Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 and thank you in advance.  Woke up to a horrible itch on my arm - looked at it -  it is swollen, red about three inches around, very warm to the touch, and now bumpy.  Looks like a spider bite... two tiny red marks in the center.  I cleaned it and sprayed bactine over area.  Is there anything else I can do or be concerned about? ### REPLY: Hi, Welcome to , It seems that you might have some poisonous insect bite giving allergic rash with severe itching. Due to bad itching nail scratches might produce some infection on the part. Go for short course of antibiotic to clear infection. Take anti-histamine like Cetirizine or Levo-cetrizine as and when required. Apply some local triple acting cream. Keep that part . Ok and bye. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, 67, taking seloken 25xl and cilacar 5. Last one month, half of tablets taken from each one. Remaining time, took cilacar 5- 1/2 taken with 4 intervals based on sys pressure while reaching 160. But my doctor advice is to take medicine in the morning 1tab seloken 25xl and evening one tab cilacar 5 tab. It is all carried out in 40 days. On 3.10.14 she took half tab each seloken 25 xl and cilacar 5 in the morning. After 4hours, we noticed the BP is 202 sys, 79dia and pulse 66. My self, husband, went to Dr and informed the situation. Dr advised to take as per priscription - seloken 25 -1 tab& cilacar-5 one tab and evening one cilacar. Today, 5.10.2014, she took as per Dr s advice. intially decresed for 2hrs from 179 to137 sys, 80 to 65 dia and pulse 71 to 68. But, after that pressure increased to 190-71-77 within 1.30hrs. Immediately we went hospital.Today, OP treament is not available. Before that, to avoid any further increase, I took cilacar 5 one tab while going to hospital. After 3/4hr we measured Bp. It is 166-64-79 and further after one hour Bp is reduced to 134-60-70. she is diabetic patient more than 15yrs and 10yrs for Bp. Kindly give your good advice to relieve from this suffering. Now diabetic under control. ### REPLY: Hi welcome to . I understand your query and concern. High blood pressure should be treated thoroughly and should be kept under control or else will lead to complications like Dilated cardiomyopathy and ischemia to the brain. Best treatment for elevated blood pressure is through . Before that adequate management and work up is needed. 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 day for 5 days a week. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 62 year old male and as the result of many years of serving my country in the armed forces I find that I have been confronted with renal damage near the point of failure. I am new to the guidance of my Doctor I wanted to use homeopathic herbals to help address the issue.I trust many of the "old folk remedies" as I grew up in rural NC and my Mother and Father relied on many of these remedies during my many first aid needs.  Should I ???? ### REPLY: Hello, Thanks for the query to . Forum. I don't know about homeopatChatDoctoredicine, but herbal formula I can tell you. Bhandari (usually camel eat it in fields) available in India at the shop or ayurvedic store. Take Bhandari 100 gm, boil it in 500 ml water till water become half (250 ml), now .  I myself have tried and treated so many cases of renal failure, you can try it. 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 found a small round hard lump (half the size of a pea) to the right of my clitoris, doesnt hurt. Is this something to be concerned about I have had half my cervix removed from cancer cells and Im worried this may be something more serious then a cyst. ### REPLY: Hi ! Good morning. I am  answering your query. Any new growth post surgery for a malignancy should be viewed seriously unless proved otherwise. If I were your family physician, I would not hesitate to refer you to your surgeon/gynecologist for a clinical review and other related investigations for a proper diagnosis and further management. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have had a pretty bad cough and cold, possibly flu for the best part of a month now, which has pretty much resolved, but I now have a pain on the left side of my back, level with the lower part of my scapula.  This is worse when I cough or breath in and seems to be going into my left arm.  I dont feel as if I pulled anything whilst coughing.  Any ideas what this could be?  Many thanks, Wendy ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. Possibilities for your problem can be muscle strain from excessive coughing or irritation in lungs. Better to do a lung auscultation to rule out any problems relating to lungs. If that is clear. Then taking cough suppressants, antihistamines and local hot fomentation will be helpful to clear your problem. In case of any positive lung signs on auscultation then chest x-ray will be required. Hope this may help you. Let me know if anything is not clear. 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 wasn t feeling well today. maybe i took too much spicy. i might have felt burns. i took pepto bismol. i used to have asthma, so i took my inhaler to improve breathing. i haven t used it in a while. i only took 1 puff, but then i felt worse. i feel as if closed breathing, not open enough. dry. ### REPLY: Hi thanks for contacting ... You have history of asthma .... So this time difficult breathing could be from asthma precipitation... I would suggest you to consult pulmonologist for resp examination including auscultation also . If rhonchi heard than pulmonary function test done to assess severity and accordingly management .... If it is severe one puff might not effective, and you might need short course of steroid or nebulization with levosalbutamol and budesonide .... Avoid smoking ..... If you have problem of acidity also pantoprazole can be taken for that . Hope your concern solved. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, My mother is affected by Adeno carcinoma of endocervix stage IIB. In her CT scan Report they have given one statement "VISUALISED BONES SHOW EVIDENCE OF SEVERE DEGERATIVE CHANGES" is this state ment means the cancer affected in bones also? Dr. pls clarify my doubt Regards, Rama ### REPLY: Hi, in regard to your mother, the changes in the X-rays, could be due to 2 scenarios. 1. if your mother is above 45 years (which is my guess), these changes could be due to osteoporosis related changes. 2. In case of advanced cancer, the release of cytokines by the body, as a reaction to cancer, could cause degenerative changes in the bones.  The treatment in both cases - is vitamin D & calcium supplements (To strengthen the bones) and supportive medications like alien .  In cases where the cancer directly involves the bones (in form of metastases) there would be seen as separate lesions and not as degenerative changes.  You can consult the treating oncologist, and he will do what is necessary.  Hope this helps.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 27 year old female, married, working as a researcher in india, weighs 49kg and 157cm tall. I have all my periods regular and on time. Hairs and nails are growing fine but facing severe hair fall and hair greying intensely. Coming to my basic character, i am very reserved type of person, talks very less but talks openly and frankly to those who i do. I have very less friends but whoever i have i trust them as my shadow. eventhough everybody see me as a matured independent person, i always owe to be supported morally by someone whom i trust as my breath. detailing about my problem, i cant control my temper. one thing is i am short tempered as well as i dont know what all i speak out when i am angry. after sometime when i realise i regret and cry a lot for the situation i have created. now the problem is very worse that i got married to a very nice calm, understandable and down to earth person. our marrigae happened one year ago and i know him for past two years. he tries to support me whenever i am angry, but now he started losing expectation from me. due to the career reason eventhough we are living physically separated, we always keep in touch through phone or other media. he visits me atleast once in two months. due to anger he is afraid that how it will be when we start a life together which we planned to start by next year end. moreover i have a feeling that my