Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was recently seen in the ER for lower abdominal pain, and was diagnosed with an acute urinary tract infection. My abdominal pain wasnt diagnosed, but I was given an antibiotic for the UTI. I took it twice a day for 7 days, and then about 3 days after I stopped taking it I began to vomit uncontrollably all day every day, and Im still doing it. I was given blood tests at the hospital and would assume they would inform me if I was pregnant.Do u have any idea what else it could be? ### REPLY: Hallow Dear, The first cardinal symptom of the pregnancy is missing a period, which you have not. So the chances of pregnancy are out of consideration. The nausea and vomiting you had is due to the antibiotics you were taking for urinary infection. You should not have discontinued antibiotics as the urinary infections are very nasty infections. By discontinuing he antibiotics, you have invited the resistant stains of the bacteria causing urinary infection. You should have continued it with some antacid like Pantoprazole and anti-vomiting medicine like steel. Now take Pantoprazole to control the acidity and steel to control vomiting, but complete the course of antibiotics. Please report to your doctor and follow the medical advice religiously. Hoe you got the message.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir ,I had civier pain & swelling on my scrotum testicles (left side) 3yrs back and consulted an urologist. as he adviced i undergone the radio diagonosis the following are the impressoins of the same1) features of left epididymits and funiculitis,2) left mild hydrocele,3)left grade 1 vericocele,4) mild spermatocele formation of epididymis bilaterally. Dr. told me its an infection not a serious issue.I have followed his medicines as he prescribed.and get relaxed from the problem.but some time  it will comme again and after 2-3 days it become normal.so i didnt take much care.now I got married and after 1 yr of successful married life we were not blessed with child.then we consult a doctor he referd semen analysis and found low count 30.75% is dead.pus cells are 20-25. and scrotum left testicle is big in size and pain is there and scrotum temp is comparitively high. so at this point what should i do? pls advice me ### REPLY: HelloThanks for query. You have history of repeated episodes of Epididymitis on Left side, and now has been revealed to have low sperm count and presence of pus cells reported in semen analysis. There is no doubt that you have infection with Varicocele on left side that may be the cause of Oligospermia and infection and your infertility... Please consult qualified Urologist and get following tests repeated 1) Repeat Ultrasound Scanning of scrotum to trace out the present situation 2) semen culture done to find out organisms causing this infection 3) Color Doppler Ultrasound scanning of scrotum to find out grade of Varicocele. You may need to take long term course of antibiotics like Doxycycline to combat infection. Further treatment will depend upon the results of these tests. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: salam sir.im student ov bhms 1st prof at iub in pak.i am searching about the scope of homeopathy in treatment of differnt disease.i want to know about this with proves that homeopathy realy works it iz not only plasibo.will u plz tel me that does homeopathy cure HIV AIDS and other diseases e.g infertility ### REPLY: **1. There is difference between HIV & AIDS, when person get infected he is said to be HIV +ve, but when the symptoms of Disease appear in the body [which could be anywhere from 5-10 years] he is said to be suffering from AIDS.2. In Initial stage, when he is HIV +ve: CD4 count is sufficient and Immune system is strong thus apart from medical management Ramayana [Immunomodulators] . 3. In full-blown case of AIDS: Since CD4 count becomes low, and Immune system becomes weak, thus he is prone to Opportunistic Infection [frequent diarrhea, recurrent cold: fever/cough] thus treatment should be started without delay with ART [anti-retro viral] Therapy along with Symptomatic Treatment from Alternate system of Medicine.PS. The Diet and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 gums have felt swollen and really irritable for the past 4 days. my tongue started to hurt aswell and now there are tiny small red bumps on my tongue and on the tip of my tongue i have tiny white dots. My whole mouth feels sore and my neck hurts a bit when i apply any pressure to it. It hurts when i swallow and its very difficult to eat because it hurts my gums and my tongue burns when i try to eat ### REPLY: Hello, Thanks for writing in. I read your problem, as you gave the details it seems that you have sever gingivitis because of that you have swollen gums. For this you need to visit dentist as soon as possible in your area for scaling and after scaling your dentist will give you the instructions how to maintain oral hygiene please follow them properly. I f you will not take a proper treatment it will progress and will destroy your teeth supporting structures this will result in to mobility of teeth and in advance stages this is possibility that you can lose your teeth. So please take a quick action. And for the tongue tiny white spots and difficulty in swallowing it is because of authors ulcer. You can take vitamin B complex and can apply McCoppin on that. But I will suggest you when you will go to dentist ask him for complete oral examination and after clinical examination and final diagnosis take a proper treatment. Take Care. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, There is a small (around the size of a quarter or a little bit bigger) red rash on my inner thigh, that every once in a while (at least twice a day) itches. It hasnt spread, but it wont go away. It also has an odd smell to it. There arent any bumps on the rash or anything either. Do you know what this could be or how to treat it? ### REPLY: Hello. Thank you for writing to us at  I will keep a possibility of fungal infection/Tina courts. The location and the fact that it itches goes in favor of a fungal infection. Groin folds is a common site for fungal infections because of the anatomy. The closely apposed body folds favor moist, warm conditions in the groin folds which allows the fungus to proliferate and form itchy patches. A KOH wet preparation made from a small amount of scale scraped from the rash to look for fungal elements will help confirm the diagnosis. I suggest you to try an OTC topical antifungal e.g. clotrimazole 1% cream, twice daily at the itchy patches. An Oral antifungal e.g. fluconazole Or terminating may also be required if the patches are extensive. An OTC oral antihistamine e.g. cetirizine 10 mg once daily will provide you symptomatic relief from itching. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, i have heterozygous beta thalassemia minor or intermedia. My HGB is 145/148 which is normal, but my MCV and MCH are low, MCV 61 and MCH 21. RBC 5,8-7,2. Feritine, Fe and everything else is ok. But my red blood cells are to small and low oxygenated to properly oxygenate organism instantly every cell. I have headaches, chronic fatique, long sleep every day. I like judo and swimming very much but i cant practice them because i get very, very thired after training. Is there anything i can do to improve my life energy? Does homeopathy helpes? Im 21, law student, but i cant keep up anymore because of my low life energy. Does some vitamine supllement alternative therapy can improve my health? Thank you very much! ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. As the cells are carrying low oxygen, so the increase in no.2. Homeopathy can't help in increasing cell size. Regular schedule along with improvement in stamina necessary.3. It's a genetic problem. Vitamin supplements are necessary to avoid other types of anemia. Blood transfusion will help. Preferably, if you want, go for red cell exchange. Stamina improvement should help. It's a minor variant. