Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I AM A 45 YEAR OLD FEMALE I WEIGH 140 LBS IM 5FT 6IN AND I HAD AN ABNORMAL EKG WHILE I WAS AT HE DENTIST I WENT TO MY PCP AND I HAD ANTHOR EKG WHICH ALSO WAS ABNORMAL SHWING A TRIPLE HEART BEAT 3 TIMES IN A ROW I ALSO HAD A ULTRASOUND AND A STRESS TEST WHICH WERE OK BUT MY DR IIIIIS STILL CONCERNED I HAVE WORN A HOLTER MONITOR ALSO MY PCP IS A GREAT DR AND I TRUST HIM THE REASON HE IS CONCERNED IS I ALSO HAVE SEVERE OCD ADHD AND I TAKE 20 MG 2-3 TIMES A DAY IS THERE ANY MED LIKE ADDERAL BUT THAT WOULD NOT MAKE MY DOCTOR SO CONCERNED AND I WOULD STOP THE ADDERAL BUT THIS IS THE FIRST TIME IN MY LIFE I FEEL NORMAL AND ABLE TO FUNCTION I AM THE MOTHER OF A 22 YR OLD 16 YEAR AND A 4 YEAR OLD SO I AM VERY ACTIVE. ### REPLY: Hi Welcome to . I understand your query and concern. Rapid heart rate and Dizzy spells can be a definite feature of heart rhythm disturbances. Irregular heartbeat is known to alter the blood supply to the brain leading to impaired function in a transient way. Few . I advise you to have a complete 24 hr holder ECG which can accurately determine the cardiac conduction abnormalities. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 in between stains on my bottom teeth, 4 bottom teeth in the front, and I floss every day and use mouth wash and brush twice a day, so why are there stains on the bottom of my teeth, could it because I rinse my mouth sometimes with perioxide? ### REPLY: Hi Dear, Welcome to . Understanding your concern. Brief answer - Extrinsic stains on teeth. Detailed answer - As per your query brown stains on lower anterior teeth is because of frequent consumption of coffee, tea, chocolate or .  It could be because of excessive smoking, excessive fluorides in your water or diet, and it could be because of certain trauma due to which tooth become dead and eventually becomes brown/black. Well all these factors and stains caused by them are extrinsic and can be easily treated. I would suggest you to maintain proper dental hygiene with regular brushing and flossing. Visit dentist and go for whitening procedure only in front tooth region commonly known as bleaching. Avoid  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my baby is 4 months old and is very fussy and crys when feeding by breast or bottle. He spits the bottle out & milk and only has 90ml (forced) per feed & around 6 feeds per day & weighs 6kg. The Dr didn t seemed too concerned about his weight last time but he is way under the recommended ml/day & hasn t gained weight for the last couple of weeks. He feeds ok at night or when sleepy but then also falls to sleep and doesn t get recommended amount. What should I do? ### REPLY: Hello, What was the birth weight of the child? Has he been on exclusive breastfeeding since birth or partial breastfeeding?  We need to monitor his weight on a growth chart and observe whether he is within the percentile of growth a child on breastfeeds and bottle feeds gets nipple confusion and sometimes refuses to feed with the bottle. How frequently is the child passing urine? How is his daytime sleep pattern? He needs to be stopped force-feeding as this aggravates the problem. Feed on demand. Try exclusive breastfeeds until six months of age. Check his weight every two weeks. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 9 and she has been complaining of a stomach ache for a couple of weeks now off and on.. we thought mabye it was her diet and tried to change that now it seems she is having these aches off and on every day and she is having loose stools 2-3 times a day what should we co what is it? ### REPLY: Hi. Thanks for an elucidated history. The child is 9 years old, pain and loose motions, not responding to change in diet. The most probable causes are : Appendicitis, lymph node enlargement (tummy tonsils), nickels diverticulitis, and so on. A proper history, clinical examination, investigations as per these findings alone can lead to a proper diagnosis. This is most important to lead to a proper management/ treatment. Blood-complete blood picture, kidney functions tests, blood sugar fasting and post-lunch, Urine-routine, microscopy, culture and sensitivity (before start of antibiotic)Ultrasonography of 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: yes i have a question well i was having a drink or two on the weekend with some freind when my chest began to have sharp pains as well as both my arm and the pain was radiating down my arm but after like 15 20 min it was gone and later that night the pain came back ### REPLY: Thanks for your question on . I can understand your situation and problem. Recurrent chest pain with radiation in arms is seen commonly with heart diseases. You are also taking alcohol, so possibility of heart related pain is more in your case. So better to quit alcohol as soon as possible. Get done ECG, 2d echo, stress test (trade mill test) and coronary Angiography if required. You may need cardiac supportive .  Don't worry, you will be alright, but quit alcohol and rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i am 36 years old and by phisic i  am normal but sex timing is too short when i started sex just after les then 1 min released and take least 2 hours for making mind for 2nd time for making sex.. some time before geting into her my partner vigaina ...i released or became cool..... thanks and Regards ### REPLY: Hello can understand your concerns see patients with sucChatDoctorplaints in my clinic routinely, and I will also help you as well in the best possible Mathis condition is known as premature ejaculation which can be treated very easily with lifestyle modifications and medicines Please let me know if you are diabetic or having any heart disease meanwhile follow these guidelines smoking and alcohol to be given up have plenty of fresh fruits and vegetables in your diet exercise regularly at least 30 to 45 minutes brisk walking or jogging you can do start stop technique or diesels exercises spend more time in foreplay Hope this helps you further queries are most welcomeRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been having lower back pain especially since having my child who is now two weeks old, i had an xray done and the radiologist said i had bilateral pars defect a L5 S1 with grade 1 anterolistheis on L5 S1, what does this mean and is this the reason for my continuing lower back pain and how can this be fixed ### REPLY: Welcome to  After going through your query I concluded that you are having chronic backache. On X-ray you are found to have pars defect at L5,S1 with anterolisthesis of grade 1. It means that you were having developmental defect in formation of part of vertebra. It later displaces under strains of life and manifests as backache. Grade 1 anterolisthesis means L5 vertebra is displaced anteriorly in relationships to S1 which is less than 1/3 of vertebral body. Its treatment is either wearing lumbosacral belt and avoid strenuous activity and analgesic. Second option is operative in situ fusion. You can discuss with your treating Doctor about it. Hope your query get answered. If you have any clarification then please don't hesitate to write to us. I will be happy to help you. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi..I recently had bloodwork done and had a SGPT level of 125. The week before my blood test, I did take some steroid pills and OTC Advil Sinus due to a sinus issue for about a week before I did the blood test. I am 5 10 220lb and doctor has already advised me to exercise and change my diet which I am doing due to weight gain , yet I also drink alcohol occasionally...mostly on the weekends, and sometimes I drink a lot on weekends. The nurse called me with my results and told me not to be overly alarmed because it could be due to meds or a virus and to reduce my alcohol consumption. I guess what I am wondering, how bad is a level of 125, could the steroids and OTC Sinus medicines have caused a spike and how concerned should I be as far as any liver damage may be concerned. ### REPLY: The level of 125 is high, but you have many reasons to have this level. Alcohol intake, weight gain and yes .  I would advise you to quit alcohol, lose weight and avoid steroids. Have the liver functions rechecked after 4-6 months. You must also get an ultrasound done and viral markers(hep B and Hep C) done.  