Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dad has recently declined health-wise and I am wondering what could possibly be wrong with him. He s 63 years old and smoked most of his life. He quit about two years ago. He also worked as a welder in a blacksmith shop for 45 years. He is down to skin and bones, literally can see shoulder blades sticking out even under a sweatshirt, yet his stomach seems to stick out as if it is bloated, and he s never been a guy with a big belly. He s picking at every bump/pimple he can find on his body. He s not sleeping much. He seems to be starting to have mind issues as well, like saying things that don t make sense, short term memory loss, etc. Most of the time he is absolutely exhausted and can sometimes barely stay awake while sitting in his chair while we are visiting him. ### REPLY: Hi welcome to  I Have gone through your query regarding your dads multi health issues. I can understand your concern. Dear, It seems that he has something serious on his mind which are disturbing him and telling upon his physical health also.  As you know mind and body are interrelated. If body is sick mind dost work properly and worried mind, physically makes you sick The most important thing to remember when caring for an adult with memory issues is to give them independence respectfully. Finding tasks for them, keeping their mind busy, and rewarding them for a job well done will promote a desire for mentally stimulating activities. Your love and care will reverse the situation for bettermentHaving a healthy lifestyle, staying mentally active, and participating in social activities may help maintain mental function or postpone its decline. Intake of balanced diet containing all essential nutrients, fiber, vitamins, minerals in natural form, a lot of water, and yoga postures to detoxify and strengthening, stretching of arms and legs and whole body & Panama -deep breathing & meditation help to acquire well balanced body and mind. It is advised to see your doctor for further guidance. Hope this helps solves your query. Take care. All the best. Wish he Gets well soon.Don't hesitate to get back TF have any further query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a hard lump by the crease between my leg and my vagina and the area around it is blue and red, no hair has grown back in over a month, the lump has been there for a month too. I dont have health insurance so trying to figure out what it could be and what i need to do for it. ### REPLY: Hi! Good evening. I am  answering your query. Irrespective of your insurance status, with the history and clinical state of the lump what you have stated, I am afraid you might have to get it clinically examined with related investigations as advised to get into the nearest diagnosis so that proper management could be done. Without a clinical assessment, it might not be possible to comment on this lump. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: husband had abnormal ecg echo test clear but positive stress test showing he may have had a heart attack.he is 59 and father had angina died at 68 with stroke husband is non smoker and non drinker,has to have angiogram,could it be a false alarm or am i deluding myself? ### REPLY: Hello, I understand your concern and would like to review his ECG for a second opinion.  An exercise cardiac stress test or dobutamine stress echo would be less invasive tests (compared to the angiogram) to help investigate for coronary artery disease.  Even though he has no cardiovascular risk factors like smoking or .  Which may lead to an increased risk for coronary artery disease.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump thaat has suddenly appeared between my vagina and the crease of my leg. I felt tremendous pressure last evenin befor I went to bed and this morning found the lump. It is as big as quarter, deep under the skin, I almost thought of a hernia. The only thing different in my life is tha I had shoulder surgery 7 days ago. Any Ideas? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have inguinal hernia or enlarged inguinal lymph node.  You should go for examination. If needed go for ultrasound study.  If it is lymph node or soft tissue tumor then you should go for fine needle aspiration cytology or biopsy of that lump.  If it is hernia then go for surgery.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey Dr. Sam is there a written test I can give my mother inlaw to show her 2 sons she has dementia and needs to see a doctor. I fear she will hurt herself as I know she can no longer live alone. Her sons don t really want to deal with it and she can NOT LIVE ALONE ANY LONGER. My doctor said there was one I could print out for her to take on your website but I can t find it. ### REPLY: Hello, welcome to . Dementia is a chronic illness. It develops slowly, due to that diagnosis is delayed in most of the cases. Before any test it is important to take detail history to know about problem, type of dementia, cause of dementia and to rule out other condition which can present as dementia like initial stage of depression. Test like MUSE (mini mental status examination) is used by trained professionals to assess cognitive function of dementia. It is better to visit nearby psychiatrist or neurologist for diagnosis and management. Wish you all the best.  . 99doctor.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My granddaughter is almost 8 years old, her sister 7 and her brother 4 years old. She complains of stomach aches during the day school and in the nights, does not feel she has to poop, and her panties are getting dirty. This is about 2 and half months after the birth of her little baby-sister which is now 3 months old. She does not feel the bowel movment. The kids are getting full attention of their parents and even are very spoiled. Can you advise me how to solve this problem. Thank you ### REPLY: Hi...what you are quoting is exactly called encopresis. This occurs when the kid has hard stools, almost similar to constipation. But what happens here is the liquid stools will seep out on the sides of the hard stools and leak out. But, the main treatment of this is relieving of constipation. Suggestions:1. Natural methods are the best to relieve constipation.2. Constipation is a risk factor for UTI3. Maximum milk consumption per day should not exceed 300-400ml4. Minimum 3-4 cups of fruits and vegetables to be consumed per day5. Toilet training - that is - sitting in Indian type of lavatory daily at the same time will help a lot. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i am a 45yr old female. I have gained weight around my waist over the last month, and would probably say I was pregnant if I didnt know any better (and also done a pregnancy test which was neg) as I have a lot of the symptoms e.g : extreme nausea (and sometimes to the extend its making me cry cause I know I would be unable to go to work cause its quite over whelming, take anti-nausea tablets when it gets this bad), feeling full, not able to eat normal portions of food without being extremely bloated and having difficulty breathing, tired and crying unexpectedly without warning and no reason.  I have been to see my GP and had bloods done which were all ok.  She gave me a depression questionaire which I answered honestly and my score was 1 out of 10 (the 1 was for feeling tired ). I live a full life as in I work hard, Im redecorating my house, go out with my husband and friends for dinner and drinks, cook healthy meals for my family, clean my house, spend as much time as I can with my granddaughter, go shopping for clothes etc.  This is starting to get me down as I cant seem to get to the bottom of it...............do you have any suggestions? ### REPLY: Hello, welcome to . If your pregnancy tests are negative than there is no need worry about it. For confirmation, you can have repeat test after few days with ultrasound abdomen. Although your depressive questionnaire is only 1 point positive but from history you have many depressive symptoms like: low mood, crying without any reason, somatic symptoms (like dyspepsia, tiredness and breathing problem) and disturbance in occupational life. It is better to get evaluated by psychiatrist to rule out depression and start treatment accordingly. Wishing you good health and all the best. . 99doctor.