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I woke up this morning, heart was pounding. My husband took my pulse, it was 110. I didn t feel like I could take in a deep breath, and area above navel felt hard (upper abdomen felt bloated). I felt like I needed to throw up. Dry heaved very hard at least 5 times. Was very weak but heart rate felt better and felt like I was able to breathe better. Tightness above navel felt better, abdomen still bloated. I do have a hernia in that area (was repaired but then failed a few months after--this was years ago). have esophagitis but didn t feel like esophagitis attack. I have several health conditions and on several medications. Had a similar episode last month, only felt more dizzy, hands tingled for about an hour later. Today I slept for about 10 hrs afterwards, so exhausted. Hands feel a bit tingly, upper body shaky. I am a zebra (when you hear hoofbeats....reference) with several autoimmune diseases and neurological diseases. Good luck ;) ### REPLY: Hi welcome to . I understand your query and concern. Atrial fibrillation is known to cause Rapid heart rate, symptoms of difficult breathing, bloating and even at times fluctuations in blood pressure. I advise you to have a baseline 2 dimensional echocardiography, ECG and lipid profile to assess the basic cardiac reserve of your heart. Restrict the intake of salt to less than 6g/day. Regular physical exercise in the form of brisk walk for 20 min a daily is useful. . Pantop 40 mg will help. Reduce the intake of fatty and fried foods. Electrophysiological study with or without Radio frequency ablation is the procedure of choice in your case. You may also need Coronary angiogram to look for any co-existent blocks in the heart. Consult a Cardiologist and discuss for further expert management. Post your further queries if any, Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hii Dr. Last Thursday I had circumcision in d morning n 2day is Monday....bt on Sat night I saw swelling jst above d soft skin n on Sunday morning I went for dressing. ...Dr said it s nt a big issue n she dressed a tap on dat swelling...So my question is hw long it will take to heel? N tell m which foods I shouldn t hav.... ### REPLY: Hi, You have undergone circumcision operation. Due to the operation, inflammation is very common and so swelling is present due to that. Anti-inflammatory medicine and Choral Forte like medicine will be beneficial in your case.  It will take one week to two weeks for healing. You can eat a nutritious diet and green leafy vegetables with fruits more for fast healing. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi  doc. i have question.my problem is aortic stenosis.i have not any clinical symptom i mean i havnt pain in my chest/fatigue/dizziness and so on. but my doctor told me some advise as you khnow.i wanted to khnow can i have take vitamin?can i use mineral suplement or not.i mean vitamin tablet.and my last  exotic question is i have alopecia and can we use minoxidile.thank doc ### REPLY: Hello! Welcome on ! Regarding your concern, I would like to explain that there is no restriction in taking any vitamin or supplements in the presence of aortic stenosis. So you may use them uneventful in case they are medically indicated. In addition, when considering Minoxidil use in the presence of aortic stenosis a point of concern may be a potential for triggering hypotension which is not well tolerated in aortic stenosis patients. Nevertheless, a careful topical prescription would be considered safe in this regard. Hope to have been helpful to you! Kind regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i wanted to know if im hypoglycemic. i must eat every hour or two or else i will feel sick. I start to shake and i feel dizzy, weak and light headed, like im going to pass out. im also quite cranky and sleepy. if i eat a sugary breakfast with no protein, i will get extremely hyper, but then i will crash. once i eat protein, i start to feel better. my mother and her mom also have hypoglycemia. im a fourteen year old female. am i hypoglycemic? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have hypoglycemia.  Your symptoms sound like that.  You should go for fasting blood sugar levels and post radial blood sugar levels.  Search for the cause also.  Go for ultrasound abdomen once.  Then 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: Hi my name is angela im 20 years old and on June 9, 2015 I went to an oral surgeon to have all four of my wisdom teeth taken out. Ever sense the day after surgery I haven t been able to open my mouth I have gone back and they put me on some arthritis Tylenol, naproxen medication, and also voltarin gel. I ve also been doing jaw excersises religiously. Nothing has helped and I am no worse I can t fit my toothbrush in mouth and it s almost to the point I can t fit my pills in either. I m terrified and just want this to end. ### REPLY: Hi. I have gone through your query and can understand your concern. As per your complaint at times after wisdom teeth extraction the muscles of mastication becomes tensed, swollen and sore leading to restricted mouth opening and pain. You should do warm compresses over the check and continue till the sides of neck. You should massage the muscles with your fingers starting from the front of ear progressing down the jaw reaching the chin. Try to open the mouth with fingers by pushing front teeth apart. You should also keep doing the jaw exercises advised by your dentist. You need to take Muscle relaxant like Flexion MR for relieving the spasms of muscles. Take soft diet and more. Of liquids but do not stay hungry. If still it doesn't improve consult an Oral Surgeon and get evaluated. Hope this information helps. Thanks and regards. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is a black, 47 y/o male with history of hypertension and diabetes. He was asleep and was awakened with pounding heart beat, shortness of breath, numbness in left hand, and a feeling of being hot. This lasted for 2 hours. Should we go to DR? ### REPLY: Hello, I would explain that his symptoms could be related to an infection or cardiac arrhythmia.  For this reason, considering his past medical history, I would recommend going to the ER for a physical exam and some tests: - a resting ECG and cardiac enzymes- a chest X-ray study-complete blood count, PCR, ESR for inflammation- blood electrolytes.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I got an infection in my wisdom tooth last Wednesday and was perscribed amoxcillin which wasn t doing much so went onto flagyl on Friday. I am now taking both and pain seems to have subsided slightly but noticed a hole has now developed in my gum and am really worried. Any advice? Thanks, Lisa ### REPLY: Hi! Welcome to . I read your query. As you mentioned infection in wisdom tooth, this hole seems to be the sinus formed for pus . You need to visit a dentist and after x-ray and examination, he can decide if the tooth can be saved by RCT or if it needs extraction. Complete antibiotic course before and after the treatment as per prescription. Do warm saline rinses. Maintain oral hygiene. Hope the answer helps you. 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: Dr. my father is on dialysis - he was told to take a calcium acetate pill 3 times per day - it is very pricy and he is not on any type of perscription plan - I asked his kidney Dr if there is something else he could take instead to cut cost - His answer was Tums? my father is 89 -Is this true that he can take Tums? ### REPLY: Hello and welcome to . As a Urologist, i can understand your anxiety. Tums is calcium carbonate.It's also used to prevent calcium deficiency. In CKD(chronic kidney disease), calcium supplement is needed. With Tums, one has to closely monitor creatinine levels(kidney function). At 89,he must be hypertensive. Again, blood pressure should be checked. If you've any doubts, send me a direct question, with reports. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 full rx of chantix, unopened. I paid $130.00 for it and now, finally, I really want to quit. Is it still effective and chemically unchanged by its age? It has been properly stored in regards to temperature. Email address is YYYY@YYYY . thank you for your response. ### REPLY: Hi, Its efficacy may decrease slightly. Most medicines stored under reasonable conditions retain at least 70% to 80% of their original potency for at least 1 to 2 years after the expiration date, even after the container has been opened. So, it may still be taken along with behavior modification and counseling support to quit smoking. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: as USG Rt Shoulder report, Sir I am near complete to complete full thickness teaar of supraspinatus tendon with atropChatDoctoruscle bellly. Fluid distension of bicipital groove, SA_SD bursa and supcoracoid recess. Suspicious small tear in cranial fibers of subscapularis tendon. Degenerative cortical irregularity of humerous. please let me know I should go for surgery. As I am cardiac patient I want to avoid surgery. What should iI do please. J.K.Arora ### REPLY: Hi, thank-you for providing the brief history of you. As your ultrasound reports suggest you have a rotator cuff injury and the pain level should be high as per the reports. Also, there are some degenerative changes in the muscles and bones around the shoulder joint as this is a common thing to happen as aging progresses. I will advise you to undergo physical therapy and regain the full ROM of the shoulder joint and also the Strengthening of the muscles of the rotator cuff by which the next plan can be decided. In my clinical practice I have seen rotator cuff injuries and with at least 2 muscles complete torn. But keeping into consideration the age of the patient we dealt only with physical therapy and regained the full shoulder functionality. Of course surgery is avoided for her and maintenance of the shoulder mobility is what the plan.I will be happy to help you further if you can give me more details about your case and can be taken further from here to avoid surgery. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am 20, just under 6 feet tall and roughly 170lbs. I have been trying to participate in No-shave-november but as usual my facial hair does not want to grow for me. Will facial hair eventually grow faster or do I need to get used to a life without a beard? Does this have to do with genetics? If so, which relative should I look at to see what my facial hair will eventually come out looking like? (Ive heard if you want to know if youll be bald you should look at your monthers father). ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  You are right. Facial / body hair growth is a genetic issue.  No treatment can alter that issue. Please do not fall into the hands of some cheating people and lose your money. There are a lot of positive points for this condition. Be satisfied. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i cough so much from the mucus some times that i can t catch my breath. i can fill up a cup or more of fluid with foamy bubbles. my mucus is clear and foamy. ive had chest exrays nose and throat doctor look at me heart monitored. im at my wits end. please help ### REPLY: Hi, If I were your treating Doctor for your case, I would come up with three possibilities, these include: 1. Allergic conditions including aspergillosis2. Metabolic condition including cystic fibrosis3. Infective conditions like tuberculosis or worms! You have to test your sputum and a CT Scan of the chest. Take antibiotics and expectorant cough syrups. 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: Hi, My name is Ali I want to ask you some thing about my mother detail is given below Colostomy done 3 months ago due to abstraction after CT scan and colon scope found adenocarcinoma in rectum and CEA report was 82 the portion containing adenocarcinoma has been removed with open surgery After Surgery CEA report is 4.45 Normal MRI both plain and contrast also showing normal from lever to pelvis no evidence found mean to say all is clear No I want to ask you that which type of therapy is necessary for my mother is Radiation and chemo is necessary or not ### REPLY: Hello! Thank you for the query. Chemotherapy or radiotherapy is advisable depending on the clinical stage of the cancer. Only in stage I and II (not every case) chemotherapy is not necessary. All others stages needs chemotherapy. You need to know that chemotherapy is used for eliminating all micrometastases. Even one cancer cell left can cause further spreading of the cancer. Such small metastasis are invisible for MRI, so this test can be decisive for chemotherapy. Such test which can tell about left metastases is PET test, however still it can not show single cancer cells. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have really mild pain on both sides of my belly, I have fever for 5 days everyday after 4pm. in the mid night the fever will up to 104 F, normally goes away in the daytime. I have been taking Advil 200mg when I was very cold and shaking. My urines color is very very very light brown. But I have no problem and no pain to go to the restroom. Could you tell me what do you think? Thanks for your help. ### REPLY: Hello, Thanks for the query to . Forum. Fever 104 F, from last 4 day and urine brown color may be due to ketone body in the urine. Usually due to breakdown of R B Cs there develops rise in bilirubin level and this raised level of bilirubin develops brown color in urine. 2nd reason may be due to some infection in kidney as there is fever also. Get in blood for bilirubin level (direct & indirect), serum creatinine level for kidney, Urine complete examination is very important. Consult a physician 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: I have a very small indention on my gums on the left side. i think i might need a root canal. however i am worried the indention is not raised, red or white it is not in the form of a patch, it is by it self like a canker sore.. but instead of raised it is depressed. i used to use dip... what do you think ### REPLY: Hello, thank you for consulting with . It can be possible that this gum indentation can not be because of tooth infection, as in case of infected tooth abscess there might be a discharge from this indentation. So it can be possible that it might be just an authors ulcer. So there is nothing to worry you just wait for 1 week if it does not go, then you have to go for root canal. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Diagnosed with DVT in October. On coumadin therapy. Awaiting results from blood tests and ultrasound. Hematologist mentioned possible causes including Leiden V, other genetic factors, and possibly some type of occultic cancer. Curious about the cancer aspect... ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  You have deep vein thrombosis.  It could be due to some clotting tendency. Clotting tendency is seen in factor 5 laden mutation, other genetic factor deficiency or some cancer.  All can lead to high chance of intravenous clotting. Please send me your reports of coagulation profile so that I can help you further. 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: hello doctor i am miss manali das.i am 30 years.i am suffering from slip disk between l4-l5-s1.i am suffering back pain from 4 years.after takeing traction,medicine now my pain is slightly low.before slip disk i was connected with several physical activities,like,gym,playing badminton,jogging,extra.but now i cant do anything.as a result i am become very fatty.doctor suggested me to lose weight.but without physical exercise it is not possible.can you suggest me how can i totaly become cured fom this slip disk.i want to do again exercise as i did before.is it possible to total cure from slip disk.and is it possible can i do again  exercise?plz help me how can i go back to normal life?and also suggest me doctors name and procedure of treatment.plz help me. ### REPLY: Hello, Thanks for your query. After going through your query I came to know that you are probably suffering from lumbar disc prolapse from 4 years. It can be confirmed by MRI scan. There are two treatment options. First option is rest in position of relief(generally lateral position with both hip and knee bend), neurotopics such as mecobalamin and analgesics (Diclofenac). This method needs patience as it take longer treatment times sometimes up to 6 months. Second option is go for surgical operation(Discectomy). After complete treatment and physiotherapy you can do exercises as before. You can discuss with your treating Doctor about it. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am taking glicomet gp1 twice a day .once in morning after food and once in the evening after food . Today I took one pill after dinner and onece more by mistake after 3 hours later mistaking it for a digestive pill I take before bed . Is it fatal ? Can I pass out in my sleep ? Should I eat a chocolate before bed? ### REPLY: Hello have gone through your question and understood your concern. Glycomet GP1 is an antidiabetic agent that contains metformin HY .  