Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 4 month baby. He is having severe cold, sneezing, nose congestion and fever 100f . Doctor prescribed synarest-af syrup 3ml 3 times aday. Antibiotic odicef-o 3ml 2 times a day. With synarest-pd nosaldrops 2drops on each side 3 times a day. Is it correct dosage ? I have doubt regarding synarest AF syrup. ### REPLY: Hi....1. Minaret AF should not be used at this age.2. Dice is also a higher antibiotic. At the same time it doesn't work for upper respiratory infection like this.3. Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do.4. For cold, you can use Cetirizine at 0.25 mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A friend has undergone extensive abdominal surgery for a cancerous tumor of the stomach wall lining. Had stomach removed, part of intestines, gallbladder, and omentum. Was in hospital for 6 weeks. On return home has not had a good day yet. Weight has dropped 41 lbs and has had fluid on lungs removed once, but now fluid has returned. Why is he not improving and why the fluid build up. At this point he 15 weeks post op. ### REPLY: Thanks for your question on . I can understand your friends situation and problem. Stomach cancer can spread to pleura (lining surrounding lungs). This pleural metastasis is common cause for recurrent pleural effusion even after removal of fluids. So better to get done pleural fluid cytology and pleural biopsy for the diagnosis of malignant pleural effusion. And if these are positiver than your friend need pleurodesis (adhesion of pleura) for treatment of recurrent pleural effusion. So better to consult pulmonologist and discuss all these. Hope I have solved your query. Wishing good health to your friend. 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 had abdominal pain and a high fever for 2 days. I went to my doctor, and he had me get a CT scan to rule out appendicitis . When I got the scan today, the doctor there said that it is likely that I have Inflamitory Bowel Disease, but that we would need some tests to rule out amoeba (I just got back from traveling Japan). My question is Could an inflamed colon be caused by inserting a finger lubed with anti-bacterial soap in your anus? ### REPLY: Hello, Jenkins, Sudden onset of fever, abdominal pain and history of recent travel maybe indicative of some form of intestinal infection. I do not believe that cleansing your anus with antibacterial soap had anything to do with this. Your doctor is right in suggesting stool tests to rule out parasites etc. I am not sure if you are also having diarrhea or bloody stools. In general, Inflammatory bowel diseases include ulcerative colitis, crohnsdisease. Bacterial and parasitic conditions can also cause this type of change on a CT-scan. Follow your doctors advise. Wish you well, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello my dad is 51 years old and was diagnosed with lung cancer which has spread to he s liver in August. Since then he has been going through chemo which he is coping with quiet well considering. We have been told that he s only option is chemo and after that there is no other options. Is this the case? Any information you can give is muchly appreciated. Thank you for your time, tara. ### REPLY: Hi, Lung cancer is mainly of two types. Small cell lung cancer and non-small cell lung cancer. I do not know what is the diagnosis of your father. If his liver has already been involved then it is a case of M1b lung cancer that is stage IV disease. In this case chemotherapy is the main treatment option but on good response with chemotherapy maintenance with Oral targeted therapy is also an option. For this treatment EFR status to be known if it is a non-small cell lung cancer. Biological therapy is another options which will be selected depending on histopathology. Consult with your oncologist. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello my names anna, i have an inpacted wisdom tooth, but when i went to the dentist they told me it didnt need removing it was just pain from growing out. But the past few days my mouth has been in agony, my left bottom molar by my wisdom tooth is very painfull, the gum is swollen and almost squiggy to touch, its exstreamly painfull, i need to know what it might be? Thank you :) ### REPLY: Hello and Welcome to , Thanks for writing to us. An impacted tooth is a tooth that gets blocked as it is pushing through the gum into your mouth. When an impacted wisdom tooth tries to come in, the flap of gum on top of it can become infected and swollen. This can hurt. You might even feel pain in nearby teeth, or in the ear on that side of your face. An impacted tooth can lead to an infection called peritonitis. Immediately start up with warm saline rinses & Betadine rinses, along with antibiotic course including amoxicillin 500 mg TDS & ibuprofen 400 mg TDS.Then visit to your dentist for check Iowa x-ray. Hope this helps you. Wishing 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: My son who just turned one on September 11. I noticed that a little below his hip and closer to his genitals kind of where his leg is connected I found a few squishy like sacks if you will and there is a couple in the same area and I am very concerenced ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I feel like some one grabbed my heart--just a quick pinch is the best I can say.  some shortness of breath but could be anxiety over this,  rib cage and left breast is tender (could be several things doing on).  What is this--should I see a Dr. immediately. ### REPLY: Dear-thanks for using our service. I will try to help you with my medical advice. It can be anxiety, but other possibility is Costco .  I advise you to try relaxation technique as yoga, do regular exercise and eat a healthy diet. You should see a doctor for an evaluation and electrocardiogram to make sure that you are not suffering an underlying cardiac problem. I hope that my advice has been helpful ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 baby has swollen glands and red throat and is finding it very hard to swallow. He has not eaten anything solid since 6pm yesterday and not had a bottle since 7 this morning and has only drunk 4 fl oz of water today. He wakes up screaming and is increasingly difficult to settle. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint it seems that your baby is suffering from throat infection leading to Pharyngitis and Tonsillitis and the most common cause for it is bacterial throat infection, however it can also be due to viral infection. Consult a Pediatrician and get him evaluated and a thorough clinical evaluation and investigations like throat swab culture can help in diagnosis. He can be advised a course of antibiotics along with pain relievers like Ibuprofen or Acetaminophen. Feed him with plenty of warm fluids and a soft and semi-solid diet. Give him sufficient rest and keep him HY . . Do cool compresses over the glands. Hope this information helps. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i m 25 years old male and i m having problem with my hair as my hair suffer a substantial loss in the frontal and anterior over the last year when i consulted with a doctor she prescribe me with morr F solution and curlzvit tablet plz let me know the effectiveness of these medicine and their side effects. thanks ### REPLY: Hello, It may be used for hairless. It will work by increasing the blood supply to the scalp or affected area. Possible side effects are: 1. Dermatitis.2. Excessive hair growth on face.3. Headache.4. Itching. Culprit is a multivitamin tablet may be useful to avoid the hair fall. So I think I answered your questions still have queries please feel free to ask. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, lately I have been have like pins and needles in my shoulder. It doesnt stay. It is happening more and more lately.. I take care of children all day. Next to my shoulder on my back it does hurt. It feels like something crawling softly..lol not really pins and needles. ### REPLY: Hello, You may be having skin rashes or allergy or eczema etc. Until examination is done it is difficult to say what it is. Apply moisturizer cream or lotion. Also, the possibility of compressive neuropathy or radiculopathy. Get it done an x-ray of the cervical spine and consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. 