Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: good morningi vommited in the early hours of the morning like a brown colour, followed by a bright mustard colour vommit, i also have wat feels like a large lump in my throat, that when swolloing it actually feels like it move however my glands are not swollen ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have sore throat or granular pharyngitis.  You should take a course of antibiotics like azithromycin or levofloxacin.  Also take saline water gargles.  Consult your doctor and 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: Hi, Doctor, My wife, Mrs. Rajni, 48 yrs, wt.-65 Kgs. Ht.-63 Inch, Vegetarian. DOB-10.10.1966, two children-27 yrs and 23 yrs (female and male) has left kidny ectopic (out of cage, placed little down and moved towards abdomen. 10 yrs. back the investigations revealed that ectopic kidney is slightly smaller in size but functioning normal. At present she is suffering from joint pain and swelling at face and limbs. She is operated for Uterus, one overy and gallbladder removed. she takes undes under noted medicines- Tab. amlovas AT 1xod, Eltroxin-100 mg 1xod, shelcal-500 mg 1xod and Uricostat-40 1xhs. Please advise at my YYYY@YYYY my cell no.-0000 ### REPLY: His may suggest complete urine test, GFR,serum creatine, and arthritis profile.Also, serum proteins levels, LFTSwelling over limbs may be water retention or edema, reason could be kidneys or liver. I may suggest mild diuretics like stride once a day, restriction of salt, measurements of BP. For joint pains, naproxen tabs twice a day after meals.Also, TSH level should be done to regulate dose of eltroxinThanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 high grade fever for On 8,9 May followed by heavy rash on all body on 13,14 and15 may. Swelling in my ankles throughout and on 21st my knee joints have been paining. Investigations revealed insufficient Vit D and raised ESR. Calcium and tests for RA are negative. Dr has prescribed T Saaz twice daily after food for 2 weeks.My question is that I have been surfing the net and everywhere it is written that T Saaz is given for RA. Is it okay for me to continue with the medicine as I don t hv RA. According to the dr it was some viral with joint pains and the pains are aggravated coz of low levels of Vit D. Please advise! ### REPLY: Hello, I have studied your case with diligence. When such patients come to our hospital I advise them blood test like CCP, HLA B27. Rheumatoid arthritis may involve small joints and early morning stiffness in joints, do you have sucChatDoctorplain? Ankylosing spondylitis typically involve spine and hips with other large joint also. There is reduced chest function in this disease. Stiffness in spine is increased do you have such stiffness in spine? It may be seronegative spindle arthropathy with RA test negative. NSAIDs, Awards (disease-modifying anti-rheumatic .  These include methotrexate and sulfasalazine. Corticosteroid injections for severe pain and inflammation in a specific joint.TNF-a inhibitors, a newer class of biologic medication. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: CDear Doctor, my son has been treated w/various antipsychotics over the past 4 1/2 years while living in Croatia.He suffers from major psychotic depression and has responded favorably to electro-stimulus treatments for his condition,whereas when antipsychotics were administered he suffered from a major crisis of neuroleptic malignant syndrome(CPK 5,000). He was immediately taken off all antipsychotics and flushing out his system was begun. He was doing alright at home w/only a small daily dose of valium(Normabel) which he would take on occaision. However he had a relapse w/ deteriorating condition characterized by not speaking,eating and drinking only minimally and anxiety w, drooling. frequently he would display a state of confusion and be oblivious to his surroundings. Lorazepam 2mg dosages are being considered w/ eventual ES treatments.However it has been very difficult to arrange this in Croatia. What is your sense of what is happening to my son,Luka? What can you suggest given this brieand incomplete history of illness?Yours,a very worried and concerned father. ### REPLY: Hello ~ Suffering from Major Depression with psychoses is a very difficult problem to have, and for a care-taker it may be taking its toll on you as well.  I understand that your son has been on various medications and is currently only on Valium.  Valium usually tends to depress the brain since it is a sedative.  I would suggest that your son be assessed completely psychiatrically and combinations of antidepressants and newer antipsychotics be tried before ES treatments.  I am unsure of what resources are available in Croatia, however consulting a doctor should help.  Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Im a 17 year old girl, I had unprotected sex about two months ago and I got my period but I feel a very small lump in my pelvic area  on the right side and when I put pressure on it, it really hurts. I dont know what it is, maybe pregnant or a cyste? ### REPLY: Hi, welcome to our site. I am , MD. Read your query. That is a very significant question and I appreciate your problem. I will try my best to answer your query pregnancy lump cannot be felt so easily. You need to be pregnant for sometime before you can feel it. I would like some more information however-Is the lump hard/soft? If soft, does it feel dense, or like fluid filled? Is it mobile? I would also suggest an x-ray of the pelvis and USG, since I cannot examine it. If possible, upload an image of it and this may help in diagnosing what it may BEI hope this helps you. Inform the reports mentioned above/if any other, so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just looked it up online and have realized that I have ringworm.....it started 2 weeks ago and I was wondering if by chance ring worm can cause mood swings or anything that could change my moods? I m 24 yrs old and I m extremely irritable and its only been going on since I first noticed what I thought was a bug bite and have now found its ringworm. If someone could please help me that would be great thanks! ### REPLY: Hi, Welcome to . Ringworm infection is a superficial mystic infection caused by fungi called dermatophytes and does not involve anything more than the skin. You could become irritable due to the constant irritation in the infected area, but ringworm infection does not cause any mood swings. Please get appropriate treatment after examination by a dermatologist and do complete the full course of treatment to avoid recurrence. Please keep the infected area clean and . 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: small sponge like feeling cysts on fingers raised near joints that some times I can pop, IF they will pop, with a very quick snap pain as they pop under the skin, then skin goes flat. Sometimes they reappear later. Are they ganglion cysts within my finger areas or sign of something else? I am female and 55 ### REPLY: Hello, * As per the perfect narration of the lesion which is sponge like and disappear quickly within the body, indicate most likely ganglion cyst which is in communication with the internal crevices of the joint space area. * Kindly get an examination with your PCP for further evaluation and if required further reference to the consultant surgeon for the resolution of the same. Hope I have answered your query. Let me know if I can assist you further. Take care .  Patel, General Surgeon ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What is the risk of spinal cord injury in a person with a unilateral fracture of the left facet of C-6? 2 years ago I suffered this injury in a mountain biking accident. No surgery was required. I returned to work 8 weeks after the incident. Presently have no pain and a slight rotational deficit at the limit of turning my head. I wish to begin cycling again but am concerned about re-injury or worse suffering a spinal cord injury from another fall. I am a 6 tall male 200#. ### REPLY: Hi, thank-you for providing the brief history. As the C6 fracture cannot lead to long term spinal cord injury. There may be a possibility of having nerve root impingement in the future if the neck muscles become weak. I will advise you to undergo and thorough clinical examination and an MRI of the neck. Also, with physical therapy you can regain the strength in the neck muscles and keep the normal anatomical alignment of the bony structures in the cervical spine, and you can avoid nerve root impingement. Using a collar while your sports is important to avoid any injury to the neck muscles and even can avoid the misalignment of the cervical spine. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I noticed what appeared to be a single pimple on the side of my penis.  It was rather hard and of course freaking out... I popped it.  Today as I went to urinate, I noticed a discharge from the urethra.  I am not sure if either of these have anything in common, but would like someones opinion on what it can be... ### REPLY: Degree understand your concerns went through your details. The discharge you had from your urethra, may not be having anything to do with the popped pimple like eruption. The discharge is simply your semen itself which is escaping through your urine. This is a natural procedure and happens many times. You just noticed now. Don't be alarmed and don't relate it with any other health conditions. Take care. 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: Hi, I recently fell of a horse and as I landed I got trod on by the horse on my inner upper right thigh. I first had lots of pain and I could not walk on it and every time I moved it I was in loads and loads of pain I then put some ice on it and it was better but it has now been 3 days and I still have a dull ache and difficulty walking and straightening my leg and it feels very stiff. However there has been no bruising at all but there was sweing... What have I done? Thanks. ### REPLY: Hello, As this fall has landed in the muscle injury. Straightening the knee will be difficult due to excessive muscle action. You need to wait for a week or so and till then continue icing to reduce pain but also use hot water fermentation to relax the muscles too. Post 7-10 days you can start slow and low-intensity static qua .  This should help regain the strength in the muscles and allow the knee to be flexible. Trying hot relax and contract-relax techniques will help improve the knee range of motion too. Hope I have answered your query. Let me know if I can assist you further. Jay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hii. I am age 35 male. I am suffering from erectile Dysfunction and low sperm count which is leading to infertility. I got myself examined and found out i have Varicocele grade I. Please suggest me good medicine which gives good benefit and no side effects. Sunny ### REPLY: Hello,If you have low sperm count then you could benefit from Varicocele surgery. Varicocele is known to cause low sperm count. So, you should go ahead with the surgery. It's not a very major surgery and has the potential to increase your sperm count. But, there are no guarantees. If you opt against surgery, then you can try medications. I usually prescribe a product from Himalaya ayurvedic called Speak. I give it for three months and usually find a rise in Sperm count after three months. Choose what you want, but I would advise in favor of surgery. 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: Hi, may I answer your health queries right now ?  Please type your query here...hello doctor!my dad is suffering from fever since ast 5 days n when he takes medicine its fine but again after sometimes he gets the same..n it starts with shiveringrecently he got operated for fluif accumilation in brainn also he is taking medicine for TB as prescribed by the doctors...whats the reason behind it and is it the symptom of some other diseaseplz help ### REPLY: Hi, Chronic infections like tuberculosis decrease the immunity of a person. The person is more susceptible to more infections. Kindly ask him to take TB medications without missing even a single dose.Also, kindly visit a physician. A chest X-ray, complete blood count with blood culture, urinalysis and urine culture may be required. He can take tablet paracetamol 500 mg 3 times a day for fever. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 partner who is obese but healthy (full doc check) has been having paind in lower abdomen then round his back, hot sweats and lack of apetite not really feeling sick but not feeling well, hasnt had a really good poo just small ones though feel the need to have a good clear out, took sachet of fibrogel last night and went a little better this morning but still sweating suddenly ### REPLY: HI. Thanks for your query and concern for your friend. The history of pain, sudden sweating, not feeling normal, not having normal stools is all indicative of few things:Intestinal infection. TyphoidI would advise your friend the following:First send the samples for -Blood: Tidal, CBC, sugar and creatinine. Urine and stool - routine tests. Ultrasonography just to rule out any organic lesion. A course of an antibiotic, metronidazole, probiotic for 5 days and then to change medicines as per the reports if need be or extend the antibiotic for 3 weeks if Typhoid is positive. If no relief after the course, then only you can go for further tests of colonoscopy and CT scan of the abdomen. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I have a question for u that my younger sister she is about in 5 class. she has a problem of doing urine on bed we try to control by making her routine to do urine at night but we are faild to control this now i wanna ask u for a best way how control this problem kindly help me for this kind act. I shall be very thankful to you for this kind act.I wait for your answer plzzzzzzzzzzzzzzz help me. thanks ### REPLY: Hi... Thank you for consulting in . I have few questions for you -1. Has your sister stopped bed-wetting at certain age and again started having it?2. If so at what age she stopped and when did it start? If she had never stopped bed-wetting form birth...you can try some behavioral changes which I can elaborate after proper history and interaction with you, but the effect will not be immediate, but it will be permanent. If it's a recurrence after attaining nighttime control, I suggest you see your pediatrician to rule out pathological causes like urinary infections or Voiding dysfunction (In which the ultrasound abdomen will pick up thickened bladder wall). Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have copd asthma 3-4-5 vertebrates are in bad shape. I had surgery on my left knee but no luck with that but the doctor said he would not do knee replacement because he would not want to put me to sleep because of my breathing problems. I can not hardly walk and a lot of pain in my back also. Is there anything you could do to help me? ### REPLY: Thanks for your question on . I advise you to first consult pulmonologist and diagnose yourself first. COPD and asthma are different entity and not the same. Treatment is also different. COPD is irreversible condition while asthma is fully reversible. COPD needs smoking cessation, pulmonary rehabilitation with chest physiotherapy and pulmonary vaccination with inhaled bronchodilator. Asthma needs identification of allergen, avoidance of it and anti-allergic . So first diagnose yourself. And you can try physiotherapy for knee and back issues. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 itching and burning feeling around the thigh crease area....and also vaginal area....why could it be? i showed a local doctor who told me could be a fungal infection and suggested me a skin cream TRIBEN-XT. But still i feel it is not okay.... ### REPLY: Hello, Welcome to , Fungal infections are more common in the genital and perineal area as these are the normal comedians of this area, which will be kept under control by helpful organisms whenever there is a change in the environment this yeast will activate produce their symptoms. As you are having the symptoms of fungal infection for which you have taken some treatment, but your symptoms has not come down, I would suggest you to undergo lab investigations like KOH mount, CBC and urine routine examination. For your symptoms you can try these measures1. Keep the area clean and . 