Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 there my 30 months old boy was born before time and was diagnosed with tonsillitis at 9 months and i started noticing lumps in his neck when he was about 14 months then after taking antibiotic they became small now he got flu i noticed they are bigger then normal ### REPLY: Hi...seems like your child has got recurrent tonsillitis. It might even be a viral sore throat or a streptococcal infection. I suggest you see your pediatrician and get a rapid streptococcal antigen test done. If it is positive then the kid will require antibiotics. If it is negative then it might be viral illness and doesn't require antibiotics at all. Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15 mg/kg/dose (max ceiling dose 500 mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Warm saline gargles will be soothing and will give a lot of relief if the kid can do that. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my mom had symptoms of a simple cold and fever. doc gived her a couple of antibiotics they were ok since the few days to finish the pills, the feveres returned. She stayed in hospital and recieved IV antibiotics there and also CBC test and Sonography the only unnormal thing was ESR=110 ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. ESR of 110 is too high. 2. Commonly chronic infections like Tuberculosis, collagen vascular disorders, rheumatoid arthritis requires evaluation. Multiple myeloma or other gammopathy also requires evaluation. CRP or c-reactive protein, which is an inflammatory marker requires evaluation.3. As all reports are normal, antibodies studies and serum Egg antibodies levels study. Protein electrophoresis and peripheral smear study maybe necessary for further evaluation. Based on reports, further opinion is possible. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I had rct on Thursday and my well Its like concrete fell out today Ive not had any pain all day but as Im ready to go to bed Ive started getting pain like a dull ache and very sensertive as I look at the tooth its got half of my tooth missing Im going to try get in to the dentist tomorrow but will it be just a straight forward filling? ### REPLY: Hello, You lost a temporary filling placed while a tooth is having root canal treatment and while waiting to complete a restoration. Did you complete the root canal which usually takes more than one visit? During root canal therapy, the temporary material keeps medication in the tooth and oral bacteria out of the canal system. Once completed, this material won't last long especially if the tooth is badly broken. Your dentist should discuss restoration options. I highly recommend a post and core with a full frown for back teeth such as molars. Your dentist will determine if your pain is common such as from some gum irritation or pressure from a sealed root canal. Take some Anti-inflammatory medication such as Tylenol or Advil. Your dentist may suggest an antibiotic if you are having discomfort with healing. Avoid chewing in the tooth area and gently rinse to keep clean. Thank you for your inquiry. I hope you feel better soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello DR..i am 20yrs old,i was suffering from viral hepatatis...2day i took my LFT..and the results are:-Total Billrubin 1.1,direct billrubin .7 and indirect is .4my SGOT is 175,and my SGPT is 208..my A/G ratio is 1.2 pls give ur valuable suggestions to me..is there any problem because of the high level of SGOT nd SGPT??.thanks.. ### REPLY: Hello and thank you for your question. There are treatments for hepatitis, but you would need to see a liver specialist to know which one is best for you. There are several types of viral hepatitis, and you need to know which one you have to determine which medication is right for you. They may even need to do a liver biopsy in order to determine the stage of your liver disease. Elevations of GOT ad SGPT are signs of liver irritation and are common in patients with hepatitis. Please avoid any alcohol or acetaminophen as these can further damage the liver. See a liver specialist for a determination of which treatment is right for you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, Want to ask , if there is any cure for VItiligo... Did lot of study and the ans every where is NO.. Person suffering from Vitiligo from last 1 yr (area includes finger tips of hands and legs) found traces on lips as well.undergone treatment for almost 8 months.. but no use.. If body cells are not producing melanin for some reason ,there should be a some or the other way to tackle it, to activate melenocytes... Need your advise to overcome the condition. ### REPLY: Hi, Welcome to . Vitiligo is an autoimmune disease. It is also considered as genetic disease. There may or may not any family history of vitiligo. In your case, I feel that, vitiligo is aural vitiligo.as the patches are on feet, hands,fingers and lips. It is found that the aural variety is more resistant to treatment. Still, you should not lose patience. Just continue treatment for few years. Trimethoxsalen tablets and cream or lotion on hand and feet patches. I usually advise in my patients and to take sun rays for few min daily after application of lotion. Tacrolimus may be applied on lip areas. Continue treatment under observation of dermatologist. You may leave treatment after few years, if no response. I hope you got my answer. 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: will nitrofurantoin macro help with a tooth infection? ### REPLY: Hi and welcome, Nitrofurantoin is the medication used to deal with gram negative anaerobic bacteria and its use is rare dentistry. If your tooth is infected I would suggest you to go for treatment because no infected tooth can be treated alone with medication. Antibiotics like amoxicillin, cephalosporins are used effectively in treating dental infections. Please get your case examined by a dentist and go for an appropriate treatment. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my doctor gave me antibiotics the last month twice,for my bronchitis,she said i had wheezing too and after that i went for a checkup to see and she said i should get an inhaler and im still taking that i had like a bark cough like alot b4 but now she said my lungs where ok and no more wheezing i usually cough 2-3 times bark cough usually normal  cough i want to know if it will go away stay the same or get worse? please help me ### REPLY: Thanks for your question on . I can understand your concern. You are still having barking cough (frequency reduced), this means your bronchitis is not completely cured. Bronchitis needs treatment based on severity. And to know severity, PUT (Pulmonary Function Test) is must. So get done PFT and start treatment according to severity. You will need long acting inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Don't worry, you will be alright with all these. 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: How dangerous is a blood sugar level of 320? My mother age is 54, she recently thought of having sugar test as she was having knee and back pain surprisingly her sugar level was 320. i am really worried about this need your suggestions on this please ### REPLY: Your mothers blood sugar of 320 suggests that she is having severe diabetes, and it has to be control by diabetic diet, exercises and tablets for diabetes. If the sugar is not controlled after two months, she may need insulin injection. With proper control of a diabetes her back pain and knee pain may become alright. In addition, she should undergo eye check up to see whether the retina is affected by diabetes. Further, she should be tested for lipid profile, blood urea, serum creatinine and urine for microalbuminurea and should be treated if there are abnormalities. With proper control of diabetes, she can very well have normal life and so there is no need for worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi so I have a wisdom tooth that grew in on the upper right side of my mouth. Ive found a hole that seems to be from my wisdom tooth cutting into my cheek right beside my jaw. I know a lot of people say that they have the same issue and that they have a pain there but I dont. Im going to make an appointment next week to see a dentist even though they scare me. I was just wondering if its a huge issue? ### REPLY: Hello and welcome. Thanks for sharing your concern. My advice to you would be please get the wisdom teeth extracted if it gives you trouble. Until then, you can relax. But since you have mentioned that there is already a hole(cavitation) developed, then this may damage other teeth too, due to food lodgment there. Lack of accessibility makes it infection prone.Therefore, please speak to your dentist and take an x-ray after which it can be comfortably extracted. Thanks. 