These tablets work by increasing the amount of insulin released by your pancreas and decreasing the amount of glucose in the blood;Glycogen GP1 can cause hypoglycemia and this RISC is more possible in your case with the ingestion of double dosage. It is not fatal, Dont worry! You will not pass out in your sleep. But you should know that it can be very, very dangerous because it can cause nocturnal hypoglycemia or low sugar that occur at night while asleep. To avoid the occurrence of hypoglycemia I suggest eating a snack before bed. A chocolate is ok! If you were my patient, I will ask to check your blood sugar before bed. Your blood glucose levels should not be lower than 120 milligrams per deciliter before bed. If this night this happens, you might need to eat a larger bedtime snack. This will avoid the low blood sugar during the night. So, you have no reason to stress! My last advice: Be careful with the doses of your  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 massive right hand ganglion it was my small at my birth but increase in size with my growth now my age 32 year i have little pain x ry no bone ....and MRI no malignancy my doctor say surgical removal but it will return again as he said he no cleand if attach with nerve what can i do make surgical remove or what ### REPLY: Hello, Surgical removal of ganglion is although not a permanent treatment, but it can help you in relieving symptoms. In some cases it may give you relief in symptoms caused by compression to adjacent structures. If it is large then I shall advise you for surgical removal. You may also discuss effect of local steroid injection from your doctor. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had chronic lower back pain for about 3 years , I have been going to a pain clinic and taking medication to try to ease the pain which is getting worse . X rays showed partial sacralisation of the L5 and MRI showed wear n tear of the facet joints has caused osteo arthritis . It also showed a grapefruit sized cyst on my overy, both had to be removed urgently ..The pain now feels like I m winded and bloated in my lower back and is agony . I went to dr s again last week and was just given more pills . The MRI was in 2011 but I know the pain has got a lot worse since then . Any ideas ? ### REPLY: Wearing lumbosacral belt during activity time in day is indicated coupled with spinal exercises, avoiding bending or lifting weighty things, hot fomentation and pills as prescribed. If pain remains unbearable interfering daily routine, spinal fusion, removal of osteophytes near facet joints, laminectomy through minimal invasive(laparoscopic)spine surgery may help.in the meantime have patience, bear on symptoms, follow protocols of treatment enumerated and observe the pain . Take mild muscle relaxants in the mornings and mild sedatives at bedtime. Use firm mattress and take up sleeping posture which is most comfortable, probably mild flexed knees and mid prone position or whichever affords maximum relief ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 5-year-old daughter is suffering from severe fever and throat infection for the past 1 week. The doctor first prescribed Azithral 200 suspension and then Advent Forte syrup. The fever has not subsided and she developed severe cough, which results in vomiting everytime she had food or medicine. Yesterday, the doctor diagnosed it as severe acute tonsillitis and added Zanocin syrup to the regimen. She also started passing greenish, mucus-like consistency stools everytime she urinates. For that, he added Junior Lanzol and Bifilac. Even then, she is having fever, but the intensity has decreased somewhat. The doctor told that only if the throat infection gets cured, the fever will subside completely. I am worried about adding the antibiotics up and up and is it safe to give all those medicines at a time? In addition, she takes Meftal-P suspension for fever also. Please give elaborate answer and advise what is the next step is to be taken? I have seen an indication that zanocin is not safe for use in children in the information leaflet given along with the medicine. She is taking Grilinctus for cough also. ### REPLY: Hi... Thank you for consulting in . 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. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Meftal-P contains Metonymic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Metal. Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. YOUR CHILD DOES NOT REQUIRE ANTIBIOTICS.THE LOOSE STOOLS ALSO ARE DUE TO ANTIBIOTIC ASSOCIATED Diarrhea. Keep her HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello DR, I am taking kaverzide 150, for blood pressure also briccanyl & symbicort preventor for asthama. I have an absuss in my mouth up the top, I went to a Dr today who prescribed me with Amoxcyllin & metrogyl 200, which I have just had my second lot of, I have just realised that it s not where the absuss is that pains it s the bottom tooth where the top tooth hits it. Can you tell me what the metrogyl does, also I have had panadol but isn t working for this pain, is there anything else that I can take to ease the pain that won t affect me with my other medicines that I regularly take. I am in a lot of pain at the moment. Have to wait until next week before I see the dentist. Is oil of cloves any good for the pain. Thank you Andrea ### REPLY: Hello, Read your query, as you have toothache this can be due to infection at periapical and due to periodontal infection leads to formation of abscess, don't be worried so much be relaxed as you are taking medication Amoxicillin with metronidazole continue that medication as you are taking and for pain you can take painkiller like retool DT or Diclofenac sodium by consulting with your local doctor. Meantime you can do Luke warm saline gargle two - three times a day. Hope this will help you. If you have further queried I will be happy to help.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ALL BLOOD TEST PARAMETERS AND LECER FUNCYION TEST, LIPID PROFILE ARE WITHIN NORMAL RANGE.BUT LYMPHOCYTES IS 41 AND MONOCYTE IS 00. NO ABNORMALITIES FELT BY PATIENT. FEW LUMPS IN NECK NOTICED RECENTLY ONE OF WHICH IS RECEDING. MEDICINE GIVEN IS CEPODEM 2OO. CAUSE FOR WORRY? ### REPLY: Hi, thanks for sharing your or your relatives' health concerns with !  Well, this lump is nothing but a lymph node recently enlarged possibly due to some viral infection that also raised the % of lymphocytes also, if the patient is an adult. In child .  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 your patient 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 taking Betnesol Forte tablet 1mg (to control my asthma) from last 1 and a half year as i suffer from asthma.Have gained 15kgs and my face has become totally round with double chin. would like to discontinue the tablets as i am having too many health problems due to it.I started taking these pills as when my asthama increases i have a very bad total nose block.so to avoid that i started this tablet and now i am too much used to it.Please its request to help me stop Betnesol Forte and control my asthma too. ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. I would like to know more about you like - your age, since when you have asthma, what are other medications that you are using, what are other medical conditions that you are having, what are your nose symptoms, have you undergone any testing, etc. Based on above details, I would be able to make suggestions more specifically. 2. There are many options to control asthma other than oral steroids (like Benson Forte).3. Were I treating you, I would suggest you lung function testing (spirometry) to know your lung capacity and severity of asthma. It would help me choose your . 4. I would suggest you intranasal corticosteroids, montelukast and inhaled corticosteroids for at least 1 month. Please note that intranasal and inhaled corticosteroids act locally and have much less side effects as compared to oral corticosteroids.5. I would also suggest you to consult an ENT surgeon who will examine your nose cavity from inside as you have long-standing noes obstruction.6. I would suggest you allergy testing to identify the substances causing symptoms to you. Based on allergy testing report, you can follow avoidance measures and an Allergist-Immunologist may prescribe you allergen specific immunotherapy which is a long term treatment of allergies.7. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.8. I would also suggest you regular exercise and a healthy nutrition which will improve your lung capacity and immunity respectively in a long run.9. I would also suggest you weight reduction as obesity affects asthma adversely. Please consult a professional exercise trainer and dietician to manage your weight problem. Of course, steroids-induced obesity will improve gradually once they are stopped.10. A SPECIFIC CAUTION: As you are taking oral steroids for 1.5 years, please do not stop them immediately - it can cause life-threatening condition. Please consult a physician, he will gradually decrease the dose while increasing other medications and only over long time your oral steroids will be stopped. Sudden stopping oral steroids is dangerous. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead and I'm sure with proper consultations and skillful treatment, you will be able to lead a healthy life. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hai, i am savitha my age 23 years folicular study report 14th day uterus retroverted 62*39.7*48mm.   RO-46.4*27.5mm LO-49.2*33.7mm. Right ovary multiple pheripherally arranged follicle. Left ovary not seen so ruptured follicle. endometrial thickness 10mm. pod collection ++28.7mm. so any problem. ### REPLY: Hello Tabitha, Your scan report for 14th day looks fine. It looks like you have ovulated. This would a good time to try to conceive. Your fertile window is 24 to 36 hours. Your right ovary shows peripherally arranged follicles. For that to denote PRO the count of follicle should be more than 10 in mild cases. But just proper diet and every day expressing for 30 minutes will make you more energetic and fit. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got pain in my Lower abdomen . Lower back and it shoots straight up to my  shoulders . I don t have fever or bleeding but the pain is just almost unbearable. It has been 24 hrs and the pain hasn,t gone away yet. Tried taking ibuprofen . Didn t really work, just helped with pain. I feel pressure in my rectal region and inside my vagina when I try to walk and I can t even sit up straight. I feel chills and hot inside my body. What s going on with me? ### REPLY: Hi welcome to  forum.  You have got pain in the lower abdomen, and back, shooting up to the shoulders. No fever or bleeding, but chills are there.  Most probably it is urinary tract infection, or meiosis. I advise you to consult a physician for diagnosis and treatment. You may have to take M.R.I. for confirmation, besides other routine tests for confirmation.  Wishing for a quick and complete recovery, and thanks for choosing . F.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I suffer from atrial fibrilation and am at present suffering with beats of 100 + per minute I am also dizzy when in af I am due to fly tomorrow which I do not enjoy at the best of times but I feel particularly anxious due to the situation with my af is it ok to fly whilst in a state of af, thank you ### REPLY: Hello and thank you for using . I carefully read you question and I understand your concern. You don't mention in your story if you treat your atrial fibrillation or not. If you are in atrial fibrillation for a long time and if you take regular medication for the frequency and anticoagulant for preventing thrombosis it is not a problem to travel or fly. You have just a little beat many high frequencies maybe because of stress. But if you are not treating your atrial fibrillation I would not recommend you to travel or fly. Because very high frequencies generated by stress may lead to unpleasant events. First you should beat your doctor to put you in a stable treatment and then you are free to travel like all other people. You should be on medications that stable your frequency and medications that prevent a thrombosis. Hope I was helpful. Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have bronchitis. Nonsmoker, no asthma or allergies. Started zpac today and inhaler four times a day. Xray shows no pneumonia. I violently cough throughout day more at night. Taking mucinex for cough production. Tonight i coughed up a small pink gel like and a small stick like substance. Could that come from esaphagus or cilia? ### REPLY: Thanks for asking your question I completely understand your question cough with pink expectoration can be due to many reasons. Bacterial infection, streaking of sputum with blood that occurs in cases of tb, erratic infections, pneumonia. You can consult a pulmonologist who can request for a chest X-ray and sputum for AFB, sputum for myogenic culture and sensitivity. By these tests infection and causative agent for infection can be ruled out. Pulmonologist can start over with some antibiotics to prevent secondary infection.thanks/ regards feel free to ask more questions may god bless you with 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: Could my diseased upper molar cause migraines, vision problems...etc?Im getting an implant in a couple weeks.  Well, the process will begin. I have been on RX migraine meds for years. I wonder if there is a correlation. Thank youCould be Candida albicans too ### REPLY: Hello and welcome. Thanks for sharing your concern. Please remember toothache or any other tooth problem rarely affects your ear and vision as the nerves are totally different which supplies to these organs. Therefore it cannot cause any vision problem. Regarding migraines, it arises due to stress and irritation caused to the nerves due to different stimuli. It can be corrected by taking medications for migraines. For your vision disturbances please contact your ophthalmologist. Hope it helps. Thanks. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am 19 years of age, I went to the doctors at 16 because my chest (sternum) goes in my body by an inch, he then said it was because I was growing, however it is still the same and looks very embarrassing, it is like I am Ill, please could you suggest something? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you are mostly having funnel shaped chest. It is inward deviation of sternum bone. Most common cause for this is calcium and vitamin D 3 deficiencies. So first get done calcium and vitamin D 3 levels and if Deficiency than you may need supplements. If deformity is severe then surgical correction is also needed. But for this, you need to first consult orthopedic and spine surgeon. 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: I am wondering if I need to contact an Oncologist for a hypoechoic lesion (11x6mm anterior mid body) from an ultrasound test. Done 5/30/14 I was sent for a cat scan which showed low attenuation lesion in the pancreas measuring 7mm. Done 6/11/14. Thank you. Joann ### REPLY: Hi, Thanks for writing in. A hypoechoic lesion in the mid-part of pancreas measuring 11 x 6 mm is usually a fluid filled structure. CT scan is required in such cases, and you have got it done. The CT scan shows a 7 mm low attenuation lesion in the same place. A low attenuation lesion again is most likely to be a cyst. It is important to know if this lesion is showing enhancement. There is also a technical parameter called HU value in CT scan. If the HU value is less than 20 then it is confirmed to be a fluid containing cystic structure. It is important to have at least one consultation with the oncologist and discuss the reports in detail. Repeat ultrasound scan might be required in 6 months. This is to make certain that it is a benign cystic lesion and not a serious concern. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have previously been diagnosed with Carpal Tunnel Syndrome in both hands and a pinched nerve in the cervical region of my neck. Lately I have been experiencing severe pain in my shoulder, upper, and lower arm (right side). I am also having some pain in the joints of both my arms and hips as well as extreme fatigue. I am having difficulty with sleep due to the pain. Could this all be due to my previous diagnosis or should I get further testing for other possible conditions? If so, then what are some other possible causes? ### REPLY: Hi, Your symptoms of right upper limb articular pain can be attributed to nerve compression at cervical spine. Reason for compression may be disc prolapse or ligamentum flavor hypertrophy.  MRI of the cervical spine with screening of whole spine needs to be done to confirm diagnosis. MRI is highly sensitive and specific for diagnosis of spine pathology.  