done ECG and 2D Echo to rule out cardiac causes. If both is the above are normal than it must be related to anxiety and stress. So try to avoid stress and tension. Be relax and keep calm. There are newer anxiolytic available in the market which are nonhabit forming. So you can try this too for anxiety related problems. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My Nephew had typhoid ,while looking after him my sister did not care about her own health,She s hypertensive & has thyroid ,had ear infection as well.Later even she fell ill and had fever and was under treatment for ear & throat ,she started talking abnormally ,later after ct scan doctor is telling that she has got a hairline clot in brain ,Kindly let me know whether it is curable and whiuch is the best doctor in Bangalore ? ### REPLY: Hi, Your sister should see a neurologist to further evaluate what the CT scan image may have shown.  An MRI of the brain would be a much better scan to obtain and if she is still having trouble speaking then, a speech therapist may be a good type of person to get your sister involved with since what you're describing may have been a stroke that affected speech and language.  If she is hypertensive and has a thyroid disorder then, she should be very careful to take her medications as directed and to check her blood pressures frequently to know whether the medicine is actually controlling her well or not.  If she also has a thyroid problem this could also contribute to some of her pictures so may wish to get some laboratory studies such as a free T4 and a TSH to check on the status of that particular problem. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 46 y/o female with c/o localized chest pain in the left side of my chest close but to the right of my sternum. Is this cardiac pain or pectoral pain? I feel like I can put my finger on the pain and it will just start to be noticeable for no reason. Do I go see a cardiologist? Thanks! ### REPLY: Hi. I can understand your concern. Ideally ECG and 2d echo should be done first in your case. If both are normal than no need to worry about heart diseases. HERD (gastroesophageal reflux disease) can cause similar kind of chest pain. HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause central chest pain and nausea. You can take proton pump inhibitors. But along with .  Avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Quit smoking and alcohol if you have these habits. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. Lose weight if you are obeseDont worry, you will be alright. 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: extreme general abdominal pain along witChatDoctorplete hematuria after intercourse with a history of nausea, chronic headaches, GERD, intermittent lower RT abdominal pain, with a history of 1 incidence of drug overdose and alcohol poisoning and numerous accounts of head trauma ### REPLY: Hi, Intermittent right lower abdominal pain and hematuria, suggest a right ureteric stone. Which due to increased muscular contractions during intercourse could have lead to acute ureteric colic pain. General abdominal pain is due to gastritis with is not subsiding due to your continued alcohol and . I would suggest that you get an ultrasound of your abdomen done along with a routine urine test to look for the stone and start on a PPI tablet like omeprazole or pantoprazole. Further management will depend upon the location, size and number of stones. Hope I have been helpful. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had an Hyperplasia complex with focal atypia regressed 2 years ago , I want to do the ChatDoctor diet and my doctor told me I can t , before he told me the only way I will not have the hyperplasia coming back is 1- need to loose weight 2- taking progesterone pills 3- getting pregnant and my question is while a women is pregnant she developes thousands of ius of the ChatDoctor hormone why I can t have much less ius of the hormone to do the diet???? ### REPLY: Hi, I am not sure how this site allows doctors to see reports, Because I see no options to see any reportsHowever, it appears that you want to lose weight and is inclined to use  diet for the same. However, the question first arise is "whether  diet is effective". This type of diet is often prescribed with low calorie which is the real cause of wight loss achieved. As far as your question goes, exogenous  is never proved to be free from side effects. You pituitary gonadal axis may get suppressed though this effect is more pronounced in males. Moreover, it should be avoided in hormone dependent cancers like breast and prostate know that you are neither male nor breast cancer case, but I strongly suggest against taking exogenous  for weight loss, which can be achieved with planned diet and exercise program ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hard long type lump at the side of my left knee for about ten years nagging