in- laws are not happy with me as i am living separated from their son and i am a reserved person. this created a block for them in my brain and i just manages them and dont feel anything for them from heart. i spoke this openly to my husband and he is supporting me and consoling me. never blamed me. but problem arises when i get angry i take names of my in laws for which he will tensed and crestfallen. eventhough everytime i try to control that it goes off my tongue. moreover he always tells me that i have attitude problem and i judge others too much. now the condition is that whenever he takes the words attitude and judgement i burst out like a volcano. this creates a barrier between us now as he is afraid to share his worries regarding family issues and also he is afraid when the smile from my face will change. now i get a feel that my husband doesnt love and care me as before and started losing faith in me. i want my family back and his happiness back as before. please help me in this. please.... ### REPLY: With your query, it's clearly understood that you are a straight forward person with independent character, and you want your own career that's good no problem but always remember straight tress are cut first not the bent ones. So whoever straight they always face this issue. Now coming to your family issue 1. You are living separately from your husband from the beginning of your marriage I believe so what happens here is understanding between both of you won't stand for longer though both of you feel that you know each other in very aspect. Openly in the beginning of any marriage living relation is must understand each other open heartedly2. Now coming into your in-laws anyone even you when you become in-law think in the same manner no one is exceptional for this so always try to understand them by keeping your legs in their shoes.3. Everybody talks uncontrollable when they are in anger, but it is our own consciousness we should be aware before we deliver our words.Finally, I would suggest you to be calm and think what to do to control your anger and make your husband to understand you better only this helps you. I believe this is not a serious issue to be considered since I see everything is in your hands you have already mentioned your husband is so understanding he will be ready to accept you for his lifetime if you can control your anger and words. Do meditation for mental peace and to get control over your anger which helps you better. 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 husband 43yrs old diabetic has had high blood sugars this evening. Just a few minutes ago his left side went tingling including his tongue. He said this tongue has a metallic taste. I took his blood pressure and it was ok & he did take some baby aspirin. Blood sugars are coming down now and the tingling feeling is diminished to both feet and shin area. ### REPLY: Hello madam, I understand your concern about your husband. A diabetic patient can have tingling sensation in his body as a result of nerve damage due to high blood sugars, but the pattern of these sensations is usually chronic, symmetrical in both feet extending up to legs(sometimes up to thighs and trunk also) and both hands extending up to forearms(sometimes arms and face also). But this is usually symmetrical and chronic. In your husbands' case it appears to be a sudden episodic, sharply demarcated to one side of the body including face and tongue(which is unusual). Being of sudden onset and restricted to one side of the body followed by recovery, these sensory symptoms mandates a neurological consultation to rule out a vascular event like a transient ischemic attack or even stroke(although, sharp demarcation of sensory abnormality including face and tongue is rare in stroke). Improved and now limited symmetrically to both feet and shin area, is something I mentioned above and well explainable with diabetes. I hope it will be of 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: I am 38 yrs old and had BP 150/100 the Dr. prescribed me Losacar 50 tablet along with Apezyme syrup. For few days after taking medicines I felt better. But now I am having same symptoms again, like headache, blur vision, fatigue ect. What should I do please advice. ### REPLY: You must check up your blood pressure regularly. There are 2 possibilities1. Either your blood pressure is . In this case you may have to stop Oscar and consult your doctor for reassessment.2.your blood pressure level has not yet met target of BP less than 140/90. In this case you may have to increase dose of Oscar. So my suggestion is to monitor your BP and then take appropriate action.my best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good morning doctor, I want to talk about my mother.she had done esophectomy before 1year n 7 months. Now she is suffering from left lower abdominal pain and when she take some food then she feel uneasy n congested and one more thing is reflux upwords when she  get up in morning after 3 hours cold ( pus) like secretion upwords but doctor said its ingested food . We have done every test but everything is normal . But what is cause for pain plz tell me- ### REPLY: The esophagectomy might have been done for some malignant condition of esophagus, and some by-pass or end-to-end anastomosis might have been done, whichyou have not mentioned. The surgical procedure may be associated with post-surical complication of GER which should be treated. The lower abdominal pain may be due to some secondaries in the GIT, may be lower GIT in this case, which should be evaluated by SURGICAL GASTROENTEROLOGIST. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: what can 1 do for panic attacks? if having them and how uid the three way cheep to stop then ?  what can you do for panic attacks in whats the cheapest way to solve them and keep that from happening my friend is having panic attacks and dont have much money for Dr? Like maybe home remedies ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. Panic attacks can be best controlled with medicines(paroxetine) (mirtazapine) or it can be controlled with cognitive behavioral therapy. But both of them will cost you. The easier way is start some regular aerobic exercises. These will improve the exercise tolerance and also improve the panic attacks. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a small lump/ bump just above my armpit. Tz been there for years and most doctors have told me it s nothing to worry about. I just turned 29 but never had a real cancer screen. This bump is not ichy but is hard to the touch. Should I be worried? Can you advice me on what kind of a screen or test to take to make sure it s not serious? thanks, jojo ### REPLY: Hi, If your Doctors have told you It's nothing to worry about then it is probably not anything serious - Could be a Lipoma or swelling containing fat cells. To be sure you can get an FNAC done. This is an investigation in which they insert a small needle into the lump and aspirate some cells out of the swelling and then examine the slide of cells under a microscope to see what it contains. You can ask your Doctor to get it done, and then you can be sure. 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 47 years old man . now  iam suffering from hepatnmegaly with fatty inflltration liver gread 2 . Iam using ursodeoxycholic acid, Meganeuron-OD Plus, omeprazole-ocid, zerodol CR . iam not feeling enjoy. Please suggest what needs to be done . and other things what is side effect of alcohol in this case.Ihave no money for mement plese help ### REPLY: Hi and welcome to . The most common liver disorders are fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar. If ultrasounds didn't find anything and viral markers are negative then you have no reason to be concerned. You should treat it by changing dietary and lifestyle habits. Do exercise, avoid alcohol, smoking, fats, fast food and carbonated .  Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be prescribed as in your case, and you should just do frequent check up. If you don't have any other symptoms then this is just slight and reversible liver damage. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When I rotate my ankle there is slight pain. when I rub my foot I get tingling sensation in my toes. Ankle pops every now and then. It this cause of concern? I don t remember twisting my ankle in any way. This is only happening with the left foot. ### REPLY: Hi... Your ankle pain and tingling sensation is due to some minor impingement of muscle and nerve around ankle....this could have happened in a previous episode of ankle twist or following an ankle injury....or walking in an uneven surface... I recommend you to kindly Do. Lot of icing in the painful area... Ankle stability exercises...and strengthening...like pushing a sand bag towards the other leg...pushing the sand bag towards outwards.away from your body...keeping a sand bag on your toes and lifting your toes up and down... Single leg calf raises. Standing on a single leg with eyes closed... Stretch your calf muscles. .gluteus.frequently... Wear a well cushioned for wear... Hope this is helpful for you.Revert in case you need any more clarification. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 two dry patches on the palm of both hands and have had it for over a year now. It itches from time to time but not always. I continually keep moisterizers on it. I am a nurse and wash my hands alot but have not changed soaps or skin moiturizer since it started. I have never had any allergies to anything and am 61yo. what could it be? ### REPLY: Hi, Welcome to , You could be having a type of eczema which is known as pompholyx where one gets multiple tiny . These are usually seasonal and occurs over palm and also on soles and side of fingers. You can apply a steroidal cream like mometasone and a good moisturizing cream. However, the correct diagnosis can only be made after careful inspection of your skin of palm by skin specialist. Hope this answer will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name I Zarina. For almost 2 weeks I have big rushes through out of my body, very itchy and same time is painfull. My lips an eyes were swollen.today I felt short of breath and itchy and pain on my head area. I feel anxious and nervous, and my menstrual ends 2 days ago but today I had blood again. I feel no energy and depressed.Thanks ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. The rashes you are talking about seem to be allergic as they are itching and involving mucous membrane and almost whole of the body. You should be allergic to something. Do consult a dermatologist who would like to start you on cetirizine or Allegra to reduce your rashes. If required corticosteroids can also be considered. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been experiencing severe lower back pain. A recent MRI suggests a compression fracture in L5. Its been suggested that I may have Osteoporosis. There is no family history of this. I am 54 years old and had a hysterectomy in 2002. Ive had chronic sinus allergies and have taken Rhinocort or some form of corticosteroid for over 20 years. I started using Vivelle Dot last October. Is it possible that the bone problems I am experiencing are related to the medications Im taking? Also what are the non-surgical treatments for this back pain. Im an active person, not overweight, and have done Pilates, Yoga and massage for many years. Since my recent diagnosis, ive been encouraged to rest. Im losing my mind. Chronic pain, no sleep and no exercise!! ### REPLY: Hello friend, Osteoporosis and compression fracture are common in people with poor Calcium content or It. D. Try to improve your calcium intake and expose to sun more than your usual exposures. Your backache may be associated with your psychological conflicts which remain unresolved. Your sleeplessness and the poor spirits show that. You can analyze them and share them with an expert Homeopathic physician. Homeopathy considers the mind and body as equally important both in health and in sickness. I cannot say that the .  Therefore, try to avoid all the chemical  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was taking medicine feliz s and collonotril from last 1.5 year but now as iknew i m pregnant istop the medicine im 3 months pregnant but the anxiety and depression repeat again. what should i do i m very much worried how i can comeup with this thing ### REPLY: Hi, I read your query and can understand your concern regarding your symptoms and also regarding effects of . Felix s (Escitalopram) is an anti-depressant and control (Clonazepam) is benzodiazepine. In your case, since you are having depressive and anxiety symptoms again, it will be advisable to start treatment again. Treatment can be of two types: with medications and with psychotherapeutic methods In case your symptoms are mild, option of treatment with psychotherapy like cognitive behavior therapy can be considered if there is a trained therapist in your locality. Alternatively, treatment with Escitalopram can be considered. Escitalopram is relatively safe even in pregnancy. The highest risk is usually in the 1st three months which in your case is over. Benzodiazepines should usually be avoided throughout pregnancy. So medicines can be started. You can discuss regarding this with your psychiatrist. In any case, treatment is necessary as depression during pregnancy can cause effects on the unborn baby too. Hope I was able to answer your query. 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: After  six months complete extractions for dentures there is a hard nodule on left upper gum that causes pain on the left side into the temple area.  When I put pressure on the nodule area with my tongue the pain will subside.  Had nodule removed by oral surgery and for a few days it was better, but the pain and nodule have returned. ### REPLY: Hello, Thanks for consulting ChatDoctorRead your query, as you have nodule after complete extraction it can be bony spicule present in jaw, this can be reduced by surgical procedure Alveoloplasty or that nodule can be fibrous growth in jaw treated by excision don't worry if there can be regeneration of growth it can be induced by denture may be irritation fibrous for this I will suggest you to consult dentist and go for investigations of growth if needed go for biopsy of nodule and if there is any point in denture causing pressure in jaw or ulceration in oral mucosa go for adjustment of denture as early as possible, Do warm saline rinses. Hope this will help you. 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: My aunt (aged 51) has been diagnosed with Esophageal cancer in Stage 4. Doctors are advising radiation therapy combined with chemotherapy. They also doubt whether she can withstand radiation therapy since she is too weak and weighing only 35 kgs. Is there any other treatment available? How long is the life expectancy? ### REPLY: Hi, Thanks for writing in. Cancer is a difficult condition to treat and if your aunt has stage 4 cancer then survival even with the best care can vary from 6 months to two years. It is important to know the exact area of cancer involvement. Cancer in esophagus happens due to the growth extending in to the lumen and then proliferating to cause obstruction to ingested foods. Surgery cannot be done at this stage and therefore radiation therapy has been recommended by her doctors. To increase passage of flow through the cancer area, you can discuss with your doctors if she can be given monitored doses of radiation followed by inserting a metallic stent to cause improvement in swallowing. Radiation is best and chemotherapy may be even more difficult for her in this case. 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: my girlfriend and i was fooling around and we were without cloths and my penis touched her vagina and i think there was some semen on it and 2 days after that she menstruated... which was a day or so late but it was a normal menses according to her and it has ended after 4 days and she feels back aches... what r the chances she is pregnant? pls answer asap i m worries... ### REPLY: Firstly, chance of becoming pregnant on 2nd or 3rd day of the menses is very, very remote, for practical purpose nil, however you cannot guarantee anything 100%. Regarding pronominal fluid and ejaculation at the external vaginal opening, one has to be careful. From your question, it is clearly evident that there was semen on the vaginal opening suggesting that there was not only ejaculation fluid but also ejaculation. The first part of the ejaculation comes out with a great force. Even when the ejaculation takes place within the vagina, some sperms are known to enter the uterus. So even if you see some semen on the vaginal opening, there is a strong possibility that some part of ejaculate has entered the vagina, which is sufficient for pregnancy. Remember, there are millions of sperms in one ejaculate and to impregnate, only one is sufficient to fertilize the women egg. Furthermore, even pronominal ejaculation also is known to contain few sperms which are known to cause pregnancy. The backache she is getting is probably due to the stress and may be the rigorous activity if at all she had during love making. Pregnancy does not give low backache. I repeat, the chances of becoming pregnant are very very very remote on 2nd or 3rd day of menstruation. The egg is released 14 days before the next expected menses and the life of the sperm is not more than 3 days. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 stomached is having very bad sharp pains my lower stomached to middle and after 8 hours of this my body from legs up to head had a very uncomfortable tingle very hard tingle like I m numb an same for my teeth they tingled as we ll my whole body got hot espically at ears and my stomache felt a little better then after 20 seconds idly did the same but I was cold this time and as I speak it ducking hurts I have no appetite and when I eat it hurts rather than crackers I went to restroom but didn t help I don t need to move for it to hurt either I feel strange and I m asking bout this because of the tingle it scared menu felt like I was goon to die ### REPLY: Hi, Thank you for posting your query.First, I would like to reassure you that you need to worry, and you would not die! We need to exclude any stomach related issues such as gastritis or acidity. This can be confirmed by doing an upper gastrointestinal endoscopy. We also need to exclude any gall balder or kidney stones, for that, ultrasound scan of abdomen would be useful. You should consult a gastroenterologist for opinion. You would improve with treatment. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For the past two weeks I have felt queasy, tired, and run a low fever (99.9). I also have discomfort in my left lower abdomen which my doctor thought was due to a twisted pelvis. He is an internist/osteopath so he adjusted it a week ago. I had a CBC run and all was good. I have an insect bite under my breast but did not think to tell him about it. Could it be related? ### REPLY: I don't think your symptoms are necessarily because of insect bite.  Low grade fever with malaise can occur in any infection - bacterial or viral in origin.  Depending upon the geography of your area, further investigations for malaria, dengue, typhoid, influenza etc. may be required.  Undiagnosed fever for more than 2 weeks is not a good sign.  A mere CBC will not be helpful.  Depending upon your ESR and CRP levels, your treating physician should be planning 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 daughter is 2.11yrs and she is suffering from fever from last couple of months. Earlier fever use to come once a month, than it changed to week and now the fever only goes till the medicine is effective i.e after ever 4 hrs the fever is coming. Her blood test report: Hemoglobin:- 10.2 against 11.5 - 15.0 PCV:- 30 against 34 - 45 RCB:- 3.4 against 3.8 - 5.0 Total WBC count:- 12,800 against 4000 - 11000 Neutrophils:- 86% against 40 - 70 Lymphocytes:- 10% against 20 - 40 CRP:- 12 against Less than 6mg/dl Need help to cure my daughter ### REPLY: Hi... Thank you for consulting in . Looks like a viral illness. I will explain to you how a viral illness behaves. 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. 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 had fever and body pain which initially resulted into typhoid. Later, the doctor @ my hometown says i am having TB,after checking my chest xray and ecg tests. I wanna know if i have active tb or latent tb. I also used to have terrible vibrations in head while coughing. ### REPLY: Hi welcome to  .... I really appreciate your knowledge regarding types of TB infection... TB infection can be active or latent... The latent infection means person having immunity and immune response against tb bacilli... Without clinical manifestation... But latent infection can be converted into active infection esp. If HIV, less immunity, transplantation like condition if present... For its diagnosis skin tuberculin test and interferon gamma release assay test can be done. For latent infection reduce . . Take care Advise : Consult pulmonologist for examination and discuss all these issue ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 question that I have not research on. When a person has low iron in their body, can it cause a siezure? Knowing that, Im a person who has epilepsy, and have recently went through hemmoroids and had a outpatient surgery for. Which, afterwards, I still going through blood in my bowels, ( with the bleeding still in my stool ) Am I loosing iron? Can it cause siezures? ### REPLY: The only vitamin deficiency currently known to be directly offensive to epileptics and can cause seizures is Vitamin B6 (pyridoxine).  Otherwise, no other nutritional supplement or vitamin has that effect directly on the brain.  Having said that the indirect effects of iron deficiency of anemia resulting in lower Oxygen carrying ability of red corpuscles can have deleterious effects on the brain which over time theoretically could cause deterioration of brain tissue which in turn could make it more likely for seizures to occur, but this would have to be a very long process before such events would begin to happen. Please rate this answer with STARS if you found it useful to what you were looking for. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What explains dull pain on my left side, I have had a colonoscopy all is well, have had MRI of left and center abdomen they see nothing. No bowel changes, I have had polio as a child and my left side is my stronger side so I tend to favor that side since my right side is my weaker side. But it bothers me that I have this dull pain that can sometimes be intense. My Doctors don t know what the problem is and I find my self thinking about a cancer that they will find to late. I have been bothered by this for a year now all tests come out normal, what else can I do. Could it be muscular but it does not feel like a muscle ache. I m at my wits end. ### REPLY: Hello, thanks for using . There is a vast number of causes of left abdominal pain. A negative colonoscopy and MRI is comforting as they exclude anatomical pathologies including cancer which is your worry. Cancer is associated with altered general condition, progressive weight loss, loss of appetite, weakness, sometimes low grade fevers; in the case of gut cancer, bloody stools, diarrhea or constipation, abdominal pain etc. The causes of such pain on the left side of the abdomen include diverticulitis, irritable bowel syn .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 38/f sufering frm CKD since 7yrs,initialy diagnosed chr pylonephritis. BP-124-84,previously Creat. was stable on 2.5-3 but sudden raised creat.-6,urea-80,Na-136,K-4.6,Ca-9.3,S.Phos-4.8 but no Nausea,Anorexia, but there r mild Swelling on foots &Hands & bellow theEyes.patient feels well.plz adv treatment. ### REPLY: Hello, Thanks for choosing . Based upon your reports and general condition please have Av fistula done and keep it for future use she may require hemodialysis in future so rather going for central line it's better to have AVF done beforehand but till then you have symptomatic treatment with lasix, calcium, folic acid and erythropoietin injection of hemoglobin is high. 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 a 27 year old male.  Weigh 224, have been losing weight through diet and exercise.  According to my blood tests I have elevated AST(49) and elevateed ALT (96).   I drink very rarely (less than once a month), and all tests indicate I have not been exposed to Hep A, B, or C.  