Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 there I am 18 years old and have varicocele in right side of my scrotum. Please suggest me some exercises and any other method that would help to reduce the size of varicoceles and kind of prevent it from worsening. I am looking for non surgical methods that can help at home. It really do not have pain but i want to take measures so that pain does not develop later. ### REPLY: Hello and. As a Urologist, let me assure you, that everyone with Varicocele, doesn't develop pain.  It needs treatment only if symptomatic. Exercises like weight training, will aggravate varicocele. Interventional radiological treatment, without surgery, is available. If you have done an ultrasound Doppler scrotal scan, to assess the varicocele, you're welcome to send a copy here, in my name, for an expert opinion. . Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 18 years old. Ive been getting nauseous every morning and afternoon for the last 3 days. Today, the lower part of my stomachs been hurting. I found it difficult to take a nap because of the pain. Now, Im noticing blood and mucus in my stool (very little stool) whenever I go to the bathroom. What could this be? And do I need to see a doctor? ### REPLY: Hi. Thanks for your query and an elucidated history. The history of passing blood and mucus in the stool along with nausea in the morning and afternoon is suggestive of an intestinal infection going in more towards gastroenteritis. Yes, you need to see a doctor as he can see your vitals like pulse, blood pressure and temperature and examine the abdomen and also give an order for the investigations and give you prescription of medicines. I would suggest you the following:Tests of blood, urine and stool (electrolytes, urea, creatinine, sugar) Ultrasonography of the abdomen. Antibiotics with metronidazole, probiotic, activated charcoal tablets' and symptomatic and supportive treatment as per the vitals and investigations. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello my name is CJ and I need help recently I watched a video about a man who was a mass killer and I thought to myself what if that was me and I thought I want to be like him but then I realized what I was saying and I felt really bad about and I still do can u please help Im not mentally ill ### REPLY: Degree understand your concerns went through your details. You have not given your age. During adolescent and adult developmental period modeling or role model adherence is a normal phenomenon and many wants to be hero or bad guy. In your case, the second happened. But you have social obligations, and you will learn to alter your mind and tune in for those social obligations. Don't worry. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 62 year old female that had shingles when I was 54. I have been considering getting the shingles vaccine but a co worker told me I would be better off getting the measles vaccine considering the current outbreak. I did have measles as a child. ### REPLY: HiT hanks for your query at . I understand your concern and situation. Shingles generally lasts between two and six weeks. Most people get shingles only once, but it is possible to get it two or more times. Data show that the vaccine prevents about 51% of shingles. It is most effective in the 60 to 69-year-old age group; its efficacy in older patients becomes less than the age of the patient increases. But yes taking a vaccine will be beneficial. You may also take measles vaccine if threat of outbreak for prevention. Yes you may get both the vaccinations together as well. Take care Best of health .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im a 53 yr. old female, 5 ft tall, weight 195lbs and still loosing weight. My problem is a burning and stabbing pain in my back and rt. hip. I have been receiving pain injections in my lower right side of my back and right hip for over a year, they seem to only last for a short time. I also have a pinched nerve in my back at L-4and L-5. the pain is so bad that I have a difficult time trying to stand up from a bending over position. One Dr. suggested that I may need back surgery if the injections continue to only last about a month. I still continue to have pain even with the injections. The pain is so intense that it interferes with my daily activities. I have a prescription for Vicodin and Zanaflex which doesnt do much for the pain. ### REPLY: Hello, Thanks for your query. The description suggests that you have lumbar disc disease with radiculopathy. The initial management for this problem is conservative by following means : - Bed rest - analgesics and occasional muscle relaxants - Methylcobalamine preparations which helps to alleviate your "pins & needles" sensations - lumbar back support while sitting for longer periods - intermittent pelvic traction If you don't get any relief within 3 weeks, you need an orthosurgeons consultation to decide upon the need for surgical intervention. 