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My blood pressure has varied from 167/111 to 80/30 for weeks now Up then down continuously as of late. I keep having chest pains, shortness of breath, dizziness, blurry vision, nausea, extreme fatigue, headaches, muscle cramps, body aches, my urine has changed frequency and smells strongly. My back hurts frequently and I am confused often. ### REPLY: Hi, It can be due to a stress or an infection. But it depends on how your blood pressure changes and at what hours. I would advise you to keep a blood pressure dairy for a week and show your doctor. In this case your doctor can help you to control blood pressure. I would advise you to have an urinalyses and blood simple to find out whether there is any infection. Wishing you a good health In case of further questions don't hesitate to ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A couple of weeks back I had an acute onset of joint pain with swelling - this has now settled but some of my blood tests have come back abnormal - I have low HB and chronically marginally raised esr and crp.  Also, my results showed abnormal lfts.  I am worried - have been referred to a haematologist but cant help researching online! ### REPLY: Hi, Joint pains would be secondary to arthritis and this would lead to raised ESR, and increased CRP. It will return to normal slowly once inflammation reduces. Your hemoglobin is reduced, maybe due to nutritional deficiency. I do not have your Lots details with me to comment about it. If you are an alcoholic, it explains your abnormal Lots, and the hemoglobin reduction could be due to abnormal nutrition. If you have any more questions, 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: I recently started having chest pains.  Have been checked out by cardiologist.  Had a stress test, then a heart cath.  No blockage.  The doctor did start me on blood pressure meds.   Being checked to see if my Acid Reflux and Hiatel Hernia is caused more damage by having a upper gi this week.  My chest is still hurting in the left upper area.  Has started hurting today while breathing.  I am a 42 year old female, my father passed away at the age of 46.  Do I just keep eliminating the issues?  Did try nitro today to see if pain would stop? ### REPLY: Thanks for your question on . I can understand your concern. No need to take nitro for your chest pain because you are not having cardiac chest pain and nitroglycerin is given in cardiac chest pain only. No need to worry about major heart or lung related diseases. You are thinking too much about your chest pain. And this causes stress and anxiety and they intern cause further chest pain. So avoid stress and tension, be relaxed and calm. No need fir further tests. Take simple painkiller like ibuprofen, and you will be alright. 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: hii have got dog byte on my knee ,but skin was not broken also no abrasive and the dog was street dog after that i didnt watched actually the dog which bited me is because of night time i am coming on the street.for around 36 days i am not taken any injection but only the place knee i feel burning sense.then i decided to take vaccination.Is it effective taking at this time gap of around for me other than knee also thie burning sense no other problems.no swelling at the bite place.this anti rabbies will work now or not ,how long a rabbies will live inside humen body and how this anti rabies will destroy the inside rabies.thanks ### REPLY: Thanks for your query at ! I went through your query! It is right that you started vaccination complete it 0,3,7,14,28 and 90 days. Rabies has variable incubation period 2 to 12 weeks sometimes longer. Treatment after exposure can prevent the disease if administered promptly, generally within 10 days of infection. Even with significant delay in vaccination still has a chance of success. It is also possible that the dog had no rabies in saliva bit must have been watched for 10 days. In that case no need to worry. You are doing the best treatment and have no CNS symptoms so very little chances of disease. The vaccine works by antibody development to combat the infection inside. Happy to take more queries! You can also write a review for me. 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 finished taking my antibiotic azithromycin last week. I am four days late for my period. I took 3 home pregnancy tests. They are all positive. Does this antiobiotic have ChatDoctor in it. I need to rule out this medication and be able to know that I am pregnant ### REPLY: Hello, You cannot get a false positive pregnancy test with the use of an antibiotic medication. A false positive test can be seen in conditions where external  supplements have been used as in the treatment for infertility. Since you have had persistent positive pregnancy tests, the next step should be to get a trans-vaginal sonogram to confirm the pregnancy, locate the gestation sac and also to note the age of the pregnancy. Azithromycin or in fact, any other antibiotic can cause failure of oral contraception and cause an ovulatory cycle. 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 90 year mother is suffering from Dementia and she us all confused especially at night. She can t relax and she gets paranoid and wants to leave the house to go find her husband that she thinks she is still alive. He passed away 8 years ago. What can I give her to help her sleep and relax. Daytime she is not too bad. Only at night she starts and she won t understand anything we tell her. The medication we tried is not helping. ### REPLY: Hello, First, this is dementia with superimposed delirium. I will not be able to tell you what type of dementia with the given information. As such, the sleeping medications are not going to help. If anything, they are going to make the delirium worse. So, please refrain from giving them. Other than that, make sure she is in her normal environment as much as possible. If not present, put a watch in her room. And make sure there is always light in her room. As for the diurnal variation, I think she is sleeping more during the day. So, give it your best efforts to keep her awake in the daytime-give her activities that she is/was fond of doing during the day. She does seem to have some component of paranoia. She would need anti psychotics like Quetiapine. However, I would recommend taking the medicine by a prescription of a certified psychiatrist only. Last but not the least-she is in delirium. She is not trying to cause you trouble. She is not listening to you because she is in delirium-in her mind and memory her husband is probably alive and since he is not around she will want to go look for him. So try to be patient with her. It might help to understand her as much as it is important that she understands you. 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 father has end stage lung cancer .(secondary to previous bowel cancer ) he is on 40% oxygen as his oxygen levels were as low as 78 on Friday. He is still up, just not moving far. (10 litres per minute) He asked what would happen if he suddenly couldn t breath. Every movement is tough so it is crossing his mind more and more. What can I expect and how would I deal with it? I would hate for the oxygen not to work and be in a situation of panic as that would be terrifying for him. i have talked to him about breathing exercises and relaxing etc. He is still at home where we would obviously like him to stay if he continues to be comfortable. Can you give me some brutal idea of what to expect. I know what is coming but I would like to be quietly prepared so I can help him as much as possible in the absence of anyone else etc. (he is 78) Thank you E. ### REPLY: Hi, lung cancer secondary to bowel cancer uncommon commonly bowel cancer metastasize to liver first, your case the lung cancer may be of second primary. Anyway as his pulmonary status is very poor it is possible that he may develop respiratory failure. At present overenthusiastic treatment by putting the patient on ventilator or similar attempts may not be a realistic approach. It is better to manage him conservatively and have an opinion from any palliative care specialist. 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: 3 weeks ago someone used my roll on / after I used it, within a 2days I felt a lump under my armpit only to Released I had a boil / in a week time it became bigger and painful, pus came out but there was a lump that had a hole inside , then after 3day I felt another lump now it much bigger and I don t know what to use or take ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You may have sebaceous cyst, enlarged lymph node with acute inflammation or some soft tissue tumor. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my sister is suffering from pain in her leg joints and sometimes become swollen.she also have high fever,but her first symthom was loss of hair,she now have stone in her galbladder.she vomits often,she loss weight .doctors dont know what wrong with her ### REPLY: Hi, These are some typical symptoms of gallbladder attack, and she should do at least ultrasound or CT scan to evaluate it more accurately. This is caused by stone in bile duct and is very common condition.  Stones are seen more commonly in obese people and those with diabetes. You need to change your dietary habits first.  Need to avoid fried food, carbonated .  You should eat more milk products, vegetables and boiled food. If there is no improvement on lifestyle or dietary changes, then surgery is recommended. I hope I have answered you query. If you have any further questions you can contact us in every time. Wish you a good health. Kindly 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: Dear Dr My Father had a bye pass surgery on 19th November 2010. Dr had advised to have Glycomet GP 2 for future. But due to having a very low sugar our doctor changed the medicine to Glycomet GP 1. The sugar level became normal for few days which was around 125-145. but since few days his sugar is again keeping low - Jan 17, 2012 at 9 pm sugar level- 74 Jan 18, 2012 at 9.30 am after tea sugar level- 164 Jan 18,2012 at 9.45 pm sugar level-84 doctor please advise in this matter and do let us know any good diebetician in dehradun whom we can consult. Waiting for your response. Regards,Upasana ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would explain that 74 is not a very low level of sugar. Anyway, if he feels symptoms like dizziness, fatigue and sweating, this could be a sign that his body does not tolerate these low levels of glucose. I would recommend reducing the dose of Glycogen GP in order to have higher levels of glucose. You should know that all oral antidiabetics can lead to hypoglycemia as a common adverse effect. That is why the dose should be adjusted based on the fasting glucose levels during the day. You should discuss with his endocrinologist about the above issues. 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: hi am a male aged 23, tested for HBsAG positive after an interval of 3 months, the doctor requested for HBeAg and hb viral load and results showed negative and less than 12 ul/mL respectively, he interpreted the results and told me that i do not have the hbv , i remain confused, doctor do help me interpret this result and show the way forward and on seriou note am taking liv.52 this is my second day of it, does have something to do eliminating the virus from me. please do help. ### REPLY: Hi, Thanks for using , After going through your history you are HBS Ag Positive, if He Ag is negative still you are infected and carrier, but disease is not active at present, so you need to take care and proper follow up is required. Periodically liver function and other tests may be repeated to know the activity of disease, so treatment may be given at appropriate time if required. Your family members spouse and child .  The  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir this is to inform you that i am married from the last two years but our we dont have consume still. i have problem of low sperm motility of 20 ml only 10 % progression rate so what is ur suggestion about it how i should get my permanant treatment. ### REPLY: HelloThanks for query. Based on your statement you seem to have what is called as Asthenospermia meaning there by that your semen contains sperms with only 10% active grade motility. It is the active grade one motile sperms that are capable to fertilize female egg resulting into pregnancy. The count of 25-30 % of active grade one motile sperm is accepted by most of the fertility centers all over the world to be normal for effective fertilization. Unfortunately there are no medication that can increase motility of sperms however following measure do help to increase percentage of grade one motile sperm 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc 3)Take anti oxidants like Almonds 5-6 everyday4) Avoid alcohol and smoking. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: In July my husband had an MRI after loss of immediate memory and it showed that he had a stroke (silent).Then after a couple of weeks he felt bad s he went to the hospital and they found a blood clot  in his left lung, and he was hospitalized for a week and he was kept on intrevinous blood thinners. He was released, and has been on warfarin since then. His memory has not improved and he is disoriented and feels bad most of the time so the doctor ordered another MRI of his brain. The report shows that he has a chronic lacunar infarct involving the right thalamus which was subacute at the time of the previous  examination. Can you give us any information that might help us understand this report? ### REPLY: Hello memory problem could be due to minimal brain damage after mini infarcts. It could be after high blood pressure which has been poorly treated. Or the clot in the lung which could have been in his legs could also have affected his brain. He should be assessed why he has hyper coagulation state (some people may have sleep apnea, or protein C or factor 5 deficiency, etc. Consult with his doctor to see. 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: My doctor referred me to have an ultrasound after I complained of ovarian/abdominal pain and bleeding. I had a trans-abdominal ultrasound, whicChatDoctore back negative. Im very petite and under 25, so was told that they may be able to get a pretty clear image with a trans-abdominal ultrasound. However, Im still a bit concerned. Is a transvaginal ultrasound the only way to detect early stage cancer, or smaller masses in the ovary? Can I be confident with my results from the trans-abdominal ultrasound? ### REPLY: Hello and welcome to , Transvaginal ultrasound gives better image of the ovarian mass as compared to trans abdominal ultrasound. If the trans abdominal ultrasound is not showing up anything, a transvaginal ultrasound will give better images of the ovarian mass. There are other investigation also which will help to find out the pathology in the ovary. If the transvaginal ultrasound does not show up anything, other investigations like ovarian aspiration or biopsy may be used. Get the transvaginal ultrasound and wait for the results. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, What is the correct treatment for osteoporotic compression fracture of the spine (D12 thoracic vertebra) which takes place due to minor trauma like fall. Patient is aged 59 and is female. Should one go for surgery like balloon kyphoplasy or any other procedure or one should go for non-operative treatment like conservative care? Please suggest ### REPLY: Hi, thanks for providing a brief history of the patient. As to see here the D12 vertebrae compression fracture surgery is totally depending upon the symptoms. If the patient has loss of mobility of the lower limbs and have bladder uncontrolled then one should undergo for spinal decompression surgery.in case is the patient do not have any symptoms like pain, numbness, tingling sensation etc. patient may not need a surgery. Usually the vertebrae heals on its own. Since the patient is a female she may have low calcium levels and vitamin D levels. For which she can undergo a supplement for the same. If the patient has pain and aches for which one can discuss with their spine surgeon for undergoing physical therapist. As physical therapy is a non-invasive and patient involved therapy. Pain can be reduced by use of therapeutic ultrasound and TENS therapy. Later on the exercises may be recommended by the physical therapist. As to what he feels beneficial for the patient. I hope I have answered your both query. Please take a wise decision. With the grace of God I wish you 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: I had a stomach virus a week ago.  A few days after I had pain around my ribs like maybe I was sore from throwing up so much.  Since then, the pain is different.  It still hurts in my midsection, most especially when I take a deep breath.  Could this maybe be bacterial?  