Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had abdominal pain during the night quite strong, which I needed to breathe through.  I thought it may go away but still persistent, at moment a dull pain continually.  Dont feel hungry, feel bit chilly, when stomach pressed by me it does not hurt.  I thought perhaps appendicitis, but dont want to waste the hospitals time if nothing to worry about. Im 64years old, female, ### REPLY: Hi and thanks for the query, Abdominal pain, especially when experienced only at night is generally from gastroduedenal ulcers. Gastritis of stomach inflammation occurring mainly at night, or in the early hours of the morning are every characteristic of this condition. This is because there is excessive gastric acid secretion at night and early hours of the morning. It might be useful to get tested for Helicobacter Pylori, a bacterium known to cause this condition, and to get a microscopy done to better ascertain the state of your stomach. This shall guide your doctor in either instituting a treatment or doing further tests. In my opinion and experience, the above propositions could be a good starting point. Thanks and hope this helps. Kind regards.Bain LE, MD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i cut my calf muscle from side to side. about half the muscle was cut. it happened 2 weeks ago and i have just started to walk on it. I don t have the money to pay for physio but wanted to know what exercises are the best to do to get my leg back to being operational. ### REPLY: Hello, As I would like to know if the wound is healed. If healed now what is the status of the movements of the foot. Are you able to move the feet up and down easily along with toes? If so then doing gentle massage over the wound region to make it flexible. Slow stretching of the calf muscles and strengthening exercises of the thigh and leg muscles should help. 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: my husband is experiencing a pulsating blood pumping, twitching feeling under his left rib.It does nt hurt. We were kayaking over the weekend,so could be a strain. He is 45 and his dad died in his early 70 s of a AAA. Should we be worried? going for physicals 12/28/16 ### REPLY: Hello, Your husbands symptoms could be related to local inflammation or infection. Considering the fact that he has been kayaking, a strained muscle cannot be excluded.  Coming to this point, I recommend consulting with his attending physician for a physical exam, a resting ECG, a chest X-ray study and some blood lab tests (complete blood count, PCR, ESR for inflammation).  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 am having internal fever more than 1 year . It is the condition where i feel cold in feet and hands. an unsual exp. since one year . now after one year i started feeling weakness also and feel like falling down sometime.pls advice with this regard ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you are suffering from continuous internal fever since 1 year which seems to be due to viral or bacterial infection. It is due to poor immunity of your body and increased susceptibility of getting infected. Need not worry. I would suggest you to visit general physician once and get it examined. You should get blood tests redone and start treatment after proper diagnosis. You should start treatment after complete diagnosis. Take diet rich in fresh juices and fruits.  .  You should take anti-allergic medication along with proper course of antibiotic along with Ibuprofen. Do tepid sponging as well to lower down fever. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am suffering from TB infection. My treatment is going on and its is for 6 months. My treatment started in may 2011. I would like to know that is it Ok to have sex and kissing during this treatment. AsI dont want spread it to my better half. ### REPLY: Thanks for your question on . I can understand your concern. In the initial part of tb treatment, patient is infectious. So better to consult avoid sexual intercourse and close physical contact like kissing with your better half in first two months of treatment. After two months, patient usually improves symptomatic with reduced cough, improvement in chest x-ray etc. So patient becomes non-infectious after 2 months of treatment. So if your cough is reduced, appetite and weight are increased and x-ray has improved then you can definitely do sexual intercourse and close physical contact like kissing. 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: hi, iam lakshmi my eosinophils are 498 in absolute count and the normal range is 40-440 and basophils are 0. this should be a cause of concern. according to pft report i have asthema but my chest was always clear. suggest me some test for clearing my doughts. ### REPLY: HI, do you have any symptoms like shortness of breath, forced respiration, tightness of chest, wheezing and coughing, bronchoconstriction released by bronchodilator like albuterol, these symptoms may be present throughout the year in reduced intensity and aggravate in special situation, or they may manifest themselves only in special situation like after moderate or severe exercise, cold weather, exposure to smoke, air pollen or fumes, formaldehyde, cigarette smoke, or even house dust. These symptoms with suggestive PFT IS HIGHLY INDICATIVE OF ASTHMA, and if these symptoms and also PFT results improves with bronchodilator (albuterol) inhalation then it almost confirms the diagnosis. Even though for your clarification you can go for methacholine challenge test, chest X RAY, complete panel allergen test, and albuterol response test.I suggest you to avoid those conditions which precipitate your symptoms, have regular spirometry to follow up this condition, take your . Wish you all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir, My penis size is 3-3.5 Inches while its fully erected. I had sex with my girlfriend and soon we are getting married. firstly the erection is not good. 2nd size is small which doesn t feel pleasure and my girl want to make it big with good girth. So I request you to please suggest me what to do to increase penis size and girth size. Thankyou In advance. Hoping for your early response. ### REPLY: Hi dear. I had gone through your query. Sorry to say it is not possible in any mean. Be realistic. Can we increase size and girth of our finger?? It is god gifted and no treatment can help. Yes there is a treatment for good erection. Medicines like sildenafil/tail can help to maintain good erection. You both require mutual understanding and acceptance that you have.3.5 inch is a good size for penetration and female vagina is highly sensitive up to 3 inches. You can make her more excited by manual or clitoris stimulation. Feel free to ask. Accept the fact and enjoy. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i drink 20 oz cup after cup of water. here lately i pee very little twice a day. i have had a uti for a year now, and my creatinine level is 1.7 high, gfr is 33 low, and alkaline phosphatase is 139 high. i know they said i have kidney deasise but from what ive read this is and means im at the end of renal fuction ### REPLY: Hi, welcome to ChatDoctorLooking to your history, it seems that you have Persistent UTI. It requires evaluation regarding the site if infection and name of organism. Do basic urine report with culture, s.creatinine, and Sonography with post void residue.GFR varies according to age, gender and other parameters. Evenif your GFR is 33 ml/min, it is not end stage(GFR Consult your nephrologist and try to find out the cause of low GFR or you can get back to me with above reports. Persistent UTI require prolong antibiotic course followed by sometime suppressive prophylaxis therapy. I think this would be helpful to you. Best wishes. TC. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 discovered a white pea sized soft lump right inside of my anus. In order to see it or feel it, I have to squat. It is not painful, although I do have itching. I can touch it and it is very pliable since it comes away from the skin. I thought it to be a hemorrhoid, but when I discovered that it was white, I know it cant be. I am a 41 yr old female with two children ages 6 and 12. Married for 18 yrs. Lump discovered 2 or 3 months ago. ### REPLY: Hi, dear thanks for the query to my  virtual online clinic. My diagnosis-Recto-anal polyp-as its painless and pliable.It's not hemorrhoid even or sentinel pile. Treatment-a-Surgeon would do bronchoscopic diagnosis and, b-needs Surgical Excision, may be on OLD basis, in your case with ligation and biopsy study of the lump.Don't worry and act fast. This would solve your worrisome query. Hope this would solve your query. Wellcome to my  clinic once again. Have a Good Day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi how is it going? My name is Isiah,22 years of age and a male; I recently start having pain in my right middle finger, it hurts when I squeeze it, or even if I brush up against something by accident. on a scale 1-10 I would say 9.5 for sure. I don t see any color s showing that its bruised but the pain is there. Ive had it for about 2-3 weeks now and it has not gone away, I have also tried icing it and it still hurts.. any idea on what it could be? ### REPLY: Its probably arthritis of middle finger taking place and some unknown trauma is also having some effect which causes pain in brushing against something. Any anti-inflammatory and analgesics 1s.o.s. dose is generally given to such of my patients. Additionally, to evaluators of herbals, I give turmeric powder to .  They get rapid relief because turmeric powder is a natural anti-inflammatory, analgesic and bacteriostatic. Hope you will get benefit of it. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir. Im a wheatish 23 year old female. Im planning to take laser hair removal treatment since I have excess hair growing on my chin and upper lips. I want to know how safe it is. Im gonna get this done by a dermatologist. Will it have any side effects? Will the exposure to these rays give rise to any type of cancer? And how many sittings should I take? Is it permanent? ### REPLY: Hello and welcome to ChatDoctorLaser hair reduction (LHR) is a very safe and reliable way for hair reduction. Apart from mild redness after the sitting which usually resolves in 1-2 hours, there are really no side effects at all, if done by a well-trained/experienced expert. Laser light used for hair reduction is not associated with an increased risk of skin cancer Or any internal malignancy. Normally 6-8 sittings will give you a good hair reduction. The hair will become finer, the density will decrease and thereby greatly reduced. It is the FDA approved for hair reduction and gives long-lasting results. Prior to LHR any underlying hormonal abnormality if clinically suspected should be confirmed by a lab test. Eg--Serum Testosterone--Serum RHEAS(Dishy .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have what feels like a lump in my hip felxor, pretty much in the crease between lower abdominals and top of the quad. One on the right hip is slightly larger than the one on the left hip, and are not in symmetrical positions. When I press on either one they move around slightly, and no real pain just minor discomfort. It almost feels like a knot in a muscle. What could these be? Should I be concerned and should I seek further medical advice? ### REPLY: Hi, Dear,Welcome with your query to . Studied your query in full depth of its details. Reviewed it in context of your health concerns. Based On the facts, You mostly seem to suffer from-Lymphnode enlargement in the groin / or could be from Lipoma. Any other causes of such a lump would be more evident after physical and clinical assessment of your lumps in that region. X-ray / USG / CT study would help you out in fixing the cause and nature of such a lump. Surgeon and if need be ortho-Surgeon would help you out in this work up. Hope that, This reply would help you to plan further treatment soon with your treating doctors. Best of Luck and early recovery. Welcome any further query in this regard, which would be replied in next session. Good Day!! . N. Senior Surgical Specialist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: good morning. i am Cecil Comonsad, i had an x ray result a few days ago it was a minimal fibrosis, i had an employer at K.S.A. but i am not fitted to work there, is there any treatment i can do or is there any other country that i am fitted to work even if i had a minimal fibrosis? please help me... ### REPLY: Hi, Welcome to health care, Oxygen therapy is the mainstay of treatment in minimal fibrosis. Other that there are some new medications like pirfenidone which may help but the other associated conditions like pulmonary hypertension also need to be treated. Inhalers, physiotherapy, vaccinations etc. help in supportive management. You may consult a Pulmonologist regarding the feasibility of above options in your case. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 doctors, i am rajani, my last MC date was 15th December 2010, every thing is going fine under treatment of my doctor. medical background- already faced many tine like Anemia, typhoid, and jaundice and thyroid(all of these were before marriage). currently doctor told me to take altroxin 150Mg, calcium 100, Ferium XT iron zintec(for some gastic problem), GRD, and vitamin syrup.I am felling pain in my back bone, small pain in stomach, baby area stomach is very hard, and also notice some white liquid with some small particle from  my vagina. is this symptoms of labor? Please let me know what are other labor symptoms.ThanksRajani ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I jaundice is usually sign of certain liver disease and high bilirubin value.  Causes of jaundice vary from non-serious to potentially fatal. High bilirubin may be due to liver diseases such as cirrhosis or hepatitis, infections, medications, or blockage of the bile duct In the developed world the cause is more often blockage of the bile duct or medications. Blockage of the bile duct may occur due to gallstones, cancer, or pancreatitis. Medical imaging such as ultrasound is useful for detecting bile duct blockage. Treatment of jaundice is typically determined by the underlying cause. If a bile duct blockage is present surgery is typically required, otherwise management is medical.[Medical management may involve treating infectious causes and stopping medication that could be contributing. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good evening, I am contemplating going to the er. I have numbness in my left arm and fingertips. it feels like my arm and fingers are sleep. The right side of my face is swollen and bruised. I am short of breath and my heart feels like it is going to come through my chest. I also have a dark tongue and it burns so I have no taste to food? Not sure what is going on? ### REPLY: Hi welcome to . I understand your query and concern. Congestive heart failure has poor prognosis in all cases if the ejection fraction is under 30%. The overall prognosis in your sons' case is marginal since Duchess muscular dystrophy leads to respiratory complications affecting the cardiac output.It's always advisable to keep the blood pressure under 130/80 mm of Hg. Avoid overt treatment to prevent lightheadedness, for this I advise you to have a baseline 2 dimensional echocardiography, ECG,HS CRP and lipid profile to assess the basic cardiac reserve of your heart. Restrict the intake of salt to less than 6gm/day. . Reduce the intake of fatty and fried food. Oatmeal for breakfast 30-50 gm taken in milk daily will clear the accumulated fat. Avoid smoking and alcohol. Semiannual follow-ups are advisable on maintenance. Once the above measures are carried out, good survival can be expected. Consult a Cardiologist for further expert management. Post your further queries if any. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i m a caregiver for a woman with psp. She rarely speaks now but occasionally laughs and sometimes smiles. when she eats or drinks she sometimes coughs and I worry about aspiration pneumonia. I have some general experience but no formal training. I don t know how to help. Can you make suggestions please? thanks ### REPLY: Thanks for your question on .  I can understand your concern. PSP is progressive supra nuclear palsy. It is cerebral disease. And this can cause diminished gag reflex. So possibility of aspiration is high in such patients. Your patient is also having coughing during eating and .  