You need not be alarmed with the value, but this value does suggest an ongoing liver inflammation so if care is taken early we can avoid father damage to the liver. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: : Hie, Daily i am performing self sex atleast once I am secreting sperm out. So can u please tell me will that lead to any problem during sex with life partner after marriage. My health status is good. My age is 22 and my weight is 55+.Hie, Daily i am performing self sex atleast once I am secreting sperm out. So can u please tell me will that lead to any problem during sex with life partner after marriage. ### REPLY: HelloThanks for query. Based n the facts that you have posted it seems that you have been indulged in masturbation and now worried about problems related to sexual activities in the future. Masturbation is a normal act of an achieving sexual satisfaction without physical intimacy of female partner and every individual practices it in adolescence. First there is myth in a mind of common man that excessive masturbation is the reason of all sexual problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body. All the problems that you are facing now are mind related and due to anxiety. Please see that you do not gate addicted to it and restrict it thrice a week. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is canker sores contagious...ive never had a canker sore it s red really swallon just appeared yesterday and my mouth and have 2 good size bumps on each side little miniature dots were my mouth is swallon one of them has a black dot in the middle all of this ### REPLY: Hi. Thanks for the query. As per your complaint canker sores can be caused due to causes like deficiency of iron and vitamin B12, stress, physical trauma to the tongue, allergies, acid reflux, side effect of medication etc. Other common cause can be herpes virus infection causing cold sores. If it is viral infection then it is surely contagious and if it is canker sores then there are fewer chances of communication of infection but still it is always advisable not to share your personal belongings with others. For now, you can start gargling with a numbing mouthwash containing Lidocaine to relieve the symptoms. Do warm saline gargles. Apply an oral steroid ointment along with Chlorohexidine ointment. You can also take a multivitamin tablet daily. You can take anti-inflammatory painkiller like Ibuprofen. Suck ice and do cool water rinses. Avoid spicy food. If there is no improvement in 3-4 days consult an Oral Physician and get evaluated. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had an uncomfortable pain in the lower rhs of my back for some 2 ot 3 months, Thought it was astrain and would go away but has not . today I have pushed my fingers into the area between where I can feel the ribs and it is quite painful when I push in ### REPLY: Hello, I have studied your case. Due to compression of this nerve root there is pain in your filthier is another possibility of Costco . Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. 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: Had recent bypass surgery,,dec13,, had cardio vert done april 2 to correct rythm, last few days getty dizzy spells,, realized to day they are triggered when I bend over putting pressure on stomach and upward,,checked vitals shortly after first event,,128/98 pulse 91,, possible fluid issue maybe,,been taking fluid pills daily ### REPLY: The symptoms you describe fit into orthostatic hypotension.  When you are on a diuretic for removal of extra fluid post bypass, sometimes over treatment may lead to fluid deficit in the body.  So sudden change in posture may cause such dizziness.  Also, many medications like nitrate, ace inhibitors which are routinely prescribed with post bypass may exacerbate the symptoms.  Maintain adequate HY .  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 Doctor, i have a pain in my right side of my abdomen, exactly on the place where liver is located. it started when i was in hospital treating for malaria, pneumonia and typhoid fever. the examination result for these diseases in different hospitals was different. but i took all the prescribed drugs. When I check i check my liver except there was enlargement of liver and spleen, they called Hepatosplenomegaly they told me that the size and function of the liver is fine. but still the pain after a year and half is continuing. sometimes it is low and other time very strong which i feel it very well when i asleep by that side. plus i have disc prostitution case which is not treated. So, my question is do you think that the problem is liver case or associated with the disc problem? ### REPLY: Hi, Where is your disc bulging located? Which level of vertebra? The possible causes of right upper limb pain may be due to hepatitis or cholecystitis or right renal calculi or right colon bloating etc. Radiculopathy of nerve root of thoracic vertebrae between T8-T10 may cause compressive neuropathy.  Please avoid spicy food, alcohol consumption, smoking and caffeine .  Use tablet Pantoprazole. Use tablet Pregabalin. If symptoms not improved please consult your doctor, he will examine and treat you accordingly. 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: help, im at breaking point, every since i had my upper back tooth pulled ive been sick. Sympthing ranging from rapid heart beats, tightness in chest, lower neck pain, tenison head ache,congestin,acid reflux, ear feel clog .Been to the doctor lot of carido test done all were fine as was kidney, and adomen test. Only thing i can think of is the dental work, becuse i was fine until i had that done. ### REPLY: Hello! Welcome and thank you for asking on ! Regarding your concern, I would explain that as all your tests have resulted normal, there is nothing to worry about! I would just recommend performing a cardiac ultrasound and an ambulatory 24-48 hours ECG monitoring to investigate for cardiac arrhythmia (if you have not already performed those tests). Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? Please type your query here... Dear doctor, My married daughter aged 23 years had an car accident and fractured her T11 and T12 for which she under went a surgery on the next day of her accident(07th sep 2010).Fortunately no nerves were involved.Titanium plating has done.Now she is pregnant almost 6 weeks.She would like to do medical termination of pregnancy due to her ongoing back che. please advice me what to do?Thank you,S.Raj ### REPLY: Hello dear, I understand your concern. Iam sorry for your condition. The medical termination of pregnancy is possible only up to 6-7 weeks. If more than that minor surgical procedure like D&C is required. As presently she is at 6 weeks so consult doctor as it will be done by medicines. Taking abortion pills by self is not safe as it is associated with other complications like incomplete abortion, heavy bleeding etc. 