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 believe I have had H1N1 - though did not consider this until this week.  First came on suddenly Dec 19 with sniffles.  Since then have had all respiratory system involvement in stages - throat painful - used salt water gargle, stuffed and runny nose, seriously plugged left sinus under eye - used saline spray, went into lungs - lots of coughing and at other times it stays quiescent although feels irritated lower center, occasionally chest hurts.  Have coughed up and lots of phlegm - dark yellow, green, and after a particularly heavy coughing spell may have light blood streaks and this has been when hard to catch my breath.  I have not seen a doctor as was treating as just a viral cold,as my normal body temp 97 and highest was 99 and then immediately dropped to 95.   Most recent 96/97 again. This is now 2 weeks.  Nose still a little runny, not coughing much today, but am feeling "slightly clogged" in lower lung.   Other meds for cold have been Benylin and Advil cold & sinus.  I have also had a touch of diarhea, lack of appetite.  My MS is currently asymptomatic and while lethargic have not had the onset of MS fatigue.  I do not like to go to the mediclinic unnecessarily, but should I be considering going now after 2 weeks even though my primary problem now is lesser degree of phlegm in my lungs?. ### REPLY: Thanks for your question on . I can understand your situation and problem. You are mostly having either bronchitis or lung infection because all your symptoms are seen in both of these conditions. And multiple sclerosis (MS) can be the risk factor for both of these. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray to rule out lung infection 3. PUT (Pulmonary Function Test) to rule out bronchitis. If both are normal then possibility of viral Upper respiratory tract infection (URI) is more. So better to first diagnose yourself and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 40 years old. I extracted my tooth on my lower jaw next to my wisdom tooth yesterday morning. Early this morning I woke up feeling very dizzy and with a upset stomach.Its been 7 hours and when I lie down the dizsiness get worse. Augmentin was prescribed to me which I took yesterday but not today because of how I am feeling. I have never had any problems with Augmentin. Could my tooth extraction be the cause of my dizziness. ### REPLY: Hello, thank you for consulting with . As you are mentioning that you got your tooth extracted and after that you are feeling this stomach upset, but the extraction does not cause this kind of symptoms, it can be because of augmenting only, or it can be the combination of painkiller which is prescribed with augmenting. It will be better that you should visit the dentist and get the medications changed. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I have a friend who suffers from ..... I dont know how to call it,...basically,...he broke up with his girlfriend 3 months ago and he seemed to be fine with it, he was the one who helped me with my break-up, we met on a dating site.... he stated in his profile he wasnt looking for anything just chat.Since my first mail to him we skype (only writing)each other every day, but he changes moods from one day to the other....one day he doesnt want a new relationship the next day he sends me kisses and plans a trip with me, he is thankful for having me and says he likes me very much but doesnt want anything cause he doesnt want to hurt anyone, he wants to be alone...I really like him I perhaps would like more but its all magic circle....basically one day full of happiness and three days later he doesnt want to live anymore..... What is this disorder called? and How could I help him? Thank you ### REPLY: Degree understand your concerns went through your description. I suggest you not to worry much. There is no mental disorder here. But there are conflicts. Several conflicts like family, role, social etc. plays its part. Basically this is combined "acceptance-avoidance and avoidance-avoidance conflict". These types of conflicts arise out of indecision in important matters. He definitely wants you but there are so many obstacles in front of him. He is unable to find a way to clear these obstacles. Naturally such change in attitude happens. He might need psychological counseling to free his mind off the shackles of conflict. For telephone counseling you can contact me through customer care at www.ChatDoctor .com. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a bony bump on the back of my head approximately where my nose is but on the back of my head. It s under my skin and feels to me like a part of my skull but the woman who cuts my hair said she has never felt that before on someone. It doesn t hurt, it s been there for as long as I can remember. Should I be worried? I have had MRI s done on my neck and cranium in the past 3-5 years and nothing has ever been brought up relating to this. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You should not worry about that.  It is normal part of your skull. Many persons have prominent area as normal variation.  No need to worry.  No, any investigation or treatment is required. 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: have a lump on my trapezius muscle between shoulder and neck it is movable doesn t hurt but is a noticeable lump I use to wear a backpack which weighed quite a bit , all the time and noticed pain on the same side where the lump is now. I suspect that is the reason why I have it any insight is helpful ### REPLY: Hello! Thank you for the query. It is quite hard to tell not seeing it. Such lump can be a lymph node, lipoma, sebaceous cyst. Lymph node is usually hard, soft and movable rounded structure. Lipoma and sebaceous cyst are soft in touch. Sebaceous cyst can have a kind of small black dot on its surface. The best way to find out what this lump is build of, is to have soft tissues' ultrasound. 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: Ive been using then Implant for 7 years now and never had a period, but recently Ive noticed my breasts have grown, Ive gained weight, and started a period yesterday. My current implant has only been in for under a year (maybe 8 months, maybe less) is it possible its stopped working? ### REPLY: Hi, The effect of hormones on the body varies with the weight in general; as the body weight increases the demand for hormone grows and side effects ensue. This may have happened to you with the new implant; yet, the effectiveness needs to be checked as you have developed symptoms soon after the insertion. Please ask your specialist to check for the position, get a sonogram to look for any cysts in the ovary and to exclude other pelvic causes. If all is well, it means that you could be in normal menstruation with the implant on. 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 9 year old son has been sick a few times in his life. 3 days ago he had a bad fever, vomiting, body aches, etc. He was much better after 12 hrs of sleep and ate a bowl of chicken soup that stayed down. The next day he was stuffy so he took a childrens allegra, which helped. However, when he lays down to go to sleep he begins to cough and quickly it becomes an out of control cough which induces vomiting. Today he was fine all day except for the allergy symptoms, and at bedtime the coughing followed by vomiting. Ibelieve he has a post nasal drip he doesnt know how to cough up, hence the vomiting. He is drinking alot of Smart Water with electrolytes, good meals, allergy medicine, etc. but nothing is working to thin out the mucus that I think is the culprit. Do I rush to the ER with no fever or body aches? I dont know what else to do.... ### REPLY: You are right, the mucus secretions tricking down from behind the nose into the throat is the reason for cough and vomiting. Your child requires the following medication:1. Steam inhalation 3-4 times/day2. Encourage him to .  