2. Apply antifungal cream over the lesions3. Tab Rifleman, 150 mg single dose.4. Oral antihistamines to reduce the symptoms of itching. 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: 30 year old daughter has started fainting. BP consistently runs low (82/56) was the most recent. Lack energy, Anemia was diagnosed.  Hospital decided after many tests that she has syncope, but gave no recommendation to help her. Tests revealed fatty liver enzymes, heart, lungs, breathing were fine. Problem with clotting was indicated. What can be done to raise her bp, keep it stable, and stop the fainting? ### REPLY: Hello, Thanks for the query to . Forum. Anemia, if hemoglobin level is less than 6 gm /DL, we call as severe anemia. If hemoglobin is, still less than this patient may feel dizziness and chances of faintness. Any person (anemic) if fainted, his blood pressure will fall, due to syncope. I wrote, blood pressure will fall, and we will call low BP. In your daughter case, no doubt, she is anemic, but low B P is due to anemia. In my opinion get treatment for anemia, after consultation with a physician and once, anemia cured, she will not develop low Blood pressure. Hope, this information will help you. GOOD LUCK for your daughter.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi..I had a recent repeat gallbladder ultrasound and they said it was contracted. A follow up visit is scheduled for two weeks. I am not having any fever, chills, nausea or vomiting. I have had a few episodes of really bad abdominal pain that radiated to my back. This happened twice recently...but the pain subsided after about 20 minutes. I took advil and also drank some apple cider vinegar with warm water as I have read that can help. I have also been eating bland for two weeks...and doing fruit and veggie smoothies as well. I am very scared and concerned. I have never had any surgery and am afraid of anesthesia. Any thoughts? Do I go to ER if pain comes on again even without any other symptoms? Thanks. ### REPLY: Hello, You have been diagnosed to be having contracted bladder, contracted bladder occurs due to gall stones (hardened cholesterol & bilirubin, inflammation). Gall stones block the bile ducts & trigger sharp pain, loss of appetite, nausea/vomiting, diarrhea & jaundice. You are suggested to be clinically examined & treated by a Surgeon. Your treatment will depend upon the severity of your symptoms & the pathology detected. You will either be treated by shockwave lithography, cholecystectomy, ERCP, etc. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in my right leg, maybe 5 on a scale of 10. The leg is swelling, I believe due to my consumption of about 3 ounces of 40 proof whiskey. Perhaps there is a conflict with my current medicines, which are:Aspirin 81 mg tablet at bedtime; Atorvastatin 20 mg daily; Clopidogrel 75 mg daily; Hydralazine 25 mg daily; Hydrachlorothiazide 25mg daily; Lisinopril 20 mg twice daily; Calcium Carbonate 600mg daily. Any ideas on the reason for this reaction? ### REPLY: Well though the history is quite restricted as you need to tell how significant is the swelling and whether its progressive with discoloration or not. But if it's a significant swelling which is progressive, there are two possibilities. In case your limb is red and quite painful associated with fever specially if u have any trauma history or if your a diabetic, first possibility is of cellulitis which is a soft tissue infection can be treated by antibiotics and anti-inflammatory . Second will be of vein thrombosis which is a condition of a blockage in the flow in your veins. To rule that out you need to undergo a USG lower limb with color Doppler which will help in saying if it's a soft tissue swelling or it's a vein thrombosis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 5 month old son has a cold sweat, He was fussy the today and it took us a while to get him to go to sleep tonight.  He didnt have a fever, about 37.2 degrees Celsius (with ear thermometer).  We are flying to South Africa tomorrow (from USA), its his first flight and its very long. ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, im just curios about my ecg result... the interpretation of the ecg personel is sinus rhytm with sinus arrhythmia non specific T wave change. but the QT/QTcB is .586sec/697sec, and the PR interval is .100sec my heart rate is 85 beat per min. QRS is .112sec my blood pressure is 140/80.  is that fit to work? ### REPLY: Thanks for your question on . I can understand your concern. Your ECG report is normal, no need to worry about this ECG. You're all values are normal. Your systolic blood pressure is 140. It is higher side of Normal. So better to avoid excessive salt in diet and do regular aerobic exercise. These will help in control of blood pressure. No need to worry about your ECG. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Thank you for your time Dr..I have been having a dull persistent pain in my lower left abdoman for about two weeks. It is just above my hip and around to my back and above my groin area. lacking in energy and feeling tired even after a good night sleep. however the pain did keep me restless last evening ### REPLY: Hello and thank you for asking , I understand your concern and I studied your case. You didn't mentioned your age and gender, so I will have to be very general. In both genders above 50 years diverticulitis can manifest with these symptoms. It could also be something connected with your spine or hip, so your musculoskeletal system. So I suggest you to visit your GP who will do a better examination that will take him in the right direction with further tests. I hope this answer was helpful to 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 what I think is a spider bite on my thigh. It s a red ring, about 1.5 inches in diameter. It s raised and hard in the center with what looks like a white speck right in the middle. It s been there a couple of days and is painful to the touch and just a little sore. Should I ice this? Or is it too late? Thank you! ### REPLY: Hi, Welcome to , I am  First of what was your symptoms ? Why did you go for urine and CT test?  Normally, epithelial cells and bacteria may be found in urine. But, to stamp an infection the amount of bacteria is important which you did not mention.  Coming to the CT finding it indicates you have a nodular mass in your kidney which is probably benign.  I wonder why the Doctor who were present during scan advice for CT guided FNAC which would definitely confirm the diagnosis and decreases anxiety.  So, go for CT guided FNAC. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 week ago I noticed a small rash on my right thigh. It itched like crazy for about two days, and then stopped. The rash stayed there, but no more itching sensation. Then a couple days ago, two more small rashes appeared. One on my left thigh and the other on the shaft of my penis. The rashes are only the size of a pinky nail. I m pretty nervous, and have searched all over the web terrified I have some sort of std. Please help ### REPLY: Hello and welcome to . Rashes in genitals associated with itching is most probably due to fungal infections. My advice is to visit a Skin specialist and let him have a look at your symptoms. He will give antifungal ointments like Clotrimazole and antihistamines like fexofenadine to reduce the itching. You have to wash all your undergarments in boiling water and have to iron them. That's because these fungus deposit their spores in whatever clothes that touch them and will produce a reinfection after 2 weeks. Hope this discussion will be helpful to you. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor.. I have a query, is ECLIA and CMIA results for anti HCV blood test the same?  we took a test for my dad on August-2013, the result was 1019 (reactive) in ECLIA. We took another test now and it shows count of 13.87 (Reactive) CMIA. Are both the same tests can we conclude the HCV impact has reduced by seeing these results. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. EC LIA and CIA both test based on different principles.  Both can be done for hepatitis C. You can compare the results of both tests. Both show positive results that can be compared. 