Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 cvid and have been on IvIG for a little over four years i frequently run a temperature as well as constant nausea and diarrhea at least 1 migrain a week most recently I have experienced chest pain I don t think this is a heart attackand lower back pain lightheadedness and some difficulty breathing ### REPLY: Treatment for CVID-1)IG may be administered intravenously or subcutaneously. Solutions of 3-12% intravenous immunoglobulin (IVG) can be used on a regular basis to maintain a trough level of 400-500 mg/DL in adults. A dose of 400-600 mg/kg every 2-4 weeks is usually required. In patients with structural lung damage, a trough level of 700-800 mg/DL is required.2)Cyclosporin A has been successfully used in patients with AVID and lymphoid interstitial pneumonitis. The administration of anti-CD20 monoclonal antibody has been used to treat autoimmune thrombocytopenia and neutropenia.3)Antimicrobial therapy should be initiated at the first sign of infection. A narrow spectrum of .  The prophylactic use of antibiotics should be avoided because of an increased risk of infection with fungi or other resistant organisms. Specific therapy is often necessary to target the organ system involved. For instance, patients with chronic lung disease often develop airway obstructive disease that requires treatment with inhaled corticosteroids and other asthma medications4)Surgery is required to treat the complications of common variable immunodeficiency (AVID). Chronic sinusitis may require endoscopic sinus surgery. Severe autoimmune thrombocytopenia or hemolytic anemia can be treated with splenectomy. Biopsy should be considered to exclude infection or malignancy in enlarging lymph nodes. If you have any doubts let me know. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor. I ve had some white stuff growing on the left side of my oral cavity for a week now. It s white and resembles cottage cheese in appearance. It s not itchy or painful, but it does make me feel uncomfortable when eating. It s not on my tongue or any other parts of the oral cavity. I ve tried scrubbing it off, but it tends to return. What s going on? ### REPLY: Hello there, welcome to  forum, according to the dental history provide by you, it is very difficult to make a diagnosis, until I check it clinically, you have not mentioned your age, or about your personal habits, because most of the white lesions or patches that appear in the oral cavity have some or the other cause, it may be linked to smoking, alcohol intake, dietary deficiencies, hereditary cause, infections,etc.I would like to inform you that start using antibacterial(Betadine) mouth wash(twice/day), it is not necessary that it(white patch) would spread, but in order to avoid it from coming back again, kindly visit an oral pathologist, who will be able to provide you with the diagnosis as well as the treatment.I hope I answered your query, i wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was 33 weeks 4 days wen my scan was done n found my cervix only 8mm. Got betnesol injections for lung growth. I have gdm also but under control with 500mg sr glycomet. On bedrest since 2 mnths wen my cervix was 2.4cm. Is it possible to maintain cervix length for another one month. Taking susten 200 n progesterone injections weekly. Does dilation happen when cervix becomes zero ? ### REPLY: Hello, Have fully trusted in your treating doctor. He has suggested right treatment for you. Please, do continue with the treatment. Secondly, I will suggest you to take bed rest in head low position. Please use blocks or bricks beneath the bed towards your leg end. This will help to create gentle slope and resting in this position will help to reduce pressure on the cervix. You can seek prescription support from your treating Gynecologist by judging your clinical status. One of the following medications to relax the uterus can be taken:1. Tablet Isoxsuprine 10 mg 3 times a day2. Tablet Picardi Retard 10/20 mg 2 times a day3. Tablet Terbutaline 2 times a day. Bed rest and uterus relaxing agents should be taken till completing 36 weeks of pregnancy. It is safe for the baby to deliver after 36 and preferably after 38 weeks of pregnancy. Injection Benson 12 mg can be repeated weekly till 36 weeks. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I am a 29 year old female and I notice lately that I can never get excited about anything...I just started a new dream job Oct 2011 and within a few weeks, I moved into a new apt. About a month after that, I got into a new relationship with a guy who I love very much and is perfect for me. But, I have always had low self esteem ever since I was young and I notice as time goes by, these feelings always come back-the result is me feeling like I dont deserve my job,relationship,good friends(I dont have many as there is, that is another story)..its like I cant trust anyone anymore and I gave up on trying to be happy. What can I do about this? ### REPLY: HI Allison. THANKS FOR YOUR QUESTION. YOUR ARE SUFFERING BY DEPRESSION AS YOU HAVE SYMPTOMS LIKE-LOW ESTEEM.GUILTY FEELING. FEELING OF WORTHLESSNESS. BUT YOU TOLD YOU CANNOT TRUST ANYONE BUT YOU CANNOT MENTION THE REASON DO YOU THINK THEY ARE CONS PIRATING AGAINST YOU. I AM ASKING THIS QUESTION TO CLARIFY DO U HAVE DELUSION OR NOT.IF YOU HAVE DELUSION THEN YOUR DIAGNOSIS IS DEPRESSION WITH PSYCHOTIC FEATURE AND IN THIS CASE YOU NEED A ANTIDEPRESSANT AND ANTIPSYCHOTIC COMBINATION.IF YOU HAVE PURE DEPRESSION THEN YOU ONLY NEED ANTIDEPRESSANT SO PLEASE GO TO A PSYCHIATRIST AND TELL YOUR DETAILHISTORY HE WILL HELP YOU. REMEMBER IN DEPRESSION COGNITIVE BEHAVIOR WORK VERY WELL SO IF DOCTOR WANT TO DO IT ON YOU PLEASE GIVE HIM CONSENT. THANK YOU .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a bulge at the back of my achilles tendon just above my heel. It is very sore and sensitive when my shoe rubs against it. I had the same thing happen several years ago and it was a tear in my Achilles tendon. Do I need to see a doctor for this? Can anything be done for this? ### REPLY: Hello dear, warm welcome to .come have gone through your concern in depth.* There are different conditions which can be possible for this presentation as - tendon cyst (bursa cyst) - sebaceous cyst - hematoma or abscess in case of injury - others.* Needs ultrasound examination of the local part for the perfect diagnosis and further management in accordance to that. Hope this will help you for sure. Welcome for any further guidance. Regards dear 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 just quit smoking for good at 20 years old. Im not a heavy smoker just cigars here and there and hookah tobacco. I have minor asthma but I am scared to death of lung cancer after I have recently developed dull chest pains. Is that even possible for someone my age? ### REPLY: Thanks for your question on . I can understand your concern. Usually Lung cancer is seen after the age of 40 years. But smokers tend to develop lung cancerous at younger age (30-40 years). In your case, possibility of lung cancer is very, very less. But better to get done chest x-ray first. If chest x-ray is normal then no need to worry about lung cancer. Better to quit smoking as soon as possible. Take simple painkiller like paracetamol. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi.am 21 year old girl and i weigh 72kg.i notice bumps on private parts after shaving ,i ve tried several methods all to no avail.pls what do i do ### REPLY: Hi...dear user., Thanks for closing ., Little bumps after shaving..., could be IRRITANT DERMATITIS., it is due to shaving, cutting of hair buds produce..., minor abrasions in turn produce bumps....,1) Don't shave hairs around genitals..., only trim with trimmer.,2) Salt water washing is allowable...don't use any chemicals there.,3) Apply Fusion cream till get good result.,4) Tab Doxycycline 100 mg daily for 7 days.,5) If itching present go for Cetirizine tablets...ok.