A bucolic such as bromine or aerosol or carbocystiene to relieve the secretions4. Saline nasal spray the symptoms do not subside consult your doctor for a complete examination and managementRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Im throwing up how come there is like brown specs or brown spots coming up along with clear mucus, I am having stomache pains, but I am on medication called azithromycin because on tonsillitis, then when I try to sleep then wake up I have a hard time breathing when I wake up and have to use an inhaler I am also coughing too, so could you tell me what it might be or what to do? Thx ### REPLY: HI, thanks for using  The brown spots that you are noting are likely old or .  This can be found in vomits due to the inflammation of the stomach. Antibiotics including azithromycin can be associated with gastrointestinal upset and symptoms such as vomiting, abdominal pain and diarrhea. The use of probiotics along with the antibiotics can sometimes decrease the symptoms. The coughing may be part of the upper respiratory tract infection symptoms (cold symptoms) or due to aggravation of your asthma. It would be best to use your inhalers to see if they would help. If there is no improvement then you should visit your doctor. 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: hello sir/mam,im 21 years old.i wont get periods regulary.i had gotmy last period on april 1st.i had participated in sex on last month(june 7th).i was first time for me and that guy.his cock was not completely in my vagina.now i was worried whether  ill get pregant.plz........help me.. ### REPLY: Hello...thanks for trusting the  doctors for your health related queries. As u told that u had unprotected sex but your guy cock doesn't enter completely in your vagina...right.for getting pregnant penis should be completely inside the vagina, ejaculation should be inside the vagina and female should be in the fertile period (that is 10-16 day of period).as u already told that u had irregular menses and complete penetration of cock happened, so there is very less chance of pregnancy. With the above discussion u can try out my suggestions-1. Relax... Don't worry, there is rare chance of getting pregnant.2. Wait till the next period occurs. If period came then nothing to worry.3. If period not happen then do urinary pregnancy test. If it comes positive then rush to nearby gynecologist. He/she can help you. Good luck. Free to ask for further queries. 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 injured my palm with a knife and stabbed into it while cooking. I received stitches and had them in for 10 days. Its been about 2 weeks without them and the left side of my middle finger is still numb. I assumed nerve damage but im just not sure how would i exactly know if that is the issue ### REPLY: Hello, Thank you for contacting me at "Ask a Doctor". I will try to answer your question to the best of my ability. I think you are right.  You may have a small amount of nerve damage, which is causing the numbness.  This is relatively common.  I would not do anything specific at this time.  Oftentimes, if you leave well alone the nerve will recover over time.  However, this may take several weeks or sometimes a few months.  Do not worry. If the situation worsens in that you are getting increasing pain or increasing numbness, then I would pay a visit to your primary care physician.  Otherwise, at this stage, I would leave well alone. I hope this information is useful for you. Please do not hesitate to message us back if you have any further questions. Best wishes, A .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a UTI that my doctor confirmed. I came down with a high fever (103.5) on friday. I have a history of UTI s, kidney infections and kidney stones twice. I went to the doctor again no Saturday and they agreed that I probably have a kidney infection as the symptoms at the time were similar to my previous episodes. They did not confirm the kidney infection with bloodwork however. They just figured that I knew well enough. They prescribed cefuroxime for me. Since Saturday I am still running a fever which I have kept down to about 100 - 101 with ibuprophen and tylenol. Now I think that it may be something else. I am not having the lower back pain that I usually have with kidney infections. I am having a lot of abdominal pressure in the front and my back is soar up closer to my shoulder blades. I have never had indegestion but if I had to guess it feels like this. I cannot lie down flat comfortably. Sometimes it feels like when I lay on my right side that my guts are being twisted on the left. I also started my period on Saturday. I also have a massive headache that despite all of the medicine has persisted for 2 days now accompanied by lightheadedness. ### REPLY: Hello are taking ibuprofen and Tylenol frequently for high grade fever, so these two tablets may be the possibility of pain in the front or abdomen and also intestinal upset (as you mentioned in the query). Fever is high grade, and you are also having intense headache and lightheadedness. Such type of fever may be due to UTI, but you didn't get urine and blood test, so please get in these tests. Also get in serum creatinine and blood urea with ultrasound of both kidneys. Since this time, no doubt symptoms don't simulate like UTI, but you are an old case of kidney infection, so we should not forget this thing. 2 Flu or upper respiratory infection may be the other possibility of such symptoms. So consult another physician and get his opinion (2nd) . Since you are taking cefuroxime and this is not effective because still you are having fever, so 2nd opinion is important.3 Malaria is another reason of such high fever. Get in blood for malarial parasite. However, there are so many other reasons of such fever, like dengue, typhoid but physical examination and 2nd opinion is important. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My ESR is 26. What diet and medicine should I take to normalize my esr. I used to have sudden hot on my left face and upper eyelid and makes the eye noticeable small and ugly looking followed by feeling of heaviness and puffy. Sometimes it goes away on its own but now its lasting for about a week. Is this the reason for my high ESR. I am 36 year old female. I have lost my confident to face people because of my weird looking left eye and cheek. My left eye has become very unattractive unlike my right eye . ### REPLY: Hi. I am glad we connected. There are some diseases which can cause increased ESR levels. ESR levels are usually increased with any types of inflammation. This may cause swelling over the face because of an infection over the face. It would be tough to diagnose this without a blood test. Getting a complete blood count done would be a good idea. The blood picture would show white blood cell count increase in this. I hope this helps. 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, may I answer your health queries right now ?  Please type your query here...Hi, My husband yawns excessively; he is often very tired. He also has problems with body temperature regulation- gets cold easily, sweats a lot. Even during the coldest night he will fall asleep with just one blanket but then wakes up feeling cold and needs more bedding. If he falls asleep with too much bedding, he wakes up overheated very soon.He also suffers from high blood pressure despite being very slim, eating healthily, not smoking or drinking. Can all of these be linked? ### REPLY: Hi! I can understand your concern for your husband. If a patient arrives in my clinic, I would advise and suggest:1. Yawning is many times a sign of low blood sugar. As you say, he feels tired, which indicates low sugar levels available to the brain .2. He has frequent body temperature changes. Normally, the body temperature varies with day and night, but the changes you mention are more than normal3. As you rightly said, slim stature, temperature changes, high blood pressure can be directly or indirectly linked.4. Slim, non-smokers can also have High blood pressure.5. Please get him examined for his blood pressure control. It should remain within normal limits. If needed, his medicines can be changed.6. Please check his blood sugar levels. The tiredness may be related to insulin insensitivity, i.e. Diabetes. Though he is slim, there are lean Diabetics also.7. Please check his thyroid levels. Thyroid problems can also have tiredness, fatigue, temperature changes. 