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: Hi Ive had quite severe pain on my left lower jaw to the point opening my mouth and swallowing was very difficult as well causing part of my tongue to be in pain. I went to the dentist as she advised my premolar which had been infected for some while be extracted which she did there and then. It is still the same day but i am feeling so sick. I feel as though Ive swallowed so much blood, perhaps even puss, i have a unpleasant smell from my mouth and feel nauseous. Is this normal?? ### REPLY: Hi. Can understand your concern. As per your complaint feeling of nausea and unpleasant taste in mouth can be due to the side effects of medicines as the antibiotics and painkillers would be given to you after extraction. The feeling of sickness and nausea along with altered taste can be a side effect of either the antibiotics or the painkiller. Although some nausea and vomiting can be experienced in case of swallowing of blood as blood cannot be digested by stomach causing vomiting. Unpleasant smell from mouth and nausea can occur due to pus discharge secondary to infection. I would suggest you to consult your dentist and explain the immediate symptoms so that he can either reduce the dose or change the medicine. If the infection and pus discharge is still present then irrigation with antiseptic solution and prescribing a course of antibiotics can help. Along with it gargling with warm saline solution and antiseptic mouthwash can help. Hope this information helps. Thanks and regards. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i just had a tooth pulled i know the tooth was infected because when i touched it the pain was bad. I explained this to the dentist before she pulled it and she said not to worry. As she was pulling it out i felt alot more then pressure i kept telling her it felt like she was pulling on a nerve not just pressure. I then started to feel pain in my bottom teeth the back one. I told her this and she just said she dont know why Im feeling that pain. She was working on the top molar. Now it has been over two hours since i had this done and the pain im in is unreal it feels worse then when i had the tooth in and now my bottom tooth is hurting to my mouth is still numb and Im in all this pain I dont know what i should do. ### REPLY: Hello and welcome, Extraction of tooth sometimes ends witChatDoctorplications like pain and swelling post extraction. Usually it takes 7 to 10 days for the extraction wound to heal and close completely provided if there is no infection.  After extraction antibiotic and analgesic coverage is must prevent infection of the extraction site and to promote healing.  I would suggest you to start with an antibiotic and analgesic course consulting your dentist, which helps in subsiding the swelling and relives post extraction pain.  Follow all the post extraction instructions and rinse the mouth with lukewarm saline or antiseptic mouth rinse. Numbness developed is due to the anesthetic solution injected in the oral tissues before extraction. This sensation is temporary, and it subsides with time don't worry. I hope this helps, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For about a month now my right shoulder tends to pop when I breathe in deeply when I lie down on my back, and recently, when I am just sitting down upright. It isn t painful at all, but it is somewhat uncomfortable and annoying as it seems to be happening more frequently lately. I m thinking that it may be due to my posture but I am uncertain. Please help me figure out whats wrong with my shoulder! ### REPLY: Hello, i have studied your case. If popping means that there is cracking sound then it is not a serious issue, and you can ignore it. If there is sub function of the shoulder then it can be due to weak muscles, and it needs proper checkup for this you need to take ultrasound of the shoulder to see if there is any abnormal tendon moving. I hope this answer will be useful for you. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed w/Providencia rettgeri, my dr proscribed ciprofloxen, I also have high b/p are there any natural remedies?  I have been taking cranberry capsules and it is better 90 %.  I was using a catheter, must not have cleaned it well enough. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No, it's not having any natural remedies. You should take the completed treatment to clear the infection. Antibiotics prescribed to you is ciprofloxacin, this is right, and you should take it. Please do not substitute the therapy with other home remedies. This will otherwise make the condition worse. If you are catheterized patient then there is nice way that you can escape from taking antibiotics. If you have used the dirty catheter than your infection arises from this situation. Now as you are free from the catheter, you should maintain good local hygiene with frequent cleaning and .  This will help in cleaning infection form the urinary tract. Please  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: AoA,Dr. i have a issue, two days before i noticed some pimple near my testes just between my penis and testes, but i saw its closely it is not like other pimples its appearing from inside and its hard, and when i press it i feel pain but there is no itching on that. Am just worried may be in future it will make any big issue for me? and if its not pimple than what is it? kindly help me. ### REPLY: Thank you for query. With the description given though the morphology exact site is not clear, It may be due to Sebaceous cyst which is common in the area. Many subside on its own if it is small size. Maintenance of genital hygiene is important.If it does not subside you may need to get it removed surgically which is a minor procedure. Consult doctor for diagnosis else get back to us with details and photos. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 scheduled for gallbladder surgery on 4 Jan 2016. During my last attack, in addition to pain, my fingers/hands swelled up. I had to freeze my ring finger to get the ring off. My fingers/hands are still swollen. I have dull pain all the time. ### REPLY: Hi, thank you for providing the brief history of you. As you have undergone the gall bladder surgery these symptoms of swelling and pain is a rare issue for the limbs like the upper limbs and the lower limbs. It could be due to lack of vitamins and also due to weak metabolism which can be possible due to post surgery status. You can discuss the same with your Surgeon as in my opinion this should not be connected to the gall bladder surgery. Also, you can discuss with him if you can perform some general exercises under the physical therapists' guidance for making the muscle property maintained for upper limbs as well the lower limbs. Post gall bladder surgery there will be even weakness of the abdominal muscles due to the incision and may need physical therapy Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,My daughter (2 yrs 11 months) was suffering from pneumonia, was hospitalized for 6 days and was discharged 2 weeks back.However she started getting mild fever (99-100) since yesterday and we gave her crocin syrup. Today we took her to our pediatric and the doctor said it does not seem to be some stomach infection and suggested 5ml Vizylac and 5 ml zifi 100 twice a day and to use crocin or meftal-p only as SOS.It is night now and she is running fever again (100.5). i have given her Crocin Syrup (5ML) but the fever is only down by 0.5 degrees in the last 60 minutes. Should i give her some more crocin? ### REPLY: Hi... Thank you for consulting in . I don't think this is related to her pneumonia 2 weeks back. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Meftal-P contains Metonymic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Metal. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I quit taking my bc pills on August 21st at the end of my period. I had a unusual period from September 17-20. Very light and brownish in color the first 2-3 days. Ive experienced weight gain and my breasts are tender and my nipples look different. Have taken a couple of hpts but negative. My husband and I have been trying to conceive since August. I also have noticed more of a milky discharge the last couple of days. I suppose to start my next period October 17t. Any idea what may be going on? ### REPLY: Hello, Milky discharge from the nipples can be observed in early pregnancy as well as post ovulation. It may take a couple of months after coming off the pills to regain normal ovulation. As you are almost due for your next period, you may wait for it and get a HPT with a fresh early morning sample 3-7 days later if you miss it. If you wish for an earlier and better confirmation, you can get the serum beta-ChatDoctor titles estimated. Hope your query is answered. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor , i am now 21 years old.i had done dental treatment done almost five years ago.i had a complicated problem.by birth my lower jaw was inside.When i went to treatment it was brought forward using twin blocks.Then braces was used to bring it back.It ended as okay.After one year settled teetChatDoctore forward.Then it was fixed using retainers.But the problem is there is still projection of teeth.It is not much visible from outside.I am not able to smile well or talk with confidence .I visited a dentist .He told me the only possibility is to take off four teeths .two from above and two from below and then put on braces.Is it possible. If teeth is taken out then can dental implants be used there.also i don t have four molars.Actually the teeth is still inside.i have asked about it to a doctor.he said it is better if it remains there since i dont have any pain or disturbance with it.will this make problem.Can you recommend any treatments.I am considering doing braces again.I am thinking of doing treatment after 2 years since I am doing my p.g.will that age be correct for treatment. ### REPLY: Hello friend. As per your symptoms you are having orthodontic relapse. After finishing the orthodontic treatment the teeth tend to move back to its original position, so a retainer is given to patient (removable or fixed) to hold the teeth in the new position. According to American standards it has to be given till the age of 22. At this age the growth of the body stops completely. Now that relapse has occurred in your case, you need to go again for orthodontic therapy that is fixed or removable depending on the severity. If minor correction has to be done better go for removable. If enough space is not there to align the teeth then to gain the space extraction of premolars (to gain more space) or proximal stripping (to gain less space) has to do. And yes, orthodontic treatment can definitely be done at this age. It's called Adult orthodontics. If you have photographs of your teeth please send me to dentist@ravishah.co.in to receive more advice. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 high blood pressure and anxiety. I have been having constant chest pain for 2 days and seems to be worse when breathing in. I am  a smoker, about a pack every 2 days. I am 35 and have been smoking for about 15 years. I have a family history of heart disease, hypertension, and diabetes. I dont get sick very often and have no other symptoms such as coughing. ### REPLY: Hello dear, thanks for your question on . In my opinion you should immediately consult cardiologist and get done ECG to rule out cardiac cause. Because you are having the following risk factors for cardiac disease. 1. Strongly positive family history. 2. Chronic heavy smoker since 15 years.3. Hypertension. So get done ECG. If ECG is normal then no need to worry much for cardiac cause. Your chest pain is mostly due to anxiety. Better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Quit smoking as soon as possible. It is very bad habit. Avoid stress and tension. Be relax and calm. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 raised, lump area on inside of my right calf. No redness or bruising. No pain in particular but I know it is there. I am 56, female with history of DVT/PE. I am on Coumadin and my last check I was 1.7. I take 2mg 6 days a week. I just noticed the swelling yesterday. ### REPLY: Hi. Thanks for your query and a correct history leading to a diagnosis. Since you are on Coumadin the most probable cause of such a lump which appeared yesterday and is large enough to be seen on the inside of the calf is most probably a hematoma unless proved otherwise. I would advise you to go for high resolution ultrasonography and color Doppler to get a confirmation. Get the coagulation profile tested, you may need to stop Coumadin under your Doctors supervision. You may not need major treatment unless the tight bandage does not help] ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About a month and a half ago, I came down with a dry cough for a couple days which turned into a productive cough. The phlegm produced was light yellow to light green at times, and often worse in the morning and early evening. I began taking Mucinex and ibuprofen to help with sleeping and congestion. The Mucinex made the cough more productive and I was able to expel some of the congestion;however, I often felt a tightness in my throat and upper chest after coughing fits. I have no history of asthma or other lung conditions. I have never had bronchitis . The main thing concerning me is the while the productive aspect of the cough has discontinued, I still have this nagging dry cough at night that keeps me from getting to sleep and staying asleep. I have no nasal congestion or sore throat , but do occasionally have headaches during the day above both eyes that come and go when heading outside. I occasionally hear a bubbling or gurggle in the back of my throat on expiration. I have not seen a doctor because a summer cold has been circulating, and I really don t feel bad otherwise. Any thoughts...? ### REPLY: You had an attack of respiratory tract infection which may even have gone down to your lungs. Though the infection is cured, you have developed `Hyper Reactive Airway Disease` which is a known occurrence. You should take frequent nebulization with also and decor and take airport inhalers 2 puffs 2 to 3 times a day. You may also take a tablet of doxyphyllin400 twice a day for some time. The symptoms should disappear in due course of time. If symptoms persist despite these measures, you may have to undergo some tests for which you should consult a pulmonologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 brother s scan report shows two 0.6 cms calculi in the right kidney. Creatinine is 1.5. He has been prescribed Oflocure-oz and Stone 1 syrup for five days. I would like to know if these medicines along with the required diet and plenty water, sufficient to get rid of stones. He gets unbearable pain and the pain lasts for nearly 5 hours. Injection also seems to take time to bring in some relief. Is there any remedy for the pain? ### REPLY: Hi, Thanks for writing in to us. Oflocure-oz contains OFLOXACIN and ORNIDAZOLE which are a combination of antibiotics. These antibiotics will treat any infections. Since there is a 6 mm stone in the ureter, it is possible that the stone might go to the lower part of ureter. This can cause obstruction and .  Taking Stone syrup will make the urine alkaline. He might have pain at this time which will disappear once the stone reaches the urinary bladder. When this happens the patient might experience severe sharp pain for few days and require painkillers for some time. Pains can be reduced with painkillers and anti spasmodic. Since creatinine levels are on the higher side, it is important to rule out any obstruction in the passage of urine. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had to have some tests run, because his calcium was low while in NICU. looking at the results his monocyte level is 13.0, when it appears as though, at least according to this particular hospital, should be between 4.0 and 10.0. He also has higher than normal potassium and ionized calcium. Is this something that should be tended to immediately, or just an indicator of a couple higher levels, for some reason? ### REPLY: Hi...very difficult to judge a babies health by just looking at the reports without knowing the babies condition. But I will try to alleviate your doubts - 1. Monocyte level just above 3 more than normal level is not abnormal.2. More potassium level could occur even if the kids arm is squeezed during blood collection of sample.3. Higher ionized calcium depends on the level of the report and clinical condition of the baby.  