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 Doctor,im 23 years old girl...recently i did my blood test and de report came like this..TPHA reachingly in blood test.. VDRL1:32 and HIV non reactive.. Now kindly doctor please explain to me about this virus becaus some doctors said this is a virus infection.. and also i like to know what type of food that i should take....... ### REPLY: Thanks for your query at ! You are suffering from syphilis which is a sexually transmitted disease. V .  It is a test with good sensitivity.TPA (Treponema Pallidum haemagglunination Test) is tested which is quite specific test to confirm diagnosis. In your case you are having syphilis. Kindly describe your symptoms? Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. 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 brothers cheeks have suddenly swollen in 2 days. He had rct of his tooth some 3 years back but it was left uncapped. Now, he is having intermittent fevers, body ache. and swelling is increasing. I am not with him. He has been admitted to a hospital. I am far off in a college studying. Please help. I have no clue! ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concern. As per your complaint it seems that there is flaring up of infection in the root canal treated tooth, and it is only leading to swollen cheek that can be probably due to abscess formation and fever is due to Septicemia as the infection can get into blood and bodies defense mechanism tries to wall off the infection leading to rise in body temperature. As he is already admitted to hospital they might be giving him injectable antibiotics and steroids as well as Acetaminophen to reduce fever. Once the fever is under control consult a dentist and get him evaluated along with an x-ray done to rule out the cause of cheek swelling and in case of re-infection in root canal treated tooth re-root canal or extraction can be done depending upon condition of the tooth followed by antibiotics and painkillers. Hope this information helps. Thanks and regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am a 33 year old male, weighing 66 kgs and height is 171 cms living in Delhi. I have severe cough since last two months. Though I have taken medicine for cough and cold, have done chest and sinus x-ray but the test were all clear. Now I am doubting that I may be allergic to something due to which I get attack of severe coughing as the day progresses. Please advise how I can determine that I am suffering from an allergy, what test/treatment could be done and where I need to go to get them done? Thank YouAdnan ### REPLY: HI, thanks for using  There are allergy tests available. They can be done as blood tests or as skin prick testing. The blood tests can be ordered by your general practitioner, but the skin prick testing may require a dermatologist or allergist. Either of these would be able to tell you the source of your allergies. Till you can source the test, you may want to consider the use of topical steroid nasal sprays and anti histamines. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been very worried lately as to whether I have cancer or not. I have Leukoplakia from smoking but I am noticing tiny bumps towards the back of my tongue leading into my throat. When I swallow, it almost feel like somethings back there, and every now and then it burns slightly as if the inside of my throat is being scraped. Does this sound like cancer? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have leukoplakia.  It can be simple keratitis or squamous cell carcinoma.  You should go for biopsy of that area.  It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am having a quite sharp pain on my left side under my lowest rib. It s at the front. I had the same pain about 3 weeks ago and the nurse said it was a spastic bowel and gave me bowel relaxant, however I was not having issues with the bowel and the tablets do nothing. Eventually the pain went away on it s own.On both occasions I have been hormonal but not on my period, and the pain worsens when moving and sneezing, but not when coughing or going to the toilet.I would rather not go back to the hospital as last time they kept talking about ectopic pregnancies and other things, which us turned out not to be but it heightened my anxiety for days after, which is rather avoid ### REPLY: Hi, Firstly, sorry to hear about your symptoms. As the history is straight away highlighting the symptoms related to two things as the pain is present just below the rib over the left side. There are some few basic important points which are not mentioned here. I would like to ask you your age and also if you have any gastric issues. The pain area is more prone for two things. Either this will be related to acidity or it may be related to heart. Take this way, If it is related to gastric you can try some anti acidity medicine, and it should be fine. In case, it's not this than the heart needs to get assessed first. Because many a time a misdiagnosed condition later becomes serious condition.  So I would like to advice your get checked with a cardiologist. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i want to go outside the country for joining ,before joining  i have done a liver enzymes test my SGPT was 98 and SGOT was 39 againg he call me back on 16 for medical ,so i have just 2 days left is there anything to maintain my SGPT with in 2 days  plz tell me i want to bring my sgpt upto 70 ### REPLY: Hello,1) First, you need further detailed evaluation to find out cause for elevated GOT.2) GOT level increase when liver function less efficiently or more load on liver to function.3) Try to avoid alcohol, take less fat containing food in diet, regular exercise, protein rich food are some basic life-style modifications to support liver function.4) It is not sure that your enzyme level will be normal within 2 days with these, but they help to reduce enzyme level within 7-10 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: Hello, I had Bells Palsy 22 years ago, and experienced full recovery except a droopy eye when I get tired. A month or so ago, I noticed a weird feeling on the same side of the face with slight tingling around my mouth. It comes and goes, but I go for days and don t notice at all. It doesn t hurt, is not numb, but feels very weak at times. However, I did see my physician, and he noticed that my face was twitching above the mouth on left side (Bells Palsy side) and prescribed medicine along with steroids. I can t remember the name of the medicine because I am here at work, but it is used to treat herbes virus and Bells Palsy. I am still having symptoms after a week on medication. My doctor is recommending a MRI, even though he still thinks it is a weak facial nerve that can be treated with steroids. I would love your opinion. I m sorry/ I just realized that this is not a free service. Thanks anyway. I was just looking for another opinion. ### REPLY: Hithis is due to neurological weakness post bells palsy. Although steroids can resolve the problem for some duration, you can start on multivitamin therapy, especially methylcobalamine to improve the longevity of the nerves. Calcium supplements after checking out the calcium levels can help to some extent. Good physiotherapy exercises like chewing, blowing help in nerve regeneration. All the best take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello I am a 17 year old African American girl with dry, sensitive skin. I have been using African black soap for my face and it works wonders to help keep my skin nice. I was also using the cream tenovate plus to treat occurrences of acne on my face. I thought the cream worked so well that I began to mix it with my daily moisturizer and apply it to my face every morning. I have been doing this for at least 1-2 years now. Well, the store that I bought tenovate from stopped selling it so I no longer use tenovate. Not too long