8. Please consult your local physician with the reports. If there are any other health issues, they also need to be corrected with blood pressure. With the control of these factors, his complaints will definitely reduce. Please feel free to consult. Wish him a speedy recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: cleaned with hydrozen peroxide and hotwater right after dog bite. It is home dog. Went to urgent care and hand was put in alchohol for 15 minutes. Doctor gave tetanus shot and a week of anitibiotics. Is there chance of rabies. Its been 4 days and dog is normal. wound is normal. no swelling or pus. ### REPLY: Hi welcome to ChatDoctorI have gone through your query. Your treatment of dog bite has gone Va well. I would like to suggest you to take water kept in copper vessel / glass for 12 hours. Dose 30 - 40 ml 4 hourly thrice for 3 days to avoid any MIS happening. Wash the wound 3-4 times with this water to further disinfect. Hope this helps solves your query. Take care. All the Westmont hesitate to come with further query if you have any. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 just had an MRI and I haven t seen a doctor to explain to me the impression. Please explain what it means. Please see below. Thank you. Grade 1 spondylolisthesis , L5 over S1 vertebrae Right paracentral disc with posterolateral annular fissure , L4-L5 level with indentation of the ventral thecal sac , narrowing of the right neuroforamina and abutment of the right descending L5 nerve root . Filum terminale lipoma. ### REPLY: Hi, Thank you for posting your query. Your MRI report suggests mild degenerative changes in the lumbar spine region.  There are mild disc bulges, which are compressing the lumbar nerves. There is also a mild listless- forward movement of the lowest lumbar bone. These changes could result in back pain and pain along the legs. Initial treatment would be with medications such a pregabalin and physiotherapy. Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi ive had 2 hip replacements and the 1st one i dont think is healing as good as the next my question is my leg keeps swelling up and i get horrible cramp pain that horrible it makes my leg lock to the extent where i cant get it back to normal can this be normal i never had a follow up in either but ive had x-rays and was told they look normal i did tell the radiographer and she said to get an appointment to the consultant again thanks ### REPLY: Hi, Thank you for the brief history of you. As reading the history, have you undergone both sides replacements. Also, post replacement have you undergone physical therapy. Most hip replacements heal, as they will be provided by calcium supplements and other medicines to provide faster healing. Undergoing a physical therapy will help to improve the strength in the muscles and reduce the swelling. Since the swelling is the common feature this cases represent, advising a physical therapy is of the choice. Also, as your mobility is reduced, the swelling is but obvious due to the low cardio endurance and mobility of the muscles and joints. You can discuss the same with the physician, as most cases seen by me recover by post physical therapy sessions and the possible near normal mobility is regained. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor! I use 3 months injection and i do not see my periods at all than I drink XANGO bt less than 50ml and it cleans everything in body, than i had unprotected sex on 28 october after i drink coke. Am not sure if am pregnent or not, i wanted to knw if it is possible to get pregnent and i want to knw if i can drink stametta to clean everything ### REPLY: Hello, and I hope I can help you today. The three months contraceptive injection is extremely effective in preventing pregnancy. There is nothing that you can take by mouth, whether it be a cleanse, or any type of medication, that will inactivate the contraceptive. It is also completely normal to have irregular periods when using the three months contraceptive injection. So if you have been current in getting your injection on time, neither MANGO nor Coke or anything that you ingest orally will inactivate the medication. Things that "cleanse" the body are usually a combination of laxatives, diuretics, or both which usually result in loss of water from the body, which can result in short-term weight loss. Products like Stamina also are just made from herbs and of no proven medical effects. So again, as long as you are getting your injections every three months, you do not need to worry about pregnancy even if you do not get your menstrual cycle regularly. So it is not necessary to use any medication to treat unplanned pregnancy in your situation. I hope I was able to adequately answer your question today, and that this information was reassuring. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my father is had an operation May last year. He is 71 years old. He has tumor/ cancer stage 2 in his pancreas , but his doctors said it was too big his stomach will be damaged if they remove it. The doctors said they made a bypass in his digestive system so he would survive. After his operation, he was advised to undergo radiation and chemotherapy but our family decided not to do so due to some reasons. His surgeon said he will live for 3 months. After 10months my father is still here but just last week he is yellowish again and he feels itchy allover his body. His urine is already black. My question is, is my father leaving us at his condition now ? Thanks. ### REPLY: Hi!it is very heartening to hear about your fathers condition. Pancreatic cancer is often advanced when it is first found, very few pancreatic tumors can be removed by surgery. Patients whose tumor cannot be totally removed, but who have a blockage of the tubes that transport bile (biliary obstruction) must have that blockage relieved. Since he is jaundiced it seems that there is reblockage from the previous surgery. It is definitely difficult to exactly predict when the end comes. It is better you take your father to Pain and palliative care center to at least relieve him of his pain symptoms. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor My name is Eltis , and I live in albania , I don t speak very well but I have a question. I hurt my knee, and could not stay long in a way the same house because the pain will start, also can not run or other. ask help from you. I hope to understand me .My email is YYYY@YYYY Help me please ### REPLY: Hi, From the information you provided it appears that you got you knee injured and since then you are having pain in that and not able run so first thing you need to do is to get an X-ray of the knee done. Start ice fomentation, give rest to the knee and take some over the counter painkillers. If this pain doesn't resolve in a week and your knee X-ray does not show an abnormality you need to get a MRI of the affected knee as well. Take care. 