Perhaps I need an antibiotic? ### REPLY: Hello. Thanks for writing to . I read and understand your question very well. I try my level bet to explain you. As you have pain while breathing, it may due to rib infection, pneumonia, obstructive disease, or it may be due to injury to your ribs. I suggest you take X-ray of chest AP and Lateral view to rule out causes. Also advise taking ibuprofen for pain. If symptom persist than consult a good physician. I hope my advice will help you a lot. Thanks and Regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a bump on my gums for a few months now. It doesnt hurt unless i push on that area with my finger. also it does not hurt when i chew or anything just when i apply pressure with my finger. It is important to note i have had a root canal in that area in the last few years. Can you possibly give me some suggestions? Thank you ### REPLY: Hi. Welcome to  . I have gone through your query and can very well understand your health concerns. As per your complaint a small bump over the gums can be due to a few reasons:1. It can be Gum abscess caused due to gum infection leading to pocket formation and abscess.2. It can also be a traumatic gum abscess caused by some trauma like with toothbrush bristles or hard food like hard chips etc.3. Furthermore, it can also be a tooth abscess caused due to infection in tooth reaching below the tooth roots causing localizing of infection and pus leading to abscess formation. As you have a root canal treated tooth in that area it may or may not be a tooth related abscess, and you should consult a dentist and get an x-ray done to rule out the exact cause of the bump. In case of abscess caused due to infection antibiotics like Amoxicillin and metro will provide relief. Warm saline gargles will help. In case of abscess due to gum infection Scaling has to be done along with medicines. In case of tooth abscess it if it does not heal Discectomy can be done. If it is traumatic gum abscess it mostly heals on its own, you can do warm saline rinses. Hope this information helps. If you find the answer helpful please give me a Five-Star Review and click on found the answer helpful as a token of appreciation. Thanks and regards. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My white blood cell counts have dropped to 2.9 from 3.7 six months ago. I had a needle biopsy on Friday. I have an enlarged lymph gland/node in my back for 6/7 years with no changes until this last year. It grew from 4.3 cm to 6.2 cm. I have no outward symptoms, no weight loss, no loss of appetite, no chills, fevers or night sweats. Do you have any thought of what might be cause of drop in white count, other than Lymphoma? RBC 4.60; hgb 14.1;hct 43.1;plat 190 down from 212; gran# 1.4 ( I don t know what that is it is marked as low on lab report). Thank you ### REPLY: Hello and welcome to , A needle biopsy is not responsible for fall in white blood cell count from 3.7 to 2.9. Both the values- 3.7 and 2.9 are on lower than the normal range, thus, the difference is not of much consequence. Low white blood cell count can occur in case of severe infection or bone marrow depression. A low granulocytes count is also a consequence of low white blood cell count. All other parameters-red blood cell count, hemoglobin, hematocrit and platelet counts are within normal limit. Thus, all other parameters are within normal limits. Consult your primary healthcare provider to find out the cause of low white blood cell count. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Gud morning Doc.. i have severe pain around my lower waistline particularly at lower back going to the right side .. i cant hardly move or twist my body to both sides, hence, causes pain. I am diagnose with generative osteoathritis at lumbar area before but i dont felt so much pain unlike this one. My urination is normal. The pain started 3 days ago after cleaning n carpentry works. I am planning to take pain reliever for d meantime. If d pain will not aftet a week i will be forced to see a doctor.. tenk u doc for ur advise now.. god bles u n ur family.. Mr Rolly ### REPLY: Hi, Thanks for your query. The symptoms that you are having are likely to be due to a nerve root compression. You need to get an MRI scan of the area done and consult a neurophysician for proper diagnosis and treatment.Meanwhile, you can follow these measures:- If the pain is severe, you need bed rest till the pain resolves. - Get some analgesics prescribed and apply analgesic spray or ointments.- While resting, keep a pillow under your knees if it doesn't bother you.- Avoid lifting heavy objects.- Back strengthening exercises and stretching exercises daily as advised by a Physiotherapist.- Avoid exercises in times of pain. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Around 10 weeks ago I was bitten on my legs by some common gnats (in the UK). Both legs became very swollen and itchy and I became itchy on my upper body also. I was advised to take anti histamines (ceterizine hydrochloride) and prescribed flucloxacilin. The problem persisted and I was prescribed a different antibiotic (can t remember which) and piriton. After two weeks of antibiotics the problem seemed to subside. 10 days after this (about two weeks ago) the itching returned. The original bites on my legs have still not healed and the itching has spread to my palms. The soles of my feet are also very tender and I have had bruised heals for awhile. My hands and fingertips are also very tender and sore. I am now taking fexofenadine which I have been on for about a week. I have had results from a blood test during this and my GP feels it is a ongoing reaction, not an infection. I am, however, becoming increasingly concerned, particularly now as the fexofenadine is not helping. Thank you for your help! ### REPLY: Dear Sir/Madam have gone through your query and read your symptoms. In my opinion, this certainly is reaction and talk to your GP regarding the prospect of using a short course of steroids, as this is what we usually do, but for that he will have to see if there is any contraindication of its use in your case, moreover the body will try managing with it but be careful of the fact that sometimes body over responds to the allergy and cause damage to itself. I hope that answers your query. If your want any more clarification, contact me back. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a 37year old female.  Last month I noticed two soft lumps in my breast.  I got a mammogram and an ultrasound done, botChatDoctore back negative.  The radiologist said the lumps were fat lobules and no further testing or treatment is needeed.  I dont feel comfortable with the lumps in my breast.  My PCP said not to worry and refused to do a biopsy.  Should I get a second opinion?  My mammogram report says my breast are dense and that a BB was placed by the lump.  Im worried.... any advice would be appreciated. ### REPLY: Hi. Thanks for your query and an elucidated history. I can understand your level of worry in spite of two Doctor and Mammography have assured you. Well, this is the best policy to have a second opinionCertainly FNAC- (fine needle aspiration cytology)could have been performed. Many times the fat necrosis mimic the same picture you have. So do not worry please, go for second opinion and insist for FNAC. This will give you sound mind. 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: Why do I feel so aggressive and jittery without a cause? I try to control it on my own without success. I am very snappy and hateful with my family and I hate that. I feel like this is a physical thing, because I have felt this way for about 20 yrs, have been put on antideppressants for many yrs but it doesnt take away all of these symptoms. I have family members with the same problem, it just literally made life so hard over the yrs. and has taken away quality of my life.... It makes me angry that it is still with me all these yrs. I want it to go away now!! So I can have a good quality of life instead of this ruining and defining me and debilitating my life as it has for the past 2o plus yrsl of my life!!!!!!!!!!!!!!!!!!!!!!!!!!!! ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The problem escalated because you were experiencing that for the last 20 years without any change in status. Change in status of the mental disorders happen when circumstances change. Therefore, initially we change the circumstances change and teach the person live and learn in new circumstances. Aggressiveness and restlessness are mainly due to wrong impulse. Neuronal triggers. Meditation creates mental and physical harmony and thwarts the neurons from impulsive behavior. Second step in the treatment process is meditation. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. 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 had iui done on 28th Oct (clomid & ChatDoctor shot) and was asked to take susten post that. Took hpt on 37 th day and got faint positive. Having cramps and lower back pain same as when having period. Is this a sign of an impending period or early signs of pregnancy. When can I repeat the test. Thank you. ### REPLY: HiT hanks for your question. I can understand your concern. If you have tested for pregnancy via urine pregnancy test and faintly positive then you may repeat it after three days. It is advisable to do blood test for pregnancy i.e. beta Highway test for confirmation. Early pregnancy symptoms are usually overlapped with pre menstrual symptoms. So symptoms you mentioned could be due to pregnancy. 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: Hello, I m 1 month 11days pregnant. I knew about my pregnancy on 3/12/15 through pregnancy kit. After that I visited gynecologist same day. She checked and inform that everything is fine. Next day morning I spotted slightly, I inform Dr. And she started inj. ChatDoctor 5000 iu & tab. Hald Sr. Twice a week. My question is that overall my health is fine. Then why she started injection? Is it safe? Any side effects of this injection? ### REPLY: Hallow Dear, Let me solve your queries one by one. After confirmation of pregnancy, if some vaginal spotting or bleeding has taken place, it is denoting that the pregnancy is unstable. In fact performing ultrasonography at this stage would inform you following information:1. Whether the baby is still viable and 2. What is the cause of this spotting. If the baby is viable, then in order to stabilize the pregnancy, we give either Progesterone or In. .  During pregnancy Progesterone is produced by chorionic tissue initially and then by placenta. Progesterone hormone is required to stabilize the pregnancy. In.  will strengthen chorionic tissue and thus will help to stabilize the pregnancy. So, your doctor has prescribed you In.  not for your general health but it is for the supplementation to the chorionic tissue. I hope this clarifies the confusion and doubts in your mind. If you feel you have got some very relevant and important information, you may please cast a "Helpful" vote to this information.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Sir, I am Trina Sen ,age 25.Currently working in TCS.I have a Gallstone at the nack of the gallblodder .I want to get operated by Leser technology not the laparoscopic.Is this Service available at india and if yes then where i can go for that.Please help me in this case .Contact No : 0000Email :  YYYY@YYYY ### REPLY: Hi.thank you for posting query at .I thoroughly read your query and understood your concerns. Gallstones are small stones that form inside the gallbladder. Medical therapy is an option for gallstones, though a vast number of surgeons around the globe prefer removal of gall bladder-surgical intervention. Medical therapy includes intake of ursodeoxyholic acid (UCA) for a period of 12 to 24 months. UCA has been shown to inhibit biliary secretion of cholesterol, reduce intestinal absorption of cholesterol, increase hepatic bile secretion, and improve gallbladder emptying. Medical therapy is useful if mild symptoms, stones are smaller (weight reduction and low-fat diet is also a part of medical therapy. Surgery lasts for less than one hour (usually half an hour). Laparoscopic surgery has greatly reduced surgery time duration and surgical complications. You may travel 7 to 10 days after surgery, though the surgeon may indicate precise time. I would also like to mention that gall bladder is removed completely in surgical intervention which may impair fat digestion. You maybe asked to cut fat completely from your diet (or keep to minimum) after gall bladder surgery. Hope to answer your concern. Wish you good and sound health. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir, i m 28 years old girl and i m suffering from typhoid and cough from last 2 days. i had a blood test.my fever sometimes increase and decreases i dunno what to do . im taking medicine prescribed by doctor. please help to recover fast. thanking youbhawna kakkar ### REPLY: Thanks for your question on . I can understand your concern. If you are on treatment for typhoid, your symptoms will settle in 3-4 days. Build your immunity by eating lots of fresh fruits and vegetables. Consume high protein diet to get over your illness. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 22 month old baby, has thrown up several times over a ten minute period both tonight and last night around the same time however is showing no other symptoms, no temperature, is allergic to dairy however hasnt had any dairy, what could be wrong with him ### REPLY: Hi, I guess there is no history of fall from a height in the last 24 hours (if yes, we need to take him to the ER). Repeated vomiting alone is caused usually by acute gastritis or gastroenteritis (in later condition, there will be loose stools also). Has he taken any ?  If no history of fall from height, fever or loose stools, for such cases I used to give acid suppressants like pantoprazole and antiemetic like ondansetron for 3-5 days. You can try giving ondansetron suspension 5ml twice daily for 2 days and report to your doctor if not relieved or any above-mentioned features are present.Meanwhile, give frequent sips of ORS solution or salted rice water to avoid deny ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Mum has been diagnosed with stomach cancer. She is 85 and it seems like it has not spread anywhere else. The doctors have told us that the treatment would be too harsh for her as she is quite frail. How long can  one live with that kind of diagnoses. Thank you(Ireland) ### REPLY: Hi welcome to ChatDoctorI have gone through your query and found that your 85 years old mother is caught with stomach cancer. In a way, doctors are right .  Instead of giving her any harsh treatment, give her some Alternative therapies . I would like to know since how long she is suffering ? What all the symptoms of her sufferings ? Is she active Any vomiting ? Color ? Has no constipation ?other things to be mentioned ? Can be administered proper remedy after knowing the details.Meanwhile, give her Homeopathy is one them, tried and tested, successfully, in some cases G Meanwhile give her Carcinogen 200 weekly twice 1 dose . Then fortnightly thereafter. Keep vigil on her diet. Give her simple, nourishing diet containing fiber vitamins, minerals antioxidant diet suitable to her age . You can check from treating doctor, or a dietitian. Supplements which have no side effects can be administered to her which are rich in antioxidant properties. Lemon has strong anti-carcinogenic properties that are already been proven.  Mixture, of extract of Lemon, Ginger, Garlic , Vinegar of coconut water, Bark of Maringá (Saharan) tree, Honey all in equal quantity in a dose of 15 ml, twice a day. With same quantity of water, before meals for 31 or 41 days as per requirement.a great antioxidant. Is good healer and also preventive. Take a 1/4 t spoon of turmeric powder twice a day, in a cup of hot milk after meals, Meals should be simple nourishing and easily digestible. Take care not to have constipation. Do Panama - Deep breathing slowly, according to her age & capacity & Walk for resistance against diseases and to strengthen the vital part of the body.  Many heart and cancer patients have been benefited from this. You Can also apply Treatment by magneto therapy, is very simple and effective treatment gives resistance against diseases, is curative as well as preventive method of treatment, having no side effects Regular fort nightly or monthly check up from treating doctor is highly appreciable . Hope this gives reply to your query Take care. All the best & get well London hesitate to get back if you have any further query any doubt get back at . Com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi was diagnosed with AF in sept last yr, started taking bisoprolol in feb, never felt better till about amonth ago where im absolutely shatterd by 2pm. is there something else I could take instead? ive left a msg with my cardiologist but hasn t got back to me yet. thanks ### REPLY: Hello. Thank you for asking on . There are many alternatives on treating, maintaining and controlling the atrial fibrillation. If you do not have airway or lung problems, I would recommend Atenolol 50 mg x 2/d (or metoprolol), which is a beta-blocker with a stronger effect on heart beat, than bisoprolol. You can also consult your cardiologist on switching to treatment with digoxin or a calcium channel blocker, such as verapamil or diltiazem. I hope I was helpful. Take care. 