after I stopped using the cream my face broke out severely and my skin darkened and it is really itchy. It has been 2 weeks and my skin has not improved. I just recently read online that tenovate is bad for your skin and now I am scared I have damaged my face. What should I use to help restore my beautiful face? ### REPLY: Hello and welcome to  Yes, indeed renovate should not be used on face, in fact using it on face and that too for acne is an absolute NO for me! It contains a potent steroid, clobetasol propionate which can cause steroid related side effects like Acne, photosensitivity, hirsutism, skin thinning, telangiectasis etc. I would suggest that you use a topical broad spectrum sunscreen throughout the day, that which offers both UV B and UV A protection, till your skin returns to normal, which might take a few days. An OTC antihistamine e.g. cetirizine 10 mg once daily would help you symptomatically with the itch. If I was the treating doctor I would have started you on oral antibiotics for acne e.g. either doxycycline or azithromycin, would be good for acne flare. Topically you could use clindamycin phosphate 1% gel twice daily over active acne. Use a gentle cleanser for face wash e.g. detail cleansing lotion, twice daily. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been bothered at night with a stiff neck...to the point it wakes me up (left side) and today I noticed that there is a lump on the back of my head, tender to the touch. If I put my palm on my left ear, I can cover the tender area with the middle to end of my fingers. It is quite tender and the more I touch it the more my neck aches. ### REPLY: Thanks for sharing your health concern with us!well, it is just an infected sebaceous cyst or an enlarged lymph node and not to worry much for this. You have to press ice-cubes or cold compress and take some broad-spectrum antibiotics like erythromycin; if not relieving within 7 days then consult some surgeon for aspiration /excision of the material inside; never poke it as this may invite infection! All the best! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went on a strenuous mountain bike ride Saturday. I had a few minor falls but nothing major. I greatly exerted myself. When I woke up Sunday, I had a lump under my armpit. It is very sore. I am assuming a may have bruised my lymph node/s. Would that cause swelling and pain? ### REPLY: Hello, Looking at your details it does not look to be a bruised lymph node. It may be an enlarged lymph node due to presence of infection or wound in its .  You may have an anti-inflammatory analgesic preparation like Advil and check for any infection or wound on affected side. In routine practice, I used to combine anti-inflammatory agent with an antibiotic (Broad spectrum). Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, I am 73yrs old,I do take blood pressure tablets,I have experience highs of 245 over 110, lows of 90 over45.I have had blood tests done all seem to be o.k. But lately Iseem to be having no energy, the heart seems to be hiting very hard,I sweat alot around the neck, and forehead, even when I am in bed, also I feel very hot inside my body which makes me feel very listless and tired. My weight is 80kl  height 5ft 9inch ### REPLY: Hello thanks for posting here. I have gone through your description. Since you suffer from high blood pressure, some of the above symptoms like pounding heart, hot inside body can be due to high BP during those episodes. Feeling of tiredness, fatigue, listlessness can be caused by a number of factors. Going by your history and my experience, I consider the following probabilities here. First is vitamin D deficiency which can cause tiredness, fatigue. Get your vitamin D levels checked and if its low, correct it by taking vitamin D supplements usually the once a week tablet. This will .  Next possibility is heart disease which can also lead similar symptoms. Don't worry, it's better to be safe than sorry. Since you have a high blood pressure history, and your age is 73, i advice you to undergo a cardiac check up which should include an ECG, 2D echo and a treadmill test. These tests are very sensitive to evaluate cardiac disease. So to summarize I would advise you to do a it D levels, fasting and post lunch blood sugars, ECG, 2 D ECHO and treadmill test. Wishing 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 Sir, I am a 44 years male. I am married and working. I have recently get my Liver Function Test, Lipid Profile and Fasting Blood Sugar done and the results are as below- 1. SERUM BILRUBIN A. TOTAL - 1.10 MG B. DIRECT - 0.40 C. INDIRECT - 0.70 D. SGOT (AST)-68 E. SGPT (ALT) - 72 F. ALP - 239 G. TOTAL PROTEIN - 7.0 H. ALBUMIN - 3.7 I. GLOBULIN - 3.3 J. A/G RATIO - 1.1:1 2. BLOOD GLUCOSE FASTING - 102.0 3. LIPID PROFILE A. TOTAL LIPIDS - 622 B. TRIGLYCERIDES - 160.0 C. TOTAL CHOLESTEROL - 198.0 D. HDL - 49.0 E. LDL - 117.0 F. VLDL - 32.0 About my profile is as follows- A. SMOKING - NO B. ALCOHOL - ALMOST DAILY 40-60 ML (DARK RUM) C. PURE VEGETARIAN (less fried, sugar, ariated drink, tea, cofee, ice cream, chocolate) D. ACTIVITY LEVEL - LOW (Sitting job for 2-6 hrs on computer, walk 1-3 Km not much physical work) E HEIGHT - 5.6 FEET F. WEIGHT - 74 KG (WAIST - 36 INCH) Please interpret the results of these test for me and advise further consultation with specialist if require. And also required correction in my life style to avoid any problem in future. Thanks and regards Surendra ### REPLY: Hi Sure . Hi, I had gone through your question and understand your concerns. Let me analyze your reports.1. Total bilirubin - raised2. GOT, SEPT - borderline3. Albumin - low normal4. Blood glucose fasting - normal would suggest you to - stop consuming alcohol daily consumption can lead to irreversible destruction of the liver called cirrhosis.- get an abdominal ultrasound done-Avoid oily, spicy food-Regularly exercise for 30 minutes a day. Visit a clinician. He/she can examine you and correlate clinically. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I get mouth ulcer for last many years..but this time I get one big around 5 mm inside my upper lip along with swelling on my upper lip for a week. It is very much burning sensation and i feel no releief from it..i consulted a doctor and she told its allergic stomittis..should go away in a couple of days. But no improvement yet.. they suggested my metrogyl dg gel..but I feel no comfort and still the swelling and mouth ulcer exist for a week time ### REPLY: Hi. Thanks for the query. It looks like a Major Althea that is a large variant of the regular canker sores. If it is not getting better, you can start applying steroid ointment over it like 0.1% Triamcinolone Acetone over it. Take vitamin B complex and lysine supplements. Do cool compresses over it. A short course of Steroid can also be advised. Do cool compresses over it. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a swollen lymph node on the right side and now the left is started. They have checked for glandular fever and inflammatories and it has come up negative. Ihave an underactive thyroid and they are now checking my t4 levels. I have very low energy and feel awful . I am on my second lot of antibiotics and on the third day and it doesnt seem to be shifting. I ve had this for at least 5 weeks now. I am on augmentin and also am having heaaches and fuzzyness. ### REPLY: Welcome at  I have gone through your query and being your physician I completely understand your health concerns.  For how long you're suffering from it? Any other associated problem? Like diabetes or hypertension? Any history of TB in past or exposure to TB? Are u having fever? Any other lymph node swelling in your body? Which lymph nodes in your body are enlarged? What is your occupation?  In my opinion you need a proper workup so that u can be diagnosed properly. If I am your attending physician I will do all your baselines starting from baselines FBC ESR CRP CHEST X-ray Lots Abdominal ultrasound Scan. It is very important to look for the focus.  