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: I HAVE CAD WIRH TWO STENTS. THE DOCTOR LEFT AND 80% UE TO IT BEING LOCATED IN A CURVE OF AN ARTERY. HE SAYS THIS CANNOT BE STENTED AND THEY DO N OT WANT TO DO A CABG. HE IS TREATING IT WTIH MEDICATION AND I WANT TO KNOW IF I WILL BE ABLE TO RETURN TO WORK. I HAVE PAIN DAILY AND ON EXERTION. HE SAYS IF I HAVE A MI THAT IT WOULD BE BETTER THAN HAVING SURGERY. ### REPLY: Hi, It seems there was a minor branch with 80% obstruction which they couldn't stent and it didn't worth to go for CABG. If it gets occluded, then a minor heart attack will happen. But there are good chances that it will stabilize with time. You should take your medications. I think you will start to feel better during a month. Hope I could help nourishing you good health In case of further questions don't hesitate to ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 5 4 and 24 years old..according to my age and height, I just found out I should have a weight of 150lbs and BMI between 20-25, with 18.5 being the lowest (or so I m told). HOWEVER, I weight about 104 pounds (47kg) and have probably seen 117lbs as my MAX weight ever. BMI is 18.13 now. I m down to 1 light meal a day, and have been like that for 6-8 months or so. I do not eat my greens nor meat..have even cut out chicken over the past 4 months. Generally survive on mini snacks, frozen food, or junk food. I went for blood tests in October, and I was told I have iron deficient anemia. I was at level 7 or 9 with my iron stores, should be at 12 minimum. I was given iron pills to take twice daily (Feramax 150) but I ve rarely been taking them (I forget!). I do not take or have ever been on birth control. Lately, I ve been noticing my nail are blue-ish purple and I generally DO NOT get hungry or am not motivated enough to eat at all. My meals have been as big as my snacks used to be in the past. I have been stressed lately and emotional too, dealing with anxiety (usually want to crawl away and hide, or sometimes forget how to breath and have to force myself) and haven t had motivation or inspiration to live..been looking for a reason to live at the moment and find meaning to life...still getting there slowly... This month I did not FEEL like I was getting my period (no feeling, no cramp, nothing). I had unprotective sex when I was 1 day overdue my period. He pulled out, and did not *** inside me. I worried about the sperms in the precum from foreplay. I took the Plan B after 18 hours of sex. I still have had no spotting, nor any cramps at all. It s been 2 full days since the unprotective sex, and 3 days overdue on my period. I usually always get my period on time, with a 26-28 day cycle. I had a 37 day cycle two months ago and last month was 25 day cycle. I ve taken the Plan B once before in September. Could it be that I generally just missed my period? What s the likelihood of getting pregnant when you re a day late on period with iron deficient anemia and possibly being anorexic, and he pulled out? Should I be worried? What should I do? ### REPLY: Hello, Thanks for your query. Without adequate iron, the body is unable to produce normal red blood cells. In young women, iron deficiency anemia can result from heavy menstrual bleeding. Non-menstruating women or men who develop iron deficiency need to have a colon exam to help identify the source of chronic bleeding. With iron deficiency anemia, your doctor will probably recommend iron supplements that contain the ferrous form of iron, which your body can absorb easily. If you use iron supplements, remember the following cautions:Always consult with your doctor before taking iron supplements. Iron supplements -- like all supplements and any medication -- should be kept out of the reach of child . Taking iron supplements with food can help prevent common side effects, which may include nausea, diarrhea, constipation, and stomach pain. Watch for  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 feel cold inside my chest. I just worked out. I ve had a sinus headache all day. I was sweating considerably more than usual during my workout and my heart rate was higher than usual. No palpitations, no dizziness, no blurred vision. My blood pressure was slightly increased yesterday, 160/82, possibly due to stress. But was 132/78 just a few days prior. ### REPLY: Thanks for your question on . I can understand your concern. In my opinion you should consult doctor and get done ECG and 2d echo to rule out heart diseases. You are having high heart rate, high blood pressure occasionally, headache and chest discomfort. All these are commonly seen in heart diseases. So better to first rule out cardiac diseases. And hence ECG and 2d echo are required. If both these are normal than no need to worry about cardiac diseases. Your symptoms are mostly due to stress and anxiety. So better to avoid stress and tension. Be relax and calm. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Can ringworm cause UTIs in males age 30? A RN just diagnosed my rash as ringworm on Thursday. Yesterday (Saturday) my roommate asked if I had a UTI cause I was going to pee a lot. I am prone to kidney stones and yesterday I had a sharp pain in my upper right back area just under the rib. Felt like it could be my kidney, but all of this could just be a coincidence. I dont have any pain in my bladder. ### REPLY: Hi, Thanks for writing in. Ringworm is a skin infection and will never cause kidney stones. However, possibility exists that if you have ringworm infection, you will have intense itching in your groin areas and this can cause other infection in the genital region, but this does not happen easily. Going to pee can be the result of minor UTI which can occur due to hygiene problems and itching. There is no reason to connect kidney stone formation and ringworm. However, please continue to .  Getting an ultrasound scan of abdomen and urine examination might help if you are having frequent urges of urine and pain in back. 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 name is Tina I m 199pounds and I m 32 years old I had blood work done and can t figer it out if my results are normal White count was 10.4 and hemoglobin is 12.3 Hematatrit was 38.2 Platelet count was 299,000 Sodium 137 Potassium was 3.8 Chloride was 102 Carbon dioxide 27 Anion gap was 8 Buns was 7 Creatinine was 0.79 Calcium 9.1 Bilirubin was 0.5 Sat was 39 Alt was 47 Alkaline phosphatase was 69 Protein 6.8 Albumin was 4.1 Was negative for salicylates and acetaminophen and alcohol ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You're all investigation reports are normal.  You should NT worry about that.  If you have any symptoms then consult your doctor and take treatment accordingly.  Otherwise, no treatment is needed from your reports. 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. Our ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, for awhile since they found a couple large nodules in my goiter- have said I have multi-nodular goiter, but it s benign...however then they said one of the nodules is cystic, but stable, that was over a year ago..because my endocrinologist wants it removed, yet why can t they do it? evidently some sort of specialized ent dr needs to...anyway - I have some sort of lumpy stuff under my armpits, I found a very large knot under my chin bone on the left side also one under my chin, my thyroid feels inflamed, I also found another knot behind my knee. I am seeing a pain mng. dr. for strange rib problems/ back & neck...he told me to see another endocrinologist...the thing is I am tired of running around trying to find a dr that will help me, my throat hurts really badly especially with the lump- now I noticed parts of my gums are whit an infected looking, I have been in pain and really tired with night sweats etc. I don t know what to do- every time I go to the dr. they don t do much but give me something for what feels like side effects or infection IDK- then they tell me to go see a dr- I HAVE BEEN TRYING TO! It s like an endless circle of hell? what can I do? should I go to the er now? ### REPLY: Hi, thanks for sharing your health concerns with !  If I were your treating Doctor for this case of multiple body lumps, I would like to go for some biopsy/FNAC test from the axillary or knee swellings as the thyroid goiter is there for so many years; it might be a bad disease like malignancy or lymph nodes! Therefore, no wastage of time.... I suggest you to go for an FNAC and CT scan of the region (s) for confirmation and to relieve your concerns! Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. 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 Chickengunia fever in August, 2014. The fever went away in 3 days. But I started feeling pains in my hand,arms and to some extent in feet. The doctor advised me to take Saaz-DS (Salfasalazine)1 g tablet/day. I have been taking this medicine for the last 8 days but with little improvement. What do you rercommend? Thanks ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion you should continue with the provided treatment. Chikunguniya have severe joint pain which cannot be counteracted by the routinely prescribed painkillers. I suggest you to take low dose steroids like prednisolone. But remember never continue steroid treatment for prolong period as it has some side effects on long terms. I will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello my daughter if 5 years old she started getting sick las monday evening with vomiting and diareah I took her to the ER and they told me is was a stomach virus she s gootten better 7 days later she still has loose bowel it s yellow at first know is brow sticky looking... Thanks ### REPLY: Hi... Thank you for consulting in . 