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: Hi Dr. Chakravarthy I m 18 years old now. And started masturbation when I was about 15-16, and since the I ve had this problem of over masturbation when I m alone. When ever I go to school( I lived in the boarding school) I did it for a few times because I didn t have all that space to do them. But when I graduated from school and started saying at home frequently, I started a masturbation section like no other. So a day came I was masturbating, and I did it for three round and I suddenly found out that my penis shut-down, I was terrified at first. But later the penis can to a stage that I cannot have strong erection , my sexual sensation lowed and many more. Normally, in the morning I do have strong erection but now they are not strong and I don t now what to do. I just feel like killing myself. Please help me out!!!!!! ### REPLY: Degree understand your concerns went through your description. I suggest you not to worry much. Masturbation is not sin. It is a normal activity to relieve sexual urge. Even animals do masturbation. Young teenage people masturbate twice or thrice daily. You came under that category. Such people reduce the frequency when they realize that they have better things to spent their energy, like education, sports or career. You are yet to find one. I can assure you, in due course, you will also find one. For the time being, don't be anxious about the practice. If you can stop, STOP. If you cannot, don't be anxious and enjoy. You might need psychotherapy and other cognitive behavioral therapies. I can help you through telephone. Please do contact me through customer care of www.ChatDoctor .com for a telephonic consultation session. 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: HI SirIm from India bangalore.Im suffering from left side stomach pain past from 1 year 8 month.Did the scanning before 6 month endoscope, ultrasound and urine cultivation test.    IM taking the treatment past from 1 year 8 by changing the doctors because it is not getting curable. 22-Mar2012     upper gastro intestinal endoscopy::    Impression :Duodenal erosious (Post bulbar) 6/4/12                          Before 12 months back, i went to concert the gastoenterities doctor, he did the scanning of ultrasaound and urine cultivation test.      Ultrasouund will be normal and urine cultivation test is e-Coli bacteria 1 lakh count.Then he sugest for urologist, urologist give a treatment to urologist test: ultrasoung KUB, trasrectal sonography, uroflometry16:04:2012tablet  Cefoprim 500mg   1-0-1 7 daystablet unirub 20 bg 1-0-1           7 daystablet cranpac          1-0-0        30 After 2 weeks i got motion in blood then he suggestted looz syrup 17-5-2012t niffutin    100mg     0-0-1t cranpac                   1-0-0t unirub 20mg             1- 0-03-7-2012t  Sepmax        1-0-1   7 dayst pantazole        1-0-1     7 dayst lactogent     1-0-0     30  Doctor he is not able to cure the disease, my immunity power also gone low after taking the too many antibiotic.He again tell the scanning of  CT SCAN---KUBMCUCYSTOSCOP    and he told the scanning to my wife  Gyac opinionpap smeacu/scan abd+pelvis  i did not done any of the scan because he is not given the clear picture.i suffered him a lot from the doctor.Please help me on this, how do it has been diagnise ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You are suffering from left abdominal pain, changed many doctors, and used many medicines. No cure since one year eight months.  The causes of left abdominal pain are, gastric pain due to peptic ulcer, irritation by irritant foods. Pancrias pain, worms in the intestine, infection of the kidney, writer, or bladder, or stones in the ureter, or bladder.  The other causes could be psychological due to long-standing problem, and it is secondary to the actual problem.  I advise you to practice yoga meditation, reading books of your interest, hearing music, and internal or external gardening.  Try to take more of curd, bland foods like bread etc. Avoid UN timely food, spices, junk foods, and oily foods.  Wishing for a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 21 year old girl has a rapid heart beat, which started recently. she is takingContraceptive pill, 5 days ago we rushed her to A&E, her heart beat was very fast, they said she had inner ear infection and her tonsils were inflamed, so she was given Antibiotics but we had to stop as  the tablets were making her worse.(heart beat).while we were in hospital they recommend that she should take Magnesuim tablets. can you please advise why all of a sudden she is having this problem? ### REPLY: Hello thank you for posting here. By what you have explained, Lt looks like she is having sinus tachycardia supraventricular tachycardia (SVT). Sinus tachycardia is a condition when we have a heart beat due to running, exercising, stress and during infection in the body. So if it is sinus tachycardia then it is due to the infection. The other variant, SVT may also be triggered by infection in the body or due to abbe rant connections in the heart conduction system. It is a rarely harmful for the patient but required medications to settle down. Only an EKG will help to distinguish between them. Magnesium also helps in stabilizing a fast heart rate. But treating the cause - infection with a different antibiotic which doe snot worsen fast heart rate is advisable.it is usually a being problem, and after she recovers her normal heart rate she may probably not get it. However if she gets it on and off then there is a conduction pathway problem for which she should be on rate control medications. 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: My wife is playing with 2 month old pomarenian dog and is bitten on the calf (above the heel). The dog dont have anti rabies injection yet. Does it mean that wife will be vaccinated. She did not clean the wound after the bite. This is the third day now. ### REPLY: Hello, Welcome to , Rabies is 100% fatal, but it is 100% preventable by proper and adequate treatment and this is transmitted by dog bite. As your wife was bitten by a 2-month-old dog while playing over the calf which was not vaccinated against rabies and first aid treatment was not given. The first thing to be done following the dog bite is thorough washing of the wound which was not done. For your wife condition I would suggest her to follow1. Active immunization with antirabies vaccine on days 0,3,7,14 and 28.2. Passive immunization with Rigs around the wound, if there is an any bleeding.3. Oral antibiotic like Tab Autoclave, twice daily4. Topical Metro ointment. 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: if im having trouble breathenig and weak dizzy and keep having sharp chest pain what i need to do i went to a cardio speciality today and she diagnios me with anteroseptal infarct and said my heart beat was in the 40s will this also cause me to continue to hurt ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. If you have been diagnosed with infarction this means that you have problems with your coronary arteries. Having blockage in the arteries can cause an infarction manifested with chest pains. If you continue to have chest pains it means that your heart is offering because it's not supplied normal with blood because of this blockage. And this think should be resolved. Having low heart rate might be a complication of ischemic heart disease. Slow heart rate does house pain, but coronary stenosis cause heart pains. So, my opinion is that you should seek medical contact and have your self closely monitored, with cardiac echo, electrocardiogram, cardiac enzymes and after they result decide what to do next. Hope I was helpful. Best regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi dr. im 42 yr old frm india. pure vegetarian. i got diagonised as type 2 diabetic in a border sice 4yrs and was under food control and brisk walking. diet etc. since tis jan i had advised glycomet tab & now recently taking glimisaveM1 tab.. 1 tab only in morng aftr brkfst. now my augar level.. fbs is 98. ppbs is 174. and nite 1tab aztor10mg for my cholestrol. now aince many wka im getting pains in pelvics and now started pain in lower bk.. i got heavy gastric probs. and 2yrs bk i had gt operated for apendicitis. i dont have any urinary infection. no symptoms of urinary probs. kly help me.. whether i am sufrng frm prostrate infections or hernia??? ### REPLY: Hi Shear, Thanks for posting your query. It seems like you have chronic gastritis. I hope you are on the right medications for this. This can be the cause of your back pain. For your lower back pain and pain in the pelvis, it is advisable to get an ultrasound scan of the whole abdomen. A hernia can be detected by this too, if present. Prostrate infection can be treated with antibiotics.  I hope this helps.