In my opinion you really should stop your antibiotics and after 48hrs your blood and urine should be sent for culture sensitivity. In the light of these reports' treatment should be started Do meet your physician so that your case can be ad . Get well soon Hope your query is adequately ad ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump under my left arm Pit..bigger than a marble..it seems to be attached..is under the skin..not on the outside like a bite..it is very hard mass..and has been there sinse Sunday..i do not have medical Insurance..should I just wait and see if it changes..there is NO PAIN WITH IT ### REPLY: Hi, dear- I studied your query to  and understood your health concerns.Don't worry as it's not a cancer.-Mostly your armpit lump is fur uncle in early stage and needs waiting.-If it pains with redness take tb- diclofenac floating 200 mg under advise from Er doctor. This will resolve your lump. If it grows in size with pointing You need to . Wish you fast recovery. Have a Gd day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi , i have a lump under my armpit thats been there for about 3 months without bothering me but the last 2 weeks its been hurting and now its hurting and its a string pulling from inside skin down to my wrist. i wen to doctor and they gave me cephalexin but now the string is noticeable. looks like a vain and hurt really bad. can you share some ideas of what it might be because im worried. ### REPLY: Hi, Dear , Thanks for the query to My  clinic. I studied your query and understood your concerns. In my opinion-you suffer from-Thrombophlebitis or lymphangitis secondary to Lump in the armpit-which is mostly Chroni-boil in the armpit with infective origin. Treatment-a-Tb NSAIDs x 5 daysb-Antibiotics-to continuec-Tb Serropeptidase-to reduce inflammatory reaction to infective cause.d-Cold compresses with ice packs. This would take care of the acute stage of the Thrombophlebitis -caused by the inflicting infective inflammation around the boil in the armpit.e-Excision of the chronic boil - would resolve you from armpit lump. Hope this would resolve the issue and would help you to plan treatment. Wellcome for further queries in this regard. Good Night. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor, my new born baby has got a neonatal bilirubin of 20.00mg/dl when he was born since 10days ago. Doctor said it may affect baby`s hearing and brain, does it true as doctor said? For this level, what is the risk actually and how to prevent it from increasing ?please advise. Thank very much, doctor. From :mr. asher. ### REPLY: Thank you, A serum Bilirubin level of 20 for a neonate is a high value. Although at the age of 10 days, it might require Double surface phototherapy only and not an Exchange transfusion. Yes, A high value of serum bilirubin causes Sensory neural hearing loss and Kernites(brain damage and encephalopathy). Your child will Require intensive DSPT for some time and will need admission into a nursery care center. Get a Serum TSH done for your child. The only treatment for high bilirubin is phototherapy or exchange transfusion(if criteria fulfilled or any complication). Put your child under a fluorescent blue light as of now and consult a Neonatologist. He will require admission. Also get a ERA and Ultrasound Skull done to rule out any hearing damage or brain damage. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband was diagnosed with AML (Acute Myeloid Lukemea) that has mutaion or moleclar change in a gene called Flt 3.  He is under going treatment and completed the fourth Chemo cycle.  Also he is on a study drug calledI Midosaturin .  I recently  read that  Imitinef Mercilet is a cure for Blood Cancer and it is available at Adayar Cancer Institute, Chennai, India.  Is it correct?  The name of the medicine is :Imitinef Mercilet ### REPLY: Hi, Thanks for writing in. Since your husband is diagnosed with AML which is a type of blood cancer, chemotherapy is one of the best solutions for him. Midostaurin is a promising medicine and is under multiple research and treatment trials. If your husband is getting this medicine then let him continue taking it under the recommendation of his doctor. It is considered effective for a type of cancer called systemic mastocytosis. The promotion of limiting merciless in some sections of media is misrepresented. Just like midostaurin, limiting merciless is the name of another medicine which was in trials some time back. This medicine was not totally curative for all blood cancers but under research for certain blood cancer types. Unfortunately due to public ignorance, this was made in to a news report and mail and circulated among unintended sections of society. It is important not to get misled by such details. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I want to be a pregnant and we are trying from 4 months but we are not getting success...My husband is 2 years smaller than me.. he is 24 n im 26 now..i had an abortion before 5 years..is it safe to use fertility tabltes for me...can u pls suggest me some fertility tablets ### REPLY: Hi, Thanks for writing to . The age gap between you and your husband doesn't matter much. So don't worry. Yes you can use fertility tablets even after your previous abortion. First line of fertility .  Before that you should undergo follicular study to know egg maturation and ovulation timing. You can discuss this with your doctor. Under guidance, you should take. 2nd line of  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a niggling pain in my abdomen for 5 days. It started as a very mild annoyance, it wasnt unbearable, and it was located on my right side, mostly towards upper right abdomen. It has progressively worsened, and today it feels as though my entire right abdomen is sore. It hurts slightly to press upon it. There have been times when I have felt the pain radiate through my groin also. I would not describe the pain as severe, more like a 5 on a scale of 1 to 10, but it is annoying. I cannot lie on my right side, in fact it is most easier for me to lay on my left side with my knees drawn up. This is unlike any pain Ive ever felt, and it does not feel as though it is ovary pain. The pain is constant, dull and gnawing. ### REPLY: Hello, Thanks for the consultation. After going through your symptoms, The pain in this part of tummy usually happens because of Stones of the Gallbladder, kidney problems and Gut Problem such as appendicitis. Because of unavailability of clinical findings of a physician and complete history, I want you to undergo little blood test Such as complete blood count, Liver Function tests and Urine examination. I would also advise you to undergo Ultrasound Abdomen and pelvis.Meanwhile, you can start painkiller which suits you as i DNT know the allergy status. Please do all these test and can revert to me. Hope You get well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had Reclast on September 18, 2003. On November I realized I had a small sore between my molars on the right side of my face. After going many times to the dentist and having taken different antibiotics, I learned today that my  molar ((#32) is cracked all the way down! Now my dentist will have to pull the tooth out. I am wondering what are the chances of me getting my jaw bone affected by this procedure? and who should remove this tooth?thank you so much ### REPLY: Hello and welcome to  forum, I would like you to know that as the wisdom molar is cracked, it needs to be extracted by an experienced dentist, it can be a specialist or a general dentist. You do not have to worry as it is not something too serious. Extraction of a molar does not affect your jaw in any way, just follow the instruction given by your dentist post-extraction. I hope I answered your query, i wish you good health, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having more hair loss. I went to siddha hospital, There they have suggested me to use some tablets, different oil, and also sikkai for hair wash. But when I started using the tablets, I felt like I am becoming fat,. So, stopped using it, Similarly sikkai and other oil making my hair more dry. So I am losing more hair. So recently one of my friend suggested to use the Scalptone tablets. Will it be useful to prevent hair loss? And How many months/days I need to consume for reducing hair loss ? Also, will it make side effect? ### REPLY: Hi, You may be having halogen effluvium most probably. Consult the dermatologist for the perfect diagnosis and proper treatment. I would recommend you to take tab biotin. Apply minoxidil solution on .  