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: hello doc im suffering frm allergic asthma and sometime I took montek lc for stopping my sneezing but 2 days back when I took tab i felt so lethargic and sleepy throughout d day and at eve i got my period which is 15 days prior.still im not well plz advise ### REPLY: Hello. Thank you for asking at . Montek LC contains two . The lethargy & sleepiness that you are experiencing may be due to levocetirizine component.Hence, I would suggest you to take montelukast only for allergy. Regarding disturbance in period, I would suggest you to consult a gynecologist who could advise you better. This is not a side effect of Monte LC. Hope this will be helpful to you. Wish you the best of the 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, I m 29 years old and trying to conceive since past 1.5 yrs. Got mantoux test positive (18X15) but x-ray was normal. Shall I start treatment for latent tb in order to conceive? All other reports of me and hubby are normal so does that mean the latent tb is not letting me conceive? What should be my next step if I wish to conceive asap? ### REPLY: Hi;welcome to  Just based on positive manitou test it is not advisable to start with anti-tuberculous . You need to get investigated for extra pulmonary TB that is TB in any other part of your body like abdominal TB;endometrial TB;or Tb of any other organ. To confirm you can do an Immunological test of TB Egg ;CIGM ;a recent addition to it is TB Gold which is a confirmed test to diagnose TB. Get the test done & if positive then after consulting your doctor you can start medicines if he prescribes. Hope this answer is helpful. 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 started with a fever of 101 Thursday evening, took some Tylenol and it went away but then I broke out in a sweat. I mean covered in sweat. A couple hours later I had cold chills so bad I was shaking. Then the process repeated itself. I went to ER. They checked me for the flu (negative) and my urine (negative). My body hurts mainly legs, feet, knees. ### REPLY: Hereafter reading of your query this fever with chills and rigor (shaking) may be due to these possibilities, these include:1 Malaria, chills, fever and rigor are the characteristic feature of malaria. Diagnosis can be confirmed by peripheral blood film and rapid card test .2 Acute septic pharyngitis (including tonsillitis) is another reason of such type of fever .3 Dengue, is another reason of such symptoms because mainly along chills, rigor there is pain in legs, body feet and knees also present. However, there are so many other reasons of such fever like chicungunea (serology test) but I recommend you consult a physician and get his opinion, if fever persists after 2-3 days (till take Tylenol as sweating was due to fever and Tylenol). 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: I am 33 yrs old my name is Ben. I have been solid plastering for 10 years now. However this morning I was working in hot conditions sweating heavily, i started majorly cramping up from my fingers to my toes. My whole body was seizing up on me. I have had cramping reoccuring regularly now for years, it got to the point where I could not continue working the pain factor was to much. I made an appointment at my local doctors he mentioned salt cubes in my water could this work to an extent. Doctor then referred me to pathology to check levels, will I get a diagnosis from the blood test. Does my condition sound like Kyphosis? Is there any cure for this condition. Thanks for your time Ben. ### REPLY: Hello, if the cause of your cramping is sodium depletion (hyponatremia) then it could work. Checking the blood levels of sodium, potassium and magnesium is essential to rule out such disorders. Kyphosis has nothing to do with that. Its disorder of the skeleton only. If your condition is related to the electrolyte disorders then you can take supplements and of course investigate the causes. Otherwise, cramping is a difficult condition to approach and in many cases no cause can be identified. You can contact me again, if you'd like further information. Kind Regards! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My nephew aged 3 years is suffering from Eosinophilia and the doctors are unable to understand the reason why it happens and no proper cure is done since 2 to 3 months it is also effecting his brain and the doctors are suggesting his brain condition as Acute disseminated encephalomyelitis. Kindly advice what to do? ### REPLY: Reclothe patient is 3 years old having eosinophilic. The normal count of eosinophils in body is 2-5 % while more than 8 % is suggestive of eosinophilic and the .  Increase up to 6 mg / kg body weight. You can also add steroid, if not treated with above medicine. As far as concerned about ACUTE DISSEMINATED ENCEPHALOMYELITIS, I recommend you consult a "NEUROLOGIST" and get his opinion because this is a disease covered by a SUPER SPECIALIST or Neurologist. 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: have been experiencing tailbone soreness and muscle soreness, burning in the buttocks and some feeling of leg weakness for approx. 1-1/2 wks. have had no injury or accident to the area. have had tailbone flare-ups before but usually only last a couple of days. am concerned about bone cancer. ### REPLY: Hello, I read carefully your query and understand your concern. Your symptoms seem to be related to sciatica pain. I suggest doing a X-ray of the colon for further evaluation. Meanwhile, I suggest using painkillers such as Ibuprofen to relieve the symptoms. I also suggest gentle stretching exercises. 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: Hi my wife is taking latetec 50 DT and frisium 10 mg for last 6 yearsnow i am seeing following changes in her behaviourabnormal thinking (disorientation or loss of sense of reality)    * agitation    * behavioural changes, including:          o aggressiveness          o bizarre behaviour          o decreased inhibition          o angry outburstsis there any serum test or some other test which can find out the content of these drugs in her bloodand what should we do to overcome her angry outburts ### REPLY: Hello and thanks for your query. Lametec and Frisian are antiepileptic medication. So, I presume that your wife is suffering from a seizure disorder. The recent symptoms which you have described could be indicative of psychotic disorder. However, a detailed history and psychological assessment are necessary to confirm the diagnosis. If her diagnosis of a psychotic disorder is confirmed, then she needs to be started on antipsychotic medication.I'm not sure why you would like to have the serum levels of these . Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a ten year old female that has experienced on and off stomach pains with headache and sore throat at some points.  The stomach pain is more common for her.  I have watched her diet and how much she eats. She was taken to the dr once before and they stated she may be "backed up". She is able to have bowel movements. Any solutions? Could it be related to her body becoming closer to menstration? ### REPLY: Hi. Thanks for your query and an elucidated history for a 10-year-old girl. The commonest cause of pain in abdomen of a girl child who is just 10 years old with a history of sore throat and headache is the tummy tonsils. Yummy tonsils mean, the enlarged lymph nodes in the mesentery, the fatty suspensory curtain for the intestine. The develop as a result of infected throat material, reaching via the intestines to the .  These can be well seen on high resolution ultrasonography and once diagnosed need a careful and continuous evaluation as to how the treatment is being helping for the resolution. Investigations::of blood, urine and stool. Throat swab for gram staining and culture and sensitivity.USG guided FNAC of the lymph nodes if possible. Treatment in the form of a 3-week course of antibiotics and anti-inflammatory medicines may resolve the problem. Ultrasonography would help to confirm or rule out other problems like Appendicitis, diverticulitis and so on ... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After two weeks of being clear of a 6 week upper respiratory infection, I have come down with another cold/virus. I have lost my voice, have yellowish mucus in nose, aching in back, and can hear it going down into chest. I also have asthma (very controlled). Any suggestions besides steam, hot tea, etc...? ### REPLY: Dear... my first suggestion is that whenever u .  At morning empty stomach u put a glass full of water for boiling and add some 3 gm of crushed ginger in it...let it boil until the half of the quantity of water is left. Now add 2 full spoons of honey in a glass n mix it with the filtered decoction of ginger.....n he it. Repeat the same at nit before u sleep.... To improve your voice u he to gargle with saline water 3-4 times a day.....avoid curd n heavy meal at nit..... be careful about your bowl movements. 