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: Hello Sir I am female lady from India.I got chicken guniea in2006 which was very very severe and as you know that chicken guniea virus does not have any shape or colour just like HIV virus as I got tested Doctors are getting confused in finding out the real problem with me can you suggest what can be behind it as I tested but still soctors are confused ### REPLY: Thank you for posting your query. I can understand that you had Chikungunya in 2006. It would have been excellent if you had given me the current symptoms or problems you are facing. Let me help you. Chikungunya is caused by chickungunya virus as you have correctly pointed out. The symptoms include fever, muscle aches, joint pain, rash to name a few. It can be diagnosed by serological tests like ELISA and RT-PCR. Currently, there is no specific treatment. It is treated symptomatically, like for fever paracetamol is given. Do not panic. Visit any government or private hospital, visit the medicine OLD and get your debts cleared Feel free to post any other question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor,My name is Abdul Gafoor. I am from Abu Dhabi and planned to come to India with my family in Mid of December-2011 only to meet a>> specialized Pediatric Orthopedic doctor to tack his Opinion for my 3 years old son, who is having knock knee problem. I attached some photographs of my son for your reference.As advised by one orthopedic specialist, we used a special type ofmedicated arch shoe around 6 months, but no progress can identified.Dear Doctor, kindly advise me, what type treat we have to follow andwhere I can get the best treatment in India? ### REPLY: I am not sure of the date and time frame in this question. If you meant 2011, that was over 4 years ago. If you mean 2015, I can help you. I was not able to understand what is meant by medicated arch shoe. I am quite sure this was not something done by an accredited doctor. You should consider going to any of the big cities in India, but I think Chennai or Hyderabad may be relatively easier on your budget than Mumbai or Delhi. Bangalore is another good option. You should visit a pediatric Orthopedic surgeon, and you will find one in any large corporate hospital. Lockhart/Forts has a large orthopedic center in Mumbai, for example. They would be able to guide you further, if you can afford private hospitals. If you wish to go to a public hospital, then that is fine too. You will need to carry all the previous reports of the child with you, including his special shoes, radiographs (X-rays), and photos or videos you may have made of his walk, stance, etc. to help the doctors reach a proper diagnosis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had sex with my girl friend while her periods...i.e on 5th day.....does she can become pregnant .....If so also....tell me natural way...How to abort it........ ### REPLY: Hi, thanks for query.  Sex during period can cause pregnancy reasons are- 1)sperm can survive for up to 5 days in vagina and if ovulation occur early as 10th day chances of pregnancy there.  2)if it is not a period, but it is ovulation bleeding chances of pregnancy is there.  3)if her period is irregular time of ovulation not fixed, chances of pregnancy is there.  4)delayed period and early ovulation can cause pregnancy.  5)take emergency contraceptive as early as 72hrs.  6)always use condom.  don't worry, if period not come consult gone.  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 went to the ER for some chest pains I was having as well as minor bloating with it. They did an EKG and a chest X-ray and didn t find anything. I later returned to the ER for some abdominal burning that was rather intense. (Enough so for me to go to the ER.) This made me assume it would be an ulcer and the doctor agree that a peptic ulcer is likely the culprit, however, without tests they can t confirm. I was told to go get ranitidine 150mg tablets and take them twice daily and after a few days it should help. I have been taking them twice a day, one around 12-1pm, the other around 8-9pm. The stomach burning has pretty much gone away completely, except after certain foods, however now I experience severe and long lasting heartburn for hours, sometimes immediately after eating food. I feel intense burning right at my sternum but no shortness of breathe. (Shouldn t be any, no lung problems. Also no heart problems so I m not too concerned about that.) I Also get the feeling of a lump in the base of my throat and the acidic taste in my mouth. Is this most likely a case of GERD? Or because of the ranitidine is there not enough acid in my stomach to digest my food pushing it back up? ### REPLY: Hello dear, thanks for your question on . In my opinion you are having HERD (gastroesophageal reflux disease) mostly, as your heart and pulmonary work up is normal. GERD is caused by laxity of gastroesophageal sphincter. Because of this, the acid of the stomach tends to come up in the esophagus and cause the symptoms like burning epigastric pain and hyper acidity. Along with .  So along 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 doctor my sister went to doctor for low fever she had tests with reports indicatingesr 85 rbc 307alkaline phosphatase iu/l 334.20s.g.p.t (alt) 57.70s.g.o.t(asp) 63.80 doctor said it is lever infection and gave antibiotics,can u please let me know is it more worrying thing ### REPLY: Hi. Thanks for posting query at . Antibiotic maybe prescribed for any other underlying infection or as prophylaxis. Usually ALT or AST values higher than "two times the upper normal limit", is considered abnormal (in some countries, ALT or AST values of more than 100 are considered abnormal). Test should be done to rule out HBV, HCV.any further questions are welcomed. Hope to answer your concern. Wish you good health. Regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell yesterday and now my foot feels like it needs to crack, kind of like it s stiff or stuck. I can walk but it hurts mostly on the inside top area. No bruising or swelling. Could I have dislocated something? It hurts near that bone on the inside near my ankle. ### REPLY: Hello, An x-ray is always good on a safer side to rule out any bony Injury. Looks like by history is an ankle sprain. But x-ray can reveal more details.  First immobilizing the ankle in the crêpe bandage or ankle brace will be good. Doing icing or hot water fermentation will be good for pain relief. In case x-ray turns out to be normal and no fracture than post 3 weeks exercise will good to regain strength. For ankle stabilization balance board training will be good. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have my tragus pierced and have had it since July. recently it has gotten infected and nothing is curing it. ever since it s gotten infected I ve been sick. running a fever, being super nauseous and my jaw has been sore. do these symptoms have anything to do with this? what are some things I can do to help this infection and these side effects? ### REPLY: Thanks for your question, I am . Reading your quarry, I would say you have a systemic infection due to entry of germs from the infected Tagus wound into your blood - a condition know as bacterial sepsis. I would advise you consult a physician so that blood samples and pus samples are collected and analyzed so that appropriate antibiotics and medications are prescribed. Yes your symptoms have a lot to do with your infected wound. I advise that if you in the future do piercings, it should be by qualified and well-trained staff who use properly sterilized equipment. Good Luck 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: I am looking for remedies for tendonitis caused by ciprofloxacin. My son took it for 4 days and has had severe pain in tendons, muscles, anxiety, depression and so on caused by the cipro. So far doctors have offered nothing in the way of treatment options. Help. ### REPLY: Hello, As the question is about the tendonitis caused by ciprofloxacin let me put my comments here.  As Ciprofloxacin cannot lead to tendonitis, so be assured that the .  