Get investigated for deficiencies of hemoglobin, vitamin B12, D3 and thyroid function. If any defect is found, get perfect treatment. Relax psychologically and keep yourself stress free.  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 my name is Vani, i have been diagonised for fibromalgia, i have chronic pain in all muscle & my right ankle, can i take mahayograj guggula, how long does it take for my pain to subside, i cry out with pain, too much to bear, all my resports of blood seems normal ### REPLY: Hello, As you mentioned in the history about you being diagnosed with fibromyalgia this condition is present with the abnormal pathology of the muscle fibers where there is inflammation. The medicine you mentioned above might help for improving the metabolism of the cell and improve the physiological process, but the inflammation can be helped with the therapeutic ultrasound therapy and pain can be also reduced with the help of TENS therapy under a guided Physiotherapist. Post the pain levels .  In my clinical practice of over 12 years, most patients with fibromyalgia have benefited from medical therapy and Physiotherapy as a combination. Hope I have answered your query. Let me know if I can assist you further. Jay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell about 10 days ago and have a large bruise and hematoma on my upper right thigh.  I still hurts and its still a huge lump, but under the lump is almost a line of hardness - it almost feels like a small rope.  I want to make sure it goes away.  What kind of doctor should I see? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have history of trauma.  So there is high chance of hematoma development.  You should .  For that you should consult general surgeon. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m suffering from a severe gout attackfor 30 days in both feet I have been drinking black cherry and drinking alkaline water while watching purine intake.    could this be related to kidney problems or my diagnosed reflex sympathetic dystrophy in my knees? ### REPLY: Hi, Gout is a disease of high uric acid content in blood that is due to increased purine intake as you have rightly understood, and decreased elimination by kidneys. There is a certain amount of uric acid that your kidneys can handle, if your intake of Purine containing foods is more than what your kidneys can handle, the extra uric acid remains in the blood and gets deposited in various parts of the body, like skin and joints. This is what has happened in your case. In fact extra uric acid even stagnates in kidneys causing stones. To that extent, yes it is a kidney problem. However, it has no relation to sympathetic dystrophy. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 14 and had his well visit yesterday.  The doctor said he had a high blood pressure and that I should take it for 3 weeks and send him the results.  His father has high blood pressure and is on medication and his Paternal Grandmother had high blood pressure was on medication and suffered from several strokes before her passing.  Should I be concerned?? ### REPLY: Hello, Thanks for writing to , I am . Yes you should look into this matter closely, usually even if there is family history still high blood pressure in an age this young needs to be looked at. Yes your doctor advised you the right thing to do. Take a diary and start writing his blood pressures three times a day with dates and then take this record to his doctor. In this age there can be a number of causes of blood pressure rise, renal artery stenosis can be one of them hormonal issues can cause it too but first best step to take is making a blood pressure chart. Till tour next visit to doctor reduce salt intake of your son, only if BP is consistently on a higher side. If BP stays on a higher side on checking the record, your doctor might run some more tests on him like catecholamine levels, renal artery Doppler, ultrasound abdomen, MRI brain, what ever he deems necessary, to rule out different causes of early onset hypertension. I hope this answered your question, If you have more queries I am happy to answer you. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter took antibiotics for whooping cough and now complains when trying to go to the bathroom , the stool is there but she can t get it out, would like to try home remedies first. Have already given her prunes and prune juice, she s a wonderful eater , lots if fruits and veggies ### REPLY: Hi welcome to ChatDoctorI have gone through your query. I can understand your concern for your daughter. It would have helped to prescribe a remedy if age, length of referring, lifestyle were given ? And situation and stage of her problem? Besides constipation. Any way, as whooping cough, is a very contagious bacterial infection of the respiratory tract.  And she already took antibiotics for whooping cough Supplements, herbs, and homeopathy may help her further, to get better faster when used along with conventional medications.  "Magnitude of the survival advantage from improved nutrition can even be greater than the magnitude of the treatment effects being targeted in current clinical . "In fact, I am of the opinion that getting adequate amounts of vitamins specially D & C, minerals and other nutrients through lifestyle changes, such as a healthy natural diet including more of fiber, green leafy veges, citrus fruit, minerals, vitamins and a lot of water Antioxidants like ginger, garlic, lemon juice with warm water, , Turmeric powder with a cup of hot milk gives resistance from diseases.  Eating small meals every couple of hours to keep up energy and replenish nutrients ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 father is 72 years old. Lately he has started getting seizures that last up to a minute. This happens once a week. He also complains about headaches sometimes and he has started forgetting things. One day his left hand went numb. I just needed an opinion of what might be wrong?Thank you ### REPLY: Hi welcome to HCI have gone through your query regarding seizure and numbness in hand of your 72 years father. It is a matter of concern. For your info, it is usually accompanied by weakness or loss of function in your arm or hand due to damage, irritation or compression of one of the nerves or a branch of one of the nerves in your arm and wrist. There are many factors influencing your fathers health to this suffering state. Main of them are-: lack of physical activity, lack of sufficient nutrients lack of sleep and proper rest , Alcohol use disorder or chronic alcohol use, Cervical spondylosis (age-related wear and tear, HIV/AIDS, Type 2 diabetesVasculitis (an inflammation of your blood vessels)Vitamin B-12 deficiency etc., You have to study, what all factors you can remove and help him lead a healthy life.  Including - Yoga, Panama - Deep Breathing, Meditation, Calamari to boost your blood circulation and detox your system under guidance of trained guide and balanced diet, including, all essential nutrients as fiber, vitamins, minrals and antioxidants Ginger, Garlic, AMLA, Aloe vera, nuts, Turmeric powder and almond oil a spoon each, in a cup of hot milk at bedtime, Coconut water, all in natural form help, eradicate Vāyu ATV (gas)(which troubles a lot in this age), alley numbness , pains and inflammation and give resistance from diseases. Ayurvedic Sharp Gandhi Patti also induces good sleep - 2 tablets Avoid food that is high in saturated or trans-fats like fried, fast foods, refined sugars and fine floor products, tea, coffee, alcohol, sleeplessness, dehydration, constipation.worry, stress all induce toxins in your body and cause you sufferings. This regime will help him It is advisable to consult your doctor before following any regime Hope this helps solves your query. Take care, All the best.Don't hesitate to get back if you have any further query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hai , iam 26 yr old. my last menstrual period was on sep 14th and my avg menstrual period is 37 days..i wil always get correct 1 week delay ,so my expecting day of menstruation is oct 21st. i used to have premestruation pains like tender brest 1 week before period but now am not having any symptoms , so i tested home pregnancy kit on oct 21st but it shows negative..could i be pregnant ? if not why am not having pre menstrual pains?please help me in figuring out. ### REPLY: HI, I understand your concern.  