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: Well, my spouse suffers from severe back pain due to many injuries throughout life and the hard work he did for many years. He can be sitting still and break out in a severe sweats...his forehead is actually beaded up with sweat and his back and chest are also wringing wet. He runs out of energy and is done by 4:30ish pm for the day. He has taken pain pills for years. Tries hard to not take them. At times, his right leg has become numb and there are times where he gets a shot or pinch through his lower back that stops him in his tracks, and almost buckles. He knows has an inversion table which he says instantly relieves the back pain. What else can we do to help him have less pain so it is tolerable? ### REPLY: Hi, I am .  I have read your question and understand your concerns. Let me try to help you Question : What else can we do to help him have less pain, so it is tolerable? Answer : Please consult a Neurosurgeon and Rule out Compressions to Nerve Roots. If there are compressions, then a surgery will relieve the pain Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. 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 a 40 year old & wish to go for a circumcision. Wish to know the shortest surgery (laser etc) and the cost associated if planned at Rajkot or Ahmedabad. Also would like to know who the best will be for this.. to go to a plastic surgeon / or a urologist ? ### REPLY: Hi .... You might have fibrosis for which circumcision done .... In this procedure foreskin removed and tight frenulum released..... If you want then neurosurgeon is best .... But it is very simple minor operation with less side effect... So you can consult general surgeon also.... After operation next day you will be discharged ... Then for alternate day daily . . You have to wear very loose cloth and undergarments for week... Cost depends on hospital you choose..... Hope your query solved. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My name is Jackie i am 21, but this questions isnt about me its about a friend she is 27 years old and she recently had a gallbladder surgery and shes on coma. I would like to know if that can be possible and if so why? I believe she had fever in the beggining of the surgery and aswell as right now that shes in coma, thats what the doctor says. ### 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. It is hard to say since I need more medical data, but causes may be from anesthesiology to severe gallbladder inflammation or sepsis. This is not important now, and it will be treated on right way I believe. 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 am a 62 year old male 5 8 and 180lbs. i have a medical history of having several strokes. many diffeent meds. i have been very fatigue lately also dizzy and my feet going numb. took my blood pressure this morning while i was resting at table and it was 162/72 pulse 52.. is this normal? ### REPLY: Hi, Read your history. See blood pressure of 162/72 is on the higher side. So you need to control it. Besides, you are feeling fatigued and dizzy. Even you have given a history of numbness.  I strongly feel that all these symptoms need further investigation. Maybe these symptoms are due to high pressure, but it can be because of other reasons.  It can be anemia, ( low hemoglobin), vitamin deficiency, electrolyte imbalance (abnormal salts in the body), or maybe .  You can start with some multivitamins but do go for some investigations like complete blood count, ECG, electrolytes and kidney tests. 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 was diagnosed with pulmonary fibrosis 2 years ago after a lung biposy... i was on prednisone for a couple of months.. but i stopped.. from now on im only using an inhaler (symbicort) but every morning as soon as i open my eyes, my cough starts... and it keeps going for more less 20 minutes.. no matter what i do it wont stop.. after those 20 minutes of coughing im just exhausted... i was wondering if there is anything that could help with my cough and the sputum ### 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-Overnight Lung Congestion and would need Cardio-respiratory assessment. Remedy Suggest -for your case Bronchial Care-with Positional Chest Tapping would reduce the complications associated with these morning cough spells. Restriction of Fluids after 4 pm. Reduce on . Reduce on Salt in your diet. Use Inhaler infrequently. Practice Deep Breathing x 3 times a day x 10-15 MTS sessions As I don't have access to cause of your Lung Fibrosis, Second Opinion from your Chest PhysicianOther causes need to be ruled out and treated if present accordingly from Second opinion from Chest Physician and Chest Surgeon. 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!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a lump deep in the right back side of my head for maybe 3-6 months. my blood cell count was normal. i read somewhere vaccines could cause this...i had a tdap around january. would this cause it? i had no other reactions to it. the node is about a half in. in diameter or so. ### REPLY: Hi, Dear,Thanks for the query to My  Clinic. I studied your query in details and understood your health concerns.-Cause of your lump on the back of head after TRAP vaccine shot-a- Yes this appears and mostly is -post-TDAP shot lump with -reactive hyperplasia in the lymph nodes -in back of your head. The cause is -reactive hyperplasia in lymph node post vaccination. This advice would help you to plan treatment with your doctor. Hope this resolves your query. Wellcome for further query in this regard. Have a Good Day...!! With Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Well im on birthcontrol and missed a day so i took two the next day and i had unprotected sex 3. days before my expected period Sunday. I havent had my period yet. But lately ive been having backpains, headaches, nausea, Sore Breasts, and ive been urinating more than usual. i Have no idea whats going on ### REPLY: Hi there, Let me answer your query. As per your history, you have very little chances of getting pregnant. Your history of unprotected sex act after completing the schedule of birth control pills, is not a period of egg formation, so chances of pregnancy are almost nil. I will suggest you to get mornings first sample of urine tested for pregnancy. In case of doubt blood beta  test and USG will be of help. In case of negative pregnancy test results, please wait for the onset of periods. With negative test results, your symptoms can be due to hormonal changes. Please do not worry.  Symptoms will disappear as you start with your menses. 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: I am 61 and have been diagnosed with cerebellum ataxia. What is the lifespan of this disease. I know there is no cure or medication that will help me. As time goes on I realize it will take over my body. with in 4 yrs I can not walk without a wheel walker and my balance is so bad I need assistance when without the walker on wheels. I am starting to have slurred speech and now my younger sister is starting to get the same symptoms just out of the blue. It gives me an empty feeling not knowing what can become of my life. I am a positive person but I truly need to know more information on this disease to satisfy myself and my sister. If you will give us some answers on this matter we would be so greatful. We do have doctors but they never gave any info on this subject to really learn more about it. We are both the type to put it straight in our mind that what is happening is what it is and we take it day by day. We are easy going and just want to evaluate what is in store for our future years. Preparing our mind for what is coming is important for us and our families. If you could give us some insight on this rare disease it would be of great help to us for setting our minds up in the future. Just in four years time I have really seen a big change in my body and walking and speech. I will be anxious to recieve your reply. Thanks for helping me. Vickie Welsh I just wasted my time and yours......it was never mentioned in the begining that there would be a charge. I am unable to pay out anymore on doctors. After paying out 5,000.oo a year for me and and same amount for my husband. I m sure you can understand that I am strugglling enough trying to pay for medical bills as it is. So sorry to have bothered you just was looking for some other doctors advice as a 2nd opinion. Thanks for reading what I had to say. Have a great spring. ### REPLY: Hello You don't necessarily need to pay. There is a free public forum. Its just that in the premium pay section you get your answers more quickly and have the possibility to exchange with doctors through follow-up answers. Regarding your query, I am afraid that more info is needed. Cerebellar ataxia is only a descriptive term, Latin for balance and coordination issues due to cerebellum (little brain) involvement, but it doesn't say much about the cause. There can be many causes so more information on tests you've had, imaging and genetic ones in order to properly classify the ataxia and its prognosis. So please write again providing such information. 