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: Hi, im a teen and ive recently had sexual contact. Soon after I have noticed little black and dim flat spots that become more noticable when I have an erection, these spots are located all around the tip of my penis mainly near the hole and on the top. I am almost certain my partner is free of STDs. Is this something I have to be worried about and if so what must I do. ### REPLY: Hi, Welcome to  forum.  It appears that you must be having these spots, even before the intercourse. They would have been unnoticed, so for.  The spots may be due to the fungal infection.  I advise you to consult a dermatologist for diagnosis and treatment.  I usually prescribe to my patient with such symptoms grisofulvin, and mixed steroid ointment for local application.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have what looks like an oval opaque white edged flakey area on the right side tip of my tongue and and another area approximately one quarter inch further back from the first site that is round/oval shape and appears blood red possibly slight indentation to puncture level. I do not recall drinking an extremely hot beverage or biting my tongue. ### REPLY: Hi.... Welcome to . You mention there are two lesions over your tongue. Without clinical examination of tongue diagnosis not occurs... Consult an oral medicine specialist for further diagnosis. Size, shape, color of lump, consistency and patter of lesion give more information about it... This lesion may be a malignant lesion so better to diagnose it first... Start a treatment as per reason behind it. I hope this will help. Get well soon. 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: Today while lying down I had sharp pain just behind my belly button that felt pulling to my genitals. I have been dizzy on and off for about 4 weeks (and am currently) with a consistent headache. I had a urinary tract infection earlier this month and was on antibiotics. I m a 44 year old woman. ### REPLY: Hi ! Good evening, I am  answering your query. With all probabilities, you might be having a PID(pelvic inflammatory disease). I would suggest you to get yourself assessed by a gynecologist, who after a general physical examination might do some routine blood tests like a CBC, ESR, Blood sugar, and a urine routine/microscopic test followed by a culture/sensitivity test if need be. Till the test reports are ready, the treating doctor might start a broad spectrum antibiotic which could be changed depending on the culture sensitivity test report. Apart from this, an ultrasound of abdomen/pelvis might be helpful in ruling out any other pathology which could give rise to such symptoms. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Am having low grade fever for last 10 days,came to notice only five days back when temperature measured was 99.4 F.Since last five days temperature is varying from 98.6 to 99.8,most of the time less than 99.4F.Then there is dry cough which not going even after cough syrup meant for dry cough.Doc prescribed broadspecturm anti-biotic for five days and till now I have taken medicine for three days.However no drastic improvement visible as yet - with left eye and forehead aching very often and feverish feeling.What should I do??Blood test CBC and ESR minor changes and urine routine is normal.In the past 30 years twice attacked by cochs disease.Slight pain on my left side of neck -glands.On High BP medication for last five year and on aspirin 75 mg for the last five months. ### REPLY: Hello Since you are having fever low grade for last 10 days. Not responding to ordinary treatment. In the last 30 years suffered with Koch's twice. Took treatment, cured. Also taking medicine for high BP. I have seen so many cases (with old tubercular lesion) where cavity get infection and low grade fever developed, so in your case this low grade fever may be due to FRESH TUBERCULAR LESION so get in X-ray chest, sputum for AFB, CBC. So consult a chest tuberculosis specialist and get his opinion. 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 I am dr Manik  suffering from postural hypertension for the past 20 yrs not on any medication yesterday started with amylodipine 2.5 also on thyronorm 100 mcg for hypothyroid please suggest drug for hypertension as my stomach is very sensitive to alopathic drugs as I get  severe reflux on taking medication ### REPLY: Hello . Thanks for using .first I would like to know about your postural hypertension, usually one gets postural hypotension.kindly clarify and mention exact level of BP. It is surprising that you are not on medicine inspire of knowing that you have hypertension for last 20 yrs! If you are tolerating Amlodipine well then it is good medicine, and you may increase the dose to 5 mg once a day. You should aim BP below 140/90. If you don't attain that target you may add medicine from ACE group of medicine. My best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So Im a extreme  anxiety person. and I freak out about things that arnt even possible. But I just want to make sure Im OK.my head is throbbing like crazy.its coming from a huge pimple I have on my scalp I hope it nothing to scary or they have nothing to do with with other. Just want to be sure so I can get some sleep. Sorry if I sound crazy. ### REPLY: Hi there ~ I understand your concerns.  It does seem like you have an acne problem, and please consult a dermatologist for the same.  It will really help to improve your overall confidence and self-esteem when you get your acne cured.  Furthermore, it is something that most people go through in their young adulthood.  I also would think that a visit with a psychiatrist would be in place.  I hope this helps with the anxiety part of things. Take care and have a lovely day! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went to my family doc because I had painful lumps under my arms. She said they were swollen lymph nodes. I just had a bilateral axillary ultrasound and nothing was found. But they didn t do any breast images. I have absolutely no other symptoms. Still waiting for the CBC, should I have asked for more tests? ### REPLY: Hi.observation will do for now. If you had a recent infection, lymph nodes usually got inflamed, hence, those lymphadenopathies. They usually spontaneously resolved. If you have a strong family history of breast cancer/problems, you could opt for breast imaging now. Otherwise, you could opt just for breast ca screening at the age of 35 via mammography and ultrasound. Depending on the findings, management would follow accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am pregnant 17wks and almost 35years old. I have not taken my thyroid meds in a year. I have graves disease, treated by radioiodine therapy when I was 21. Three years ago, I started to get full body cataplexy drops, expecially after climbing stairs or elevations. Hospitalizations many times ruled out many cardiac and sleep study concerns. It was found that any slight decrease in my postassium level caused the hospitalizations after comparing notes for every visit. The doctor experimented and left me on IV potassium for a week and my levels would not go past 4.0 to make me hyperkalemic at any point, but did not make me feel better. Once the symptoms stopped, I would get released. Finally, they diagnosed me with hypokalemic periodic paralysis and potassium supplement nor potassium sparing diaretic would suffice. It actually made it worse. Ultimately, after discovering that sipping Pedialyte slowly all through the day kept me out of the emergency room, they put me on time released low dose potassium capsules 4x a day (10meq) as well as noting my thyroid levels had finally thrown me into hypothyroid after all these years since therapy. A year ago my TSH w T4 reflex was 1.80 and today it is 13.6. My potassium levels have been fine and I do take B12 monthly injections since I was 20 for pernicious anemia diagnosed by spinal tap a year before the Graves disease. I will see my endocrinologist this