21st October, ( the expected day of period) was earlier to test by urine pregnancy test. Please repeat test now (after minimum 8 days delay in periods). It may turn +ve to confirm pregnancy.  In case its -ve, the delay is likely due to hormonal imbalance. Which is to be investigated by hormonal assay, USG abdomen & treated according to cause. Consult a gynecologist please.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Can you help? I have a pain in my top front tooth , I went to a dentist two years ago and he said i need a small filling in this tooth and from then on I have had pain. I have been back five times to him also another two dentists and I am told there is nothing wrong. My mother passed away at the time I had the filling so one dentist said it was stress . ### REPLY: Hi, if the filling was done without a proper cavity preparation, which could be by two ways-one, if the carious structure was not cleaned up properly, it leads to caries spreading underneath. Secondly if there is pulp exposure while deep cavity preparation, it leads to persistent pain after the filling. Please take a ray and go for a root canal treatment to get rid of the pain.  You may need a crown also if there is discoloration. 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 names sharlene im female 30 yrs old Ive been getting pain in my left side chest I also suffer from reflux which has been causing awful heartburns and Im not sure if its just my left lung or its my heart thats hurting. Dull like pain sometimes I feel it at the bottom of my ribs??? Unsure whats wrong and if its caused by smoking ice in a crack pipe ### REPLY: Hello dear, thanks for your question on . In my opinion your chest pain is mostly due to reflux disease. But better to rule out cardiac cause first by ECG. If ECG is normal then no need to worry about cardiac cause, HERD (gastroesophageal reflux disease) appears more for your symptoms. Follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Start Proton pump inhibitors. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in bed to prevent reflux. 7. Avoid any kind of smoking. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 not sure if I got an electric shock or not, but earlier i took out the plug for my laptop charger and i felt a shock, i immediately drop the charger. Now i am feeling numbness and tingling on my left hand, left land, and my head. Should i seek emergency treatment? ### REPLY: Thank you for asking .  My name is . Well if you are experiencing numbness and tingling still then get medical attention as soon as possible. Get an ECG to check the heart status Complete blood count Urine count to check muscles enzymes... It's normal to feel these symptoms for few hours but if you are experiencing continuously and is there any history of loss of consciousness along with visible burn to skin then kindly get consultation.I hope It's nothing but prevention is better than cure... 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 had a total hysterectomy in 2011, everything is fine, but my back pain is getting worse, I am always constipated, hurts when I have intercourse, and I am always bloated. Maybe its nothing but my back pain is killing me with also being constipated all the time. ### REPLY: Many thanks. For constipation you need the following simple treatment.1.dink lot of water.2.avoid food like banana, milks and its products, potato,chocolates, coffee,3.eat fruits, veg,fish, meat , lentils, whole meal bread.4. Movicol match daily or flee seeds husk 1 teaspoon daily. For backache you needs MRI of lumbosacral spine and then consultation with neurosurgeon. Please check urinalysis as well for any infection ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i just did blood work and they told me my red blood cells are low. anemic she said. to try to eat five times a day. I have been trying to force myself just to eat. be hungry, but just can not eat. what kind of shake or something can drink that will help me? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You are suffering from anemia. It can be due to iron deficiency, vitamin B12 deficiency, chronic blood loss or other cause.  You should search the cause of anemia first.  You should go for complete blood count with indices and peripheral smear examination.  If needed go for anemia profile.  It will give you exact diagnosis. Then you should take treatment according to diagnosis. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor i have 11month old baby his birth weight was 4.10 kgs he had gained weight upto 7.8kgs at 7th month then he got fever and got admitted in hospital for 8 days from then he had not increased his weight and he often gets cold .please suggest to increase his weight and to get resistance. ### REPLY: Hello, I take this opportunity to tell you certain scientific facts and relieve your distress -1. An active is a well kid even if she/ he is not eating well.2. Development of a kid is as important as, or I would say even more important than growth alone.3. As the kids grow their interest in food decreases and interest in play activities increases so that they eat small quantity and run away to play. As parents, we need to be more patient and feed than less quantity but more liquors per day.4. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed her calorie dense by adding good amount of ghee to it.5. I suggest you not to use appetite stimulants on long run as they may cause . Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my dog head butted me on my chin and slammed my bottom teeth into my top left teeth yesterday. I only have 2 teeth on left side after my canines.Is it a bruised tooth or nerve and how long does the pain last?  Each time I eat the pain is almost unbearable.  Thank you ### REPLY: Thanks for your query, I have gone through your query. The pain can be secondary to the impact, or it can be because of the broken tooth. Nothing to be panic, consult an oral physician and get it evaluated, you need to take radiograph like IOP AR to confirm the diagnosis. Once the diagnosis is confirmed, we can treat accordingly with either root canal treatment or medication.Meanwhile you can take a course of antibiotics like amoxicillin and metronidazole combination(if you are not allergic)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: Hello Doctor I took  my brothers blood pressure today and found it to read 128 over 70 and  pulse rate 111 beats per minute is it too worry about  ? He said it has  been like that for a while, he is on medication for high blood pressure as well as psyciatric drugs. ### REPLY: Welcome at  I have gone through your query and being your physician I completely understand your health concerns. What is his age? For how long you're suffering from it? Any other associated problem? Like diabetes ?  Any history of heart problem? Is he having fever?  As far as BP is concerned it is in normal range, he needs to stick to his medications. Which .  