What other conditions could be causing this? ### REPLY: Hello and thank you for asking . I have read your reports and I understand your concerns. Normal range for AST is 10 to 40 units and for the ALT is 7 to 56 units. In most cases, liver enzyme levels are only mildly and temporarily elevated and most of the time don't signal a chronic, serious liver problem. Your AST/ALT are slightly higher than normal range. In these numbers no reason to be worried much. Here are some reasons why you might have AST/ALT in those numbers:-use of pain medications, particularly acetaminophen (Tylenol)-Certain prescription medications, used to control cholesterol-Stress-Obesity-steatosis or steatohepatitisIf I was your doctor, I would tell you to not worry right now. You need to do again the blood tests after 1 month probably and try not to take any alcohol, or painkillers. An ultrasound of your abdomen, would help to check if your have a fat liver, or stones in your gallbladder and the elevated enzymes would correlate with these conditions too. Observation with lifestyle modification may be undertaken for up to six months. If your enzymes remain elevated or worsen you need to check up again with a gastroenterologist for farther evaluation. If you have any other question, feel free to ask me. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hurt myself playing ball hockey where i felt alot of pain between my thighs and along my pelvic area. I pushed it a bit but quit playing for awhile after the pain became really severe i could barely walk or sleep after i played but over usually a weeks time the pain would recede. I have seen a doctor a few times. At 1st i was given anti inflammatory pills then a cream then i had an xray that showed nothing. Im about to start a new hockey season but i feel really apprehensive because while i dont feel pain there normally when i cough or certain movements i feel pain like if i move suddenly or if im pushing weight with my legs i feel a sharp twinge but its gone right away. I dont wanna go back to the doctor but i dont want to go thru all that again. Any advice would be greatly appreciated thankyou ### REPLY: Welcome to , Short answer. Your pain is due to injury in the muscles with or without hematoma Detailed answer .when a hockey or an object is hit in the muscles it will cause an injury to the muscles. So I advise you to take a good rest for 2 weeks If you have a normal reapply ice indirectly. By covering with a towel. Take NSAIDs for your pain. Hot wax bath helps there is no external wound apply elastic crêpe bandage in the whole of your thigh. The bandage must not be very tight.it must allow the blood to pass through. Review after a week. To your doctor. Hope this explains. With regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 5 weeks and 1 day out from partial hip replacement, wound/incision on side of thigh isnt healing, oozing yellow pus.  now doctor is cutting off all antibiotics to see if they can finally get a positive bacteria sample (previous two cleanouts / tests showed no infections.  what to do?  othro wants to wait 10-14 days and go back in again.  is this superficial or deep tissue infection? allergic reaction to partial hip replacement hardware, slow healing due to compromised immune system? she also has feltys syndrome. ### REPLY: Hello. Thanks for writing to us. After a partial hip replacement, the discharge like you are having can be due to an active bacterial infection in the area or a reactive fluid from the joint due to inflammation. You need to get the fluid cultured for proper diagnosis. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is presently eight years old and she was under foracort 100 inhalation since her fourth year. Presently, for the past six months, she is administered Budesonide (Budecort) 200 twice daily to control the wheezing . What are all the likely impact of these medicines on her general health and growth because of the continuous inhalation for the past 4-5 years. When these medication can be stopped. ### REPLY: Welcome to . Steroid medications given by inhalers are usually safe, as there are less systemic side effects (side effects on other body systems). Both Forecourt and Decor are steroid medications. I would like to know:How has her control of Asthma/wheezing episodes? Has she been admitted in hospital? Is she getting any other asthma medications along with steroid inhalers? It is also important to continue monitoring her growth - weight and height whilst she is receiving steroids. Has there been any change in her growth profile over past 4-5 years? Steroids given in higher dosage or pretty long period of time (as in your case) can have impact. However, it is important to weigh the balance of these side effects vs controlling her asthmaInhaler medications can be stopped gradually provided her symptoms are well-controlled and regularly followed-up. I hope I've been able to answer your queries. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 46+ years old (Height -175 cm, Weight -80 kgs) with sound health. I get good sleep at night and do regular exercise. My blood pressure remians 125/85 normally and I went through a through cardiovascular pathological checkup (including TMT & ECG) recently and the results were normal.Recently Ive noticed that my blood pressure remains 130/ 95 immediately after waking up in the morning (I checked it for the last seven cosecutive days), and it gets normalised as the day progresses. Plesae advice. ### REPLY: Hereafter reading the medical details provided by you, I would like to tell you that your blood pressure is within normal limits. The normal recommended range of blood pressure for adults is up to 140/90 MMH. Your diastolic is just slightly raised, but that could again be due apparatus mechanical error or can also be examiner dependent variation. So just maintain healthy lifestyle habits, and you will be all fine. Just relax. I wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Recent blood tests done on me - CBC w/Differential/Platelet - show my red blood cell count is 5.35. Hemoglobin is 16.1. Hematrocrit is 48.3. I take B-12 injections ev. other week because my entire ilium was removed and 1/2 colon due to Crohn s Disease in remission since 1979. Reason was that I needed iron injected since I could not absorb it. Have been taking these injections since 1985 with no problems. These CBC numbers have been heightened a little since that time anyway & my GE doc said it is to be expected. Now my new, younger GP says he s concerned about the numbers because it may show I need oxygen through supplemental therapy. I presently have Idiopathic Interstitial Pulmonary Disease, DX in 2012. My GP wants the CBC redrawn now. He thinks the numbers are too high. I don t. I also was DX with Peripheral Neuropathy in 2003 - I take Lyrica for that. Your thoughts for the doctor s concern? ### REPLY: Hi, The fact remains that you are taking an injection of iron and vitamin B12.  These are the 2 main components that are needed for blood formation. So, personally, I think your older GP is correct.  However, to be fair, loss of oxygen intake capacity due to lung disease also causes the hemoglobin to rise. Peripheral neuropathy does not play a role in it. The ideal way I would suggest is to test iron and vitamin B 12 levels.  If these levels are high then the injection of iron and vitamin B 12 can be stopped. Monitor hemoglobin monthly thereafter. If it remains high then the lungs are the trigger. Else the injection may have been the cause.  This is, of course, assuming you have no acute problem needing urgent treatment. 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: Okay, so I m 18, 5 6 and 262 pounds, although I don t look that much. Anyways recently I ve been having random muscle twitches in my right calf and left leg hurts only when I m laying on my side and my other leg is lying on it. It s not sore when I walk or lay on my back or stomach. Any help? ### REPLY: Hello, Your symptoms could be related to a pinched muscle or a metabolic disorder. For this reason, I would recommend consulting with your attending physician and performing some tests:- vitamin D and vitamin B12 plasma levels-Blood electrolytes- Complete blood count, PCR, ESR for inflammation. Nerve conduction studies would help examine your nerves. You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I started chilling and running fever Monday night.  If I take tylenol I can cut the fever but have had to take it ever four hours.  I also have an ice pick type headache on my right side.  I took an UTI home test it tested positive for Leukocytes and negative for Nitrite.  