week but I am worried that the OB referred me to a maternal/fetal medicine specialist. They are getting familiar with electrolyte imbalances and taking the proper chromosome testing for my age and I await results. I am concerned about possibly getting paralysis attacks and falling while pregnant. It has not happened since I got pregnant, even though I feel awfull and stay in bed or on the couch. I am assuming the thyroid levels contribute to this worse feeling of my life because of my own neglect. I thought thyroid medicines made my heart race and made me have paralysis attacks more often, so I stopped to prove I dont have them as often when not taking Synthroid or Levothryroxine. The only other abnormality any specialist came up with during hospitalizations was a nuerologist noted strange brain waves during the test they make you hyperventilate to go to sleep (I did not sleep, only paralyzed myself) and he noted a small sclerosis on my hippocampus that was missed from a different hospital. I have not followed up with the nuerologist in fear because he had no answer for what causes it. Is it possible that tweaking my thyroid levels with treatment can cause the electrolyte issues to suddenly reappear and make it unsafe to be unattended or exert myself as before, noted by my frequent hospital visits of the past? My second fear is how much worse can it get until I deliver if I do not treat my thyroid? So in short I ponder: Obey doctor and suffer possible hypokalemic paralysis attacks/cataplexy body drops and treat as they come, or can the consequence of not treating my thyroid be more harmful to myself and the baby? I am not sure how bad a thyroid can get over another 20 weeks to guess which suffering of myself is worse, by for the baby, I am not sure how either symptoms can affect him. ### REPLY: Hi. I can understand the concern you have regarding your baby. The most concerning for me at this point would be the report of a high TSH, since you were off thyroxine supplements, because hypothyroidism during pregnancy is known to affect the fetus and its development including neurological development. So I think a visit to your Endocrinologist should be done as soon as possible, and this needs to be corrected. Otherwise, you will need to check and monitor your potassium levels and take supplements as required. You must already must have been informed about avoiding high carboy .  Hypokalemic periodic paralysis is a condition known to be associated with hyperthyroidism. So take care and get your thyroid status corrected. 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: HiI have a small nodule at the back of my testis that was checked by an urologyst a year back and he told me it is nothing to worry about. It is just a nodule on the tail of epididymis. Now couple of days back I found that the tail like portion is become like a small lump, little hard and it seems it is connected to testis. Could you please tell me if this is normal or not. I am very much worried. ### REPLY: HelloThanks for query. Based on your statement I would state that you have what is called as Cyst of Epididymis(Spermatocyte). This can be confirmed on Ultrasound Scanning of scrotum. Spermatocele is a benign cyst that develops in tail of epididymis due to partial obstruction and contains clear fluid. It is always benign in nature and does not need any treatment. Treatment is needed very rarely if it increases in size or becomes painful. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a hard (concrete hard ) lump , lower right back....it seems mobile and has gone from smaller than a ping pong ball to about egg size. If it is what I fear most, I will seek a hospice and no chemo/radiation for me. Seen too many go through those and all they did was prolong their misery and suffering. . . what should I do next ? I am on norco 10-375 1 every 8 hours prn for arthritis...wonder if that has caused this ? Pain is bad enough from this lump that I only sleep about an hour, sometimes 2-3 before the pain med seems to have worn off. I cannot take anti-inflammatories as I am on aspirin therapy...also cannot have any MRI s as I have a stent in my heart. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some soft tissue tumor like neurofibroma, dermatofibroma or other mass.  You should go for biopsy or fine needle aspiration cytology of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have MS. I cannot use any of the three computers at home as the nerves in my body start to burn and buzz.Strange as it may seem, I can use my computer in work.Needless to say this doesnt make much sense. And it didnt to my consultant. Very embarrassing.Can you help? ### REPLY: That is very strange and interesting. I would start with the ergonomics of eacChatDoctorputer as ms symptoms are related to temperature and position.  As I'm sure you've noticed cooler temperatures will help your symptoms.  The other aspects to check would be the back support and height of the arm rests, monitor, and keyboard.  Most ms symptoms come from the cervical spine which controls limb position so changes in body positions might affect you.  Hope that helped ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor. I am Amardeep Dhamija from India. I have been having my son (age: 18yrs) treated for persistent back ache for 1 year and 4 months now. The problem was diagnosed as arising from low Vitamin D levels ( 2.80) and Vitamin B12 (below 83) levels on 02Dec 2011. He was given ARACHITOL shots and also put on D-gain. I showed him subsequently to an endocrinologist who had a liver test done (SGOT: 14) and (SGPT:14) , Serum Bilirubin (1.37) and Conjugated Bilirubin (0.52) on 18 Dec 2011. Thereafter, I took him to a very senior orthopaedic surgeon who put him on Calcium and Vitamin B12 supplements . Ever since, he has been taking them. His latest tests done on 21 Feb 2013 show Vitamin D 46.40, B12:699 , Calcium 10.00, SGOT: 34 and SGPT:69. Related to this or not, my son also was suffering from Nausea, vomitting etc for which he was prescribed antacids by an endocrinologist. These symptoms have alleviated somewhat. Query: Sorry for the lengthy background but is SGPT level of 69 something to worrry about. I should also like to mention that he is in the final year of school and preparing for exams and is under considerable stress as are other kids like him. Lifestyle: sedantary for about 2 years. Please advise regarding his liver condition and generally what he should do. His back ache is considerably reduced and is only intermittent (normaly when he sits for prolonged hours). Thanks. ### REPLY: Hello, Although the most common cause for high levels of SGPT is generally due to consumption of alcohol but since he is a student, I am ruling this reason out. The other apparent cause in your son could be prolonged use of painkillers which he might have taken for his persistent backache. Other reasons could be obesity, high triglyceride levels in blood or even diabetes. I advise you to get his lipid profile done. Since there is no particular for its cure, I advise following things regular exercisesStop taking any pain killersTake fresh fruits and green vegetablesAvoid junk foods like pizzas, burgers,noodles etc. and colas. Reduce weight and be in required range of BMI. Get his SGPT repeated after 3 months and if you still find it high, then consult a gastroenterologist and get tested for hepatitis markers and other relevant tests. 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, ia m 19 years with 4th month pregnancy recently i have suffered with cold and cough Know Cold Was Cured But Cough Is There The PROBLEM is that when I was trying to sleep Some thing has happening in my body that I was not getting sleep with small sound coming from me which can t be recognised by me that can find with my life partner this creating sleppless to me what is the reason ### REPLY: Hi, .  