If you are happy with my suggestion, kindly rate and thanks. I wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 52 male 165lbs . severe elbow pain. progressed over a year period. blood work for rheumatoid arthritis - negative. had mri however orthopedic doctor only reviewed back injury. having weakness in lifting. back ground seizure disorder since 2000 , hairy cell leukemia since 2004, psoriasis scalp. keyboard player, used to be athletic, surfed. ### REPLY: Hello, Thank you for contacting me at "Ask a Doctor". I will try to ad .  There are several causes for elbow pain.  In your particular case, I would suggest initially obtaining a sample x-ray to rule out such conditions as arthritis, loose bodies, bone spurs, et cetera.  If the x-ray is normal.  It is possible he may have something like a tendinitis or sometimes called epicondylitis.  This behaves very similar to a typical tennis elbow. Typical treatment would include the use of anti-inflammatory medication such as ibuprofen.  You can apply ice if the area is tender and painful. Sometimes in these particular situations.  I will try a localized cortisone injection, which is often very successful.  Other treatment options include the use of physical therapy. I would suggest consulting with your doctor again and possibly getting a referral to either a sports medicine specialist or an orthopedic surgeon.  I am sure that they will be able to help you.  Furthermore, I hope this information is useful for you. Please do not hesitate to message me back if you have any further questions.  Thanks again for contacting us. Best wishes, A ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was involved in a car accident over a year and a half ago. I have had surgery once already and really nothing bad was found. I still have a golf ball size swollen place on the inside of my knee. My dr. said the fat pad was inflammed and gave me a cortizone shot right in the pad itself. It has constantly had pain since the wreck but the shot made the pain so much worse. I had another mri but havent gotten the results yet but am in so much pain. Any suggestions to tell my dr. as he said he has never seen the fat pad swell so much and not know why? ### REPLY: Hi, thank-you for providing the brief history of you. A thorough clinical examination is advised. As you have swelling in the knee and is not coming down it could be a fat tissue as mentioned by the doctor. Undergoing physical therapy like therapeutic ultrasound therapy should help dissolve the swelling and post which exercises to strengthen the muscle and tighten the skin will help improve. In my clinical practice such cases respond well to physical therapy regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am considering removal of a synovial cyst on my L4-L5, the pain has become unbearable and miserable and 2 epidural shots have not helped. This is my second time having this, after 3 shots last time, I had 18 months of relief but this time it s worse and I know they will keep recurring. What are the risks and details of surgery and the recovery plan and timing? ### REPLY: Hi there, welcome to , thanks for your question Synovial cysts are fluid filled soft tissue structures which are formed due to degeneration in the joints between bones of your back (known as facet joints between L4 and L5. I. e 4th and 5th spinal bone in your situation). These cysts get filled like a balloon filled with water when you stand or walk and get deflated when you rest or lie down due to decompression like a deflated balloon. Since they lie in proximity to the nerves in your spine, they are associated with pain radiating down the leg, similar to sciatica pain seen with disc herniation During early stages when the cysts are small, the pain can respond to steroid injections which help in reducing the inflammation associated witChatDoctorpression of the never. But once the cases reach a certain size the mechanical compression of nerves become significant and atop responding to injections. At this stage surgery is indicated. Surgical options include only decompression or decompression with fusion with screws. Whether to use screws and fuse or not will depend on assessment for instability of the bones at the involved level by X-rays/CT scan or MRI.However, most commonly most of the synovial cysts in spine respond cert well to decompression surgery wit encouraging results. Hope this answers your question. All the best with best regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 year old hit and bruised all of her front teeth top and bottom about 4 months ago.  Just recently, she will cry when I help her brush because the gum at the base of her two bottom teeth "hurt really bad".  I noticed right at the base of the teeth the gum is white and squishy, only on these teeth.  The tissue almost looks dead.  What could this be? ### REPLY: Thanks for using . Read your query. You have not mentioned in your query, whether she had undergone any treatment after the hit. Was any of her teeth treated? The symptoms described suggests an abscess formed and when pressure is applied in that area is causing pain. I would advise you to visit her periodontist and get a radiograph done to see the position of the teeth and also the abscess.Also, the underlying permanent teeth position is to be evaluated for planning the treatment as soon her permanent teeth will be erupting. For the pain you can give paracetamol as and when required and if required antibiotics after consulting the dentist. Hope this was useful, Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my son who is 2.5yr lod had severe gastric problem and vomitins so when i visited the dr, he prescribed junior lanzol 15m & ondem. later for two or three he was fine, and now again he is feeling nausea....... can any one pls say wat is wrong with his health....... ### REPLY: HI...by what you quote I feel that the KID 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. 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: I have been having pain in my tailbone.  I do not remember injuring it.  Xrays show no fracture.  It was diagnosed as tendinitis.  I take Mobic and Ultram for the pain.  I am unable to sit for very long.  Could there be another diagnosis or treatment? ### REPLY: This is a pretty common set of symptoms. There can be practically anything in the area and MRIs are done to evaluate if there is a growth (blood blisters common these are called hematomas) generally of normal tissue. This can be removed. There can be irritation or fracture of the area this can be ad .  Or nothing is seen. Medicines that damp down nerves like anti-epileptic medications are most commonly used. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has been diagnosed with pneumonia and has been on antibiotics for 6 days now with no noticeable improvement. I just noticed he has two hard pea sized bumps on the back of both arms. Initially I thought they were auxiliary lymph nodes but his physician has said they are too low on the arm and are not nodes but cysts. Is this cause for concern? Is this relevant to the pneumonia? ### REPLY: Hi thanks for contacting ... Pneumonia caused when immunity low. It might be hospital acquired also. Vitamin A deficiency and environment pollution also contribute.... The cyst you have described is not related to pneumonia ... It could be simple benign cyst... It can be removed... If needed FNAC can be taken from it ... Complete antibiotic for pneumonia.... Fruits taken more... 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 wondering why I have another upper respiratory infection?  I was diagnosed with bronchitis this fall and it finally went away after 3 rounds of different antibiotics.  A chest xray was taken and they said it was fine.  Should I be concerned?  It took me almost 3 months to be completely recover from bronchitis.  