Meanwhile, start tab. Regain. Visit to orthopedic surgeon with report for detailed clinical Examination is needed.  Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 6 year old complains about heart ache, when i listen to her heart, it sounds like she just finish running beating too fast and she says she dsnt want to breath through her nose cause her heart hurts, is this concerning, shoul i take it to the er asap? ### REPLY: Yes it is very concerning it can be a congenital heart disease, which should be diagnosed and treated as early as possibleCongenital heart defect (CHD), also known as a congenital heart anomaly or congenital heart disease, is a problem in the structure of the heart that is present at birth. Signs and symptoms depend on the specific type of problem. Symptoms can vary from none to life-threatening. When present they may include rapid heart rate, rapid breathing, bluish skin, poor weight gain, and feeling tired. ADVISED 2d echo as soon as possible to rule out cardiac anomaly. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 kidney infection last month. I went to emergency for it and I get clipro antibiotic. but now I feel the same system as I had last month. Please let me know if my kidney got infection again and can I get heal forever ? Thank you so much. Stephen ### REPLY: Dear sir/madam, you have not mentioned what kidney infection. Whether it is urethritis/cystitis/pyelonephritis/prostatitis. So if you are having same problem again, then get urinalysis, urine culture and sensitivity and ultrasound abdomen done. Depending on this you can be started on antibiotic which is sensitive (depending on urine culture and sensitivity report) if tests reveal urinary tract infection. So better to consult nephrologist/urologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 to go to the emergency room 3 times in the last month. The problem starts out the night before where I sweeting badly by the next morning my mouth becomes numb and my tongue I have a sinus headache I have a problem breathing I become really weak and lose my ability to stand. The next thing I know I having convulsion. My feet and my anal area start having a burning pain and my hands feel as though their turning numb. After awhile at the hospital everything starts to return to some what normal. All the tests they do at that time come back normal. What do you think is happening to me? ### REPLY: Howell come to ChatDoctorI really appreciate your concern, the only matter of concern is convulsion if this is the convulsion then better to get done the CT of brain and EEG just to rule out the late onset of epileptic seizure if it is not detected anything in tests then it can be hysteria, it could be due to general weakness, but it does not seem to be anything serious, in differential diagnosis, anxiety and depression is likely, you have not given any basic information like age and gender else something better could have been thought hope this information 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 grand daughter is 16 years old and she has not gotten better in 2 weeks with 2000 mg Amoxicillin then was changed to Zithromax. She has been tested for Mono twice and both were negative. Her symptoms are: headache, light sensitivity, fatigue, back pain, very sore throat, neck stiffness, hot and cold flashes, body aches, loss of appetite, cough, stuffed nose and nausea. She is overweight and has been bitten several times over the last few months by mosquitos. Do you have any idea what it may be? ### REPLY: Hi dear...at beginning the symptoms you mentioned are not indicative of mononucleosis only but there are other causes for that....you can't be assured of mononucleosis except with investigations like monospot test and hydrophilic ab test... ..if it was negative we can repeat it as ab test may give false results before 3rd week .....you mentioned Avery important point in history of disease that she was bitten a lot by mosquitoes...we cant ignore that matter...as these symptoms lead us to think about malaria or Lyme disease .....the most important thing to know is your localization area....if there are cases of malaria or Lyme disease of this area...you can search about it simply...simple steps will help you to good results....and treatment will be easy and no more stress....wish your granddaughter healthy long life.......thanks for contacting us ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 previously suffered with prolapsed discs at L4/5. I had a discectomy in 2012 but this did not fix the problem. I now have more prolapsed discs all in the same region with severe sciatica and numbness. Some days I am able to manage the pain but others it is terrible. My question is firstly, would you recommend further surgery? Secondly, i have two children but would like another. Would I be able to carry a baby to full term and have a natural delivery with my back problems or would this make it worse? Thank you ### REPLY: Hello. I have been through your question and understand your concern. Lumbar disc surgery is sometimes associated with recurrence of disc herniation at the same level. This is because it is impossible to take out all the intervertebral disc. If you have back pain and sciatica, then you need to have a lumbar MRI, which I presume you did. If there is a herniated disc that explains your sciatica, even in the level of your previous surgery, then you should consider a second surgery. But there should be a clear radiologic and clinical correlation. Pregnancy with its weigh gain and increase in the normal anterior bending of the lumbar spine can worsen the back problem. So I recommend a Neurological or Neurosurgical consult to evaluate the radiologic finding and your symptoms to see if there is any indication for a second surgery. Hope this helps with your question, please feel free for further questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes, my grandson is having severe thickening of the skin on his hands and soles of his feet. The skin cracks and bleeds and big hunks of skin fall off. He has been to several doctors and so far no one is able to tell him what it is or how to treat it. ### REPLY: Hi, thank-you for providing the brief history.a Thorough neuromuscular assessment is advised. As mentioned he is suffering from scleroderma in the hand and feet. I will advise something which as per my knowledge should work. Try undergoing a physical therapy. By the use of therapeutic ultrasound therapy underwater. As this will produce the ripples in the water and an activation of the microvasculation of the skin. There is wide based physics behind it. As by having the activation of the microvascular system, there will be improvement in the blood supply. As the improved blood supply is needed for the soft tissue and cellular functioning to the optimum. It may sound a different therapy, but there is nothing harm trying, since there are no side effects. Also perform regular breathing exercises as increase in oxygen in body will help improve the metabolism and immune system. Also, you can keep me updated for the same as I can further assist how to keep a change of mechanism and newer protocols. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a chronic cough that has been going on  for 5 years.  I do not have a sore throat.  But sometimes the coughing causes my gag reflex to get stuck and there is sometimes flem.  I do have cysts on my thyroid - could this be a part of the problem? ### REPLY: Thanks for your question on . I can understand your concern. Yes, Thyroid cyst if enlarged and compressing internal tracheal wall, can cause chronic coughing. So better to consult ENT doctor and get endoscopic examination of throat to rule out this. Also consult pulmonologist and get done clinical examination of respiratory system and PFT (pulmonary function test) to rule out bronchitis because this can also cause chronic cough. PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilator and inhaled corticosteroids (ICS). If thyroid cyst is the cause then you will need to have time do surgical removal of cyst. 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: I see that from a recent lab results that my MPV is 13.  My cholestrol is 236, my ldl is 153.  My trycilrides is 185.  