Muscle pain, tendon pain, anxiety, depression cannot be caused by ciprofloxacin. The major side effects it can cause it - nausea, vomiting, dizziness, rashes, diarrhea, stomach upset etc. It might be something else, so figure out this we need some part of the past medical history.  Also, you can observe the symptoms for 2-3 days and give him paracetamol as a supplement, if the symptoms subside it won't be 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: hello doctor i have mvp in my heart my father dead early 50years his age by heartattack.i have thyroid also and high prolactin and i am taking medicines for thyroid 100mg daily and for prolactin cabgolin medicine twice a week.some times i feel my heart beat is slow and my left hand full paining i scared because of mvp is it possible for heatattack and my age is 37 doctor told no need for medicines for mvp(mitral valve prolapse)now can u pls help me in future can i take any precaution for this mvp problem. ### REPLY: Hello thanks for posting here.I have gone through your complaints. First when you say slow heart beat we need to confirm whether its really slow or u feel that way. For this you have to measure count your heart beats or pulse or alternatively take an EKG, when you have such symptoms. It can be counted by placing two fingers on the forearm just below the wrist on the side of the thumb. Count the pulse for at least 20 secs and multiply the figure by 3 (to get one minute reading). If this figure is above 55 then you need not worry. Since you have hypothyroidism, your heart beats can be slow when you are on medications. You can do a thyroid function test to check your thyroid levels and to ascertain whether the doses you are taking are proper. Regarding MVP, usually teams no treatment unless there are other complication associated with it. MVP can cause leak from the valves - which needs no treatment if mild. If valve leak is moderate or severe, then you should be put on diuretics. This leak can be ascertained by a 2 D echo. However most patients of MVP I have seen have non-significant or no leaks and require no treatment. Also, it does not put you at the risk of heart disease. Your site pulse maybe due to thyroid issues. don't worry even if complications raise, everything can be treated with medications and you won't require any surgery. Regarsing precautions which you asked, there are no specific precautions, but you must be regular with your follow-ups and 2 D echo must be done every year. 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: please tell what it means to my son,s life if he has . he has upper left or right quadrant pain. he is seeing a doctor where he lives and they are running tests. the doctors have ruled out gallstones so far and found a black sludge in his gallbladder. what does this mean? ### REPLY: Hi, Gall bladder (GB) sludge is a very frequent finding on ultrasonography. Normally the GB will appear to be one smooth fluid filled sac (esp if the scan was done after an overnight fast). This is because, bile being liquid allows the ultrasound waves to pass through easily. If there is a stone, it will reflect some waves back and this will make it "visible" on the ultrasound. GB "sludge" is a term used when the bile, instead of appearing as a single smooth layer in the GB appears as two different layers. This happens when the bile in the GB has two different densities, so one "sinks" in the other. This heavier sludge usually consists of crystals made up of cholesterol and pigments. This usually occurs after a pregnancy, rapid weight loss and prolonged fasting. The sludge usually does not cause any symptoms, but has rarely been blamed for biliary colic, pancreatitis and rarely cholecystitis. But more commonly the sludge usually disappears on its own and rarely requires any treatment. Hope this helped, and thanks for the question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I had a baby in march after I had him I went back on the depo-provera injection(this was my usual contraceptive before I decided to get pregnant and I didnt have any problems my periods stopped completely after my first injection). I had my first injection 2 weeks after his birth. I have been spotting ever since. I have now had 5 injections and it doesnt seem to be stopping. On my last injection 20-08-13 I was prescribed norethisterone. I have just started taking them but I am wondering if my body is not able to have the depo-provera contraceptive anymore? ### REPLY: Hello, I would be happy to help you with your question. Breakthrough bleeding on the demo shot is not uncommon.  It is definitely less common after you have been on it so long, though in some women there is thinning of the uterine lining that leads to this breakthrough bleeding.  It is appropriate to treat this with norethisterone, but I believe that you would also benefit from an ultrasound of the uterus and a discussion of other forms of birth control. I hope that this helps and 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 somewhat small immovable hard lump on the right side of my rib cage. It had swelled up and became painful and the Dr told me it was probably a lipoma and that it should be removed. Its been about a week now and it has shrank down and isnt as painful. Is this normal for a lipoma and should I still get it removed? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma, neurofibroma or dermatofibroma.  Excision is the treatment of choice for all.  You should go for excision biopsy and histopathological examination of the lump.  Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is unable to speak the words from the mouth are not coming proper we have consult the doctor and he asked for CT Scan which is done and the report will be there tomorrow. I had a doubt that my father is suffering from brain haemorrage..pls suggest what to do ### REPLY: Hello, I believe you should take your father immediately to an EMERGENCY DEPT of a hospital.  He will need a neurological examination and likely requires additional nursing care and working aside from a CT scan of the head.  He should get an MRI and MRA to look for stroke. If he's had an aneurysm bleed then, his status needs to be closely monitored in an ICU to be sure he doesn't require emergency NEUROSURGERY. 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: my partner had a helicobacter pylori blood test done which botChatDoctoring up as 50 my partner had a helicobacter pylori blood test done which both times come back 50/50 PLEASE PLEASE I WOULD APPRECIATE ANY HELP I M SO DESPERATE My partner for 5months almost been suffering with stomach pain burning in the upper stomach a metal taste in her mouth feeling nausea no appetite causing her to loose weight eating food makes her pain worsen she had a blood test twice for helicobacter pylori and it come back 50/50 what does that actually mean that its present???? the doctor prescribed her 3diffrent types of medcine for 7day course 8tablets a day including antibotics She has a endoscopy coming up I m worried so much and i want the answer really to what does 50/50 mean?? for a hp blood test thankyou so much for any infomation ### REPLY: Just cool down Chanel, don worry so much or else u will start having ulcers in your innards. So it's fine that she is undergoing an Upper Gastrointestinal endoscopy. These symptoms are related to acid peptic disorder and u know what she could possibly have an ulcer too ....It's very likely...during endoscopy they will c how much damage the acid has caused to her stomach, they will also take biopsies and will send samples for HP culture, so u will be absolutely sure if there is HP. Even if she has HP and ulcer it is no big deal in today sage these are very easily curable. Till then keep taking tablet Antacid DSR twice daily ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a 23 year old male, i have aleft perinephric haematoma, 1cm grade II renal cortical injury, undisplaced, Spinous process fracture L1 and L3, it was treated on the 8th of may. i was just wondering, what i can and cant do in terms of eating, drinking, and exercise. can i consume alcohol. can i ride a bike( not at the same time). as i was told to rest by the hospital, but rest is a vague term i wondered if you could suggest some more clear guidelines. im normally a very active person so not knowing what i can do is driving me a little bit mad ### REPLY: Hello and welcome to .  