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: Hello Doctor, I have been suffering from fear and anxiety for the last one month which has lead me to experience,panic attacks and insomnia. I am 32 years old and do not have any other problems.Pls help me as this has been affecting my daily life and is slowly leading me towards depression Thank You ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I assure you that you cannot reach the stage of depression or schizophrenia with just anxiety and panic attack symptoms. You need to understand anxiety and panic attacks so that you come out of it. Fear is fear for an object which is present. Anxiety is fear without an object, fear is just subjective. Panic attack is due to the subjective fear about a circumstance at its extreme. Why should we become panic to a thing which is extremely normal to others? That is where our anxiety and apprehension comes into play. Reduce anxiety and apprehension and you shall be alright. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My five year old daughter has had a fever since yesterday around 7 pm. It goes up to 105 but I can bring it down with a cold bath and some Motrin. She also has a cough that sounds wet but not coughing anything up. She complains her head hurts. She has a white tongue with red spots ### REPLY: Thank you for following up. She has mixed infection. I suggest1. For fever, you can use Paracetamol suppositories 10-15 mg/kg/dose, in addition-Tulsi juice, physical methods(cold bath)2. Lozenges-Sualin, Strepsils 1 tablet 4 times for resolve.3. Kuka syrup(1/2 teaspoon 2 times) will work for inflammation and cough.4. Antihistamines (Cetirizine syrup)5. Vitamin C 1 tablet one for 10 days.6. For boosting immunity-Zincovit 5 ml once a day for 1 month.7. For white tongue-clean with soda water, apply Candid 5 .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor, i am prescibed by doctor to take netueogest 200 at bedtime, should i be taking it before doing sex or after doing sex, and what are the chances to get pregnant for me, as i was trying for last 1 year, but consulted a doctor 2 months back, she gave me some dates for taking these medicines, these are 28-8 are the fertile period, and from 4-14 have to take theser medicines, so i do have to stop trying  sex after 8th. ### REPLY: Hello dairy understand your concernnetueogest 200 Contain progesterone. It makes uterine environment favorable for implantation and support early pregnancy. It should be taken in second half of period after ovulation. If you have regular 28 days period then take it for 10 days (from 15th to 25th day of your cycle). You should do daily sex form day 8th too 18th to become pregnancy. You can ask your doctor to share my opinionated stress, take healthy diet, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my wife is 27 years old , 5ft 6" and 150lbs . She had a blood transfusion after delivering our daughter about a month ago she sometime complains that her skin is itching / scratching, is this a result of the transfusion or is it related to the pregnancy? ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. No, it is not related to pregnancy.2. Check bilirubin levels, if elevated, will need liver function tests.3. Pregnancy complications, would not be seen after delivery. Allergic cause or hepatic cause requires evaluation. Check for eosinophils, IGE levels and liver function tests. Avoid scratching, as it will start a cycle of scratching by releasing more chemicals. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doc, I have been using postinor 2 for a year now..normally I take them two tablets every month...that is once per month. I have never had any side effects and it works perfectly for me, only that it changes my menstruation cycle. My friends recently told me that prolonged usage of postinor 2 could cause infertility. that it should be taken only twice per year. Is it true that chances of causing infertility are high?Thanks.Lydia ### REPLY: Hi, No, long-term use of the pill may not affect your fertility. Once you have stopped taking the pill, you may take some time for your body hormonal balance. It could be a few months before your menstrual cycle settles down into a regular rhythm. Long term use of hormonal pills can cause other side effects like fluid retention, weight gain, headache, hypertension. For these reasons you should avoid taking them regularly. Take care. 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: my son is 6 and started a little cough last monday week ago then thursday he was complaining of sore tummy had diarrhea and sore throat also high temps of 39, the last 3 days he has had high temps on and off and coughs that much he vomits and has lost his appetite and is just drinking water but just then pretty much vomited up all he had in him, what is wrong?? ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs or nonspecific multiple symptoms like this, could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. 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. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is Brandon! I have the feeling my mind is going to shut off and that it is disengaged from my body, I have recently been to the ER and they are treating me for anxiety . Tonight was my first half dose of cipralex and I feel like I did when I went to the ER the first time. My arms legs and finger tips seem to get affected and my mind will not stop racing. Does this sound like anxiety or a reaction to the meds ### REPLY: Hi there, thanks for asking. As you mentioned, it appears to be related to the side effects. It usually happens with the first few doses. In is not uncommon with circle that people experience such symptoms. In most of the time it will disappear after several days to several weeks. If the symptoms are still present after a few days, you can tell your doctor and ask him to combine it with an antianxiety medication since it is common to do it at the beginning. Rarely, but important to know, it might be related to reaction of your brain to this medication. So if your sleep decreases to just several hours, and it persists over time with this medication, you should inform your doctor to evaluate again your situation. I wish you the best health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I HAVE A QUESTION IF I HAD UNPROTECTED SEX ON MAY 9 & MAY 10 HAD A PERIOD THAT WAS LITE AND ENDED ON MAY 27TH. THEN HAD UNPROTECTED SEX WITH SOMEONE ELSE ON MAY 30TH AND IT JUNE 24 AND I HAVE NOT GOT MY PERIOD. WOULD I BE PREGANT BY THE FIRST GUY OR LAST GUY. SORRY I KNOW IT SOUNDS CRAZY ### REPLY: Hello dear, I understand your concern. Once the period come the pregnancy is 100% ruled out. But the doubt arises as you are saying the period was light. But if there was pregnancy prior you would experience the pregnancy symptoms like nausea, vomitings, increased urination, sore breasts. Because they are usually present 2 weeks after the missed period. Now a urine pregnancy test can be done to rule out the pregnancy as the period is missed. If the test is positive then ultrasound needs to be done. The ultrasound helps accurately in diagnosing the age of pregnancy. And helps in knowing the probable date of conception. But there is a rare possibility of pregnancy with first guy as you got the period and experiencing no pregnancy symptoms. Hope this helps. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MY CHILD OF AGE 4 YEARS IS SUFFERING WITH FEVER FREQUENTLY .MEANS A COUPE DAYS EVERY MONTH.ALL TESTS FOUND NEGATIVE BUT THE PUS CELS VALUE IS 10-12.CAN U PLEASE EXPLAIN WHETHER IT IS A MAJOR OR MINOR AILMENT...? AND HOW TO CURE IT...N WHAT IS THE EFFECT OF THIS PUS CELS VALUE TO HEALTH.. ### REPLY: Pus cells 10-12/HP in urine indicate urinary tract infection which is the possible source of the fevers the child is suffering from. You need to take it on a serious note and visit a doctor and get it treated with a full course of antibiotics. Pus cells are basically white blood cells that have died in the process of fighting the infection in an effort to control it. It is not the pus cells but rather the infection that has negative effects on the health of the individual. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 23 years old and 10 weeks pregnant with my second baby. Couple of days ago I have been having bright red blood in my stool it s like dots of blood or strike of blood but not to much, I m not constipated at all and I don t have hard stools. Couple of moths ago I did have a stool test and it came back negative for blood since before pregnancy I was always having Nasea and excessive gas in my small intestine and for that I had endoscopy whicChatDoctore back that I have hernia and the doctor said I have excessive bacteria in my small intestine which I have been prescribed flagil for it. But now recently I have been seeing blood in stool ### REPLY: Hi, I had gone through your question and understand your concerns. As per your complaints its likely that you are having hemorrhoids. It's very common in pregnancy, you should visit your physician and may do photocopy, CBC, pt/apt, Hepatitis profile to look for cause of bleeding. Other thing is that you may be having dysentery as your physician had prescribed you Flagyl. It's better that you should visit your physician as it can cause anemia and anemia is bad for both your and your baby health. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate to ask. I will be happy to answer your questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I bent down picking up my sons clothes from the floor, as I was coming back up I hit my top head on the corner of my marble sink very hard. The spot is hurting midly and seems a bit softer than how it felt before. Should I seek immediate medical care? ### REPLY: If you develop symptoms of significant dizziness, nausea, vomiting, or start to feel unusually tired or sleepy then, you should seek immediate medical assistance. From what you are describing you suffered a nice thump to the head but nothing else. Your symptoms are not consistent with any form of traumatic brain injury. Call your doctor and set up an appointment. You seem to have developed a small bruise on the scalp or contusion. Consider placing an ice pack on the head for the next 48 hrs. And you'll feel good as new.  Don't come up so quickly in the future when you bend down. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 concerned about a lump in my right armpit .. I have had a small pea sized ball before there that has come and gone and I thought it was irritation from my bra where the wire sometimes digs in but this time on my period I have a lump and it is bigger then I have had before can this be from my period or what could it be and it hurts a little bit to touch and I m concerned on what it could be ### REPLY: Thanks for your question on . I can understand your situation and problem. Following are the likely causes for armpit swellings. 