I welcome you to  VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. Furthermore, I will try to suggest you the best possible treatment options. Furthermore, I think you are having Small airway spam. Furthermore, I will suggest Cap Among Laverton 625 mg twice a day for 5 days and Syrup Pricier 2 SF thrice a day for 5 days will be of help. Also, warm salt water gargles after every meal and steam inhalation will be of help. I hope this answer helps you. Thanks  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mother is in the hospital and her white blood cells are elevated to 28 and antibiotic does not seem to be helping. she originally was admitted for chest pains and abdominal pain and was also treated for uti which has been clear, but her white cells are elevated and geting higher. numerous test has been done in search of any other infections but nothing has been found. should i bee concerned ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  Your total WBC count is high.  It is either due to infection or due to some other cause like leukemia. Please send me your complete blood count report.  It will help to reach 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: I am CRF Patient. Undergoing dialysis weekly twice. i am taking cresp once in 10 days and iron once in a week my urine out put is 5-6 times a day iam not taking any diuretic to increse can i take ZYTOR or FRUSINEX 100 can i take cresp once in a week how to naturally control potassium at present iam consuming daily cucumber and pine apple is it ok please advice ### REPLY: HiT hanks for the query.1) Dy tor can increase the urine output. However, it needs to be administered under the supervision of a nephrologist2) The dose of crest has to be adjusted by the nephrologist to target a Hemoglobin between 10-12gm/dl3) Citrus fruits, bananas, tomatoes, green vegetables are rich in potassium. One of the ways is to cut and boil the vegetables and discard the water before eating. Hope this helps 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, I wanted to know what might be causing my back and chest pain. I have had pain in the mid section of my back and chest on the right side. My doctor prescribed me naproxen for it. I have also been an alcoholic for a least five years now which I think it might have something to do with it. I have been taking naproxen for over a month now but it only seems to temporarily relieve the pain. I do a lot of physical work on my job but the pain doesn t seem to affect it then. The pain is always at its worst when I m relaxing like sitting on the couch or sitting at the dinner table. It hurts the most getting out of bed in the morning. Do you think this might be a serious liver problem. I am 32 y.o. And I have been drinking at least three to four pints of vodka week for the past five years. Any help would be appreciated. Thanks ### REPLY: Hi, Welcome to . After going through your query I think you are suffering from chronic backache. Treatment of back pain is exercises and analgesics (diclofenac SR). Sometimes strong analgesic(such as attract three times a day after meals) is required. Consulting with treating doctor is advised.  Sometimes vitamin D deficiency is the cause so get your vitamin D checked. If it is low then vitamin D supplementation(weekly with milk) can be taken. Also get checked your Vitamin B12 level checked. As pain is on rest, so it should also be investigated to rule out ankylosing spondylosis so get x-ray spine and x-ray SI joint, ESR,C reactive protein and HLA B-27 should be done. Avoid long continuous standing. Sit in a straight posture. Eat milk, fruits and green leafy vegetables daily. I think your query answered. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 some what severe sore throat for over a week .I have treated it with every otc med I can think of.I went to an independent clinic that claims I have an upper respiratory infection. I am in a lot of pain and have a low grade fever that only breaks with ibproferin .They will not give out antibiotics .What can I do, go to my primary doctor for antibiotics or is there anything over the counter that will clear this up? ### REPLY: Thanks for your question on . In my opinion you should do following things simultaneously to achieve good relief in URI.1. Avoid oily and spicy food.2. Do warm water gargles 5-6 times a day.3. Take Caroline group of antibiotic. 4. Take antihistamines5. Take anti-inflammatory . Take all these for 5 days and if not improved than get done chest x-ray to rule out lower respiratory tract infection (LETI). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 neck has been feeling tight and when streched it pops and it makes a noice or feels like a noice that something is rubbing like when you rub a ballone. also i notised a lymph node that has gotten biger in my neck and when toched it sends a tingly sensetion in the vain or nerve where the lymph node is and there is like a pain on both sides of my head with a tingly sensation. i also feel a little bit dissy and kind of anxious sometimes and have trouble sleeping like my mind is always thinking. Also my throut is red but it does not cause me any discomfort ### REPLY: Dairy understand your concerns. Your neck swelling could be due to thyroid swelling or lymph n ode swelling. Consult a general physician to confirm. Tightness around neck may be due to anxiety you mentioned. Thinking is a process and cannot be stopped even in sleeping. We have to streamline our thinking by actively engaging in work, leisure time activities, hobbies etc. Worries cannot cure diseases, worries encourage body problems to go on. But being happy even though you have problems, can cure your problems. Be happy. Wish you a good future. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 top molar extracted and having sharp burning pain from jaw into ear and all up my right side of face to top of my head. Ibuprofen, advil, aleve, ice packs not helping. What can i do? And this procedure was just done 7 hrs ago. I had one removed last weej and wasnt this bad. Office is closed and no answering service. ### REPLY: Thanks for your query, I have gone through your query. The pain after extraction of the is common, it will be there for another 1-2days and gradually reduces. But the pain will not be this much severe unless there has been a bone cutting during extraction. Nothing to be panic. If I am your treating doctor, I would have suggested you to take a course of antibiotics like amoxicillin 500 mg and metronidazole 400 mg TID for 5 days (if you are not allergic) along with analgesics like diclofenac and serratiopeptidase combination. If the pain doe snot subside in 2-3days, consult an oral physician. Do saline gargling. 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: MY GRANDSON WAS DIAGNOSED WITH PARVO VIRUS. HE IS 14 YEARS OLD AND GOT SICK VERY SUDDENLY AND WAS URNNING VERY HIGH FEVER - 103 DEGREES. NOW HAS A RASH ON HIS STOMACH, HE STARTED THIS LAST SATURDAY NITE. MY CONCERN IS THE LAST TIME HE WE WERE TOLD HE HAD A VIRUS HE WAS 2 YEARS OLD AND HE HAD A VERY SEVERE CASE OF WEST NILE. ### REPLY: Hi.... Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. But as you quote there is rash - It could be any viral erythematous illness - the possibilities are Hand Foot Mouth disease/ Chicken pox/ any other trivial viral exanthem. I suggest you use calamine lotion as its giving results along with oral antiallergic like HY . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a very uncomfortable pain in my back under my right shoulder blade. Using it doesn t seem to make it any worse or better. It hurts no matter what I do. I am a female, active, age 66. Slightly overweight. 5 ft. 4 in. 178 lbs. I have been told a have spinal stenosis. I do golf, garden, and keep my own house. I do take daily doses of ibuprophen for inflamation. ### REPLY: Hello have understood your symptoms, There is radiating pain from your shoulder. Usually cervical disc bulge leads to nerve compression and subsequently articular pain in your arm and fingers. I will advise you physiotherapy like Inferential therapy and auto traction for early recovery. Static and against resistance guided exercise therapy may help in this case. You can consult physiotherapist for that. MRI cervical spine will help you to see severity of nerve compression. I will advise checking your it B12 and it D3 level. 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. 