I have gained a lot of weight over the last 2 years due to severe stress. My diet hasnt been the best, but not overly bad. Should I be overly concerned with my lab numbers? ### REPLY: Hello and thanks for writing. I can understand your concern and would try to help you in the best possible way. Your cholesterol and particularly LDL which is the bad cholesterol is on the higher side. It is probably due to stress and recent weight gain that you have mentioned. I suggest that you immediately go in for some lifestyle changes like:1. Take low fat low calorie diet.2. Avoid fast foods3. Begin a regular physical activity program like walking, jogging or some sports.4. Avoid stress5. Avoid smoking and .  Set a target weight and start working towards it. Doing the above things will for 3 months will definitely improve your numbers. You need to recheck these results after 3 months and if still elevated you would require a cholesterol lowering medication to achieve the target. You may also get your fasting blood glucose, thyroid levels, HbA1C levels, vitamin D levels checked as they are commonly associated with deranged cholesterol. Furthermore, you may consult your GP and discuss with him reading these investigations. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 english is not so good. patient is my husband .he cant walk properly .always tell me my legs is paining. his hight is 6ft.ek rainy season me vo bhig gaye the. teen din tak vo need me rahe.now one doctor tell him to take cetil 500mg,gabapin nt, ebasil 20mg,ostium k2,corus, acenac p,.these all are costly medicine. i am so much vorried. ### REPLY: Hello, It is important consulting with a neurologist for a physical exam and some tests in order to investigate for the possible causes underlying his leg pain: - Peripheral neuropathy - Peripheral arthropathy - A bulging disc in the vertebral column - A muscle disease, etc. For this reason, some other tests may be needed: - A Doppler ultrasound of the leg vessels - Nerve conduction studies - Complete blood count, PCR, ESR for inflammation - Muscle enzymes (CPK, LDH) - An X-ray of the lumbar vertebral column. You should discuss with his doctor on the above tests. Order to investigate for the possible causes underlying his leg pain: Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 11 weeks pregnant with my first child and having been suffering with the symptoms associated with a kidney infection for 2 weeks -having undergone the routine blood tests it was stated how i have low white blood cells and the GP subsequently asked me to complete a urine test. Having completed 2 such tests they confirmed i had an infection and started me on a course of Amoxicillin today. Any further advice would be much appreciated regarding whether there maybe an underlying cause to the low white blood cells and the possible risks to my unborn child? Many thanks B.Buckland ### REPLY: Hello, and I hope I can help you today. Low white blood cells (which are the disease-fighting cells in your body) can occur both as a result of a disease that lowers your white cell count (like HIV) or by consumption when your body is working hard to clear an infection. In your case, your doctors were concerned you had an infection in your body causing your white blood cells to fall. They found the infection in your kidneys and prescribed an antibiotic, which is it works, should clear the infection and your white cell count will return to normal. Your white cell count and you're having a kidney infection does not affect the baby at all as long as you are treated properly and follow your doctors' advice. My only concern is that if you truly have a kidney infection, amoxicillin is not a particularly strong antibiotic for urinary tract infections. So if you have taken the medication for a few days, and you still have fever higher than 38.5 Celsius, (101f) or bad flank pain occasionally IV antibiotics are needed for treatment. I hope my answer was helpful for you today and that my advice was helpful. 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: sir,my fathers age is 64 years and his weight is 65kilograms  he have diabetes from 20 years.now his sugar levels are normal with below 100 at before fasting and 145-170 after food .now he had a hard particle in his foot .it is bout nearly one inch and he got pain when he is walking .His doctor suggested to remove it in the hospital .but my father is scared .some one told me that with out opening that he can wear slipper which diabetes doctor suggest.is it possible, please suggest me what are those slipper and where do we get that slipper ### REPLY: Hi. Read and understood the history about your father. The slippers meant for diabetic patients can be made at home, you have to buy thick padded slippers made up of rubber. You can mark the area of affection on the foot with a marker and take impression on the slipper. Cut that part with a cutter to accommodate the lump so that the pressure on it will be nil. Well as a Surgeon I would examine the lump, try to see the reason and then only decide whether to keep it or to excise it. Keeping some lumps can cause more complications later. I would also go for preliminary color Doppler study of the foot to see whether the vascularity is compromised or not, a very important aspect in diabetes. Keep the sugars within normal limits. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an xray done today for a cough that has lasted for 6+ weeks. I was diagnosed with laryngitis and bronchitis after no illness on December 26th. Cough has persisted, short of breath, wheezing and taste of blood in mouth.I am an ex smoker who smoked for 21 years and quit 7 years ago.I grew up in a house of 2nd hand smoke.I am nervous of what my xray may find.Dr put me on Levaquin now too. ### REPLY: Respected user, HiT hanks for using .come have evaluated your query thoroughly.* Joaquin has excellent results for laryngitis and bronchitis.* Along with that take other precautions for better recovery - Avoid oily, spicy, excess sugar, chilled beverages - Gargles with salted lukewarm water and added peppermint oil 3 times a day-Basil leaves with turmeric in boiled milk give additional excellent herbal support for speedy recovery. Hope to clarify your query Thanks for using  .com Wishing fine recovery Regards dear take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter had a spinal operation to remove a non cancerous tumor. It was reported that her hemoglobin has dropped from a12 to 9 to now 8. The Dr said that a blood transfusion may be needed? What does this mean for ones hemoglobin to drop to an eight? Why a transfusion? Please explain! Thank you ### REPLY: Hello, THX to contact us. I understand your concern. If I am your doctor I advise you cancer is a catabolic condition which catabolize many of the nutrient of the body. Condition known as Paraneoplastic syn .  So anemia is common is cancer. You can take the blood transfusion for the severe anemia will be happy to answer more of your concerns, kindly know me, Wish you a very good health at . . Infectious Disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 would like to know if any of the medications I m taking would give me tremors in my hand which are moving up my arm and neck over a period of several years. Possibly affecting my left eye. I also lose my balance easily. I m taking Integral for Mitral valve prolapse, Verapamil, Singular, baby aspirin. ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. YesThey can cause Tremors Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in  at http://bit.ly/ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir, I have notices a small red spot in my hard pallate for about 3 weeks before, after that it lasts for approx. 07 days and go away, but surrounding area gets red spot as concentric circle, in this way is goes outside by disapearing the old one by forming new spot. I am an ex smoker, this type of symptom I have faces about 01 year and 03 year ago. please suggest sir. ### REPLY: Dear friend thanks for sharing your concern it is good to know that you have quit smoking now. Do not worry. Your palate shows signs of inflammation. That is why there is redness.  sometimes a specific lesion of the hard palate called DERMATITIS NICOTINE is seen in smokers. The red spot represents dilated and partially occluded orifices(opening) of accessory palatal salivary gland duct.  This inflammation is caused around the accessory palatal saliva gland duct.  On discontinuation of the habit this should go.  Observe for any associated changes. If so report to the dentist else you can wait and watch for few more weeks.  Meanwhile you can take capsule megajoules 01 OD for fifteen days.  