1. Boil 2. Sebaceous cyst 3. Enlarged lymph node 4. Lipoma etc. Armpit area is having a lot of hair and perspiration. So possibility of boil and sebaceous cyst is high. Maxilla is having many lymph nodes, so possibility of lymph node enlargement is also there. So better to consult doctor and get done clinical examination of armpit lump and ultrasound examination of Maxilla. First diagnose yourself and then start appropriate treatment. Avoid too much moisture and keep proper hygiene of armpit. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 stubbed my toe on a bedframe and initially thought I had broken it....the next day I had a lab test scheduled and my ALT serum resulted in a 74. I am concerned. I am 21 years old 6 2 about 245lbs. I am considered overweight. What are the possible explanations for it. Could it be that I bruised my toe the night before or could it be a fatty liver . I don t drink, and if I do it s once a week when I bowl with friends. Any quick reasons please ? ### REPLY: Hi Ron Thanks for writing in.  Your raised ALT has nothing to do with your bruised toe. But it has to do with your obesity. It is what is known as NASH- Non-alcoholic steatohepatitis. You need to lose weight. Also, vitamin E also helps reduce the inflammation of liver. As of now the inflammation is mild. You need to check you Liver function test every 6 months - 1 year to see how it is progressing.  PS : Avoid alcohol and .  Hope I have answered your query. If you have any further questions I will be happy to help Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello I am Alexis. I have went to my babies ultrasound at 20 week and it showed that my baby had a small cyst in or on his bladder. I went to his 26 week follow up ultrasound and was told that it is smaller. What is going on? Can a cyst get smaller? Is everything okay? ### REPLY: Hi, welcome to . Cyst in or on the bladder is most probably an ureteroscope and may lead to block the passage of urine from the kidneys to the bladder leading to that side renal dysfunction. You can show the problem to a pediatric surgeon for either fetal intervention if possible or intervention just after birth. Also, to diagnose the lesion, you can go for a fetal MRI. Hope, the information helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump on right side of face that they have determined is muscle. It is 5 times bigger then other side and has gradually grown over past year. I had an MRI last week where they determined it was muscle. The dr wanted to do a biopsy which they performed yesterday. The dr. Has not seen anything like this. ### REPLY: Hello, I can understand your concern. As you have already been through biopsy, any diagnosis can be ascertained after the report comes and the report suggests what kind of cells constitute the lump, whether it is harmless or cancerous, etc. The possibilities include hypertrophy of the muscle, tumor of the muscle tissue, infection of the parotid gland (salivary gland present in the area) etc. After the report comes, you can go for the suggested treatment based on the diagnosis. You may have to go for cosmetic surgery to remove the extra mass on the face and gain facial symmetry and aesthetics. I hope this information helps you. Thank you for choosing . I wish you feel better soon. 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 recently came to know about my hepatitis c . I m also diabetics in the range of 120 to 140. Doctor prescribed me Silbostin 3time daily , Ursokem 300 mg 3 time daily & Zanocin OD 400 mg . In my ultrasound dotor mentioned Panchram of Coarsened Liver Echotexture. In my earlier Ultrasound other doctor mentioned Diffuse Chronic Disease ( Cherros ) Difference in utrasound is 16 days only why the difference of opinion ### REPLY: Hello, Welcome to , Medical literature shows that antiviral medicines are used to treat long-term (chronic) hepatitis C. These medicines can help prevent the hepatitis C virus from damaging your liver. Sometimes treatment doesn't permanently lower the amount of virus in your blood. But some studies have shown that treatment may still reduce scarring in your liver, which can lower your chances of developing cirrhosis and liver cancer. Further medicines to treat hepatitis C don't work for everyone. Chronic hepatitis C infection is cured or controlled in about half of the people who are treated with a combination of peg interferon and Riboviria. I suggest you discuss this with a gastroenterologist (specialist in liver diseases) and then your doctor will decide what is good for you depending on further testing. 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 doctor, my father is having following reports that was diagnosed due to jaundice .... BIOCHEMISTRY --------------------------------------------------------------- bilirubin-----3.97 mg/dl conjugated (D.bilirubin) -----1.17 mg/dl unconjugated (i.d.bilirubin)------2.80 mg/dl Total protein -------6.80 mg/dl Albumin---------3.60 mg/dl globulin---------3.20 mg/dl A/G Ratio-------1.12 mg/dl Sgot------- 116.00 Iu/L SGPT------124.00 IU/L Alkaline Phosphatase------572 U/L SEROLOGY --------------------------------------- HEpatitis B Surface Antigen ( HBsAg ) Negative Please give me details wahat test should be done further and some medicine to cure this disease ### REPLY: HiT his is definitely ABNORMAL - moderate impairment. One test for one virus is negative.... There are other tests for Hepatitis B and there are other viruses., that should be tested Not necessarily virus - there are other reasons - like gall bladder and pancreas... An ultrasonography and/or CT scan of abdomen may be needed... Physical examination is a must.  