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 22 and since yesterday keeps getting a crushing pain in the left side of her chest which last a few seconds,and makes her feel dizzy, but when she went to see a doctor he listened to her chest with a stethescope and told her that there was nothing wrong with her. She has been feeling tired lately and is looking pale so I am still worried about her ### REPLY: Thanks for your question on . I can understand your concern. Left sided crushing type of chest pain with dizziness should be looked for heart diseases first. So get done ECG and 2d echo. If both these are normal then no need to worry about heart diseases. Sometimes anemia and thyroid diseases can also cause similar symptoms in young patients. So get done hemoglobin estimation and thyroid function test (TSH, free T3 and T4). Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter has been diagnosed with hep c. She had liver biopsy - no cirrhosis, but fatty liver. No mass. Pathologist reports grade 3, stage 2-3. This was a general report over the phone. He said he would give her details at her appointment, which is over 2 weeks away. ### REPLY: Hi and Welcome to . I appreciate your concern for your daughters' illness. Since the detailed results are still awaited, the standard treatment for hepatitis C virus infection depends upon the genotype of the virus involved. Treatment for hepatitis C usually involves using a combination of the following two medicines:1. In. Regulated interferon given weekly (it stimulates the immune system to attack virus)2. Antiviral Riboviria capsule or tablet given twice daily. (It stops hepatitis C from spreading inside the body)The duration of the recommended course will depend on which genotype of the hepatitis C virus she is having. For genotype 1, a 48-week course is recommended. For all other genotypes, a course of 24 weeks will be recommended. A blood test is done at 4th and 12th weeks to check the response to treatment. If the test shows that the medications are having little effect in removing the virus, it may be recommended that treatment is stopped as further treatment may be of little use. Hope the suggestion given above could be useful in getting her treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dr. This is jaya here,almost 3.5 yrs of marriage n 2.5 yrs of miscariage,till then no chances of pregnancy,consultind n infertility dr. ,,went through laproscopy ,in the august2012,now according to dr. Suffering from endrometriosis.....LMP was2nd dec, on 7,8,9,10,11.dec. took lupiFSH. Injection ,n as result. my follicle size isstill very small,plz advice me I m very dipressed now ### REPLY: Hi, Your treatment depends on stage of endometriosis found on laparoscopy. If its stage III or IV, it's better to go for IVF. If its stage I or II you can try the treatment you are taking along with GUI. Also, i follicles can be small after 5 days of FSH in., they will grow after more injections, so don't lose hope & continue treatment. It's better to start FSH on 2nd or 3rd day of manses for better response. Wish you good health. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have high cholestrol level since 2003 when i checked it for first time. In 2010, i tested my colestrol, sgpt, uric acid and fasting sugar. the later two were found normal and the earlier were high. cholestrol was in range of 260 and sgpt in range of 75. In 2012, a doctor advised me to check my whole lipid profile. I carried tests for all and it wasfound that my cholestrol was in of 280, TG in range of 900, LDL 23, HDL 90, SGPT 72. The doctor prescribed some medicine for me which lower some cholestrol and TG level but did not help me in lowering SGPT level. I did not properly continued the medicines and stopped taking after a month or two. I had also carried tests for lever biopsy and Cardiac angio. Both are neomal. My age is 36 and i had fatty lever issue since long. My height is 7.5 and weight is 67Kg. At the moment i have cholestrol level at 257, TG 1027, LDL 27, HDL 77, Uric acid 8.25 and sgpt is 37. How can i overcome with my high lipid profile level and contorl uric acid. ### REPLY: Well you have distinct dyslipidemia and mildly deranged liver dysfunction possibly pointing to metabolic syn . But since your weight is reasonable, and your SGPT has returned to normal you should start rosuvastatin10mg with fenofibrocholic acid for treating lipids along with Eurostat 40 mg at bedtime. Follow regular exercise, fatt free diet and evaluate after 3 months. If Sept is not rising and reports are within target range you may taper dose of rosuvastatin to 5 mg along with vibrates with regular follow up at 6 months. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 terrible bout with kidney stones this past summer. I had one on the right side that passed & a very large one on the left that I had to have surgery to have a stent put in & then SWL (shock wave lithotripsy). It broke the stone up & some of it passed, but then I had to have a second surgery with another stent & then laser to continue breaking up the rest of the stone. My last x-ray on Oct. 22, 2014 showed that I am now stone free. I understand from my urologist that I need to drink maybe as much as 3 qts of water a day, which I get about 78 oz now. I am trying to work up to 96 ozs. My question is: I have read in Dr. Whitaker s book, published in 1995, that 1000 mg of magnesium citrate & 100 mg of vitamin B6 daily will prevent me from ever getting another kidney stone. Do you agree with this? Can those amounts of magnesium & B6 hurt me? I am a 70 year old female & have never had a kidney stone till now. email address: YYYY@YYYY ### REPLY: Hi, welcome to ChatDoctorLooking to your history, i, as a nephrologist, understand your concern. Stones which are obstructed in urine passage, first, require its complete removal to relieve obstruction. Then, it requires evaluation of cause of kidney stone and type of stone. Adequate water intake with salt restriction, decrease intake of nonveg protein and normal calcium intake are the general measures to prevent kidney stones. Magnesium, citrate and It B6 can prevent stone formation. So, it is safe to take above medicines in recommended doses to prevent kidney stones. I think this would be helpful to you. Best wishes. TC. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my brother is 47 yrs. old and was diagnosed with multiple myeloma 5 yrs ago. He has had 4 transfusions in the past 5 weeks.  He woke up 4 days ago with shortness of breath and was taken to the hospital.  He had another transfusion and found black spots on his lungs.  Could he now have lung cancer.  He has also lost 40 lbs in approx. 6 mos.  Is he at end stage? ### REPLY: Thanks for your question on . I can understand your concern. Multiple myeloma can spread to lungs and cause multiple lung metastases. These metastatic lesions look like black spots on lungs. So we should definitely rule out lung metastases in your brother s case. So get done PET scan first. If it shows increased uptake then he will need Biopsy to confirm the diagnosis of cancer. And lung metastases in multiple myeloma suggest poor prognosis. So if these spots are cancerous then he is having life expectancy of less than 1 year. Hope I have solved your query. I will be happy to help you further. Wishing good health to your brother. 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: suddenly my baby has a cold fever and start vomits,anything i give him to eat he throughout,he feeling hungry and more milk to drink but i cant take him milk to drink even a any kind of drink,i gave him a panadol syrup but he throw out all the syrup give me solution what i have to do plz help me, ### REPLY: Hi, It seems that he might be having viral infection giving this problem. Firstly stop vomiting by giving ODEM syrup and after giving this syrup do not give anything by mouth for about one hour so that ODEM should retain in the stomach and stop vomiting. After vomiting stops then give paradox syrup for fever. Then gradually give him milk, water regularly. If vomiting does not stop then consult your doctor, inject able medicine might be required. Ok 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: hello doctor, i have grade 1 fatty liver i am 23yrs old and i weigh 110kgs .i am not diabetic , thyroid reports also show normal behaviour, i have this fullness in my chest area which makes me feel more heavier and i hate this feeling . i am taking dompan and with it gelvel. i want to know in how much time will my liver recover and what to do about this fullness in my chest? ### REPLY: Dear sir, Fatty liver is commonly associated with alcohol or metabolic syn . You should definitely lose some weight(at least 10-15 kg). This is probably the main cause of your liver disorder. You need to change your lifestyle, diet and sport habits. The treatment of fatty liver depends on its cause, and generally, treating the underlying cause will reverse the process of stenosis if implemented at an early stage. It is usually last for 4-6months if u do what i ve advised. Fullness can also be symptom of obesity, liver enlargement, gastritis or colon disorders. You need to see if your dietary changes would affect on your fullness feeling. If not u should do gastrostomy and colonoscopy to rule out some other diseases.  Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an MRI and along with other things they said I had Microvascular ischemic disease, and MS like symptoms and atrophy  of the venticuler atrium hope this makes sense to you.  I have been severely dizzy and light headed would this be caused by the above?   YYYY@YYYY ### REPLY: Dear microvascular ischemic isn't a disease. It is a radiological finding which need to be correlated with clinical findings. Anyway there is nothing to be worry because those MRI findings probably might be related to brain hypoperfusion due to chronic illness such as arterial hypertension or diabetes. You need to consult your neurologist and start treatment with antiplatelet (aspirin 100-300 mg per day). You can use betahistine for dizzy sensation and light-headed. Wish you all the best don't hesitate to contact for further inquiry ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, lately(in the last 2 weeks) I have noticed my ejaculate has changed consistency and contains thick jelly like clumps which can cause discomfort while passing through the urethra, I am displaying no other symptoms and am starting to get concerned. I am 35 years old, a non smoker and very light consumer of alcohol and also have a pretty good diet, lots of fresh fruit and vegetables but with fast food being consumed about twice a week. Average sex life, about 2 maybe 3 times a week ### REPLY: Degree understand your concerns went through your details. If you do not feel or encounter any other symptoms like discoloration, blood content in your semen, itching, .  Semen clumps and texture depends on many things including the water content, protein and other mineral content etc. You may consult a sexologist or infertility specialist for having a confirmation for your peace of mind. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello dr. iam XXXXXX from XXXXXXX.newly married.we are in love and arrenged marriage.after marriage we are not happy in all.now from three days we are fitghting countinused.she starting hate to me.but still i love to her.when we fight last time i was slape to her.she totally hate to me.now we didnt talking . im totally confused sir.please help me. ### REPLY: Dear Train After first few months love and hate relationship is not abnormal however this should be occasional not frequent. Any negative emotion and if the same continues for long is injurious to either of the partnership both need to discuss things together and learn to increase love rather than hatred. Things should be resolved by not paying too much attention to each other's mistake.Moreover, some vacation spent which gives both a break from stressful life of modern days is a good way to repair old wound. Hope this resolves the problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was just wondering how long after stopping Yasmin contraceptive pills completely do you expect to have a period? I stopped taking them about a month ago but still havent had one and was just wondering whether this was normal? Thanks for your help. ### REPLY: Hello, Thanks for letting us know your health concern. It is not normal to miss a period for so long after stopping the hormone contraception as with .  You need a sonogram of the pelvis, preferably in the trans-vaginal route, to know the status of the pelvic organs and plan further management. If pregnancy is excluded, you may be prescribed medication to induce a period. Return of ovulation usually occurs in one or two cycles. Please maintain a healthy weight, healthy diet and regular exercise. 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 keep getting pimples when my periods approach every month. I used to have a lot of acne which is now in control. But one or two pimples remain and by the time there spots are gone fresh ones come up. I am left with some holes ob my face. And I also have whiteheads around the nose . What can I do? Your help will be gratefully acknowledged. ### REPLY: HI, thanks for posting your query Acne starts during puberty as a result of hormonal changes, which stimulate oil glands to produce oil which collects in the gland ducts and leads to black and white heads, pimples which may heal leaving pigmentation and scars IT is very common to see new acne just before the periods because the hormones are at high levels. The following measures may be of help: Don't pick or squeeze the bumps as it increases chances of pigmentation and scarring the white heads extracted regularly a salicylic face wash twice a Cayuse retinoid cream .025% on the acne prone areas at night FOR the acne scars you can undergo punch excision, microdermabrasion, subdivision, Fraction laser as per dermatologists advice for premenstrual flare various medicines have been tried like Pyridoxine(vitB6)50-200 mg per dayIbuuprofen or rofecoxib tabletsThese are started 1 week before onset of periods till the periods last, but should be taken only by discussion with your doctor. Hope this answers your query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have a lump on my aroela close to my nipple it been there since feb. 2011. I had my son in sept. And I breastfed for like three months and stopped cause my breast were too engorged so I put cabbage on them to drain the milk. Well yesterday I felt a pain in the lump and it looked like it wanted to pop so tonight I took a nice hot shower it popped right in white liquid came out also with thick white stuff and a little blood. So now Im trying to figure out what is going on. Please tell me this is nothing to worry about ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have breast lump.  You may have galactose, inflamed cystic lesion or benign breast lesion.  Chances of cancer is low.  But you should go for mammography and fine needle aspiration cytology.  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: doctor, m married and 30 aged men. now days my semen discharging out without any dream.i used to know that after finishing all.some days even i couldnt feel thats happened. m married and while doing sex i cant make delay,m not allow her to hold my dick long time or doing oral sex,because once she touch i cnt control discharging.please is there any good medicine for controlling it.m experienced in sex,but then also i couldnt make delay.but i can do sex 2 to 3 times per night..please help me ### REPLY: Hello, It may be due to performance anxiety. For that you may require complete hologram, lipid profile and electrocardiogram after physician consultation. Along with that Avoid stress. Avoid strenuous activity and take proper rest. Take balanced diet and keep your self HY .  Till then, you can take tablet sildenafil one hour before sexual act. Hope I have answered your query... Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Ive been sexually active for about 3 and a half months now. Im on birth control and have been for more than a year, but lately Ive noticed spotting. This has been going on for a week and now its finally starting to get heavier, as Im taking the sugar pill as apart of the birth control pack. I also noticed some blood in my stool. Is there a chance that I had a miscarriage? ### REPLY: Hi, Dear. Welcome to . Spotting can happen if you are using birth control pills. And at the time of taking sugar pills you can have regular flow, so nothing to worry about it. And having blood in stool is not a sign of miscarriage, it can be due to constipation or any other reason, not related to pregnancy. So do not worry you will be ok. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lumpectomy in April 2010 followed by brachiotherapy and chemo.  The insertion site of the SAVI device never healed.  In June 2011 I suffered a massive infection in my  breast.  The infection has resulted in a large lump of scar tissue that has fluid inside.  