Do use mouthwash daily, medicine 2% for fifteen days.  Take nutritious diet and remain stress-free. This helps. 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: Sir, I had hair loss since 1year due to stress and i did dieting (vitamin deficncy)without any doctor suggestion..i consulted a doctor he prescribed me..antioxid-hc and finpecia in how many months i can get thick hair?? And im also useing minoxidil solution. Pls Help me sir.. ### REPLY: Hello and welcome to ChatDoctorFirstly, since you know the cause for your hair fall, we need to correct the same. Stress and unhealthy diet causes deficiency in the body, and therefore causes hair to fall and become unhealthy, and makes the growth slow. It will take time and good treatment for new hair growth. It is a common complaint and could be also increased due to stress, work, hairstyling products, Dan . Also, you need to check for other causes like thyroid problems, low iron /hemoglobin, any illness like fever, typhoid, any long term medication. Any genetic hair loss, or balding in the family could make you more prone to hair fall. You can check with a dermatologist regarding any tests required to check for these causes. I would advise you to start on a hair supplement capsule like Seraglio Men or Collinear daily for 2-3 months to see improvement. Any treatment needs to be taken for a few months regularly to see good results. Consult the doctor regarding how long to continue minoxidil but do apply it regularly. Be sure to take a nutritious diet and adequate rest, avoid stress. Avoid harsh chemicals. Finpecia tablets will help you if you have a genetic or family history of balding. It would be better to slowly reduce and stop the financial after consulting your doctor, and check improvement with the other medication alone. You can go in for other cosmetic hair treatments as a later option if medical methods don't work, but it may not be necessary for you, as your hair growth should improve once your general health improves. Use a suitable shampoo and conditioner like Hair4U. Hope this helps you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir,my wife is pregnant with 33 weeks by now,and doctors say that it s underweight and they need my wife to undergo a scisserion operation and get the baby in 35 weeks,will this really affect the baby s growth and mother s health?sir please help me ### 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 suggest you the best possible treatment options. There are certain situations like intrauterine growth retardation - means small weight baby, and placental insufficiency - means less blood flow to baby and less amount of water around the baby.  Such conditions need to deliver the baby by cesarean surgery. In such cases, it is better that baby is safe outside the womb. Usually at 35 weeks of pregnancy, baby has less risk.  But the treating doctor usually helps out the baby by giving Injection Beta methadone. This helps baby to breath easily. So Trust In your treating Doctor. All things will be fine. May God bless you with a bundle of joy. 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: Thank you for your time.  I have swollen glands under my left jaw bone.  It feels like three separate bumps that are about a half inch long.  I noticed them about two months ago when my allergies got bad.  I also noticed a painless bump on the top front of my shoulder just past my collar bone.  It is hard.  My shoulder is sore from wrestling last week so I am not sure if is related to the glands under my jaw.  Could these glands be swollen due to my allergies? ### REPLY: Thanks to ChatDoctorHERE I CAN UNDERSTAND YOUR PROBLEMSwollen glands below the jaw are lymph node enlargement due to either infection in mouth or in blood.allergies are rare case s of swollen glands swelling over the shoulder region also may be gland engagement don't worry, please undergo for CBP, ESR , ULTRASOUND OVER THE NECK Region allergies you can bale levocetrigin 5 mg once daily take antibiotic metronidazole 400 mg thrice, along with Latin 200 mg twice daily take some anti-inflammatory .  Ok ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir..18th dce me and my wife had make love when period is running..(on 4th day)... Sir just 1 time my penis put into her vegina without sperm.. Then i felt little bit worried..so i took her unwanted 72 pills.. Her periods cycle is 28 days.. Naturally her periods comes 13th ..but periods till now not come.... Sir my question is why periods till now not come??? is she get pregnent??  sir plesase ans on it... We are very worried...so please ans on it..... ### REPLY: Hallow Dear, You have taken hasty steps after the intercourse and have landed into a stressful situation. The egg is released 14 days prior to the next menses. Egg has a life of 24 hours and the sperms are active for 72 hours. Hence, a period of about a week is a fertile window. In short, during menstrual flow, there is no egg present and hence there is no possibility of conception. So there was no necessity of any protection by Unwanted 72 pills. You have given her Unwanted 72 pill. This pill has following after effects:1. There may be some bleeding a few days after the pills. 2. The following period may get delayed by about a week or so. So there is no reason to get worried about delayed menses. Wait patiently, and she will get the menses (Provided you did not have any other incidence of unprotected intercourse during the cycle). One more word of caution : Blood is a very good medium for pathogenic organisms; hence there is a great risk of infection if you perform sexual intercourse during the bleeding phase of menstrual cycle. Please avoid it. I hope this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my son took his blood pressure at a drug store and it was 8":30 at night the first reading was 150/103 then he took it minutes later and it was 137/137/99.  He woke up this morning with a purple bruise at the corner of his eye where the tear duct is...  should he be on meds or will diet take care of this? ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. You should not worry. I'll try to explain you something and give you my opinion. You should know that we talk about hypertension if we have mean value that exceeds 140 / 90 mmHg. A person might have high value during emotional and physicals trees so It's mandatory to judge on mean values. Usaly in young ages we deal with secondary hypertension meaning that it's a secondary house of it. This might be a renal disease, an endocrine problem or a cardiovascular anomaly. High blood pressure values might give headache, blurred vision, ear noises, retinal hemorrhage etc. So, if I was the treating doctor I will recommend some examination like a cardiac echo to evaluate heart function and structure, a full blood analyze, your urinary catecholamine and a holder pressure monitoring to evaluate the values during day and night. After all this we can better judge if we have hypertension and how to treat it. Hope I was helpful. Wish your son good healthiest 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 there, I am 35 male, married for almost 7 years and  have been taking 10 mg esomeprazole for almost 10 years and started taking beta blocker 25 mg atenolol and 5 mg amlopres for about 6 months. I and my wife trying to have a child for 2-3 years without a success. Could this infertility due to these drugs Im taking? My semen analusis normal except for the morphology being 23%. Is that normal? ### REPLY: Healthier are so many "MISCONCEPTION" about certain medicines, but I am writing about side effects of omeprazole and atenolol. Esomeprazole side effects:Headache, diarrhea, skin rashes, pruritic, dizziness and rarely GIT upsets. It means NO EFFECT not causes INFERTILITY. Side effects of ATENOLOL:Rash, breathing difficulty, headache, fatigue, depression, nightmares, sleeplessness, cold hands feet, bronchospasm, constipation and anesthesia. It means NO EFFECT not causes INFERTILITY. Amlopress means amlodipine side effects:headache, insomnia, somnolence, nausea, abdominal pain, flushing, palpitation, dizziness, pruritic, rash. No infertility. I mentioned side effects of all these . MORPHOLOGY ;Normal fertility is associated with sperm counts of >48 million/ mL with a motility of > 63% and > 12 % exhibiting normal MORPHOLOGY. In your case it is 23 %, so good thing. Hope this information will help you. ### END