I have in the past had UTIs. ### REPLY: Hi, Welcome to , Your UTI home kit is indicative severe urinary tract infection which could be the reason of your fever with chills and headache. Also, you need to be detailed medical history and thoroughly clinical examination by a urologist to get ruled out any other kidney pathology. You should also undergo complete hologram, urinalysis and ultrasound PUB. You might require antibiotics (quinolones specially levofloxacin in high dose or amoxicillin with clavulanic acid) to combat urinary infection completely with other symptomatic treatment like analgesics, anti-inflammatory and antacids with urinary alkalizer like liquid catwalk. So, You can consult physician or urologist for further advice. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 just tested SGPT and SGOT and reading comes to 158 and 87 respectively. I had viral fever for last 10 days and was taking paracetamol - dialy dose of 2 tablets for last 6 days. fever is normal now. Further I had quite anumber of antiobiodics for dentel infection 2 months back. I took antibiodics for more than 10 days - average 3 tablets a day as suggested by doc.  I do not drink now. I used to have  60 ml of alchohol daily  (started in 2013 only )or sometimes one can of beer. Is that the reason? ### REPLY: Welcome at  I have gone through your query and being your doctor I completely understand your health concerns.... Are you having jaundice? Any history of fever?  Based upon the history I don't think the medicines which you have used have caused it. In my opinion it is most probably due to the ingestion of alcohol intake. You should get your gamma GT levels done and meet hepatologist.you should also get your ultrasound done to look for the texture of liver, is it fatty or not?  Hope your query is adequately answered 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 am 533yo female with numbness and tingling in ring, 4th and 5th digits on left side. pain down back of upper arm. also pain under armpit and in chest and back area just above my breast. getting no relief from NSAID s been going on for 4 weeks now. can get any relief other than lying down, Sitting is the worst,,do I have a pinched nerve? ### REPLY: Thanks for your question on . In my opinion it is neuritic pain only. But as a rule, any left sided chest pain must be rule out for cardiac cause. So get done ECG and 2D Echo to rule out cardiac cause. If both are normal than no need to worry much. It is mostly neuritic pain. This can be due to 1. Nerve entrapment2. Vitamin B 12 deficiencies. So get done B 12 level. If lower than start supplements. Also follow these steps. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 tongue suddenly swelled and woke me during the night. Benadryl eased the swelling but I developed a thick white coating on the whole tongue. This all happened yesterday. Today my tongue started peeling and is now bright pink and I cant really taste anything. ### REPLY: Hello, Your symptoms are clearly indicative of oral yeast Infection or oral thrush. Thick white coating is due to thrush. Bright pink appearance is due to inflammation of tongue with damage and inflammation of tongue papillae that is causing loss of taste. You should consult an oral physician and get evaluated. For now, you can start gargling with Statin mouthwash that is an antifungal mouthwash and along with it suck Clotrimazole lozenges and take plenty of probiotics like yogurt and garlic.  .  If the Infection does not clear, the physician can advise you oral antifungal medication like Fluconazole, Itraconazole, etc. 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, about a month ago I observed some very small white grains (like needle heads) just at the edge of my penis glans under the prepuce. They are just a few in number and present like a semi ring. Sometimes these grains become a little itchy as if some needles are being pushed there. Also, the smega deposited underside the glans has increased in quantity and is very foul smelling. Earlier it used to be almost negligible and without any foul smell. None of these was present before a month. Can you please help me out. ### REPLY: Hi, It seems that this is due to collection of smegmas on glans. Due to non cleaning of glans there is deposition of Sega giving rise to thick collection and foul odor. Remove collection of smegmas by averting fore skin of glance gently and clean glans penis. If there is soreness on the part, apply antibiotic cream. Make a habit of cleaning glans by averting fore skin daily while taking shower. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son has had a really high fever of 103,4 for over 2 days. Today i took him to the er. They said it was a uti and that his white cell blood count was low. I also just found out that crones diease runs in my husbands family. Could this low white cell count mean my son has this diease?? he is only 5 months old. ### REPLY: Hello and welcome to , Bacterial infections like urinary tract infection (UTI) can cause low white blood cell count. Appropriate treatment of UTI is required with appropriate antibiotics. The white blood cell count will improve once the infection clears.Crohn's disease is not known to affect the white blood cell counts directly so this is not a symptom of Crohn's disease. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is Chris, i have been unwell now for a few months. i have lost 30 kilos in 12 months. i ahve been to the doctor, i have had elevated HB, elevated LFT s, and now apparently a concern for a LDH, the gp tells me he needs to see me urgently, what does this mean? i am unable to see him for 2 weeks as he is very busy, should i be concerned ### REPLY: Hi, Thanks for posting your query. You must consult with your treating doctor on urgent basis as you have history of severe weight loss, deranged liver function test with elevated hemoglobin. Although you have not mentioned your symptoms, yet there appears to be possibility of polycythemia Vera or immunocompromised states. You should go for complete blood count, erythrocyte sedimentation rate, anti-HIV, reticulocyte count, peripheral blood film examination. Any delay may cause progression of disease with difficult to treat. Take care, get well soon, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi im sam, currently 16 years old i ve been masturbating since I was 12 or 14 and I ve noticed whenever I sit too long and stand up i lose my vision and everything turns into black for 3 sec then i also notice I lost my concentration at school and memory loss a lot i recently had a lower back pain but now its cured can you tell me what to do ? like what to eat or do I will highly appreciate your anwser ### REPLY: HelloThanks for query. You had been indulged in masturbation since 4 years and now facing problems related to general health.First there is myth in a mind of common man that excessive masturbation is the reason of all problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body. All the problems that you are facing now are mind related and due to anxiety. Following measure will help you to boost up your confidence and improve your general health .1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc3)Take anti oxidants like Almonds 5-6 every day.4) Avoid alcohol and smoking. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: One side of my face feels heavy.I was having very bad headaches in my right temple. Eye irritation and pressure behind my right eye. The area around my eye and also my cheek was inflamed. I went to an allergy specialist. She gave me enough prednisone and antibiotics for a sinus infection even though she didnt see one but she gave me it just in case if the infection spread up behind my eye. The medication only lasted a week. After the medication the pressure was gone and my eye felt better. But my cheek felt and still feels heavier than it did before. When I get acne on that side of my face it is very sensitive and swollen. Is this all just inflammation or what? Id like to mention that my right tonsil is swollen too.What could this be and what doctor should I go to? ### REPLY: Hi, Your headache is a tension type of headache, and it is not migraine at all for what you have taken treatment and get relieved. Now, acne is an inflammatory lesion with blackheads or comedones mostly limited to face. The skin becomes warm, sore to touch, slightly shiny and heavy feeling at the site any inflammation. You are also having swollen tonsils might be infective or non-infective. You will require antibiotics (quinolones or accolades group preferred) both oral and topical forms with anti-inflammatory and analgesics. You must consult your dermatologist for further advise getting rid of acne. 