This is suggestive of aspiration more. So your patient is at high risk of aspiration pneumonia. Better to feed him in sitting position. Avoid further feeding if he develops coughing. Nasogastric tube feeding is much safer in such patients. This reduces aspiration and chances of pneumonia. So discus all these with doctor and plan accordingly. Hope o have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, I was doubtful about the my unprotected sex last night want to take postinor 2,i already took the postinor 2 two times ,one is 4 months back and the other one is a month ago.And I recently(2 months ago) undergone surgical termination of pregnancy.Now,again can I take the tablet.My question is that taking postinor 2 multiple times in a year will effect my further pregnancy? ### REPLY: Hello dairy understand your concernPostinor 2 contain high progesterone. You have used Posting so frequently in one year and also undergone medical abortion. It causes hormonal imbalance, ovarian hyper-stimulation, menstrual irregularity infertility issue in the future. So I would suggest avoiding excessive use of the posting 2. Use it only for the emergency purpose. Use barrier contraception like condom and diaphragm regularly to prevent the pregnancy. If you did sex in fertile phase of the cycle then only take posting 2 last time. But in future avoid posting avoid stress, take healthy diet, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: long time now, I get severe upper middle chest pain, whne I walk few yeard keeps on increasing as I co9ntinue walk pulse bit rapid, WHEN I sit for a few miniutes it goes down gradually agin if I waqlk it comes back severe NOT HEARETBURN, MY HEART OK says Cardiologist, gastyro entrologist suspect GORD or to do endoscopy of isophagus SOMTIMES pain comes WHEN sleeping I do jogging in the morning NO PAIN COMES I BURP a lot whne I get up from bed after meals NO OTHER symptoms BLOOD pressujer ok controlled by ATENOLO NOTEn onme tablet a day even sinujs tachycardia controlled no diabetic NON smoker Non acholic WHAT coulfd this mystery CHEST PAIN BE very long Whne I ehert or WALk setlles down if I REST for 5 min or so sometimes very severe feels panicky nervous about this pain DOES NOT settle for nitro lingual spray PL ADVICE ME I am 77 years a male pensioner I do qwalkinga lkittle with difficuly becos of this PAIN COMING always have normal sex life sometiomes END OF SEX pain comes ### REPLY: Hi, I cannot say in your particular case, but generally, you'd have a stress test to evaluate for angina. Possibly with nuclear studies. Then, some other possibilities is esophageal spasm (but nitro almost always works WELL for that). Reflux and of all things diaphragm or upper stomach spasm and metoclopramide might work. Oh, you'd want to check for aortic aneurysm, although it is a bit of a long shot. But you have to rule out cardiac origin. I hope this answers your query. I remain at your disposal in case further medical assistance is needed.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 28years old n been married 4years. no children.had myomectomy on dec4.  on march15 i got my  date. on 9th day ie(23/03/11)went for FOLLICULAR STUDY report was rt. overy 8*8mms, lt.overy 10*10mms , endometrium 6mms on 11th day ie on 25/03/11 rt. overy 8*8mms, lt.overy 10*10mms , endometrium 6mms whap happens if endometrium does not increase? if it is same even on 14th day also what should be done? ### REPLY: Hello, No, an increase in the size of follicle indicates that the ovarian function to produce eggs is not occurring as it should. The endometrial thickness on day eleven at six mm is okay. You need further evaluation by FSH levels or AMH levels regarding your ovarian function. The FSH test is done on day two of the cycle. Also, I would like to know if your mastectomy was done laparoscopically or open. And if the uterine cavity was opened or not. As these could affect the pregnancy. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i want my body  feels like heat not fever specialy back of my head and slight faint like doctors said that you have no problem but weakness but its long time now from last 1 and half month this problem is going on the body is not feeling fresh joint specially both knees are paining. ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern, this is a functional complain and some psychological elements plays the role behind this, you need to stop thinking about the bizarre ideas, in such cases I initially try "Tranquilizer" and this gives excellent result, but important is you need to keep your stress level low, and the best option is" Tab Chlordiazepoxide three time in day" hope this information helps you, have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a very small, non-itchy, pimple like bump right in between the side of my shaft, and my scrotum.  It was like a white head.  It popped very similiarly to a pimple.... sorry to be gross.  It is not at all painful, but it does scare the hell out of me.  It did leak a very tiny amount of blood.  There are no other "pimples" like it, and there are none directly on the shaft of my penis. Should I be worried about Herpes? ### REPLY: Thanks for posting your query to . As I understand this bump are probably SEBACEOUS CYST, as these are commonly develop in this area. You don't need to be worried as it donor cause any harm. But you need to be careful as pressing or rupturing it can introduce infection so don't try to break it or press it. If they are bigger or multiple you need to consult to general surgeon for its surgical excision .hope this information will be sufficient for your query .rate me if you are satisfied with my answer .feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m sitting here at my desk, typing on my laptop and it feels like palpitations all over my upper body. I had a holter moniter done a few months ago which had no serious results. But the palpitation feeling is frequent and has been since yesterday. I m very concerned as I am a cardia patient. I noticed that I have been vomitting alot lately when I eat something that doesn t agree with me. Could this be the cause. I do drink coffee and tea, but never had these symptoms as severe as they are now. ### REPLY: Hello Thanks for posting here. I have gone through your description. Since a holder done months back is normal, a heart arrhythmia issue is less likely. I recommend you to get your thyroid function tests done. Thyroid abnormalities can cause symptoms like palpitations and. Irregular slow or fast heart rate. Also get your it D levels checked which can also cause palpitations. Wishing you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , 3 days ago I was given a TDap shot. The first 2 days, I felt sore on my right upper arm and could hardly lift my arm. Today, I noticed a lump on my supraclavicular lymph node and its sore and tender to touch. Could this just be one of the side effect of the shot. Before I was given the shot, I had a cold which i got from my husband. ### REPLY: Hi. Thanks for the query. . I have gone through your query and can understand your concerns. As per your complaint swollen lymph nodes that are tender are most commonly indicative of infection in the body and mostly tender lymph nods indicates infection. As you have also got a TRAP immunization it can also be a cause as at times immunization can cause symptoms of fever and swollen lymph nodes as they are antigenic components. . If the lump is painful you can give him anti inflammatory painkiller like Ibuprofen and also a short course of antibiotics can be advised after consulting a local physician or emergency service. You should wait and watch for a period of 15 days and if in this duration if the lymph nodes starts resolving its fine but if it does not, you can consult your physician and get evaluated and a biopsy /FNAC can be diagnostic and can be treated accordingly. . Hope this information helps. . Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? Please type your query My 8 year old was hit in the head with a baseball bat. It immediately had a knot, no bleeding. He seemed fine and has been since. Tonight, I noticed a bald spot where he hit his head. Should I be concerned? ### REPLY: Hello dear, The knot formation in head after injury is due to accumulation of fluid & blood, and it is called Hematoma. The blood cells accumulated are eventually broken down and absorbed in the body. But this is a slow process & takes times to disappear completely. Till that time, symptomatic relief is obtained by analgesics preparations, ice compression & adequate rest. If it still persists or there are any other associated symptoms like fever, vomiting, loss of consciousness, convulsions, etc...then it will be better to consult his Pediatrician. Under such circumstances, a proper clinical+ radiological evaluation will be needed to rule out any pathological cause for symptoms. Till then, maintain adequate HY . There is no need to worry, he will be fine. Wishing your son a 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: I have blood collecting under the nail of one of my big toes. There has been no trauma, nor injury. I first noticed it when I trimmed the nails, and then then it began oozing coagulated blood brom underneath. No, I did not cut the flesh, other than trimming back some dead tissue left from dead fungi tissue. Thank you for your time and Information. Ray ### REPLY: Hello, Bruises are nothing but a collection of blood that develops after minor trauma. Nothing much to worry as it will settle by itself even without treatment. As a first line of management you can apply ice-packs for symptomatic relief. Also, you can take anti-inflammatory . If symptoms persist, you can consult an orthopaedician and get evaluated, in that case you might require an MRI scan to look for any small fractures. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband who is allergic to cats, decided to pet one today only for about 15 seconds. I have him a wipe that I keep in the car and he wipes his hands off right away. However within 15 min his eyes were very red and itchy. When we got home he washed his hands and flushed his eyes. He went out to blow leaves off the drive when he came in the sclera of one eye was so swollen it was hard to close. Should he go to ER ? Or cold compress it? ### REPLY: Brief:Detailed:Cellophane You for contacting . Welcome to . I am . According to the history, the description of symptoms you gave, and the course of events that happened lately.In my opinion your husband got allergic reaction by coming in contact with the cat, this reaction also caused edema and redness in his eyes. Yes you have to visit an ER for that, they might want to give him a shot of antihistamine or steroids or both. At home, you can get OTC antihistamine like clarity 10 mg and take it, but for allergic flare up I would suggest you to visit an ER. I would suggest you not to panic this thing is very treatable and can be controlled easily, but even in future your husband has to stay away from cats if he is this much allergic to them. Stay blessed. I Hope this answers your question, if your have more queries feel free to ask, I will be pleased to alleviate your concerns. Wish you the best of 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 too much pressure in my heart and had an arteriogram and the dr said too much pressure and is sending me to the pulmonary dr for medication. I do not understand how this is going to help. I get completely out of breath from doing anything as walking up the stairs or even when I am cooking. My diagnosis is pulmonary hypertension. I do not consider myself as having high blood pressure when it runs 119/60 sometimes will go up to 130/70. ### REPLY: Hello, Pulmonary hypertension is different from systemic hypertension. The blood pressure which we usually take is systemic blood pressure or left sided pressure and pulmonary hypertension is right sided pressure, which can be measured by echo and angiographies. Usual cause is lungs problem leading to this. So probably your lung has some disease which is causing this and your symptoms. So need to be diagnosed with lung disease and its treatment accordingly. Also, for Pulmonary hypertension, you will probably be started on Tab tadalafil, ambrisentan etc. Hope this helps 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, i recently have an x-ray for employment medical reqirements. The result was Minimal Koch s infection, left upper lobe. I asked my Doctor if i need to take any medication, but he said that no need to take medicine, really i have a cough that time. He told me to return after 6 months for another X-ray. Can it affect my application for a job? Thank you. Please help me. ### REPLY: Hi Thanks for such delicate question. I want to tell you that if once TUBERCULOSIS develop in the X RAY, it will remain there forever and these are actually fibrosis (calcified healed lesions or scars) old scars. It will remain for life long, sorry to say, but this is for whole life. I don't know it will affect your job or not because now these are healed lesion i.e. practically you are not a tubercular patient, but you were a tubercular patient in past (appeared in X RAY). Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a chest infection, with a temp 0f 40.5 that didnt go down all week last week. On saturday my temp went down but I have lost my voice completely. I havent been able to go above a whisper for 5 days not and im wheezing when I breathe. I sthis normal? ### REPLY: Hello, Welcome to . I understand your concern. Not able to speak loudly is due to swelling of vocal cords. This may happen due to many reasons like infection, overuse of vocal cords or allergy. In your case, you have already mentioned that you have had chest infection with high fever. I assume you are already on some antibiotics and if so, this should go away in some more days. If you have not already started antibiotics, then I advise you to consult doctor and start a course of antibiotic along with chlorehexidine gargle and lozenges. You have also mentioned that you are wheezing while breathing. This may be due to swelling or narrowing of air tubes. Your chests need to be auscultated to differentiate between them. If there is narrowing than you should take bronchodilators like albuterol along with steroid inhalation. In case of swelling due to infection, a course of antibiotic will be sufficient. Hope this will be helpful. 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 names emily and I m 18... for the past year I ve been irritated to anoying little sounds like if my tap drips or my fridge making a noise or if its windy outside or if something creeks I get these feelings: tingling, emotional angry or crying, grind my teeth, my heart rate increases, I get hot ETC... how do I stop this its just getting worse... what is this called? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Anger is a negative emotion, and we should learn to avoid those incidents which gives us negative emotions. Body bio changes do occur during emotions and those changes during negative emotions are harmful for the body. Therefore, please understand those incidents which gives you anger and either avoid them or change according to them. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Recently I broke out with a rash, that followed the presence of skin eruption, and papule/blister like condition on my skin, especially my torso.  Doctors initially thought this was due to allergies, and allergy testing did show signs of inclreased histamine, and increased Ig E.  I was treated with three doses of cortisone injections.  Condition has not gotten better. What else could be causing this problem. ### REPLY: Hi, There can be multiple of possibilities of the recurrent rashes. You have not mentioned your age, sex and occupation in your history so that I would have helped you better. After reading your history I can tentatively make a diagnosis of allergic rash turning into blister. You search for any specific cause before its development. Take a course of antibiotics such as ciprofloxacin or CEA .  Do not pinch, pop or squeeze the area. Give proper rest to the affected leg and keep it raised. For pain part you can take tablet paracetamol or diclofenac two times. If at all it is recurring then can meet specifically a dermatologist for best possible diagnosis. 