It is attached to my pecs and is only moderately uncomfortable. The surgeon says it is OK, the radiologist says it needs to go as it makes any cancer diagnosis in that area difficult.  I have had OT with massage, light therapy and Kenesio tape.  I would like a few outside opinions on whether I should keep the "messy" tissue, or get it removed. ### REPLY: HiT hanks for posting your query. I appreciate your concern for the large lump of fluid filled scar tissues. I have read your problem diligently, after going through it, I am of the opinion that you have developed a progressively increased and heaped-up scar that has a fluid and referred to as Keloids. Since you are not comfortable with it, visit a dermatologist so that it can be removed by one of the following procedures:1. Intralesional steroid injections are given once every 4 to 8 weeks into the keloids) and usually help flatten keloids2. Cryotherapy: Freezing keloids with liquid nitrogen may flatten them but often darkens or lightens the site of treatment3. Laser: The pulsed-dye laser can be effective at flattening keloids and making them look less red. Hope these suggestions could be of great help to you in getting the treatment. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: How can I know if Im depressed? And what should I do if I think I am? Im a 21 year old Swedish male whove just gotten enough of being tired, Ive barely went outdoor at all the past year or so, except for buy groceries and stuff, and even that I can find myself without mostly of the time. The times Ive seen my friends the past year is to be counted on 2 hands. ### REPLY: Hello You have symptoms like easy navigability, poor social interaction, less number of friends. If these are only symptoms present then it can not be labelled as a depressive disorder. But depression in milder from may present with lack of energy, easy navigability, pervasive sadness of mood, sleep dysfunction, poor or increased appetite, pains in body etc. symptoms. Still if you want to know about your symptoms you can visit a Psychiatrist for evaluation. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husbands blood pressure is 206/93 and I am trying to persuade him to meet me at the er. He saw his family dr today and she gave him a bp med but it is still over 200.  He is taking suboxone and thinks It may be related to this.  Should he go to the er? What should I watch for tonight if he wont go.Tarah ### REPLY: Hello, Thanks for writing to , I am . With this blood pressure he should visit the ER he needs his med to be changed, and possibly the work up should be done to see the cause of the problem, he should also keep a check on his weight and salt intake, I would suggest you to take him to ER .this Blood pressure can be dangerous. I hope this answered your question, If you have more queries I am happy to answer 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: I had a blood test done last November and my calcium blood test came back 10.8. I guess the standard range is 8.4-10.6. I have had another follow up test but I do not know what the value is . I m going on Monday to a specialist in Ames for this. Is this something I should be very concerned with? ### REPLY: Hello, your levels are not that high and sometimes technical reasons may cause it. A repeat measurement is needed. Measuring the parathyroid hormone would be very helpful as well to estimate the risk for a parathyroid adenoid, which is a common cause of mild hyperkalemia. Also, have you been using anything that has an effect on calcium like supplements, . I hope I've helped! If you'd like more information, please let me know. I'll be glad to answer. 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: for two days my mouth has been swollen on the jaw bone near where the wisdom teeth a located. Now this morning i cannot open my mouth and even swallowing is extremely painfull. I cannot even see inside my mouth to tell if it is an abcess, could it be an abcess from the symptoms described? ### REPLY: Thanks for your query, I have gone through your query. The pain swelling and limited mouth opening is because of the wisdom tooth infection called periodontal abscess leading to cellulitis. The infection in the pterygomandibular space can cause this type of symptoms. Consult an oral physician and get a radiograph done and take a course of antibiotics like amoxicillin 500 mg TID and metronidazole 400 mg bid(if you are not allergic). Do saline gargling. Get the wisdom tooth removed under local anesthesia by an oral maxillofacial surgeon. I hope my answer will help you. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i have neck lumps at the back of my neck,or more like two large masses,im experiencing extreme exhaustion and im cold,even when its warm,i can actually feel my neck crunching where the masses are and im sleeping 18_20 some days,iv also got lower back pain that makes me feel nauseous some days,im so scared to go my doc as im a single mum with 5 children ! Can someone help me,i know im very unwell but dont know what ?, maureen 46 x ### REPLY: Hi! Sorry but must ask you to see a physician urgently! Well, we've discussed the various possibilities of neck lumps in this forum before also, but your case seems something different! Here, the lumps are not innocent; they are associated with so many systemic symptoms like exhaustion, cold-feeling, nausea and compression/pain!Therefore, these could be some bad lymph nodes containing tuberculosis, organisms or even lymphoma/malignancy rather than simple cysts, lipoma or neurofibroma...Therefore, urgently see a physician for a needle biopsy for confirmation of the diagnosis and its management. 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: low back pain  ,    anxiety  ,  dizziness  ,   very hard to  concentrate  tired all of the time  ,  very bad tingling in both feet  ,   burning dry eyes need drop in early morning    ,prescribed by doctor i000mg each day,     diagnosed by a  doctor with naturopaty ect_ ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. Neuropathy can present in this way with burning sensation over the limbs. You have not quoted the name of the medicine that you doctor has prescribed but one of the common causes of neuropathy is B12 deficiency. It needs to be replenished with alternate days IM injections. Also get a thyroid levels tested as hypothyroidism can also lead to this kind of symptoms. You can get a TSH level done. Further if nothing comes from the investigations then depression can also lead to this kind of symptoms. But all said the b12 treatment and thyroid investigations should be done before. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Well I have been taking Welbrutrin 300 mg XL now for a year, I am a dental assistant but struggle because I have adult add not fun, I have taken Concerta and Strattera but did not handle that well at all.  Welbrutrin works for me but its not enough for focus, attention, memory.  I do well at my job but I internally struggle everyday.  She just added Cipralex 5mg to Welbrutrin, what will this do for me inregards to my problem?  Will it make me gain weight and affect my husband and I sexually? Your help is much appreciated, thank youDenise ### REPLY: Hello, Thank you for consulting with . As you are mentioning that your doctor has prescribed you now Circle in combination with Wellbutrin, there is nothing to worry as She must be knowing your condition much better. Yes there are side effects of Circle like sexual dysfunction, but it is not necessary that each and every patient should encounter these side effects, it is very uncommon as only 1% of patients encounter them. You should be relaxed and start with the medications first. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am a 44 year old female. Long story sorry. 