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: dear doctor i am really upset .my brother aged 23 is a mental patient and is undergoing treatment for 6 long years without any improvement.....instead his condition is getting worst.he was otherwise a normal person but wrong treatment has made him worst so much so that he is suffering a lot now....earlier he only got depressed but now he hurts him,throws tantrums,once he even bite my mom when he got angry...he is not eating anything and is hurting himself....he has even got a tendency to commit suicide ....we went to Ranchi and Vellore but they said that he is not a mental patient but a patient of severe depression .....please help! ### REPLY: Hi Basmati, From the symptoms you have given, it appears that he may have something called as "Personality disorder" in addition to his mood/depression problems. This kind of problem needs long term treatment and family members will be an important part of this treatment.  SIMIANS in Bangalore, Institute of Psychiatry Ranchi, CMC Nellore.....are few names that jump to my mind which can handle this kind of problem effectively. As I said this will need lot of assessment and therapy is long. Please ask for a "Personality disorder specialist" to assess him. In regard to admission, it will be only needed when the risk to himself or others is very immediate or very great otherwise, we always like to manage this kind of problems in their own surroundings. Management will include medication but psychological/talking therapies play the biggest part and most lasting effects. Bottom line, please get someone more experienced in personality disorders to assess him. Good Luck to both of 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 treatment of TB is going on from 9 months BUT doctors are unable to tell that TB is in which part. So please tell me. my reports are: x-ray : clear mantoux: positive (34*28 mm with 10 TU in 48 hrs) E.L.I.S.A. - IgM: 1.51 ESR 9 months before: 60 present ESR : 90 Symptoms i feel : joints pain, emptiness of head, less vitamin D 23 ### REPLY: Hi and welcome to , thank you for your query. These findings can't reveal in what part TB is, and you need to do some more detailed imaging tests such as MRI or pet ct to verify tuberculosis source. These blood results indicate inflammation due to tb. Your symptoms are sign of systemic infection, and you should continue with therapy but do those tests I've recommended verifying how extended tb is at this point. Wish you good health. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr I dont know if you can help. This morning after cleaning my teeth, I notice it looks blue across just below and upper my lips of mouth not in a straight line . This was not their before. All I had was just soreness even some foods apples, hot drinks and toothpaste using realyl burn and hurts. ### REPLY: HelloThanks for consulting ChatDoctorRead your query as you have soreness in your lip this soreness can be due to allergy to any antiseptic solutions if used in cleaning of teeth, or it can be due to thermal burn, or lichen plans, .  In meantime do warm saline gargle two - three times a day, you can apply ointment like McCoppin or mugel of sore lip and consult oral surgeon for examination of lip. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Helllo my qustion regards my boyfriend. about 5 years ago he fell on an exhaust pipe and got engine oil in his wond. the doctors got rid of most of the oil but not all of and i was wondering if the oil is still in his system? i ask this because sometime his heart rate can slow right down and i worry about it ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would explain that it is a very long time since that episodes. So, there is nothing to be afraid about the engine oil, as his symptoms are not related to this episode. Is he active? People who make a lot of physical activity, usually achieve lower heart rate, compared to the others. But, if he has shortness of breath, or fainting like episodes, I would recommend performing a cardiac ultrasound and an ambulatory 24-48 hours ECG monitoring to exclude possible cardiac arrhythmia. Hope to have been helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi.i am suffering from the pain in leg after a fracture in the 5th metatarsal region.had a mri last day that shows 1.Edema of soft tissues surrounding base of 1st metatarsal is seen. 2. Edema is also seen involving medial talar tome. 3. Slight edema is seen involving anterior part of cuboid and lateral cuneiform bones.findings may suggest possibility of complex regional pain syndrome(type-1). 4.Bones appear bright on T1 and T2WIs suggestive of ostopenia. The doctor has prescribed for hot water fermentation and voveran tablets as an anti inflammatory medicine but i have a reaction with diclofenac composition.So can i take signoflam tablets for the same as i am taking it for the past 3 days and for how long i can take it to reduce edema. ### REPLY: Hi, Causes of your difficulties may be neuropathy or ischemic issues. Neuropathic are seen in diabetics or injury of spine nerves.  If this is not your case then these symptoms are indicating circulatory problems in legs which are common in this age and there may be present atherosclerosis that obstructs blood vessels and causes pain and blisters to form.  You should do Doppler ultrasound of the leg or CT angiography to rule out such obstructive changes, and then it can be treated properly by medications or by surgical and radiological procedures.  Also, you should have Aspirin and have elastic stockings applied, and should avoid cold environment and long walks.  In most cases, it can be managed with medications, but sometimes surgery may be required in severe cases. Hope I have answered your query. Let me know if I can assist you further. Take care .  Rammstein, General Surgeon ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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- Thank you for taking my question.  I had an endoscopy 3/09 due to a constant tight feeling in my upper middle abdomen.  (Still there to this day).  When I woke up from the endoscopy they had me do a barium swallow.  As I came out of the anesthesia I realized I had severe pain in my esophagus.  It was painful to even swallow water.  It lasted about 10 days.  But at the same time I realized that if I move my chest muscles, I feel great pressure in my chest (still to this day). And slowly it became too painful to talk.   I have a voice, but the vibration of it hurts something in what feels like my esophagus.  It becomes very sore. (also bumps in the road etc any vibration hurts.  Question 1) could that endoscopy injury with the barium poured over it be causing these problems?  2) If so, what is going on?  Scar tissue? Barium irritation/inflammation? 3) How to remedy? Thank you so much for your time.  Im in constant pain and I cant use my voice.  Kari ### REPLY: H. Thanks for your queries and an elucidated history answer your queries:1. Yes it is possible that the endoscopy injury added on with barium study can cause such a problem / pain as you explained .2. To know what exactly is going on you need to undergo another endoscopy and probably a CT scan of the chest. 3. Remedy: for the remedy to be correct, we need the correct diagnosis as to what is the exact problems, for this you need to undergo another endoscopy. *There may probably an injury at the cricophrynx and larynx, hence you have the pain, and can not talk, you have vibrations too. CT scan of the neck is also necessary with that of the Chest. * Till then take PPI, Antacid gels 3 hourly, Risperidone, soft bland diet and continue whatever your Doctor must have advised you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have every now and then but recently more than usual little bumps on my thighs and hips, like small pinhead bumps that make my skin feel rough, its making me feel very self concious and i would like some help as to get rid of them, i would like to avoid laser treatment. ### REPLY: Hi, Dear,Welcome with your query to . Studied your query in full depth of its details. Reviewed it in context of your health concerns. Based On the facts, You mostly seem to suffer from-Multiple Viral Warts on thighs and hips-which are caused by HPV Papilloma Virus. Treatment-By TCA-Trichloracetic acid locally/or By Anti-Wart Cream on OTC medicines in pharma shops. Imiquimod cream / Aureomycin injections in the warts would resolve this issue.Thus, your lump seem to be related and connected to the Viral Warts causing Papilloma warts. Other causes need to be ruled out by second opinion from Dermatologist. Hope This reply would help you to plan further treatment soon with your treating doctors. Best of Luck and early recovery. Welcome any further query in this regard, which would be replied in next session. Good Day!