A good history is in need. The best option is to see a liver specialist (hepatologist).  You will have to do more tests / some of them may have to be repeated several times over a period.  No medicines - without a proper diagnosis.  The most important things will be to avoid alcohol / paracetamol and so on.  No medicine should be taken without doctors advice - most of them may have the potential to worsened the doctor - earlier, the BetterTTV care Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello DrI am a 48 years old male, height is 1.63 mt weight is 68 kgs, I have been to a routine medical check up last month in my Abdomino-pelvic sonography results says The Prostate is enlarged, measures 37 x 36 x 33mm( 24gms ) do I need to worry or is it normal?? I am suffering from bp for long time and I am under medication and borderline blood sugar.Thanks and RegardsBebnfdkjnandes ### REPLY: Hi there, and thank you for your question. I appreciate you concern regarding your prostate, but I would like to put your mind at ease here. The readings you've noted in your inquiry are within normal parameters according to the information I have. A normal adult prostate can weight between 20-25 grams and have dimensions of 40x20x30mm. If anything, It's very slightly increased in one of the dimensions but really nothing to worry about. Also, if you don't have any lower urinary tract symptoms such as difficulty to start urinating, weak stream or . The best way to screen for prostate pathology is to have a prostate exam done by your doctor, which entails a digital rectal evaluation, and combining those findings with a blood test of the prostate specific antigen (PSA) levels. I hope this helps and good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: male 48 during sex when im coming I have excruciating pain starts at the base of my skull and it flows over the top of head clear to my eyes on my right side of my head its happened four times now first time it took 2 minutes for the pain to go away second time it took 4 minutes to go away the third time it took longer for the pain to stop the fourth time it took 12 hours and I still have pain ### REPLY: Hi, thanks for writing to . Sex headaches are headaches brought on by sexual activity. most of the time you need not worry about them. Sometimes they occur within seconds of orgasm and sometime occur as throbbing pain. If the pain is occurring gradually don't need to worry much, just take an analgesic like paracetamol. But if it occurs abruptly then you should consult a doctor. Hope this solves your problem. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My partner suffers from Steven Johnson syndrome due to an accident back in 2004 he has metal plates in his head he recently has felt as if the metal plates are cracked and moving apart now for the past 3 days he has had a severe headache followed by a severe nose bleed that lasts for anything from 10 mins to 30 mins resulting in the headache clearing He is awaiting an appointment with neuro surgeons any advice ### REPLY: Hi, I would explain that his symptoms could be related to uncontrolled high blood pressure or an infection (considering the fact that he has metallic plates inside his head). I would recommend you to closely monitor his blood pressure values. It is also important performing some other tests: - a brain CT scan - complete blood count- coagulation tests- PCR, sedimentation rate for inflammation. Hope to have been helpful! Wishing all the best, 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 left foot feels like it is being squeezed. The only time it doesn t bother me is when I am walking. It hurts constantly sitting, laying down and standing. Had an MRI-X-rays. Doctor first thought it was mortons neuromia but then told me it wasn t . I had a broken patella in 2012 and when I was doing PT for that, well that is when it started. I was put on a stationary bike and from the time on it has been so painful Any ideas? Joan George ### REPLY: Hide contrast bath, alternately dip in hot and cold water for 10 minutes twice a day. Use silicon insole in footwear, to prevent shock on walkingAvoid prolonged standing. Apply Voltaren gel after fomentation. It could be plantar fasciitis or non-specific inflammation set about by walking pressure, some individuals prone to it. Above measure will do you good. Also take pregabalin(lyrics)75 mg twice a day for a month for nerves of feetConsult a podiatrist. Beware of faulty footwear. Best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am diagnosed with Thrush and the doctor has givein me a Permasol wash PRN, chlorhexidine 1% cream ON & miconazole 2%w/w cream BD. I tried applying twice but it aggrevates the pain and itch so much that I had to quickly use water to flush. Also, my Clitoris & the skin between the anus and vagina bleed, especially the skin part which keeps tearing. Is there any cure that is quick and effective? :( ### REPLY: Hi, I understand your concern. If you have been diagnosed with thrush, then, apart using Parasol wash, I'd advise discussing with your doctor to start oral antifungal therapy. Try to keep a good local hygiene. Some of my patients have got good results in applying Greek yogurt locally. Avoid sexual intercourse until full improvement. Avoid eating foods high in sugar especially in simple sugar. 