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 me and my husband been trying to get pregnant and everything on my part is good, and dr even put me on fertility to up our chances, heres the thing. My husband is 45 and never got anyone pregnant and did not even use condoms, of course I made him get tested when we got married over a year ago. Im 22, and my dr said everything with me is good. We been trying and I noticed my husbands sperm is kind of clumpy. Is that normal? He does think he might have low sperm count but does not want to check it out something about his man hood. Anyways, do u think its low sperm count? He also smokes a lot and drinks once in awhile. ### REPLY: Hai, Definitely low sperm count will lead to infertility. Sperm count can be done under laboratory investigation only. By seeing a seminal fluid we can't assess low sperm count. As per your quote your husband lifestyle indicates more chance of infertility. Because smoking and chronic . We need your husband semen analyzed with that report we can have a clear status of his reproductive organ (testes and other related organs) functional level. With that report kindly consult an infertility specialist for further treatment. Thank you Hope I answered your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good Morning to you all, This is re-my mom, diagnosed four years since,with chronic liver disease and portal hypertension,Spleen enlarged to about 15.9cms,gall bladder epidematous,both kidneys are normal,pancreas are normal,intra hepatic vascular bilary radicals are normal ,portal vein patent,no evidence of focal leisions in the parenchyma,Liver apprears hyperechoic and coarse with irregular surface.Span: 10.9cms, ascites.At times irrevlevant talks. Like to have enough of food but unable.At preset admitted to a hospital just a day before.Already on im inj.maxipime antobiotics.I would like to have your good advice on this subject.Anything to do in medical sciences? ### REPLY: Hi, I am so sorry to hear about your Mom. Your mom is presenting with features of Liver cirrhosis and portal hypertension with hepatic encephalopathy (ire-relevant talk). Liver cirrhosis is divided into two stages clinically 1. Compensated - where the patient has cirrhosis but absolutely no symptoms and 2. Decompensated - (your Mother) where symptoms of liver disease begin to appear - like jaundice, ascites (fluid in the belly), venereal bleed (omitting blood) or hepatic encephalopathy (irrelevant talk, sleepiness). Most patients with early decompensated cirrhosis can be managed with medications which includes blood pressure pills to prevent bleeding, water pills to prevent fluid accumulation and lactulose to prevent encephalopathy. But as liver disease progresses, it becomes more and more difficult to manage the symptoms and at this stage the best option would be to proceed with a liver transplant. This will not only remove all problems associated with the cirrhotic liver, but also replace it with a new healthy one. Of course Liver transplant is not offered to everyone and will depend on multiple factors like age of the patient, cause of liver cirrhosis, social support of the family and so on. Hope this helps, and please do not hesitate to contact me for further details - rxsuresh@gmail.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was curious to know what could cause burning sensation in the knee cap. I have not injured the knee in anyway. I don t have difficulty walking. The burning just shows up once in a while meaning I could go days with no problem and when it happens it may only be a few times in that period. Any thoughts on this? ### REPLY: Hello, The symptoms seem to be related to patellar tendinitis. It is an overuse injury of the tendon that connects the kneecap to the shin. It can cause burning and pain in the front of the knee. I suggest using anti-inflammatory medications such as Ibuprofen to relieve the burning sensation. If the symptoms continue, I suggest seeing an orthopedist. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 69 years old and had my gall bladder removed last October. All of my enzymes are now in a normal range except my GAMMA GT which was 831 last week and I have constant itching all over my body. I had an endoscopic exam of the duct to make sure that there were no residual stones which was negative. I do not drink or smoke. Please tell me why my GAMMA is soooo high? ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. Possible injury to liver parenchymal or hepatic artery, but it should be established by doing MRCP for retiring possible lesions. Also, high GGT may be caused by alcohol intake or certain medications, so these should be considered as well. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have swollen Lymph nodes, I have had this for the second time. First time they took one out and found it was normal, but not normal. ??? My symptoms are, Hot spells especially at night, not assoiated with hot flashes, extream fatigue, pain in lower abdomine that travels any time any where, worse at night. Nausious all the time especially after eating, over weight and can t loose weight even though I eat almost nothing. I do eat healthy, veggies and fruit don t seam to trigger it any different than any other food. I have seen a few Drs and am to see a colon specialist on the 4th. My nodes started swelling last night making it unbearable to sleep. worse ones are in abdomine. Last time I went to the hospital they did basiclly nothing, the meds they gave me made me sick. There has to be a reason for this. No one seams to be able to or want to help. Any ideas? ### REPLY: Thanks for your query at ! I am Infectious Disease Specialist! I went through your query! There are various causes of lymphadenopathy (Viral, bacterial, tubercular infection), lymphoma, leukemia, etc. You need thorough examination and set of investigations(ZN stain from FNAC and cytology) to come to diagnosis whether viral, bacterial or tubercular in nature. In your case as you have evening rise it is likely "Tubercular" in nature pulmonary or extra-pulmonary. But I recommend take a course of antibiotic for 2 weeks to see if it resolves before you get investigated for other causes. You will need antibiotic prescription. Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a long history of chronic sinusistis, I even have had septum and sinus surgery before, but my level 4 allergies to dust and pollen are too much and I wake up every day with vacuum headaches. I feel like there is a constriction and weight above my eyes causing bad headaches, dark circles , eye strain, etc. I am currently taking asterpro and mucinex. I just purchased allegra but historically those one-a-day allergy pills never worked for me too well. ### REPLY: The latest research is that dust, pollens increase all allergies the food is the culprit in these Caesar get your allergy test done for specific antibodies for milk, egg,rice, wheat,potato after you can start sublingualimmunotherapyman time you start tab metro 200 MGM daily tab flunarazine 5 MGM night tab montage FX twice a day no steam you can add spy tosses 1/2 SF BDD for 3 weeks post after with results ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Doc Just need to fine out whether I can use autrin and ferritin capsules 2gether as I was 28weeks pregnant low iron doc only put me on autrin 5weeks after @ my 33week app. So my baby passed on still birth @ 35+ weeks! Plse which 1 is best as I had a C-section on 1 march 2014! Still feeling very tired though! I m anemic now! Plse help. ### REPLY: Hallow Dear, During Pregnancy, you need to consume iron preparation. As it is during pregnancy, the blood gets diluted. Moreover, you mention that you have iron deficiency. Iron deficiency makes you anemic. Anemia during pregnancy makes the pregnant woman prone to many complications like weakness, infection, intrauterine growth retardation, excessive bleeding after delivery, after delivery infection, etc. Hence, even a non-academic woman also needs to take iron during pregnancy. Moreover, you are due for Cesarean delivery. So you should build your hemoglobin and make yourself fit for surgery otherwise you may require blood during surgery. Even anesthetic complications are also common in anemic patients.  