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 am a female in the early twenties and I suddenly have this acute pain in my lower back near the spinal area at waist just above the tail bone area. I have not had any history for back problems so this is very sudden. I can t actually walk with the pain and it feels like whenever I actively apply any pressure or squeeze the muscles in the area especially when walking,the pain gets really bad. ### REPLY: Hello! Thanks for being with . Sudden Onset of back pain In 20 years female could be due to1- Coccydynia2- Just a muscular back pain3- Mechanical back pain4- Cited deficiency 5- Prolapse intervertebral disc (less like in your case) in that generally patient has radiating pain in lower limb/due you have any sudden jerky movement while jimmying or have suddenly lifted any heavy things? I would suggest taking an opinion of an Orthopedic for better clinical correlation and to get an X-ray sacrococcyx region and Cited levels. For pain relief you can apply hot fomentation and nice gel locally and mild anti-inflammatory like Diclofenac and paracetamol. For more queries you can write to us. 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 am 16 years old girl suffering with low grade fever upto 99.9 F since last one month. sometimes having abdominal pain. most of the check ups like bloood test,urine test etc were found normal. what extra should be done. please suggest. my height is 52. now my weight is 47 kg. one month back it was 55kg. ### REPLY: Hi. Thanks for your query. I hope you have also done blood tests for Thyroid function. Increased thyroid hormones can give such symptoms. Another reason can be abdominal tuberculosis, typhoid, chronic enteritis or colitis. You have to undergo the following tests::CT scan of the abdomenX-ray chest Upper and lower GI endoscopies. Blood tests = CBC, ESR, blood sugar, kidney functions, liver functions and other tests as per the clinical examination. Quantifier gold test for TB. The treatment will obviously be according to reports of the tests. The response to the treatment has to be continuously monitored. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 34 years and trying to conceive a baby.i have just one baby,my blood flow has become so low that i use two pads only fro six month.my last date was 23 and i started at 20.byt just two or three drops of blood and some dark brown colour water or blood.it is not flowing..just i go to washroom and clean it.....is there any roblem or it will affact my fertelity ### REPLY: Hi and thank you so much for this query am so sorry to hear about this change in your menstrual flow. I understand your worries and no woman would stay indifferent when faced with this. We would need to establish the exact cause of this change before being able to tell whether it can affect becoming pregnant or not, However, most women do experience subtle changes like this at least once during their reproductive lives, and it never has any real established cause or interferes with them becoming pregnant. I will recommend you get evaluated and managed accordingly if any problem is found by your ORGAN. You shall then receive a specific answer about the chances of conception. I hope this ad .  Thank you so much for patronizing our services, and please do feel free to ask for follow-up clarifications and information if need be. I wish you the best of health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,Ive done liver function tests a couple of times in the last 2 weeks. Ive higher values of ALT (Liver Function Test). Value varying between 65 and 85. Can these values be brought to normal just be improving my diet?Im 31, Male, smokes 5-8 cigrattes a day. Ill be grateful for your advice. Thanks ### REPLY: Hi welcome to . Thank you for posting your query. Yes, ALT levels can be brought down by lifestyle changes and regular physical activity. ALT is the most sensitive indicator of liver cell injury. Elevated ALT levels occur in fatty liver, hepatitis, liver cancer, cirrhosis.liver problems can also cause kidney problems, heart problems, strokes.I advise you to avoid alcohol completely and quit from smoking, have a healthy and balanced diet. Avoid fatty foods. Go for regular increased physical activities, if you have diabetes keep the blood sugar levels under control. Go regular check-ups from your 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: my daugter is ten years old and I will say she has never seemed to be a well child. She has delt with a great deal of allergies in her life and is on sublingual immunotherapy drops. Last year in august we discovered a 1.5cm lump in her left supraclavicular which she has had two ultrasounds to confirm the second of which confirmed and increase in size to 2cm around march. she was sent to see an oncologist which is also her allergist who told us not to worry its just due to her allergies that the node is swollen because its not growing fast enough and she is not loosing weight. She is a small child (thin and short) to begin with. She has also been diagnosed with IBS by sick kids before all this came about after an ultrasound of the digestive track due to pain in the stomach and constipation/ diarrhea . Now she seems to get quite a few days of the month that she is very lathargic and pain in the stomach area just under the breast bone. I am very conserned regarding possible lymphoma but unsure if being a year since we first found the lump and no other b symptoms that we can think of other than being lathargic more frequently if this is still a possibility or the allergy diagnoses is more likely/ ### REPLY: Hello, I am a bit confused as your allergist is also an oncologist, and you need to figure out what he is board certified in - allergy or oncology? The important investigation in this regard is a complete blood count, Lots, thyroid functions, the ultrasound reports and a FNAC report of the lump from the pathologist and reviewed by a Hematologist. Supraclavicular lymph node swelling is a significant swelling that must be investigated in detail. Her alleges and SLIT does not take precedence at the moment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Not sure if I have the flu or pneumonia - symptoms came on quickly - intense headache, cough, fatigue, fever, no appetite, came on 5 days ago. Cough is deep and productive but clear. Fever has been low grade (100 - 101) but I typically run sub-normal. Fever hasn t raised for about 24 hours and headache is gone except for pain when I cough - which is frequent and sleep interrupting. I think it s the flu but a friend is concerned about pneumonia. It does not hurt to take deep breaths ### REPLY: Hello dearWelcome to .come have evaluated your query thoroughly.* This seems more of bronchitis scene rather than pneumonia.* Suggestions for better outcome - . - Balanced nutritious diet.- Avoid smoking, alcohol.- Gargles with salted lukewarm water and added peppermint oil 3 time a day.- Keep record of temperature.- Avoid exposure to excess cold, dusty environment. Consult later doctor if required. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my baby is 7 weeks old. Both PKU came back that she has the biotinidase deficiency. Doctor sent her for blood work to test for that specific deficiency. Called today and was told normal range is between 4 and 12. They told me that her results was a 2. What does this mean? ### REPLY: Profound biotinidase deficiency, the more severe form of the condition, can cause seizures, weak muscle tone (hypotonia), breathing problems, hearing and vision loss, problems with movement and balance (ataxia), skin rashes, hair loss (alopecia), and a fungal infection called candidiasis. Affected child .  