pain on and off I did not have any injury and I don t do any kind of sports was told by a doctor a few years ago it might be a cyst in the cartilage I never went back they could not see anything on the xray but the lump seems to be moving from were it was to the top right of my knee please help ### REPLY: So the lump is painful, moving, hard, for many years but without any injury and not detectable with x-ray! That I could conclude from your description; anyway, thanks for your information shared on ! Could you please repeat your x-ray in some other lab in the mid-flexed position and a lateral view report is necessary in this case; because I think I is definitely a cystic lesion like bursa, ganglion or some loose bodies etc...benign definitely and not to worry!a recurrent patellar dislocation is another possibility. Therefore do the test and revert us; 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 can hardly urinate mmy blatter is full and it hurts at nite I wake up all the time having to go but cant,when I can start a stream it starts weak always and goes for a short time and stops and i cant start it again im going crazy what can I do amd i dont have an infection ,had a test,this goes on 24 hrs a day, I have a appt to see a specialist but hecant see me for amonth and ahalf, so far away ### REPLY: Hello & welcome To , Your history is not complete. Please let me know about your age, sex, duration of the problem, any history of diabetes, kidney stone or any urinary bladder problem. But till now you can do one thing, ultrasound of lower abdomen. After knowing the complete history, doctor can suggest you the correct treatment. Hope so you are getting the answer of your problem. Thanks & Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I been challenged with increased heart rate for the past two weeks and don t exactly know what the symptoms are. Of course the common: I am under work stress, changing jobs, and moving, plus being a mother to two young children. But my heart rate increases in the evening, almost to an anxiety attack level. ### REPLY: DearWelcome to ChatDoctorWe understand your concerns went through your details. I think you are being reasonable. That is a good sign. Your heart rate fluctuates mainly due to stress and related anxiety. You will be able to feel the heart over your chest skin. That is natural on a stressed body. I will not say there is nothing to worry. You need to worry about stress. Either you adjust with the stress creating situations and take it easy or avoid the stimulies. Please understand, prolonged stress could create many health problems. Please consult a physician and follow his advice. Exercise, proper dieting and happy life contributes to healthy life. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My obgyn has recommended prolia injections. I am76, female diagnosed with osteoporosis I had a severe break of my left femur I have had bilateral knee replacement and I have serious back problems degenerative disc s and scoliosis . I m really afraid of the prolia injections for many reasons...HELP? ### REPLY: Dear patient prolix injection contains denosumab which is recommended for post menopausal osteoporosis. Denosumab has many side effects which needs to be monitored. But it is also very effective.  I would advise you to undergo DEXA scan first to assess severity of osteoporosis so that treatment can be decided accordingly. If mild osteoporosis you need to increase calcium intake and calcium tablets taken orally. Also bisphosphonates should be started weekly. For moderate osteoporosis start both calcium tablets containing isoflavones and bisphosphonates. For severe osteoporosis injection perioperative can be started which needs to be taken for 5 to 6 months. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife took a fall and hit her head.  She has a pretty painful knot on the back of her head.  She is in quite a bit of pain and did feel a little nausea & dizzy which has passed.  We are icing her head now.  Do we need to go to the ER or wait and see if the knot goes down? ### REPLY: Hi there, If your wife lost consciousness, is over 65, or on blood thinning medication such as Coumadin (warfarin), Plavix, Prada, or Lovenox, or has a history of bleeding disorders, then I recommend you take her to the ER for a head CT. if your wife did not lose consciousness and is not on a blood thinner, and doesn't have any history of bleeding disorders, then it is reasonable to continue to ice the affected area. I recommend 15 minutes of ice on, 15 minutes off and repeat as many times as possible. I hope I have answered your question. Feel free to contact me if you have any further 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: Recently had xfix on leg before surgery for broken tibula,  The pin areas of xfix hard to  heal.  was constant oozing from site.  Now I believe the fluid was transferred to my eye area, which is now about swollen shut, and oozing from eye lid, not in the actual eye.  