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: Im 29 years old and just wanted to know What are the chances of getting pregnant after having a laparotomy ... I had the surgery on March 2010 when I was 3 months pregnant! My son is now 2 and my husband and I have been trying for the past 6 months but no luck yet. I m scared to think that I won t be able to conceive anymore ### REPLY: Hi, Thanks for your query, To answer your query, we will need details of operation. What was exactly done and what structures were removed. If I presume it was done for ovarian cyst/tumor which is a common cause of laparotomy at this time of pregnancy. In this case also even if one ovary or its part is retained during operation, then chances of pregnancy is there. Go through the operation notes. Best of luck. Hope it 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: Dear Doctor,  Yesterday I have done my Liver Function Test and observed that the SGOT and SGPT are increased to 653 and 1164 respectively. Besides my Bilirubin (Total) is 4.4. During last two months I have been taking Levonorgestrel and Ethinylestradiol tablets for my painful periods. I am suffering from abdominal pain with dark urine and less appetite.    What are possible causes for this abnormal test result? What are the precautions? ### REPLY: Hello! Thanks for putting your query in . I am a Gastroenterologist (DM). This high elevation in transaminase levels in you may be due to:1.  .  Acute viral hepatitis (Hepatitis A, B or E)So I will advise you to stop these medicines and get test for acute viral hepatitis (IGM anti HAD, IGM anti HEV, Bag, and IGM anti HBC antibody)And get repeat liver function tests may be after a week to see for the trend of these blood tests hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My self Savitri and My age 55 years old. I have leg pain last four years . when I sit for a long time or walking some time I feeling unbearable pain and burning sensation. I take ayurvedic , alopetChatDoctoredicines. but no result. I have hopeless. What I do. ### REPLY: Hello, There are few possibilities for your leg pain. First, I would suggest you to check vitamin B12 levels, because this is one of the common cause of leg pain.  Because you are already in menopause, there are every chances that calcium and vitamin D could also be low in your body and that can cause bone pain while walking. Also suggest you to go for blood sugar, creatinine and lipid profile.  So I would advise you to start vitamin B12, Vitamin D3 and calcium supplements daily. Also need to use western toilet, walk daily, physiotherapy for knee joint, take healthy diet containing vitamin C, D and B12.  Hope this answers your question and let me know directly if you have any further relevant queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey so i was drunk yesterday and felt sick so i forced myself to puke a few times to try and make myself feel better, and the last time a puked a really small amount of blood came out, i was wondering if thats ok.  This was an isolated incedent and besides being kind of hungover this morning I have felt completly fine all day.  Do you think I am ok? ### REPLY: Hi and thank you for asking can understand that this is a frightening experienceVomiting blood, or hematemesis, is the regurgitation of stomach contents mixed with blood, or the regurgitation of blood only. Regurgitated blood may appear brown, dark red, or bright red. Vomiting blood in some cases it may be triggered by minor causes. This includes swallowing blood from a mouth injury or from a nosebleed. To exclude stomach problems better to do a fibrogastroscopy to confirm it. But in your case my opinion is that this situation has been due to excessive alcohol. So be careful with .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello,my name is aadesh patel,i am 35 years old,i am suffering from lest side partial weakness,before 15 years the left side eye is locked so there are double vision,but after there is left side weakness,also my hand and legs size are some different.also i can t walk for more, ### REPLY: Hello, The weakness from childhood may be possibility of some muscular dystrophy or developmental abnormalities etc. Stroke in young also may present like this, but my advice depends upon the causative of your problem. For the diagnosis I need your history and scan findings. Please post your MRI scan report and other blood investigations I will advise you about your health problem. Take care. 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: Im 68 years old, white male, and have been diagnosed witChatDoctorplex PTSD, severe depression (clinical) depression, and am on a plethora of medications.I have psychotic aspects. I have a feeling of impending doom awaiting me, and am doing my best to try to look positively at my life. Why is it that I always feel like I have to wait before I,m free from anxiety to tackle something new?. I feel like my life will be over before I get started. ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. It seems your anxiety disorder has not been completely treated, and the symptoms are still persisting. You have not mentioned which .  Otherwise, I could have suggested you some more measures which can be taken up in your medications. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi ,I have had a lot of troble sleeping for years now.I hart rate is fast and quite strong most of the time. my blood presure is allways high when I go to see a doctor or dentis, but at home its mostly normal. most of this started after sugery several years ago. ### REPLY: Hello, Regarding your concern, I would explain that your symptoms are related to White Coat Syn .  You should know that these changes in blood pressure values are caused by the anxiety and fear when consulting with a doctor or a dentist. There is no need for any treatment, as these blood pressure fluctuations are not harmful. So, just relax and don't worry about it. 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 wife is 36 she gets confused about most everything, put things in odd places, falls asleep when i talk to her, headaches,feels sick,shakes, swets , i took her to the hospital many times.yes she smokes, ive found her asleep on the front porch and many other places, sha has a hard time urinating too. i need help i never know what im going to come home to from day to day. i have a next door naigbor whatching her while im at work. today the niegbhor said she found food all over the floor and my wife asleep in the kitchen .please help ### REPLY: Hello! Your wife symptoms could be related to a sleep disorder (sleep apnea, narcolepsy or other types of hypersomnia). A metabolic disorder (thyroid dysfunction, a .  For this reason, I would recommend consulting with her GP for a physical exam and some tests : -a polysomnography for sleep disorders- a chest X-ray study and pulmonary function tests-thyroid hormone levels-kidney and liver function tests-blood electrolytes- fasting glucose- a urinalysis for infection. You should discuss with her doctor on the above tests. 