Lifelong treatment can prevent these complications from occurring or improve them if they have already developed. Partial biotinidase deficiency is a milder form of this condition. Without treatment, affected child ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m having diarrhea right now with stomach pain/cramps. I m ok with the constant bowel movement and I m willing to wait it out. It s the stomach pain that I want to get rid of. How do I do that without impeding bowel movement? I mean, I would prefer to constant bowel movement so that whatever is causing the diarrhea will be flushed out. ### REPLY: Hi. Thank you for your question. Let me ensure that you are fine and need not panic. There can be a lot of causes leading to such symptoms. The commonest one being bacterial infection of Intestine. I generally advice following to my patients:1)Antibiotic course preferably with Norfloxacin and Metronidazole for 5 days.2)Adequate diet.3)Oral Rehydration Solution to be taken frequently. Hope I answered your questions. Wish you a healthy life, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 swelling of my left eye as well as rashes on my arms, elbows, back of knee, and face. My lips swell periodically and my lips are covered in tiny little dots (feels like sandpaper all the time). I want to know if the fact that I use an e-cigarette with propylene glycol in the juice if I have developed a potential allergy and how do I make this go away. It is becoming very dry, but the rashes are still present. I have not used my e-cig since last night. I stopped all day. ### REPLY: Hall the symptoms are in favor of Allergy. For diagnosis, you have to find out of allergy in your house, work place. Consult your doctor he would perform some tests for allergy. Blood test for BC Total Eosinophil County G EUrinalysisStool examinations for ova & cystAllergy may be due to food. First stop taking milk for few days. Then egg. One by one every Food items. Avoid cosmetics, fumes,perfumes. Consult your doctor for complete examination.Don't worry you shall BR write. Give you feed back. 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 55 yo son has end-stage liver failure . He recently completed the medication regimen to eradicate his Hep-C, and last couple of lab results show no discernible trace of Hep C . He has an appointment at UAB on Tuesday for his three-day workup prior to being placed on the liver transplant list. He has continued to decline, suffers almost daily with nausea , lack of appetite , wasting. Today his thigh-high edematous legs began to weep. I have cleaned them well and wrapped them with absorbant gauze , and elevated them above the level of his heart. I will try in the morning to put on compression stockings after - hopefully - some of the swelling decreases. If I am unable to do so, should I wrap them with ACE bandages, and if so, what pattern, fig 8 or circle up? The trip to UAB is about 4 hrs. What precautions should I take when driving him there? Thanks so much - this is the hardest thing I ve had to do in my 76 years! ### REPLY: If compression bandage is not possible then you may use ACE bandage by lightly wrapping it to cover maximum area in circle. While travelling antisemitic may be given in advance. Liver transplant waiting sometimes very long and patients some times cannot wait so long. Mesenchymal Stem cell therapy may be used as a tool to pass time till liver transplant as this delays the progression of complete liver failure and improves quality of life. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 broke my metacarpel bone from my wrist about 9 days ago. I was not offered any pain meds and it is more painfull now than when i broke it. I have been taking hydrocordone 325 mg for my arm which was origanally perscribed for my knee which i am having surgery for next month. After 4 of these a day I am still in constant discomfort at sleep and at work. Would you percribe a higher dosage? if you was my doc ofcoarse. ### REPLY: Dear patient For metacarpal fracture only pain medication will not help, it also needs to be protected in splint for 4 weeks. Once it is splinted you will not require any pain medication.  You need to consult expert orthopedic surgeon in your area and get yourself examined.  Cock up slab is to be given for 4 weeks.  If you continue to take pain medication without splint it is not going to help. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...hallow doctor, i have been having a problem of bleeding gums since i was a kid and im now 21, i have tried to use different medication but i dont see any relief, i am now using mouth wash only, please help me ### REPLY: Thanks for using . Read your query. Bleeding gums is due to the inflammation of the gums, which will reduce once you get your scaling done. I would advise you to visit your local dentist and get your teeth cleaned and then use the correct brushing methods to maintain it. Do chlorhexidine mouth wash for a while. If the bleeding is still persistent, visit your GP and get your blood profile and systemic conditions evaluated. Hope this was useful. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes I need help in Dental area I m Indigent ---Take carte of Brother who is Impaired but if I don t get teeth out i m subject to dying due to extreme natural of peridontal disease----I don t have money I m filed for disability ---Have notes from emergency rm. that I m in need of this I almost Died in 2010 due to teeth they are dragging me down alom ng with other health problems ### REPLY: Hello, Periodontal diseases arise due to- Poor oral hygiene maintenance weak bone supporting teeth systemic diseases associated like diabetes, epilepsy,hypertension. Please do get an ultrasound scaling done. Brush your teeth twice daily in back-forth and up-down motion. Avoid vigorous brushing and always use soft-bristled toothbrush. Rinse your mouth after every meal. Hope this helps. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i am at 6 month of pregnancy (data of delivery is 02 sep 2010). last i observed lot of orange discharge with no pain. i feel the baby movement however i feel tired. i was 2 times in emergency in 5 feb and then 6 april due to viginal bleeding but every thing was OK then. i have had a problem of membrane displacement but now there was no such displacement seen in the recnent echographi. your advice will highly be appreciated, regards. ### REPLY: Hello, I have gone through your query and understood the concern. Orange vaginal discharge during pregnancy is not normal, and it indicates some amount of spotting mixed with the normal white discharge; alternatively, vaginal infections also can cause such type of discharge. A local examination is necessary to detect the cause. If there is no infection and there is no active bleeding, you can manage by observation. Absolute bed rest preferably in left lateral position, monitoring fetal movements and any increase in the discharge, observation for any leakage of liquor are required. Wish you safe motherhood. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 regular cycle every month this month due to low iron  level i got my periods only for 2 days(usually 3days normal next 3days very mild like spotting total 6 day) and my iron level is 6 micg/dl,shall i continue to plan for pregnancy this month(lmp 21-02-14) and i am very much afride to conceive because of low iron level my first prg was missed abortion second was caesarian boy baby 4 yrs now planing for second baby ### REPLY: Hi and thank you so much for this query. I will no advice that you plan to conceive with a very low iron level. What is your hemoglobin level? This is more indicative than simple iron levels. As you plan to conceive, it is always a nice idea to get consulted for preconception counseling and get a prescription for vitamins that would make sure the chances of your child to develop an abnormality are greatly reduced. What is the cause of persistent low levels of iron? You should get evaluated and managed fully to stop worrying of this all the times you have to talk about pregnancy. In itself, it is good to have a good iron store and hemoglobin levels. Thanks and wish you well. 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: hi. I had some numbness around my right knee a week ago. two days ago, my back has been hurting. I didn t take any medicines. Now the numbness is spreading across the body upwards. While body movements are fine, i can feel the numbness too. it has spread till face. I have a history of slip disc. Have a weak spine and am overweight. How alarmed should i be about this numbness ? ### REPLY: It is necessary for u to be armed with due to your past history of disc prolapse and over weight.i advice u to consult your orthopedic and have the necessary investigation done. The best Inst for your condition is MRI ls spine with whole spine screening which would help u in visualization of your defective site. And I also recommend u to loss weight in a regular and healthy manner with regular exercise ### END