How can I stop the oozing and get the swelling reduced?  Thanks ### REPLY: Thanks for posting you query to .oozing is due to inflammation of tissue it could be infective or non-infective, so you need to undergo culture and sensitivity examination of your fluid.collect this fluid in a sterile container and send it to microbiology lab .this test will help you find out cause of infection and effective antibiotic to cure it .for your eye complain you should contact to ophthalmologist for proper examination of eye. Further you should take care of your surgical wound with proper . Hope you would be satisfied with my answer.  Feel free to communicate if any query.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: Dr. Sadie, i hope that u can help me with my situation right now and give me the best advice as possible. My name is Adriana and im 23 years old. I have had 4 csections ( 3 live 1 deceased) in the past 5 years. I currently found out that i am pregnant but unsure of how far along i am. I did not want to get pregnant and was taking care of myself as much as possible. I am scared due to the fact that i was high risk in my last two pregnancies. As much as i love my kids i cannot have another one and the dr. that attended me on my last csection repeated to me that i could not have another one because it could be extremely dangerous. I do not know what to do, i have not told anybody and i feel like im in a hole that i cant get out of. What do you suggest i should do ? If you could please respond to me at YYYY@YYYY . Thank you for your time. ### REPLY: Dear A .  Pregnancy after 4 Cesarean sections does carry a very high risks of rupture of the uterus during delivery and even sometimes during pregnancy, retained placenta after delivery if it is implanted over the scar, post delivery bleeding, etc. If you are under 9 weeks of pregnancy and are sure that you do not want to continue with this pregnancy, you may opt for termination of pregnancy by medicines which carries very low risk even after cesarean section. WHO has recommended two regimes for such terminations:1. Tab. Mifepristone to be followed after 24-48 hours by Tab. Bisoprolol 2. Tab. Bisoprolol only regime: Tab. Bisoprolol every 3-12 hours for up to 3 dosesThese are very effective and safe methods for terminating pregnancy up to 9 weeks of gestation. It is advisable to ensure the completeness of abortion by ultrasonography. These medicines are prescription medicines and need to be procured by Gynecologists prescription only. They should be taken as per the instructions of Gynecologist. These medicines cause developmental abnormalities in the baby; hence the pregnancy should not be continued if the medicines fail to abort; then the pregnancy should be terminated by surgical methods like MVA aspiration. Since you are having 4 previous Cesarean sections, it will carry some extra risk; however under expert supervision, this can be carried out fairly safely. If you decide to continue with this pregnancy (which I would not advise), you will have to be under continuous supervision of Obstetrician. The integrity of the scan may be assessed by repeated frequent ultrasonography. Any discomfort over the lower abdomen should be reported to the Obstetrician immediately. You may have to be in the hospital during last month of your pregnancy. This will have to be a planned cesarean delivery. This delivery has to be a hospital delivery. Please maintain your health. Keep your hemoglobin within normal range by regular consumption of iron and high protein diet. Please visit the Obstetrician for antenatal care more frequently and follow the advice religiously. I hope you got the messages. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 found a lea sized lump an inch below my sternum, it is quite painful when touched, it s a little pinkish, I ve had it for about a week now, should I be worried? For additional info, I m 18, female, no health problems whatsoever, I d really appreciate any sort of answer ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in full details updated from you. I understood your health concerns. Based on your query data, In my opinion, Dear You seem to suffer from Painful Acne just below sternum. Pinkish color indicates the infective nature of it. For your age where acne is common, unless You get Second Opinion for the clinical evaluation of the lump, It's very difficult to comment on the lump, with the available scanty information.Hence, I would suggest Consultation from Surgeon to check for the exact cause of such a lump. Other possibility in that region, the lump could be an Epigastric Hernia, which is painful to touch, and occurs only when you are coughing or lifting some weight.USG study would help you to fix its nature as Epigastric Hernia. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. . N.M.S. Genl-CVTS -Senior Surgical Consultant ### END