The iron taken during pregnancy in part goes to the baby in the uterus giving the baby also iron storage. Autumn and Ferritin - both are good iron preparations. They are not only safe but are essential medicines during pregnancy. You may choose either of them. To achieve best results, please take these tablets about half an hour before the food. Iron absorption is best in acidic medium. Please do not take any antacids. They hamper the iron absorption. Along with the iron, please take good high protein diet as it is required along with iron to form hemoglobin. Please continue taking these tablets even after the delivery till you are breastfeeding your baby. I hope this helps 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: it is my uncle who is 50yrs old and admitted in gurunank hospital ranchi.he was given medicines for malaria and typhoid but wen the treatment was on he behaved a little abnormally. he was admitted in de hospital on 13th while the fever was from 5th. now from the ct scan dr.s have given different opinion about the brain scan. some say its menegitis while other say its viral fever and some say its a side effect of the high dose medicine he had. his situation is critical but dont knw wat treatment is on. kindly revert as to wat to do in such case. ### REPLY: Hello, The condition which you have mentioned are all possible with your uncle. High doses of medication can cause confused and agitated behavior. But this is usually short-lived. Meningitis is a possibility if he has continuous fever, headache, neck rigidity. Meningitis can be better detected in MRI of brain and not CT scan. You yourself can read the BRAIN SCANS report or ask your doctor to explain to you the details. The treatment for typhoid, malaria and viral fever are all different. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a golf ball sized lump in the right side of my groin, where the leg and the pubic area meet, it has been there for almost a week. The past couple days I noticed my pubic bone area has been tender and now seems to have a swollen vein that goes to the clitoris. I was wondering what this could be and if it needs to be treated by a doctor? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some mass or hernia.  It can be easily differentiated by examination. If it is hernia then you need surgery like meshplasty. If it is mass then you should go for fine needle aspiration cytology of that lump. It can be benign or malignant lesion.  Then you should take treatment according to your diagnosis. 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 . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: when situations get extremely formal,i start stammerring...when i fear i start stammering...i always set my mind that i wont stammer,ill be confident when i speak to an unknown person or a person holding a lot of importance...but most of the times i stay fumbling over words unable to make a fluent speech. can you suggest me something by which i can get rid of this problem? ### REPLY: Hi. Thanks for the query. Do you fear the possible scrutiny by people in authority in formal situations? Do you become too much cautious about how you look, ?  In these formal situations? If answers to these questions are yes then you are suffering from social anxiety disorder or social phobia. That is your real problem is NOT stammering but excessive fears of unwanted scrutiny by strangers, superiors etc. in formal situations. The treatment for social anxiety consist of behavior modifications, cognitive behavior therapy, role play, guided imagery techniques which are taught by psychologist & anxiolytic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a friend who is going thru a stressful time. His best friend was in an accident & may die. He has been visiting the hospital & spending time with the friend s parents. He says hes trying to be strong for them but that he is a mess & will go to therapy next week. What im curious about is that he says he cant talk without wanting to vomit . I have had anxiety attacks etc & I have never experienced this nore ever heard of it. Any idea what could cause it? He has told me that he used to be very anal. (His words) he has also said he has OCD . ### REPLY: Hello and welcome to . Thanks for your query. I'm sorry to hear about your friends difficult situation. I hope his therapy helps him to manage his stress. Now, regarding your question, anxiety can manifest itself as psychological as well as physical symptoms. The physical manifestations of anxiety can vary widely and can literally present with symptoms of any system in the body. Moreover, when the mind is anxious / in a state of arousal, there can be a heightened perception of sensations and stimuli, which would otherwise be ignored by a non-anxious person. So, it does make sense that your friends' nausea sensation could be anxiety -related. Please encourage him to see a psychiatrist for a detailed evaluation and management.  Wish you all the best. -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is mn,i reacently took a home pregnancy test and it came up as a faint positive i did it and walked away so im not sure if it could be vapor or not i have missed my period but i dont know weather its because im thinking im pregnant so much is this possible is there such thing as a false positive? ### REPLY: Hi, I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options. If you have missed your periods and your urine pregnancy test is positive, it is most likely to be positive. False positive test means test is positive but blood beta  test is negative.  This can happen due to some defects in test kit. I will suggest you to get blood beta  test and USG done to confirm your pregnancy. I hope this answer helps you. Thanks .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,m suffering 4m hayfever,bad sneezing n dry cough,had symptomatic relief 4 smtime vd nasal spray den had sinustab,m confused how cn i get a permanent cure,cz m vry tired of,n i think m expecting,dint do test,want 2 knw is this flu n allergy safe during pregnancy?pls prescribe smtng herbal 4 my condion.thnx,reshma ### REPLY: HI, thanks for using  If the symptoms have been occurring over a 4-month period then it is not likely the common cold but allergies. Treatment would involve: (1) avoiding the source of the allergies if they are knownThis would significantly reduce your symptoms(2)continue the topical nasal spray and also consider the use of an oral antihistamines allergy should not adversely affect your pregnancy. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother aged 74 years , due to wheezing problem , she was advised to go for dialysis. Her creatinine was 3.4.After dialysis (4 times) , her creatinine came to 2.00. Now she is taking diet as advised by Neprologist. She is taking dialysis twice in a week . If we increase frequency of dialysis ie  once in ,10days , does it affect her health.She is taking very less quantity of diet. Her weight is considerably declined from 55 to 48 kg within 15 times of dialysis. Please advise.She is taking medicines for  thyroid, and kidney as advised by doctor. Please advise.. ### REPLY: Hi and thank you so much for this query. I am so sorry to hear about this chronic kidney disease that your mother has and the need of frequent dialysis. Increasing the interval of her dialysis sessions would just make things worse by causing a sharp rise in the creatinine levels again. The best way forward is to strongly consider her for renal transplant as this is the single and most effective treatment of this condition. Dialysis does help in the short run but very unlikely to be an excellent method for long term purposes. I think her diet is too restrictive, and the doctors should consider increasing her daily calories. I hope this helps. Furthermore, I wish her well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a rash that comes and goes on different areas of my body my hands(red itchy stinging) left and right side of my torso, both arms etc.  right now its on the left side of my torso but its two huge bumps that started from a rash. also causes chills ### REPLY: Hello, Thank you for posting on . The condition you have referred to is called Urticaria or hives. It's an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up. You may have to go for specific tests like patch test, food prick test, IGE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various antihistamines for long duration(at least 3 months) with or without oral corticosteroids. For non-responding cases there are many other .  