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 history of reacting to antibiotic by developing a strong reaction of allergy to yeast and fungus. Normally Drs in the past prescribe for me Mycostatin and that works succesfully. Unfortunally last time I forgot to mention this to the Dr. at the emergency outfit that I went so I have develop a rash so bad , and is extending tgrough my body. I have talk and consult several DRs who don t believe me, they give me steroids(they don t work) also vicoden and tramadol they don t worlk . I don t take opiates since I m allergic to them. Can you help me?. All I need is a prescription for Mycostatin. I do not have diabetis, renal or liver problems or high blood pressure, I m very healthy . Can you give me a prescription for mycostatin or the name of a Dr who will listenj tol me Thanks. ### REPLY: Hi, Welcome to . It is not clear whether you are allergic to antibiotic or that you have a yeast infection. Doctors will prescribe antifungal medication if they suspect any kind of fungal infection. You have to trust your treating doctor here. If you have developed an allergy to some antibiotic, then you have to take anti-allergic medication rather than antifungal medication. Please follow your doctors orders and do not try any self-medication. 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 have a very swollen cheek along the jaw. I visited the dentist on Tuesday morning and was told I have an abscessed tooth where the infection has gone into the cheek. I have been on the prescribed medication since Tuesday lunchtime and today the swelling is far more prominent and I am having difficulty opening my mouth. ### REPLY: Hello, Your infection is not under control and symptoms are increasing. Call your dentist to report that your condition has not improved and is worse. Your dentist will need to increase the dosage or change your antibiotic. Make sure you are following directions on taking all medication. I usually recommend Amoxicillin 500 mg or 875 mg depending on how often you take the antibiotic. Your dentist will recommend the next step for treatment of the abscess. You may need other oral conditions evaluated as well. Take anti-inflammatory medications in addition to the antibiotic. Tylenol and Motrin are effective choices. The choice of the antihistamine Ben .  Keep well 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 my husband had been having this burning sensation and white patches on tongue..doc thought candida gave meds for it helped some but same time ive been making him gargle with lemon juice....has helped a bit but now doc thinks its not candida....i also make him scrape it off after he swishes....doc also said doesnt look like cancer at all pharm. said same thing he said looks like dry mouth.....he also does smoke ### REPLY: Thanks for your query, I have gone through your query. The burning sensation along with the white patches occurs in candida infection and erosive lichen plans. Or it can be two separate lesions like leukoplakia(white patch since you are giving history of smoking) and erythematous candidiasis(redness and burning sensation).consult a good oral physician to rule out these two conditions. If it is candidiasis then you have to take topical antifungal like candid mouth paint. If it is leukoplakia, you have to stop the habit of smoking and take antioxidants like capsule lycopene. If it is lichen plans then you have to take topical steroids like triamcinolone acetone (0.1%) 4-5times daily for 1 week. You can also take topical anesthetic and analgesics like Anabel gel for the pain. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had chronic bacterial prostatitis for 5 years. I ve taken levaquin, ciprofloaxin, flagyl, and doxycycline. It helped but once the meds were done symptoms came back. I ve been dealing with this for way to long and I m young. My doctor only prescribes me antibiotics 2 weeks at a time and I know they have to be taken for at least 4 weeks. Is the fact that I only take them for 2 weeks the problem? ### REPLY: Hello there, Thanks for your question. I see from your quarry you suffer from chronic prostatitis. It is a condition which requires four to six weeks of appropriate antibiotics. It is also recommended you partner s also put on treatment alongside you too for better else you will reinfect yourself once you are treated. Practice protected sex with your partner(s) all through the course of your treatment. 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 normal blood pressure of 120/80, and I have been under a lot of stress last two months-marriage, and went to the doctor yesterday and my blood pressure is 126/63 and BP is 64. Is this ok? I also lost 15 pounds and am now 105 pounds. Oh, and Im 50yrs. old. ### REPLY: Hello, Few strategies to reduce the stress and I hope once you follow these things you will ace to overcome stress1. Diet: Ensure intake of an adequate quantity of fiber. 2. Servings of vegetable salad and two servings of fruits (One preferable citrus fruit). A proper diet does miracles and rejuvenates. Orange is a good source of anti-oxidants. Avoid junk food and fast food especially pizza, burgers and excessive sweets.2. Ensure adequate water intake: Follow the rule of one which I usually advise. One glass of water one hour before and one glass of water one hour after every meal will ensure adequate consumption of water. The recommended intake of water is two to three-liter in a day.3. Early morning Exercise: Brisk walking for 30 minutes at a stretch preferably in the garden will be very helpful. Walking is the best exercise, it also promotes the release of endorphins (naturally occurring painkillers released in the brain) which causes mood elevation and a generalized feeling of well-being.4. Avoid tea or coffee or nicotine and alcoholic beverages5. Start your day with a glass of lemon water with two spoons of honey added.6. Don't take work so seriously: We all have the feeling to excel in our respective fields and don't spend adequate time with our self trying to understand our own needs. Spend time with your family and friends.7. While working takes frequent regular breaks: Taking regular breaks will not waste the time, but it will increase productivity, concentration, and reasoning.8. Avoid late-night socialization9. Avoid starring for a longer time at the computer screen or TV for a longer time10. Steam inhalation before going to sleep will be very refreshing.11. Multivitamin and calcium supplement. 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: Hello Sir, I am 35 yrs old and from last 15 days suffering from sneezing and blockage of nostrils. In a normal, one is open and other is block and it changes. but some time both is closed. I have started to take Celen (Vit. C) from today. I am allergic from dust. Sneezing is started when I get up after sleeping most of the time. Please tell me the medicine and other precaution for cure it. ### REPLY: Dear friend, You symptoms seem to be developing after allergy. Early morning sneezing is also a sign of chronic allergy and some simple things to do over a few weeks would help you. Avoid dust exposure as much is possible, cover nostrils & mouth when be in a dusty situation. Try covering you head during night and identify whether morning sneezing also happens because of temperature variation during night (sleeping directly opposite a fan, extra cool or warm room etc.). If so avoid this. For blacked nose take steam two-three times daily. Start breathing exercises.deep breath.hold.and release slowly. Many times daily. When severe symptoms are there, use over the counter anti-allergic medicines with decongestants. You can continue with It C. persistent blocking may lead to a sinus infection so consult a Physician or ENT person if things don't get better.  Do well. .  ### END