2 years ago I started having ache in my left breast - Nurse practitioner said a swollen lymph node. Then my shoulder (front) started aching, then it went to arm. A knot appeared in the elbow (inside), then tingling to fingers, with occasional tightness in chest, ache in collarbone and back of shoulder even up back of neck. I had EKG and it was fine, blood work (CBC) it was fine, mamo was fine, ultrasound of elbow didn t even show the knot, ultrasound of heart and aorta was fine, MRI of shoulder showed some tendenosis, but that s all. A nerve test of arm was fine. Symptoms started diminishing. My breast still gets sore some and raising my arm high will pull at it. Then a year and half ago I had ACL reconstruction. A week ago, I had to have orthoscopic surgery to take out scar tissue and fix it. I could not get it straight and it was getting worse. I was walking with a limp. About 3 months before that I started headaches almost daily and almost always on the left side. Then I started having a pain in my left jaw. I could not open it wide enough to even bite a cupcake. That lasted a week, then I got what seemed like a cold. I coughed up phlem and some mixed in blood. It went on for 14 days, by the end it was mostly clear and some bit foamy. I took Amoxacillin for 10 days. Cough went away, but jaw still hurt. I took it for 7 more days. No change and now my arm (left) was hurting again. My blood pressure was 126/?70. It is usually 112-116. I had struggles at work and it was a week before my 2nd ACL surgery. My dr. thought it may be stress. She said she felt no swollen nodes. They told me to take Cymbolta. I took it for 2 days. We had to go to Fl. for a funeral, I forgot to take it on day 3. My arm seemed fine and no change in my jaw so I quit. 4 days later was that 2nd surgery. I had IV fluids and antibiotic. 4 days later, my jaw still sore and a sore on my gum, my tonge thick and white, my throat very red, white patches on my inside jaw and then a day later teeth achy. Dr. said sorta looked like thrush, but not as fussy. Ordered oral nystatin 4 times a day. Dentist said thought it was thrush. Dentist took panoramic x-ray. No absess, no lessions, jaw joints look good. Said probably stress. I had had some episodes of lightheadedness too - especially when looking down. Then some pressure in back of neck. Woke up with throat tightness one day. Went to ENT 2 days later after dentist. Hearing test ok, eardrums ok. He felt my throat, felt my jaw, looked in my mouth and said yes thrush, dry tongue, and probably stress - said to call dentist and get mouth guard for night. He said the muscle runs down throat and can cause a tightness. I have also had a tender spot on an off on the forehead left side and the right temple area. I was doing great today 1 day later and feeling good until as I was cooking dinner, my left arm started aching again and then a pressure in my back of my neck then head feeling heavy and large then tightness in my throat. I could breathe fine, but it felt tight. About half hour the tightness subsided, but arm still ached and in front of shoulder hurt. That lasted for about another hour. Then ache went away I felt good for about 10 minutes and the tightness in throat started back with some pressure on and off in sinus to nose. Mostly left side. Still breathing ok. A few burps which were hard to get out. Like something wouldn t let the air out easy. I can swallow, but it feels like a blob in there. I am so concerned. I have 2 little kids and I worry something really serious is being missed that needs taken care of now. Please help. I don t know where to turn or what to do. So worried. ### REPLY: Madam, I think you are aged enough to enter the menopausal stage and your concern for breast lump with pain is understandable too. Now that MRI and repeat examination of breast with pain as presenter have said no cause for worry. But your restful pain in oral cavity, Cough etc. are pointers to more proneness to infections which are getting resolved with attention received but are heavily depressing for you to bear along with some elevations in your B. P readings impel me to advise you better undergo Diabetic profile to rule out its onset already in view of subtle symptoms Pershing with you for years. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi. my heart tends to speed up a lot for no reason. i just measured it and it was 115 bpm. im fairy healthy, i run a lot and my normal resting rate is around 60-63. i have no idea what causes this. im sitting down and suddenly i feel the pulsing all over my chest. ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you should immediately consult cardiologist. Sudden rise in heart beat even at rest is commonly seen in cardiac rhythm disturbances (arrhythmia). And these can be life-threatening if not diagnosed early and treated promptly. So better to consult cardiologist and get done 1. ECG 2. 2d echo 3. Holder monitoring (24 hour continuous monitoring of ECG). You may need anti arrhythmia .  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: hello i am 25 years old i have PCOD from 2years have i am over weight day by day i am gaining weight. i am having daily twice glycomet sr 500mg tablets. i also have irregular periods i have also taking meprate tablets. kindly suggest me. we are  also planning to conceive. ### REPLY: Hello dairy understand your concerned is complex disease and treatment response is variable. I would suggest taking proper treatment under advise of gynecologist with regular follow up and monitoring by USG scan, ovarian follicle study. Your period is irregular and you are overweight. So main aim of treatment is regularized period and decrease weight. Once your period will become regular, chance of pregnancy will be high. You can take crimson 35 for 2-4 months to regularize period. Continue to use glycometMeprate can be used in second half to regularize period can ask for following medicine to become pregnant:Clonidine citrate,  injection and FSH injectionAvoid stress, take healthy diet, . Avoid excessive sweet, oily/fatty food Hope this may help noncontact further if follow up needed Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 54y.o caucasian women, hx Gall bladder removal, kidney stones , sleep apnea , obese,reflux, High uric acid and calcium levels on HCTZ (for calcium levels) Allopurinol , Protonix . Recent labs elevated glucose 283, A1C 9.5 (typically 6.5 or less), Triglycerides 123, Cholesterol 181, HDL 40, Alk Phos 151, ALT 58 Bun 10 Cr .55. Concerned as doc wants to start Amaryl. Your thoughts ### REPLY: Dear Mam. You have to accept a fact that you are a diabetic. I advise you to get your anti dial medications start ted as soon as possible. Get your urine tested for albumin and eye for diabetic retinopathy, ECG for cardiac status. Good news is that your creatinine and bun are normal so far. Get a strict dial control to avoid any damage to your kidneys as they are already under stress in diabetics. You have kidney stones, in case they are in ureter or causing any obstruction they can lead to hyperglycemia. You have not mentioned your uric acid levels. I suppose you have achieved menopause. Let us know your uric acid levels before I can comment on treatment for it. But to the earliest start your treatment for diabetes. You need to reduce your weight at any cost. Sleep apnea and diabetes both precipitate heart problemsStay healthy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ride bmx, and recently I fell backwards pff my bike at a decent speed. I dodnt think much of it but minutes later I started feeling pain at the bottom of my spine. It bothered me the rest of the day. The next say I rested and did minor activity and the pain lessened. I went to ride my bike again today at the skatepark and the more active I got, the more I started feeling the pain come back. Anything I can do to recover? ### REPLY: Hi, thank-you for providing the brief history of you. A thorough neuromuscular assessment is advised. As mentioned by you that you had a fall and post which you are having pain in the back. Now to understand this further a clinical special test are needed and a palpation of the muscles of the spine. Now, post this and X-ray, an MRI or a CT will be performed to check the status of the bone and the soft tissues. Later on, rest, Medication and physical therapy will be advised. Based on your symptomatic improvement the physical therapist will help you learn the exercises as to strengthen the core, pelvic floor, upper back, lower back, lower limbs and upper limbs. A combination of all of these will help you get rid of pain and also a good strength in the muscles to ride again. In my clinical practice I have seen cases with such pain, and they all recover with 99% success rate. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have red bumps showing up all over my body. They are very sore, filled with blood and puss, warm and hard to the touch. It takes about a week for it to scab up. One will pop up and a few days later another one appears. They are pretty big. What could this be? ### REPLY: Hello, Welcome to ChatDoctorThanks for posting your query in . Your symptoms are most probably suggestive of Staphylococcal infections. It is usually caused by bacterium Staphylococcus aureus. It may be a boil or folliculitis. Staphylococcal folliculitis affects hair follicles on the face, scalp, neck, trunk or limbs but not the hands, soles and mucous membranes where there are no hair follicles. Folliculitis usually appears as a group of red bumps, which may develop into pus-filled blisters. I would advise you to go for topical antibacterial treatment like Juridic acid and mupirocin. Treatment should last up to 10 days. To prevent getting such infections, follow these measures:1. Regularly wash hands, avoid nose picking, nails biting and skin scratching.2. Wear fresh, comfortable, airy clothes.3. Do not share razors, towels, clothes, bed lining with others. 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: My 11 month old son has had diarree for 2 days. We started giving hydrol and a probiotic yesterday evening to stop diarree and dehydration.This morning he still had a diarree nappy. What other remedy can I use to stop this soonest? His bums are also extremely red due to the diarree and does not heal due to the constant diapers and this is extremely painfull. Your assistance will be much appreciated. Thank you Christel ### REPLY: Hello, It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.  There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic-associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 also have been experiencing a lower left abdominal vibration, no pain. Started on July 18th. I had been painting and scraping the garage, on a ladder. thought maybe this triggered something. It went on, off and on for 2 weeks. We went to visit our son and NYC. Put on 45 miles walking. no problem. Came home. Off and on vibration started again, then stopped completely for ;7 days. Now back again. I am 64, weight about 148, take advair for asthma. The vibration is annoying and scary because I don t know what is causing it and hoped after it had stopped for 7 days that it would go away on its own. ### REPLY: Hi. Regards. Thanks for an elucidated history, which say you have walked 45 miles too. This indicates that there is no intra-abdominal problem. The vibration in the left lower abdomen looks to be due to the tics of the musculature of that part of the abdominal wall possibly due to a pinched nerve, or an automatic discharge of the nerve or may be a disc in the thoracic region. Get examined by an Orthopedic Surgeon / General Surgeon to get a physical examination done, an ultrasonography of the abdomen and an MRI of the thoracolumbar spine. Relax, this is not a serious problem, although it is definitely an irritating one. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 53 male. I have been extremely thirsty for over a week now. I can t seem to get enough liquid to satisfy the thirst. I m a pre diebetic and I do drink a lot of vodka. It seems like I m not hungry nothing sounds good to me and that s usual. I have to go to the bathroom to urinate all the time. I will make an appointment with my Dr. this week, but what do you think of these symptoms and is there anything I can do to help stabilize me. ### REPLY: Hello there. Thanks for posting your question on . You said that you are pre-diabetic, but what is your blood sugar level? Frequent urination that is polyuria and increased thirst i.e. polydipsia are common symptoms of diabetes. I would advise you to get your fasting and postprandial blood sugar levels done. Also, a glycosylated hemoglobin should be done to know the status of your blood sugar in the past. I would advise you to stop ingesting alcohol as it will only increase your chances of getting diabetes. Diabetes is often treatable by lifestyle modifications like proper diet, exercise. I hope that answers your question. If you have any other queries please feel free to write. Stay Healthy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 friend is having blood pressure problem since her childhood. Recently, she has been having cough problems. Its like she is coughing all the time now, even puking food & has lost weight in last 3-4 months. She told me that her doctor has confirmed dust allergy. She has consulted many doctors but none of the medicines are working. Can you tell what to do now ? ### REPLY: Hello dear, welcome to .come have evaluated your query for your friend.* All symptoms are serious only if not taken care properly.* If confirmed case of dust allergy, and ruled out other causes, guidelines for her better outcome-Allow her to maintain HY . - Consumption of balanced nutritious diet.- Regular walking in fresh air, deep breathing exercises, YOGA.- Avoid smoking, alcohol if using.- Avoid exposure to dust, pollen containing atmosphere ; if needed to use triple layer face mask wisely.- Avoid stress, anxiety.- Have regular sound sleep of 8 hours.* Regular check up with your physician time to time. Hope this will help her for sure. Wishing her fine recovery. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: How to get rid of a chemical burn ? ### REPLY: Hi... Shea., Thanks for choosing ., CHEMICAL BURN....normally due to Corrosive substances... e.g..acids, bases, solvents, reducing agents, alkylate.....mainly it gives itching, burning, bleaching and tend to produce., tissue necrosis...,1) Thorough cleansing of affected area by huge amount of WATER.,2) Remove any blisters and dead tissue at the burn area..., covered with Sofia Dulles....3) Mupirocin cream..... T. Bact (GSK) apply on that area.,4) Cap. Ampicillin and oxacillin 500 mg 2 times daily for 5 dies., treatment is depends upon......site, extension and degree of chemical burn....ok.bye good luck., ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 8 year old daughter has a thistle stuck in her finger, and it has become reddened and looks dark. There is no swelling, but you can see a darker spot in the middle of the wound. I cannot see anything to be able to remove it now. Will it go away on its own? ### REPLY: Hi dear, If there is anything stuck inside, we need to remove it to avoid foreign body reaction or secondary infection. Just have a look with a magnifying lens, if available, to look for anything stuck there. If not seen, try giving analgesics like paracetamol or ibuprofen 3 times a day for 2 days to reduce pain. A darker spot can be caused by the prick itself. If pain recurs or the area becomes progressively red and swollen, kindly take her to doctor, as this indicates thistle stuck there or secondary infection. Hope I have answered your Quertle me know if I can assist you further .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr., I had back surgery 12-31-2013. Since my surgery I have had no pain at all in my back. However before the surgery, my right leg has drop foot (this is why I had emergency back surgery), It has not recovered . Last week I slipped on the ice and yesterday I had x-rays done yesterday. I just picked up my report and The findings were There is posterior fusion of L3-L5 with disc innerspace devices. Vertebral body heights are within normal limits. There is grade 1 anterior subluxation of L4 on L5. L5-S1 has sever disc space narrowing. Impression: 1. Lower lumbar fusion as described above. Hardware appears intact. 2. Grade 1 anterior subluxation of L4 on L5. 3. Severe disc space narrowing of L5-S1. I have not been able to get ahold of my back surgeon and am very scared. I am in a lot of pain now. I have not had any pain since my back surgery. My drop foot is making it easy for me to fall. I wear an AFO on my right leg. Can you explain to me if this situation is severe and if I messed up perfect back surgery by my fall. What is Grade 1 anterior subluxation of L4 on L5. Will this require another surgery. I am scared to death. The L5-S1 severe disc space narrowing, I don t believe would be caused by falling. If it is can you let me know. I just turned 55 and currently have no one to get answers from. I lost my husband in 2011 at the age of 53, so I am very scared and depressed that I may have real hurt myself and require another surgery. Can you help explain what this report means. Thank you, Kim ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. It seems that your fall has aggravated your condition. You need to visit a Neurosurgeon at once Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in  at http://bit.ly/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: Hello I have two porcelain crowns on my front teeth which were placed on in jan 2007 one had to be replaced in 2011 because it cracked the remaining one was fine until nov 2013 I began having tightness in the tooth when I lay down either on my back or sides and when i wake up the tooth takes 2 hours to adjust to a normal feel it sort of pops back into place and i hear it popping  It seems as when im sitting up and position my head to the side the tooth moves.  