As a Urologist, i can understand your anxiety.You've had a major injury to kidney, with fractures of the spine tip. In your case, rest would mean, avoiding lifting weights and straining. After 2-3 months of the injury, a CT or MRI scan, shouldve been repeated. This would show, if the healing is progressing normally and if rest is needed. You can take normal diet and certainly . If you've any other doubts, send all reports to me, as a direct question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is three and just starts screaming and crying in the middle of the night and we cant get her to calm down this usually last about 20 mins we try waking her up and explain that mommy and daddy are here and she has nothing to be scared about but it just causes her to scream more and kick and hit. is there something we can do to help this ### REPLY: Hello, Sleep terrors are part of sleep. Terror on some days are ok but on a daily basis are troublesome. Instead of telling your child that you love her at .  Just see that the child is not having any issue at home with siblings or you. If these things do not help, take help of psychiatrist as they are trained to help such issues. 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: Last night I experience intense pain in my upper abdomen that was actually in a band all the way around my back. The pain was so intense I had trouble catching my breath for a while. It eventually subsided, still there but not as intense. In the morning the pain was gone but my muscles feel sore. ### REPLY: Hi ! Good evening. I am  answering your query. If I were your doctor, I would have first done a physical examination of your abdomen, followed by some blood tests like a complete blood count, a liver function test, a serum amylase and lipase, blood sugar, urine routine and microscopic, and possibly an ultrasound to rule out gallstone disease/pancreatitis which could give rise to such excruciating pain in abdomen and back. Also in the history, if you consume alcoholic beverages and do smoke, then I would insist on complete abstinence from both as both could cause pancreatitis. Till the reports are ready, I would advise you to adhere to a bland diet, and avoid any oily, fried and spicy food, and prescribe you with an anti-spasmodic and a proton pump inhibitor for a symptomatic relief. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I would like to know the meaning of the following: MR Scan of brain reveals normal grey-white matter differentiation of both cerebral hemisphere. There are patchy white matter hyperintense foci on T2 weighted sequence in the perpendicular & subcortal white matter of both cerebral hemispheres. These lesion are iso-to hypointense on T1  & bright on FLAIR sequence. None of these lesions are bright on diffusion sequence. These features are consistent with chronic white matter ischaemic changes due to small vessel arteriosclerotic changes. No mass effect / midline shift seen. bilateral basal ganglia are normal. Apart from this cerebellar hemispheres & brainstem, internal auditory canal & its content, ventricular system, sellar and parasellar regions, and calvarium are mentioned as normal.I would appreciate the meaning of this. Please reply in English. Thanks, Greg ### REPLY: Dear thanks for your question well your MRI brain says ischemic changes in your cerebellum its show white or hyperintense signals that's show due to ischemia or loss of blood supply to that region of the brain so what to do don't worry only you have to control your blood pressure and sugar in normal limit and course your cholesterol level you should take tab Asgard 75 mg one OD and tab Lilibet 10 mg one HS and if your have blood pressure I will tell you according your reading ok ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes, my father had severe chest pain 3 days back. his angoigram results are negative. he had fitted stent 5 years back , but there is no blockage now. now there is no pain but only a chest heaviness.doctors are saying it is chest myscle pain, reflux and so on. pl advise ### REPLY: Thanks for your question on . I can understand your concern. No need to worry about cardiac chest pain as his angiography is normal. Chest Heaviness, chest pain are seen with acid reflux also. So tell him to follow these steps.1. Avoid large meals, instead take frequent small meals. Avoid hot and spicy food.2. Avoid stress and tension, be relaxed and calm.3. Take pantoprazole tablet on empty stomach twice daily.4. Go for walking after meals. Keep 2-3 pillows under head in bed to prevent reflux.5. Quit smoking and alcohol if he has these habits.Don't worry, he will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. 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: had a mri in october need neck surgery had scheduled for friday doctor wont do it without another mri went to get it and couldnt handle the small machine had back spasms it was to enclosed and small so now cant get surgery for at least another 2 months am in alot of pain what can i do ### REPLY: Dear Sir/Madam have gone through your query and read your symptoms. This is pathetic, nowadays open coil MRI are becoming reality and your surgery is postponed for two months because of this, the thing that can be corrected by surgery is not manageable by medicines, so please do not be overdependent on analgesics and get yourself operated early. I hope that answers your query. If you want any more clarification, contact me back. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 incredibly worried since blood tests that were taken following a kidney infection revealed abnormal liver function.  I was subsequently referred to hospital for an ultrasound which showed a small solitary, well-defined mass in my liver and I now have to for a CT scan.  I am terrified that this is cancer.  My hospital report says ESR 38, CRP 118.  It does not mention that the mass looks cancerous but says that it is does not appear to be typical of a haemangioma, cyst or abscess.  The pancreas, gall bladder, bile duct, kidneys, spleen and aorta appear normal.  The GP says that she just does not know what it is. ### REPLY: Hello, thanks for using . I had gone through all the details posted. Report shows that CRP is very much elevated, and you were saying mass in liver, but specific characteristics of mass lesion was not done, so I can comment whether that is of benign or malignant one. Triple phase helical CT Abdomen is the investigation which can differential benign from malignant lesions. Serum AFP levels may help. Common risk factors for liver cancer are cirrhosis, Hep B, Hep C. 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: I ve been sick for about 5 weeks with various upper respiratory issues. I went to the doctor again today with a sore throat, and she gave me some amoxicillin/penicillin. Upon inspection of my throat tonight, I found a rather large yellow lump in the back of my throat. It isn t near my tonsils (not tonsil stone) but rather in the very back of my throat, where post-nasal drip can be found. What is this yellow lump? ### REPLY: Hi thanks for spring your problem here in this forum... Yellow lump that you are telling about in the posterior region is most probably the post nasal . .that is found when the damaged tissue gets infected...if your doctor have examined you then it may not be something dangerous...you should take the medications advised by doctor...hope it will be fine soon...I will add one thing to do saline Gorgas frequently.....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 currently has a somewhat stuff nose kinda more pressure then stuffy and I am so dizzy I will be sitting and just loose my focus and spin also my jaws hurt. Yesterday I was popping my ears alot and streching out my jaw to do so and today i woke up and my jaw is so sore. Is this normal? Can I take anything to help the symptons? ### REPLY: Hello, Some fevers that occurs as a result of viruses like dengue and chickengunya are notorious in causing joint pain that lasts for quiet a time, ranging from few days to few years even after the subsidence of infection and fever. In such cases pain will wean of gradually, and no specific therapeutic measure is available to be considered as curative. Treatment measures are supportive, like hot saline fomentation, hot packs, physiotherapy. Over the counter painkillers can be taken but for a short duration of 3-5 days only. You need to take hyaluronic supplementation, which may prove to be effective in long run. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END