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 was recently diagnosed with a neuroendocrine carcinoma or carcinoid. Apparently it started in my ear and metastasized to my neck and brain (right temporal lobe). I m very scared of whats going to happen. It s very rare according to the doctors I have been talking to. I just wanted to know if I have surgery, what is the survival rate and possible complications? Thank you ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have neuroendocrine carcinoma with multiple metastasis. It is already a later stage cancer. Surgery will not help you much as it is widespread. So treatment of choice remain chemotherapy and radiotherapy. Chance of improvement are very less. It has poor prognosis. Life expectancy is not good. Consult your doctor and plan accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . 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 m 21yrs old.i got many pimples few days back but they are gone now.but it left spots on my face and even neck .they r many spots.even i usd 2 b fairer bt bcoz of al pimples and its spots my skin tone has changed.it became dark.nt much dark bt cmpared to my previous tone,it changed to dark.some one suggested me betnovate cream.bt i startd using betnovate N cream.as i came to know about its benefits of vanishing my acne spots.will it work?do they have syd effects?plz help. ### REPLY: Hi NASA, Betnovate-N is not a treatment option of acne or dark spot. It has many side effects in chronic use on face. Side effects are like...i) Rosacae-persistent redness on cheek. Ii) Hypertrichosis- excessive prominent hair might be appeared on face. Iii) Thinking of skin and telangiectasia-skin may become thin and appearance of some visible veins iv) Acne-Pimples may erupt/ aggravate after with .  You should remember that facial skin is a delicate and sensitive part of your skin. You must take care of it. Never try anything on face without consult of a physician. We are facing Betnovate-N problem in Dhaka, Bangladesh. With regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i ve been diagnosed with depression and bipolar 1. i ve had this diagnosis for years. i want to know, i have this feeling in my heart , sometimes it ll feel like it bursted into a million pieces, or that its sinking, sometimes it ll feel like a hole/empty space and sometimes i feel like its not even there. can it have anything to to do with my diagnosis and is there anything i can do about it. i am suicidal and i m afraid of what im capable of with this feeling persist. ### REPLY: NIC ! Listen to me every person has some mental issue, so don't overthink and made it worst. Do you love sport join one, if your hobbies are dead make them alive, like dancing, singing, ?  Music and sometime study too. Ok ! Do you take your medicine regularly. Some time this medicine you take for depression will give you suicidal tendency? So ask the doctor for medicine change, and do not completely depend upon medicine, do above I say. So I can see your smile again. Bye. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had depression and started taking zoloft. I have been on it for 3 months now and lately have felt my heart racing and pounding and an irregular heartbeat. I already have 2 blocked arteries and have been feeling fine with the heart condition for years until recently, could the zoloft be causing these side effects? ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. Its unlikely that the aloft be casing this side effect. It is considered one of the safest antidepressant. You may get an ECG done and check for the QT interval. It may be prolonged in certain cases. If that is the case, then you need to with .  Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: when I sit forward my jaw seems to be sliding forward, like it isn t being held in place by the muscles like it should be. This is a new symptom for me. I normally have a normal bite, but if I sit forward, like looking down at a tablet computer in my lap or sitting at a desk working, my jaw slides forward creating a significant underbite; I noticed this because it causes great pain and headaches.... I don t know what to do? ### REPLY: Hello, In my opinion, it could be a subluxation of the TMJ disc, so you just need to see a TMJ doctor for a quick reduction that takes a few movements. Until then, open your mouth and measure The height of the mouth opening, it should be 3 fingers. Push your lower jaw backward with your hand towards your neck. This can help reduce your symptoms. Hope I have answered your question. Let me know if I can assist you further. Amman Darragh, Physical Therapist or Physiotherapist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am suffering from allergy since end of August.  The diagnosis is different from different doctor.  One said is chronic urticaria, another said is due to food allergy, another said is hormone changes and cause my immune system to attack when ever I had ate something which will cause allergy.  After observation, I notice that prawn, crab stick, shrimp paste will cause my allergy.  At the beginning, it only appear only on my back thigh.   