I am coughing again (not a lot) and have green mucus. ### REPLY: Thanks for your question completely understand your question actually in chronic bronchitis cough will remain either less or more through output if cough with expectoration, that too if sputum is yellow or green or foul smelling that means there is a secondary bacterial infection which happen edit can be associated with other symptoms of fever or breathlessness better to consult a pulmonologist who can start you on antibiotic sit will be better if pulmonologist will send a sputum culture and sensitivity so that if inspire of the empirical antibiotics if cough and purulent sputum remains accurate therapy can be started cough in chronic bronchitis is a mechanism to clear out excess of secretions that is a normal phenomenon in bronchitis that protects airways to get damaged due to retained secretions, which can lead to infections exact treatment for chronic bronchitis is inhaled .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The husband of a client who suffered subdural hematoma at age 16 through football accident, now 60 years old, has been exhibiting impulsive spending,impulsive socializing, anger behaviors, which have increased over last 10 years, culminating in spending and anger behaviors worrisome to his wife.  He was diagnosed with PTSD around,95 and now receives disability payments.  It seems to me the PTSD may have been a misdiagnosis conjured by attorney who helped him with disability re-application.  My question is: would his original hematoma be implicated in his current behavioral problems? ### REPLY: The current scenario depicted by you appears to be a part of mood disorder (likely to be Bipolar Disorder late onset type) where mood fluctuations do occur between depression and mania. Hematoma sustained at age of 16 is unlikely to implicate current symptoms directly however there could be a possibility that he also had some neuronal damage like concussion or minor intracerebral bleed which can manifest later. Sometimes Personality changes are seen in cases with head injury which develop within a year or two of the damage. Here in your description it is not clear whether these behavioral problems started gradually after injury or has been noticed only off late? Nevertheless it would be advisable to get him evaluated with a neuropsychiatric, get an imaging (MRI brain preferably) if not done in recent times as well as monitor for any memory & other cognitive deficits. This could help not only in identifying the cause but also in planning intervention if required. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 29 n married for 10 months. my cycle is 5-6/30 days n regular.according to my last medical report my doctor gave opinion as: non-grand normal size ovaries. both ovaries show multiple growing follical not more than 0.7 on either side. largest follical measuring 1.4 into 0.7cm.:i had taken inj.hmg massone inj IVF. c 5000 tab. Mc levo tab. Follic acid my doctor said that i am fine but why i am not getting pregnant? please help me my husbands report is also normal. ### REPLY: Hi welcome to . I have gone through your question. Your both reports are normal is suggesting "UN explained infertility", I would advise doing follicular scan for next 3 cycles starting from 9/10 day of your cycle and see whether clicked are developing or not. If not then take some follicular stimulating medicines after discussion with your gynecologist. Hope I answered your question. Would be happy to help you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is maria i,ve experience a breathe taking flutter a few days ago. now i experience sudden heatwave throughout my body and a feeling in the chest not pain but uncomfortable. all centralize in the middle of chest. and i keep taking deep breath. ### REPLY: Hello Maria! Thank you for asking on ! I understand your concern, and would like to explain that your chest fluttering sensation may be related to a possible paroxysmal appearance of a cardiac arrhythmia. A careful medical evaluation should be done, including a physical exam, resting ECG, some blood tests (complete blood count, thyroid hormone levels, cardiac enzymes, blood electrolytes level, PCR, etc.). If suspicions are raised a cardiac ultrasound and an ambulatory ECG monitoring test should be done. Only after a thorough evaluation, it would be possible to appropriately ad . Hope to have been helpful! Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: semen analysis report as follows...collection time:12-35PMexamination time:12-55PMvolume:1.02Mllipuedreaction:AlkalineMICROSCOPICactivity motile:10%sluggish motile:10%no motile:80%spermatozoa(TC):10 Millions/MLothers: 10 to 15 pus cells presentwhat does above report mean... plz.. help me ### REPLY: What is your age? Your sperm count is low, and it shows infection as also very poor motility of the sperms. You should get a Semen culture done at the earliest and take a month-long course of antibiotics as suggested by the culture report. Then the semen analysis should be repeated so that a true report without infection can be assessed and then your chances of having a child will improve, if that's what you are looking for. Take care and feel free to ask more in detail. 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: ok so i just found out that i have mitral value prolapse, depression, arthritis in my neck, anemic, vertigo, syncope, diagnosed bipolar, sublaxations in my back, non-epileptic siezures, panic attacks, and anxiety disorder. Now they think i could be diabetic, and getting tested for sickle cell anemia. i need help. what do i do? i stay in my house for fear of falling and getting admitted to the hospital. ### REPLY: Hello! Thank you for asking on ! I carefully passed through your question and would recommend consulting with your attending physician for a physical exam and some tests: - a resting ECG-complete blood count and Hemoglobin electrophoresis- thyroid hormone levels-fasting glucose and HbA1C for diabetes. The vertigo could be related to the arthritis in your neck (chronic degeneration of the cervical column). Anemia can exacerbate all this clinical situation, causing low blood pressure and low oxygenation of the brain cells. So, the main thing to do in this situation is tried a cervical collar, treat anemia and perform a cervical MRI study in order to examine better your cervical spine and rule in/out the possibility of surgery. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 13 and my weight is 33.5kg This is about human intestine worms, more specifically pinworms, 1. Can they be as small as 1mm?(because i keep itching everywhere on my body) 2. If you see a doctor and got the medicine for it, how to you keep any more unhatched eggs around the house or on your clothes from infecting you again?( cause i went to the doctor before and ate the medicine but somehow my itching got back after a month) 3. Is it a bad thing to have worms inside you? 4. Is there a way to kill these worms by eating something not a medicine(something like orange or lettece)?(cause I really don t want to bother my mum again to take me to the doctor after only just a month) 5. how do you keep other people from getting infected in your family when you have them?(I don t want my mum to get the same thing) 6.does doing sports such as swimming kill them off gradrually? ### REPLY: Hi Dear, Intestinal worms such as pin worm and thread worm are small but visible to naked eye. It is their eggs which are too small to be seen by naked human eye. These worms lay their eggs at the anal opening at nighttime and cause irritation, leading to itching. When you scratch the anal opening due to itching, these tiny eggs get collected under your nails and when you eat something these eggs get transferred orally to the stomach where they grow into adult worms and the cycle is repeated. To avoid reinfection, keep your nails closely cropped, wash your hands with soap and water regularly, especially after toilet. Do not insert your finger in . Don't worry your mom will not get the infection. I have no idea of any natural edible substance capable of killing these pests. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 aged 52had ent problem which extended to brain and seizures started she was recomended 100 mg thrice she has been regularly taking for last five yrs. once or twice she forgot to take medicine and she had mild attack of seizures. please advise precautions. ### REPLY: His am . I have read your message. I think I can help you. The symptoms that you have put up in the query-ear infection extending to the brain-can possibly suggest a venous sinus thrombosis or meningoencephalitis. Now these are treatable conditions. But sometimes, it does leave damage behind, and therefore the seizure medicines need to continue. Your wide is taking 100 mg tablets thrice a day. The most like medicine should be phenytoin. If not, please let me know. My advice will concentrate the precautions based on phenytoin (of course, some of them are generalized precautions and can be followed irrespective of the medicine in use). Precautions are as follows-1. Avoid flickering lights.2. Avoid sign boards.3. Avoid blinking lights.4. Avoid  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 endoscope 5 weeks ago and becme very unwell after it with a high temp and cough then two weeks ago I was diagnosed with Bronchopnuemonia in my right lungI was given two antibiotics which I finished last week and steroids which finished yesterday. The cough finally stopped last week but I have a really bad pain in the top on my ribs on the left side and I got a cramp in my right ribs last night ... is this normal after all the coughing or should I be worried? Thank you ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. There are two possibilities in your case. 1. Pain can be due to spread of pneumonia in left side.2. Coughing can itself cause musculoskeletal pain. So better to get done repeat chest x-ray. If chest x-ray is normal or resolving for bronchopneumonia then you are mostly having musculoskeletal pain due to coughing. But if x-ray is suggestive of worsening of pneumonia or new lesions then you may need antibiotic again. So consult pulmonologist and get done chest x-ray to rule out worsening of pneumonia. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My name is XXXXXXX I have these white pimple like bumps on my scrotum. They don t hurt or anything, they don t pop when i atempt to pop them. I have tried lancing them with a sterile needle when i do a puss like substance comes out i have one small cluster of about 6 in a nickle sized area and a few others around the scrotum sizes range the biggest one i have is a little bigger then a pea the others are significantly smaller. ### REPLY: Thanks for asking in  forum IN Short: It is sebaceous glands visible/cystsExplanation: As per your explanation I think you have sebaceous glands visible/cysts with sebaceous secretion within the cyst. You need not worry about this as these are harmless. If you meddle with it, it may get infected and cause problem.  So leave it like that only and if it is cosmetically unacceptable then visit a dermatologist for further help and treatment.  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 neighbor knocked on my door to inform me that my son had pass out...approx 3-4 times.  He was standing talking to him and he pass out approx 20-30 sec.  Came to....neighbor began to walk son home not far less than 20 ft and he did it again about 2-3 more times.  When I open door, son on ground looking up at me dazed.  He refuse to go to DR.  I took pressure 96 over 71 with heart rate of 109.  Giving fluids and feeding.  Also game potassium and asprin.  What else should I do...other than try to convince him to go to DR.  He says hes dehydrated.  Also 32 yr old male, 59, 165 lbs ### REPLY: Hello! Welcome and thank you for asking on ! I understand your concern and would explain that these episode of fainting could be related to different causes. A low blood pressure could be the cause, as the blood pressure that you refer is low. Anyway a careful check-up from his GP is needed to exclude other causes like a possible cardiac arrhythmia or epilepsy seizures. I would recommend performing some tests to exclude the above-mentioned disorders: - resting ECG-chest x-ray study (aorta)- head up tilt test (for orthostatic hypotension)- an EEG (for possible epilepsy)- some blood lab tests (complete blood count, fasting glucose, kidney and liver function tests, blood electrolytes, etc.). Meanwhile, the best thing to do is to give him plenty of fluids and monitor his blood pressure. Hope to have been helpful! Best regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , my 2 years old daughter fell and cut her eyelid horizontaly in the crease and it doesnt seem to stop bleeding... Is she going to need stiches?how ling should i wait , Should i just go to the hospital now? And how can i know if she scratched her eye? I put an ice pack and its a little swollen ### REPLY: Dear Sir/ Madam, Thank you for posting your query at .com Good that you have given her first aid of ice pack. But I advise that let pediatrician see her and examine. If needed pediatrician will divert your to ophthalmologist opinion.  Swelling is due to the inflammation caused by injury. If the bleeding is continuous she may require stitches. Hope she feels better at earliest!! Your vote of thanks is much appreciated!! With 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 had a .5 golf ball size hematoma on the top, close to knuckles on right hand on 2/9.  The week after the trauma it would turn bright red in the evening.(  While making dinner)  Now , 9 days later I have a painful filled sack between the knuckles ( size of Quarter) .  Do I need to follow up with doc? ### REPLY: Brief Answer:You should see a surgeon. Detailed Answer:Hello, Thank you for using . Generally the subcutaneous hematomas after trauma does reabsorb by them selves within three weeks or fewer. The color changes from that of a purplish-blue bruise to yellow and brown as the blood chemicals gradually are metabolized and the hematoma resolves. In case of persistence and organization within a sack, as in your case, then should be done an biography and then should be evaluated by a surgeon. The surgeon will evaluate the possibility to .  As it hurts, may be the hematoma is infected because it is a favorable place for bacteria to grow. You should take some oral anti-inflammatory  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 an achilles tendon repair and spurs removed 5 weeks ago last Friday I fell and felt something snap  . Totally confirmed it snapped in two. I have just spoken to my doctor and instead of surgery he wants to cast it. And see if it works , my dilemma is ins. Wise I am 100% starts over at first of yr. What should I do demand surf? ### REPLY: Hi. Thanks for your query. Read and understood your concerns. Noted that you had a tendon tear and got repaired but to fall. It got opened up. This can be confirmed by MRI. This will decide whether you need re- surgery or cast can help. If you have abdominal pain due to ulcers, it is wise to undergo an upper GI endoscopy. Start on PPI like Omeprazole. Domperidone and an antacid. Soft bland diet. No stress or strain. Get review regularly till both the conditions are cured. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: She woke up with severe pain in the upper left side of her upper neck (at the base of the skull)  initially this was coupled with headaches..about 3 to 4 days...but now at the 5th day headaches have subsided. The pain area is very tender and painful to the touch.   She went to Chiropractor for an adjustment  but it was of no help.Any thoughts ### REPLY: Hi and welcome to . The history of the condition you mentioned is suggestive of migraine, or a cervicogenic headache, which is it being caused due to stiffness in cervical spine due to bad posture. A few simple neck exercises will be helpful, like :1. Chin tuck in exercise, 2. Side stretching neck exercise3. Side to side rotations be done frequently, with minimum of 5 repetitions spread 3-4 times in a day. During the headache avoid, lights and music, this may aggravate the headache. Instead, make a towel roll and place it under the neck and lie down for a few minutes, try to gently press it in between for a hold of 10 seconds.DOTS:Lie in prone position, it effects the cervical spine curvature negatively, leading to more stiffness. Physical therapy will prove more beneficial than Cairo in this regard. I hope this information is helpful to you. Take care and have a nice day :) .  ### END