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 have frequent urinary tract infections. A few years ago I was taken to the emergency room with a temp of 106.7 after passing out in the kitchen. I was septic. I am diabetic, drink lots of water and other fluids. What can you suggest for me as a home remedy? ### REPLY: Hi Thereafter going through your query I understand your concern. I would like to tell you that Urinary tract infections are more common, more severe, and carry worse outcomes in patients with diabetes & often caused by resistant pathogens. Poor immune system, poor metabolic control, and incomplete bladder emptying, fungal infection may all contribute to the enhanced risk of urinary tract infections. The treatment for your UTI will depend on what type of infection it is. But You can prevent UTI by practicing good Hygiene techniques like-Wiping front to back is essential-Go to the bathroom and empty your bladder immediately after sexual intercourse.- Every time you empty your bladder, try to make sure it is fully empty.- Keep your diabetes under the best possible control. Hope to have been Helpful. Kind Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My doc prescribed the following tablet... 1) Fertyl ( once a day in Period for five day) 2) folvite- (once a day) 3) fertisure F ( Twise a day) My period is irregular. it s takes one or two months. We are trying for baby from last 2 years and have done HSG test ( Normal) also trying with follicular monitoring test. But not succeed. Now my doc told me change tab GoodOva Tab ( once a day in Period for five day) if its help me to conceive then ok other than doc suggest me for Laproscopy to find out what is real problem?and after that if IUI test. My Husband semen analysis test is normal. what should we do? pls tell me natural way to conceive. Thanks in advanced. ### REPLY: Hi, Welcome to . Your main obstacle for conception is an ovulation (egg not forming every month). If ovulation had occurred for more than 6 times in past with Ferry/Moldova tablets (indicated by regular period of 28-30 days while taking tablet), it's better to go for laparoscopy to know & correct the cause. If it has not occurred OR has occurred for less than 6 times, you can continue with the tablets. If particular dose is not causing ovulation, dose of tablet can be increased to induce ovulation. With the history you described, conception should be easy with ovulation induction tablets (Ferry/Moldova) alone. Hope this helps you. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: as per scanning report my liver position is found as below.Liver normal in size and diffuse homogenous increased echotexture. No mass lesions. No IHBD,  PV>Normal, CBD; Normal;  kindly suggest what is stage of my liver and what precautions has tobe taken by me ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your ultrasound report of liver is almost normal without any mass lesion. Its size is also normal. So nothing to worry much about that. Go for liver function test once if you have any symptoms of liver disease. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a tiny, round feeling bump under my skin on the back of my shoulder. A few years ago I was in Ft. Lauderdale and neglected to use sunscreen while jetskiing. Due to this stupid mistake, I also have procured some freckling on this same shoulder from skin damage. This lump is painless and for a while could only be felt when pushing on the area. I can now see where it is located, though it hasn`t changed in diameter. There`s no coloring or pain- only when pushing to try and drain it. Also, recently i have discovered on the front side of this same shoulder a U shape, very faint, red exema looking scratch (Im not sure how else to describe this new mark). Im starting to get worried about skin cancer. Im 18 and have no insurance so please help. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some dysplasia changes or hyperplasia. Chances of skin cancer is less likely at your age. Still you should go for biopsy of that lesion once. It will give you exact diagnosis whether it is skin cancer or some other lesion then you should take treatment accordingly. Treatment of skin cancer is excision followed by radio or chemotherapy according to type. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Three years ago, I had a pulmonary embolism on my lung. It was treated with Herceptin (sp) and warfarin tablets. After the treatments ended, I felt something travel from the location of the embolism to the side of my left chest . every so often I feel a soreness in the area of my upper left side, then the soreness goes away for a long time and then the area will be sore again, My dr says my heart is working fine, do I have a problem here ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you should consult pulmonologist and get done CT PULMONARY ANGIOGRAPHY to rule out worsening of embolism and development of pulmonary infarction. As sore feelings in chest can be due to pulmonary infarction.  So we need to rule out this first. So pulmonary angiography is needed. If this is normal than no need to worry much. This can be due to anxiety. So avoid stress and tension. Be relax and calm. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...I have an 8 year old daughter with a hot, itchy rash that has presisted for a week with low grade temperatures controlled by nurofin. the rash appears and disappears all over her body. at one stage her hands and feet swelled up. she is now experiencing pain in her wrists and one knee. ### REPLY: Hi thanks for using  Please consult a doctor and look for throat infectionRoutine blood tests has to be done including AS title, CRP,ESR Streptococcal infection can cause these type of problemsAntibiotics has to be initiated There are some viral fevers which can present like this .Hence, doing a Blood count will give you a clue.... Typhoid fever is another possibility ... You can do a TIDAL test usually we do TIDAL test after 7 days of fever....thank you.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, I am 43 year old women. What are the treatment options for infertility in older women like me? ### REPLY: There are limited options for treating older women who are menopausal or premenopausal. Older women usually respond poorly to ovarian stimulation and the live birth rates even with IVF treatment are significantly lower than with younger women. The older women are at increased risk of having medical problems in their pregnancies and deliveries. In order to improve the success rate of IVF treatment in older women, some clinics recommend assisted hatching, blastocyst embryo transfer, and preimplantation diagnosis and only transfer normal embryos. Furthermore, in some countries the transfer of high number of embryos is recommended.  Other options of treatment include egg donation using eggs donated by younger woman, embryo donation if the male partner also has a sperm problem, surrogacy if a woman (traditional surrogate) agrees to become pregnant using the male partner sperm and her own eggs, adoption and foster care and accepting child-free living. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 came to europe last month and all of a sudden i had stiffness and severe pain in neck, shoulder, both hand and finger joints, mild fever and flat reddish rashes in under arms and thighs. As per doctor advise, I took aspirine, caltrate vitamine D3 and voltarene L.P.75mg for few days. I had noticed blood in the stool and stopped the medicine. After 15 days the pain subsided in the neck and hands but slight pain persist in finger joints. kindly advise ### REPLY: Hi, thank-you for providing the brief history of you. As you have pain in the joints a thorough clinical examination is advised. Also, such sudden pains can be probably due to either of the factors like - Rheumatoid arthritis or Viral arthritis. As both contains similar symptoms and needs a clinical examination and also the blood routine for RA and Viral arthritis. Based on the clinical findings and laboratory finding the diagnosis will be easy to make and . Also, physical therapy will help to reduce the pain and aches along with Strengthening of the muscles. In my clinical practice most cases with RA and Viral arthritis respond well to a combination of  ### END