Hope this will help you in resolving your query. Thank you  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got 6 or 7 atacks of uncounsiousness on early mornign near about 6 to 8 am only, while i wake up my hands and legs nurve are stichhing and i feel tiered. One doctor told me its a diprration attack at that time my Blood pressure was bit high, Other doctor told me after Getting normal report of MRI and EEG that i have a normal problem of epylepsy and suggested to have valparin chorono 300 daily two times, While i have it twice in a day i faced a problem of Loss of appetite so have daily one tablet in a day but after six month now i have a problem of lake of understanding,confusuion,problem to remember routien work, problem to speak and explaing and understanding. So my problem is that really i have a epylapsy or not ? if yes then valparin chorona 300 is not suits on me or what ? now what should i do to solve this problems (Side effects) plz tell me should i have it anymore or not? i have no attacks of uncouncisosness or epylepsy since 8 months. Please help me and advice me what i have to do ? ### REPLY: Hello sandeepWelcome to  The sudden onset attacks of unconsciousness especially in morning are alarming. They may occur due to following possible reasons-One thing is hypertension, kindly get your Blood Pressure checked as due to postural hypotension in a hypertensive person sudden fall may occur. But it doesn't occur repetitively. Other possibility is Seizure Disorder. In epilepsy or seizure multiple loss of unconsciousness may be observed even without typical movements of extremities. In most of the cases cause can not be established and MR scans and EEG come normal. Start of Anti-Epileptic .  These are to be taken for long time (usually at least 3 years as per guidelines).  You were on valproate throne 300 twice a day, and you are now taking 300 per day. Valproate in a lot of people during initial phases of therapy may cause nausea, vomiting, dizziness as side effects. Due to this appetite ultimately decreases. But decreasing dose against the advice of doctor is not advised. The problems of lack of understanding, confusion, memory loss etc. don't occur with valproate at 300 per day. It is otherwise safe  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lump in my neck that only I can feel. Its near where my jaw bone meets my neck. Have had it for a few years now. When I have asked doctors to feel it they couldnt tell where it was. You cant feel it as a lump but when I push on it I can feel it pushing onto the tissus below and it is a round shape. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have enlarged cervical lymph node or some pooled muscle mass.  You should go for ultrasound neck first.  If you have enlarged lymph node then you should go for fine needle aspiration cytology or biopsy of that lump.  It can be reactive hyperplasia, tuberculosis or lymphoma. You should take treatment according to diagnosis.  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: It seems my baby is having some stomach cramps. He had this yesterday and we have given 6 drops of decolic infant yesterday night. Today the whole day he was fine, but it seems he is having the same problem even today also since 2 hours back. Will it be safe to give decolic infant today also?? As it would be for back to back days. He is 26 days old ### REPLY: Hi... Thank you for consulting in . This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to .  Unless the air comes out like burping or flatus this discomfort will be there and next time check if she is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief. The two best ways to relieve this distress is - 1. Do not put him in lying position after feeding till he burps out the swallowed air.2. If he is still crying - put her in prone position and keep patting his back gently so that he passes off the flatus and gets relieved. 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 this is manoj and I ve dark patches around nose and mouth, how to get rid of thid? And also I have dark scene color where I normally shave over the face as compare other skin color on my face. In short my face skin color is dark as compare to body. Pls suggest me something to remove this ftom my face as I am getting married soon and this is really annoying me. Thnx. ### REPLY: Hello, welcome to , as per the description you have been giving, i suspect the skin condition of yours will be 1. DARK PATCHES AROUND NOSE AND MOUTH POINTING TOWARDS A CONDITION CALLED PLASMA OR IT MAY BE PHOTO-PIGMENTATION , DUE TO EXCESSIVE EXPOSURE TO SUN-LIGHT2. DARK SKIN IN THE SHAVING AREA OF BEARD POINTING TOWARDS- POST-INFLAMMATORY PIGMENTATION, EITHER DUE TO ROUGH SHAVING OR REVERSE SHAVING OR USAGE OF CHEAP QUALITY TRIMMERS anyhow you need to be examined properly and should be seen directly by eye to know the level of pigmentation u have, and perfect treatment required for you... I advise you to consult a dermatologist for further evaluation and treatment.until then start using good non-oil based sunscreen lotion .MANY OF NEWER TREATMENT MODALITIES FOR UR CONDITION.MOST EFFECTIVE IS CHEMICAL PEELING...CHEMICAL PEELING WITH SLC peel system (salicylic acid +lactic acid +citric acid) will be more effective for u.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My wife is taking Duzela for the past 3 weeks. She is facing aggravated symptoms now like confused thinking, suicidal thoughts etc. It was not like this before. And also she is getting weak, drowsy most of the times. What do I do now? Can I stop the medication? ### REPLY: Hi, Based on the history your wife seems to be suffering from severe depression. Duel (duloxetine) is actually an anti-depressant which seems to be not effective in controlling her symptoms of depression. I suggest you to take her to the emergency room of your nearby hospital for possible admission and treatment under the care of a psychiatrist. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I slipped on ice and fell down every stair on my butt. It hurts a lot. It is not bruised. But i can t sit down to long or lean down to die shoes. It is right above my butt crack haha but i have to sleep sideways and can t lay upright or it hurts. /: help? haha what do you think it may be? ### REPLY: Hello, I read carefully your query and understand your concern. The symptoms seem to be related to the injury of the tailbone. I suggest doing a X-ray of the colon for further evaluation. Meanwhile, I suggest using anti-inflammatory medications such as Acetaminophen to relieve the pain. I also suggest using cold compresses for local application. Hope my answer was helpful. If you have further queries feel free to contact me again. 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 recently saw an oral surgeon because i have what appears to be white spots on my tongue. he said that it looked like keritosis. he also said that it could be from when I previously smoked cigarettes for 30 years. he recommended I see an ENT for further evaluation. He did not do a biopsy because he said the white spots were all over the tongue and to do a biopsy in just one area would not be helpful. I have had this problem for about 4 or 5 years that I can remember. ### REPLY: Hello, Thanks for consulting ChatDoctorRead your query, as you have white spot on tongue it can be due to fungal infection commonly known as Oral thrush, or it can be due to your smoking habit induced lesion like leukoplakia, lichen plans, or decapitation of papillae, geographic tongue, frictional keratitis due to sharp cusp of teeth. Don't be worried so much I will suggest you to consult good oral surgeon and go for visual examination of tongue to rule out the cause of infection or lesion. In meantime do warm saline rinses, maintain proper oral hygiene, use tongue scraper to clean your tongue, use chlorhexidine mouthwash. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor!  All of my siblings had chickenpox recently. I am 23yrs old and I suspect that I have chickenpox.But there are no lesions in my body yet, I just thought there might be in my stomach and intestine. I feel pain in stomach. I also have cold and cough. What should I do to confirm that it really is chickenpox. ### REPLY: Hello, Chickenpox, patients present with fever, malaise with rash characterized by maculopapular, vesicles and scab in various stages of evolution. For diagnostic purposes, a swab is taken from the active lesion at different stages and confirmed it in virology lab. So first note down if any symptoms present or not. If symptoms then go for lesions. So you are not having any symptoms, no lesions, so no Chickenpox. As far as concerned about pain in the stomach may be due to tension or hyperacidity caused by tension. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been suffering with abdominal pain for the past two months. Back in forth to doctors and hospitals. I do have an umbilical hernia. the pain is not in the vicinity of the hernia. It started out as cramping pain and was put on bentyl. I felt like my symptoms have not gotten better by taking the meds. Now the pain is more like burning. I took a CT scan that showed the umbilical hernia with fatty tissue. I had my gall bladder removed in march. Nothing shows up on my organs of concern according to the report. It says no inflammation or obstruction is visable in the intestines. my blood work turned up good. no high white blood cell count. This is totally aggravating me and I had to ask my doc for anxiety meds from the stress this has put on me. the burning is mostly on the upper abdomen left and right sides. put there is pain in other places. Any ideas on what this could be? ### REPLY: Hi ! Good morning. I am  answering your query. The umbilical hernia itself could give rise to some kind of .  However, the burning sensation in the upper abdomen could be due to a coincidental esophagitis because of HERD (gastrointestinal reflux disorder). If I were your doctor, I would advise you with the following:1) Elevate the head end of the bed with two blocks on each side, so that the regurgitation does not occur while lying down, and the contents of esophagus and stomach flow down with gravity.2) Some modification in your diet like more of roughage, enough liquids, avoidance of oily, fried, and fast food, and avoidance of alcoholic beverages and smoking if you do.3) Regular routine exercises like morning walk depending on your medical fitness.4) Prescription for a prokinetic agent and a proton pump inhibitor for symptomatic relief and to have a control on the acid production and facilitate movement of gastric contents downwards.5) Routine stool test for ova and cyst and treat them if positive. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I habe problems going to the bathroom to poop. i have pain in my anus and lower belly. i have went to my dr but she just gaved me fibers. i also feel dizziness and lots of tiredness in my eyes like they are heavy or like when you are really really sleepy. ### REPLY: Hello! Thank you for the query. Pain in the anus is usually caused by rectal fissure. It's a kind of wound in the rectum which gives lots of pain when passing the stool. However, it is not characteristic to have lower abdominal pain with this issue. As fissure is usually caused by constipation, this seems your main problem. Constipation can be caused by bad diet, hypothyroidism, medicines (ca-blockers, antidepressants) or colon cancer. Tiredness, heavy eyes feeling can be also caused by hypothyroidism. Dizziness and tiredness are also present with low hemoglobin due to colon cancer. That is why, I suggest you to visit your doctor once again. Blood work, thyroid tests and abdominal ultrasound should be done at first. If you are older than 50, colonoscopy is strongly advisable. If you are young person, please consult general surgeon and have rectal examination. To improve fissure condition and make it go away please follow this steps:- increase fiber rich products and mineral water intake-start probiotic supplementation- do not push hard on stool-wash your rectum after every stool-have sat baths with Oak Bark twice a day-ask you doctor about Nitroglycerin cream Hope this will help. 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: yes please ... my girlfriend just recently went on the pill after child birth ... child now 16 months old. She has been dealing with alot of stress and not sleeping very well now she called me from work to tell me she is feeling dizzy and light headed and has been for about 4 hours. what can she do ? ### REPLY: His had gone through your query. Need to relax. Analgesic like paracetamol help to reduce headache. It is stress, and it can be reduced by making certain lifestyle modifications. Some natural ways to treat anxiety and daily stress exercise, meditationRelaxation like deep breathing and hyperventilationProper sleep and healthy diet.Stress-free activity pleasurable activityMusic and hobbiesPositive outlook and confidence All this will help you to counter daily stressMedicines like mild dose of benzodiazepine and mild dose of SSRI. Benzodiazapine will help in sleep and reduce stress due to its anxiolytic effect. In SSRI mild dose of Escitalopram and paroxetine like . Best wishes. 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 knee pain beneath, and around knee cap, mostly on the interior side of knee cap. Knee feels stiff, but no swelling. I have had this issue for some time with no relief. Shooting pain comes with stress on joint, especially when trying to lift with resistance. What type of injury is this likely? What stepa should I take moving forward? ### REPLY: Thanks for contacting . You have problem of stiffness of knee and pain problem that may be because of arthritis problem. Take one x-ray for further diagnosis. Consent a physician for further diagnosis. Any injury may cause bursitis means inflammation of bursa. Avoid excessive straining of knee. Proper physical examination and history give exact idea. I hope my guidance is helpful to you. Take care. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, I have been taking restly the blue colour tablet for sometime now, because of stress and family problems at home. Not taking it regularly, sometimes alternate days, sometimes daily or on and off? I am worried about the side effects, what do I do, is there any alternative? ### REPLY: Hi dairy admire you for positive outlook. Restyl contain alprazolam which has the highest habitual potential. Please avoid it if possible. There are many other anti stress medicines which has less addictive potential. For ex. Mizoram .5 mg You can use it as and when required. Some natural ways to treat anxiety and daily stress are exercise meditation deep breathing and hyperventilation proper sleep stress free activity do pleasurable activity music and hobbies discuss with friends see all thing with different angle positive outlook confidence all this will help you to counter daily stressed well shorthand you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Father in  Law is 82 years old he had high blood pressure when we visited the dr. a week ago 190 over something.  anyway he gave him medication and yesterday went for a heart stress test, the blood pressure has not gone down.  They did not say anything yesterday as it still should of been high.  This morn. again it was 191 over 108, I took it 3 different time the lowest reading was 188 over 96, I check mind to be sure the monitor was working and I was 122 over 72, should I be concerned and take him back to a doctor today???? ### REPLY: Hi you should take him back to the cardiologist and blood pressure should be taken manually three times at an interval of 10 minutes, an average of 3 readings should be considered as his blood pressure and please do write your question clearly, I check mind to be sure the monitor was working, and I was 122 over 72, I cant understand the meaning of this line, still stress test would be done only when blood pressure is below 140/90. Hence you should take recording manually over two hands three times separated by an interval of 10 minutes, ### END