I have some sensitivity in the tooth and noticed a small bump on the gumline in nov 2013 that used to hurt to the touch for 2 weeks then the pain disappeared but i still have the bump but no pain when i touch it.  Several dentists have stated "it doesnt look like an absess" or "i dont see any inflamation"....can u help?  right now the symptons are mild and more of a discomfort but paranoid it will blossom into something serious if i dont take care of it now ### REPLY: Hello, thank you for consulting with . As you are mentioning that you first experienced pressure in the tooth while lying down it proves that there was some infection started in the tooth. And when you noticed some swelling on the gums the infection should have been turned into pus and spread to the apical region. The dentist must not have noticed it as in the starting, x-ray does not show any changes. You should visit your dentist and get the crown removed with root canal treatment of the tooth. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have recently been given a mouthguard by my dentist as I grind my teeth at night and when I put it on my top set of teeth it instantly makes part of my gums white like it s putting pressure on the gums, and the longer I have it on the more discomfort I get from it a it starts hurting my teeth. It s bearable but i find myself wanting to take it out in the middle of the night, I was concerned, is this normal?- will my gums get use to it, is it affecting my gums? Thankyou. ### REPLY: Hello, As you are mentioning that this mouth guard is putting pressure on your gums, which is uncomfortable for you this means that there is some problem in the fitting of this mouth guard, as there is some discomfort in the starting, but it is not so severe. You should visit your dentist again for the fitting as he will make some modifications and the problem will be solved. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , My Daughter is 9 months old... she is being suffering from cold ( symptoms include running nose, hard breathing , sneezing , coughing) for the past 10 days and she is currently on medication( azithral, Hicet, Prozeet LS) .I was informed that she is suffering from Allergic Wheezing . she is not eating solids since she is not able to sallow.... she drinking only milk.. Am worried about her weight . ### REPLY: Hello welcome to ChatDoctorSince she is suffering from a respiratory tract infection she will find it difficult to swallow solids as it would be painful. Apart from milk give her hot soup, vegetable stalk.  You can also give mashed rice in a liquid form. There will be slight decrease in weight in this period which is not to be worried about. This will be because of the medicines she has been taking so long. Hope this answers your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hiim a female 34 years old. for 2 years i suffer from feeling extremely hot in my hands , face and all my body as if i have high temperature. All my hands , face , & body change into red. Ive to sit in cold area otherwise the heat get more. Im worried.most doctors surprised from my case. what might it be? ### REPLY: Hello, Your case needs further investigations. First, we should rule out hormonal problems. So, get thyroid function test done together with sexual hormones balance. Next, should check your cardiovascular system to rule out pathologies related to blood vessels. And, of course rheumatologist to consult further to rule out hematological problems. Discuss this further with your caring doctor.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 on my knee with great force from a really high tree... after that for a few days my knee was really swollen and hurt to walk and move. Now its about a week after and there is still small amounts of swelling near the top of the knee cap and I can only bend it to 90 degrees but I feel fine to walk... should I be worried? ### REPLY: Hello, I have studied your case. As per your history there is possibility of soft tissue injury in knee. Most commonly meniscus injury occurs may be associated collateral ligament injury. You may need to do MRI knee to see for any functional defect. As per your symptoms you need to do physiotherapy and knee exercises to improve range of motion. Rest and ice fomentation along with supportive brace will help to reduce locking episode and pain. Small meniscus tear can be managed conservatively with physiotherapy with USG and TENS. Large meniscus injury can be managed by arthroscopic repair. Another possibility of patellar ligament tightness which can be evaluated clinically. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Our nearly 6 month old, completely healthy and happy granddaughter sways her head constantly when on her tummy or is being held. It is not because she is sleepy. At first we thought it was because her head / neck muscles were not strong enough, or because she was swaying to the music. She is sitting up fine,alone, though she still has to concentrate on sitting up. Her head is still when she sits up, perhaps because she is concentrating on her balance. One family thought is that perhaps her eyes don t move, so she moves her head to see! The baby s mother will ask at the 6 month check up in a week +, but we are interested in what you have to say. ### REPLY: Hi, Is this associated with head tilting to one side, or any abnormal jerkiness (nystagmus) of eyeballs? When these three features occur together (head shaking, head tilt, nystagmus), it indicates a condition called spasms nu tuns, a benign condition that usually resolves in few months. All features may not be there initially, and may come in succession. In such cases I used to take MRI brain to rule out any abnormality and reassure the parents. Your doctor will discuss with you on coming visit. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a dull and tight pain on and off in my lower left abdomen. It hurts more when I need to use the bathroom. Tends to hurt more when I get up and moving around but feels a bit better when I lay down. I thought it might be an imbalance of good and bacteria so I started taking digestive health to help with potential gas problems. This has been happening for about a month. I have no fever. ### REPLY: Hi. Thanks for your query. Self diagnosis is the most dangerous thing that you can do. Since you have a problem of pain in left lower abdomen for a month with increase when you have to use bathroom or on getting up. Taking probiotics alone may not help. I would advise you the following:5-day course of an antibiotic and metronidazole. Probiotics and diet restriction - stopping all the foods and beverages. If this does not help, you need a colonoscopy and a CT scan of the abdomen. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, I have a question.Am pregnant and have sugar and taking insulin 8 units in the morning and 6 untis in the night and my sugar levels are well in control. I want to know if i have temptation for sweets some times can i consume few sweets. Is it advisable and if i take sweets will it affect my baby.I am in my 36th week. regards, Vijaya ### REPLY: Hello, and I hope I can help you today. I am very sorry that you happen to be diabetic during her pregnancy. It is very difficult to achieve good sugar control, and the fact that you are on insulin shows that a good diet alone is not enough to control your blood sugar. So, if you deviate from your diet and increase your blood sugar levels, you are undermining the work of the insulin that you already take. The baby grows the most during the last month of pregnancy, and eating sugary foods or having a high blood sugar can make the baby grow very large and get fat which can increase the risk of cesarean section and birth injury. So I know it is extremely difficult, but it is not medically advisable for you to eat sweet things like candies, dessert and sugary .  You only have one month left of the pregnancy, so please try for your babies sake to adhere to your diabetic diet as much as possible until the birth. In some  ### END