He needs to be looked for. Is he running fever? Normally it should be between 60 and 100.do make a chart of his pulse rate along with BP. if it is consistently greater than the 100 then do meet your doctor. Meanwhile stay calm and continue with your medications get well soon Hope your query is adequately ad ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 wife is taking Valparin Chrono 500mg tablet from past 8yrs. We married last year and now planning for the child. We just wanted to know what needs to be taken care at this time. The doctor who had treated my wife is not available for the next 2 months. Hence seeking your support to answer us. Thank you Deepu ### REPLY: Hello and welcome to . Thanks for your query. Valarie Throne is an ant-epileptic medication, which is used commonly for the treatment of seizure disorders as well as a mood stabilizer - to treat psychiatric disorders. Taking Valarie in pregnancy can slightly increase the risk of congenital defects in the baby. However, the decision whether to continue the medication or not will depend on the nature of your illness for which it has been prescribed. So, please discuss this with your doctor before making any treatment decisions. Taking Folic acid supplements can decrease the risk of problems to the fetus due to Valarie. Wish you all the best.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi.  I live in lone tree colorado.  We have a linden tree in the back yard, I have tested being allergic to this tree.  The last week I have horrible allergies.  What is the blooming period, how long does it last?  Are there any over the counter medicines I can take?  I already take zrytec.  Mostly I am unable to swallow. ### REPLY: Hello, Welcome to , As you are known allergic to tree pollen, you should be very, very careful during the blooming period it may be dangerous to the life. I would suggest you to undergo absolute eosinophil count (AEC) which will be raised in the allergic condition. For the present symptoms you can take Tab Zyrtec, which you are having which helps to control the symptoms, but it is temporary. You need to avoid these pollen allergens to protect yourself from getting these allergy symptoms.Otherwise, you have to prefer immunotherapy either with subcutaneous immunotherapy (SUIT) or sublingual immunotherapy (SLIT). Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is 3 in March. In the last 4 weeks she had suffered with a viral infection and a urine infection. 5 days ago she had a fever of 42degrees and was sleeping, having nosebleeds and vomiting. The doctor said it was another viral infection. For the last three days she has slept for the whole day and night, she isnt eating anything and is extremely pale. Shes had more nosebleed and is complaining of sore feet and belly. Her stomach feels hard on the left side. She has a slight cough.She see her GP yesterday who prescribed antibiotics and said she had a chest infection and swollen glands. It just doesnt seem right to me, she has slept all day again today and has no energy and has had a nosebleed that lasted for about 15 minutes....maybe Im just being a worried mum but do these symptoms sound like anaemia or leukemia. Im really worried about her but dont seem to get anywhere with the doctors. ### REPLY: Hi. I completely understand your worry and I do empathize with you. I feel your child needs at least a basic investigation to see her blood counts and infection parameters. If the country you reside permits self investigation, please go ahead and do the following tests. Complete blood counts and smear, ESR,liver function parameters, PT, patients and urine microscopic analysis including biochemical analysis (urine dipstick). If the above is not possible, please do consult a pediatrician at any tertiary health set up and also an ENT specialist to rule out local causes of nose bleed. I'll be happy to help you further in this regard.  . S. Sri Vichy Chennai ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 would be some warning signs or symptoms for a one year old girl with problematic brain lesions? the lesion is located in the vision/hearing part of her brain. she is extremely clumsy and has a very hard time keeping her balance. I am worried that the lesion is not benign like the dr seems to think. ### REPLY: Hi, Thank you for asking question on . Brain damage in less than one year old child will have delayed milestones and speech delay and sometimes mental retardation. Some may have hearing and vision problems. Better consult pediatrician or neurophysician. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 24 yrs old male. today at around 5 pm, I had an unprotected intercourse with my girlfriend (age-22,average health, no serious aliments). within 2 hours, she took a emergency contraceptic pill. But, still, I am confused and worried. whats the next step. how will we get confirmed that no pregnency would occur. what is the right time from, now to have an pregnency test, if necessary. If pregnency occurs, how sooner can she go for an abortion. will it be safe for an abortion in case of ectopic pregnency...please sir, help me...otherwise a mistake at in the heat of the moment would our personal and social life...please sir.... ### REPLY: Hi, I think you can do a urine pregnancy test if her periods get delayed.  If positive consult a doctor if you don't want pregnancy.  Medicines are available for that.  Ectopic pregnancy is very rare and can be diagnosed with ultrasound.  So, if she develops severe pain and bleeding after her menses delay and pregnancy test is faintly positive, ectopic pregnancy can be suspected. Hope I have answered your question. 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 recently haven`t been eating much, and now when I do, especially sweets, my chest hurts. I had a handful of M and M`s and now the lower right part of my chest hurts. I tried drinking water but when I swallow it just hurts more. It isn`t anything severe, just a dull and uncomfortable pain. Why is this? ### REPLY: Hello dear, thanks for your question on . In my opinion you are having HERD (Castro Esophageal Reflux Disease). It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. And chocolate (coco) is dilator of lower esophageal sphincter.  So actually worsens reflux. So try to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and anxiety. 4. Start proton pump inhibitor. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in the bed. 7. Take less chocolates. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 strained my body when i was awkwardly trying to both pull a lever on a rope down from toward the ceiling with one arm and lift from the floor up heavy garage door since the automatic opener was broken ... since then i have experienced pain in my back - between my spine and my right shoulder blade ... but also, when i move my right shoulder inward and forward into my body, something in there is clicking, like maybe something was dislocated ??? not sure ... but looking forward to hearing what you think the problem is ### REPLY: Hello, Thanks for your query. From the description given its likely that you have sustained muscle sprain. The pain is due to associated muscle spasm. So it is important to relieve it. I would suggest you the following which will definitely help1 Hot water Fomentation: Either by towel soaked in hot water or by hot water bag. Intermittent application of heat for 15 to 20 minutes each session 4 to 5 times a day will be helpful2. Muscle Relaxant: Oral taken muscle relaxant like Chlorzoxazone along with analgesic like Diclofenac Sodium will be helpful3. Local application of Diclofenac Sodium gel will be helpful. 4. Adequate rest and avoiding sudden movement. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i am guyanese and i would like to ask a few questions. i am 24yrs old and i currently weigh 97lbs. my height is 155cm and i dont have any medical history. my question is that i am curious about trying birth control pills since condoms give me yeast infections. i consulted with a doctor in my country and she prescribed NOVELON. how safe is it? will i be able to conceive afterwards? will i gain weight? i aslo should let you know that i have had three D&Cs within the past three years. this is why my fiance and i are trying to avoid conceiving until after we are married which is in 2013. thanks. waiting on your answer ### REPLY: Hi, Novelon is a very effective means of reversible contraception. It is very, very effective with a failure rate of less than 0.03%, when taken correctly and regularly. It would be advisable to you, especially since you are keen to avoid conception. Another good alternative for you would be the intrauterine copper T. It is also reversible and you don't have to remember taking a pill every day.Also, it is non-hormonal. With Novel on you will not have any problems conceiving later, nor does it cause weight gain. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: in night after sleep i wake up after 1/2-1 hour n feel in both arms after that gastric problem n den feel like some suffocation some time i get relief by aciloc 150 mg some time remains  for 1/2- 1 hr i also suffering from hernia heart shown mild enlarged as per echo pl suggest d treatment ### REPLY: Your symptoms and signs are due to anxiety and neurosis and there doesn't seem to be any serious medical problems I would suggest doing some biofeedback and a regular exercises also for gastric problems that you should not eat the 3 to 4 hours before you go to sleep I would also recommend not to take any medications I should be corrected the naturally. Your normal echocardiogram confirmed that you do not have any medical problems on her heart problems signed a doctor but its in thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, I am a 44 year old mechanic with chronic back/knee pains. I have a narrowing in the L4/L5 area and, sciatic problems there also. I have been taking 10/325 Norco on and off for many years now(under supervision). My problem is that it does not seem to take away my back pain for very long anymore. Is there an extended release pain medication that would possibly work better??? I am assuming that my body is building a tolorance. Unfortunatly, I think i am dependant on the pain medication in order to continue my career. I am not up for any kind of back surgery at this time(no health insurance, and have watched mother go through 6 surgeries for the same thing, and she is still taking pain medication.) am I dependant, or am I a drug addict??? ### REPLY: Hello, I have studied your case. I will advise MRI spine to see for any nerve compression leading to back pain. Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor. You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case. I will advise checking your it B12 and it D3 level. If MRI shows disc compressing on nerve root then surgical decompression is permanent solution. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, i have a bad breath problem.most dentish i reffered say that my oral hygeine is good. even after i brush my teeth the smell is there.it is persistent the whol;e day.can you please let me know where and whom should i contact and treated for this problem.Should i get test for Tmau done as well I have problem of bad breath since long time almost from childhood. even after brushing my teeth the smell comes and persist for the whole day. The dentist I have visited tell me that my oral hygeine is good . I do not know how to treat the problem. I recently also read about Fish Odor Syndrome disease. Though I do not have any issue as to urine but bad breath is there. Can you provide me contact details as well where i can get treated for this problem . I stay in Pune. Is there any hospital / clinic in pune which can offer treatment to me. ### REPLY: Hi, You should understand that matador is caused by many reasons like decayed teeth, poor oral hygiene, gastric problems, Sinusitis, liver disorder, diabetes, smoking, alcohol consumption, tobacco chewing. If the problem is due to calculus and plaque it can be removed by scaling and polishing of your teeth. Flossing of teeth and tongue cleaning using tongue scraper should be done daily. Any systemic problem should be identified by a physician and appropriate treatment for it should be obtained. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 16 year old daughter was diagnosed with a pineal cyst about 3 years ago. It was 4x4, we were told to just wait to see what happens. Lately she has been experiencing headaches, dizzy spells, heart palpations, and arm numbness. it has not been checked in 3 years because she was not symptomatic ### REPLY: Hi, thanks for posting your concern in the . Pineal gland cysts are often incidental finding and smaller ones often do not require any intervention. However, as you haven't gone for a follow-up and your daughter is symptomatic now, she needs immediate clinical examination and imaging (CT scan or MRI) to rule out any enlargement or development of pineocytoma or carcinoma. An obstructive HY .  CSF examination may also be required to rule out a neoplasm. Hence, my opinion is-1. Please consult your local neurosurgeon at the earliest.2. Please do a CT scan or MRI of brain (depending upon your doctors' advice) if neurosurgeon is not available for immediate consultation. In case no change is detected in that area, clinical examination of the cervical spine may be required along with imaging (X-ray, MRI) to rule out any abnormality. For any further information, please write back to me @ http://www.ChatDoctor .com/doctors/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother is 74, and within the last 6 months, I ve noticed a huge amount of short term memory loss, and it doesn t seem to be getting better. Today I got a call from her...and she doesn t remember how to pay a bill. After talking a while with her, she mentioned this last summer she had an episode of severe dizziness and couldn t remember who she was or where she was. She didn t tell me at the time.She s generally very active, cuts her own grass, maintains the house (she lives by herself), things like that. She s also very healthy, takes no medication, and is self-sufficient. I talk with her every day, and a few times a week I visit and have breakfast or dinner with her. She forgets what she is talking about and must tell her repeatedly about current events, none of which she remembers. Could she have had a stroke? At some point, I will bring her to live with me, but she won t discuss it yet. She is VERY reluctant to seek medical treatment...she even hates taking the occasional motrin. ### REPLY: I read your question carefully, and I understand your concern. From your description your mother seems to show manifestations of dementia. Dementia can have many causes, stroke being one of them, however the most common one and also compatible with your mothers symptoms is Alzheimer's disease. Naturally some other potential causes must be excluded through tests such as brain imaging to exclude stroke or tumor and some blood tests such as blood count, glucose, liver and kidney function tests, electrolytes, thyroid function tests, Vitamin B12 levels. If after the tests and medical evaluation the diagnosis will remain Alzheimer's there are some available treatments to slow down its progression but unfortunately not to halt it altogether, only slow it down. Eventually she will need constant attention as she will not be able to function independently. However, as I said that diagnosis must be confirmed first. I hope to have been 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: Hello doctor. I have been havin a toothache since few days. I ws told few months back that the tooth needed a root canal. A temporary coverin ws done but within days it came off and exposed tooth since then. I ws advised meftal - forte tablets to take for pain by a chemist. Please advice ASAP if i should take to subside the pain for now. Within 2 or 3 days i would be visiting a good dentist. Thank you! ### REPLY: Hello, I am glad to assist you. The temporary filling placed would be expected to wear away if only placed to cover the tooth while expecting you to return for a root canal therapy. The filling needs to be removed to enter the center of the tooth and clean out the canals to complete the root canal. You will have a temporary filling until the canals are sealed, and you can plan restorative treatment with your dentist. An antibiotic such as Amoxicillin may be necessary if pain and swelling is present. This will help control the spread of inflammation from the infected tooth. I usually recommend taking a combination of two Advil and two extra strength Tylenol to control a more severe pain until you are able to visit the dentist again. Thank you for your inquiry. I hope you will feel relief soon. ### END