The rashes will start with like mosquito bite and very itchy, and getting more and more after I scratch.  It will appear on the next or next two days after I ate the food which will cause my allergy.As advised by doctor, I had took a 10 day course of Aerius and Asthator.  The rashes came back 5 days after my course had ended.  Then, I took Loratadine for another 10 days.  Like previous, the rashes came back after 5 or 6 days after my course had ended.  I noticed that the allergy reaction and area affected become more serious each time I stopped.  Now, it even appear on my arms, waist, swollen on my lips, cheek, eye lids, neck.  My lips or eye lids will swollen 15-30 min later if I ate the food which will cause the allergy.Currently, I follow the advice from a doctor, not to completely stop eating food that will trigger the allergy to let my body to accept the food.  I will only take Loratadine if the rashes appear a lots.Pls advise what should I do to stop or cure this forever? ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. Of course, I would first think of "Chronic Urticaria" as a diagnosis, but it is important to find the cause.2. As you have symptoms after taking prawn, crab, shrimp, etc. I would suggest you to go for allergy testing (both serum specific IGE and skin rock tests for seafoods). This will help to know whether you are actually allergic to seafoods. (seafoods are very common to cause food allergies and avoidance is the best measure)3. However, as you have chronic urticaria and also, as you develop symptoms after 1-2 days of consumption, I would suggest you other investigations for chronic urticaria also. For my chronic urticaria patients, I advise Complete blood counts with ESR, C-reactive protein, serum ANA, thyroid profile, complete urine and stool analysis as primary investigations. However, I would mention here that nearly 25% of patients with chronic urticaria have all normal reports.4. For treatment purpose, I would suggest you to avoid foods that cause your reactions (the most important aspect of any allergy, I would disagree with TH concept of "acceptance by body"). 5. I would also like to review your other medications like painkillers, contraceptives, and some others which might be contributing to urticaria.6. I usually suggest my such patients to take an antihistamine like HY . 7. Furthermore, I also suggest them to avoid too hot/spicy foods and sudden temperature differences. Woolen, tight clothing can also irritate skin and hence not preferable for urticaria patients.8. I usually prescribe my such patients a good multivitamin-multimineral supplement and high dose vitamin D after checking vitamin D levels, which might help in some chronic urticaria.9. If psychological stress is a concern for you, please adopt some relaxation strategies as stress can worsen urticaria.10. Please do not scratch the itchy areas as it aggravates itching. I would suggest you to apply a lotion like calamine over itchy areas instead of scratching them. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i am a male of 37 years. recently i have got a bump on the palate and my upper front 2 teeths are aching badly. I am getting a severe headache due to this. Feeling very uncomfortable of the Jaw and Gum pain. Not very sure on the reasons how i got it. I chew tobacco and would that be a reason. i am bit worried. Never did i get this type of problem before. I also started with a running nose and it gets dried after some time. Please help ### REPLY: Thanks for using . Read your query. Swelling in the upper palate region along with pain in the front tooth suggests an abscess (periodontal abscess). It is not mentioned if any of these two teeth are decayed. For the pain you can take ibuprofen (if you are not allergic to any medicines). I would advise you to visit your local dentist and have your two teeth checked, followed by radiograph. Root canal treatment will be the main line of treatment. Antibiotics may be required on prescription by your dentist. Do salt water gargling. Stop chewing tobacco and it is very compulsory. Hope this was helpful. 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: Heloo mam/sir.m 21 yr /f . M very worried about my complexion .i have normal skin with wheatisChatDoctorplexion also my forehead is darker than the rest of my face..and my hands and foots are also dark.. please suggest me something that make my skin fair n flawless..also suggest me something for hand and foots...thanks ### REPLY: Thank you for query. Natural color is the best color.it is always better to have natural color than go for whiteners. Dark skin have melanin which protect you from various skin cancers. So please avoid any fairness/cosmetic creams. I do not advise use of any cosmetics for becoming fair. Cosmetics do more harm than good .wash face regularly at least 2 times a day with gentle cleansers like detail. Do not rub or use harsh soaps. If you still persist use sunscreens in the daytime at least 3 -4 times a day which also helps in preventing sun tanning. Sunscreens protect from pigmentation if used at least 2-3 times per day. Mild keratolytics like salicylic acid can be used if need be under supervision of dermatologist. You can get back to me for any clarifications. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Planning a baby. - TSH levels were 22 about 5 months back and now its about 0.28 ng/dl - Prolactin level was 68 and now its 0.3 ng/ml - Was on treatment since 5 months. Had medicines/ injections for ovulation for 3 cycles. From the ultrasound scans, doctor suggested everything is fine and eggs ruptured fine and that we can expect news. Unfortunately it didnt happen. - Semen analysis for the partner show its fine What can be the possible reasons and possible solution for the same in order to get pregnant? Please advise. ### REPLY: Hi Dear, you did not mention your age here, nor you mentioned since how many months/ years you are trying for pregnancy. If you have started just recently, please do not label yourself as a case of infertility. In case the try is since more than a few months, still you cannot be labelled as a case of infertility. The reason being your hypothyroidism. With that your TSH goes high and so does your prolactin level. That makes conception difficult. It is very common and hence when you treat your hypothyroidism, automatically your prolactin falls down increasing your chances of conception. Now your TSH and prolactin levels are just fine for you to conceive normally and do not reduce the dose of thyroid tablet even though the reading of TSH is less than 0.3. You need to keep TSH before and after conception below 2.5. You also do not need any injections for ovulation. Keep a very normal routine for another 3 months and do not monitor yourself for the ovulation. With healthy diet, weight, exercise and continuation of thyroid replacement medication, you will continue getting normal cycles and hence normal ovulation during these months and there is very high chance of you conceiving on yourself without the aid of injections for ovulation. In case you are overweight and in spite of normal TSH you have irregular menstruation then you will need assistance from infertility specialist for induction of ovulation and further management after these three months. I hope this helps you. For any further query get back to me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am from Canada and suffer chronic pain and fibromyalgia for 25 years. I am on methadone as one treatment and it has been recently altered here. Methadose solution for pain 10mg/ml Methadone HCI 10 mg/ml. Dose, drink 1.5ml four times daily. I can not take this as I said it has been changed. Now the government has made it sugar based cherry flavored, gag reflux crap. I have tried to wean my self off but have experienced anger, smashing plates, cried out for doctor assisted suicide as the pain and withdrawal of this drug is making me crazy. I am on subcutaneous lidocaine infusions weekly, nerve blocks in neck and shoulders, cortisone injections in both hips for bursitis and nerve blocks in lower back, L4,L5. I suffer with herniated, degenerative discs, c5,c6 too. I have osteoporosis, parathesia, IBS, awaiting surgery for bladder prolapse, endometriosis which required hysterectomy and oophorectomy and numerous laporoscopies leaving me with adhesions which are a constant cause of further pain. I am a chronic pain disease sufferer and to the world I look great...haha! I initially started to write to you only for advise on taking myself off methadone but here I went on and on. The list is long and I see many doctors and pain specialists however my quality of life is nil and I am only 55 years young. I can not seem to find answers, help or hope other than being prescribed opiates, methadone which has been changed to suit the government not the patients needs and numerous medications that make me worse. I am on a roller coaster of hell and pain and now I am withdrawing off this horrible new recipe of methadone as I throw up trying to take it. Why change something that was easy to take to this horrible sugar based cherry cough medicine taste that burns to the pit of my stomach whereby I need gravol settle? I am frustrated, in pain and have talked to nurse on line tonight...she told me to go to the hospital...LOL! Right! I can not live in this pain...my doctor retired, great guy...now I have a woman who has nine kids and never can catch up or give a you know what about her patients. I give up! This is only the tip of the ice berg...you have now idea many health issues I have! I have to leave my city to go for help to Vancouver, thank God for HOPE AIR! They took me to the last appointment with my Neurosurgeon and he has ordered another MRI, will be seeing me after or before if I can not take the pain! I am a mess...What happened to good doctors??? How did we get FIBROMYALGIA??? I have a clue...DDT spraying all over the playground I grew up in...playground was a gas line and electric power field...what do you think of that? Five out of six women who played there as children were not able to conceive!!! Gee, I wonder! I am on a quest to find answers and thought perhaps I would start here...I doubt I will get an answer though...Great! Off to cyber space this goes...I am from Canada and You are in the States! Nice! I was on a Canadian site...how all of a sudden does it go here and now I need to pay! Well, thanks for nothing....I will proceed elsewhere because I will find an answer and from you...obviously not! ### REPLY: Hello, While you do not necessarily need to pay here as there is a public forum section (only premium section requires payment) as you seem to have realized yourself it is difficult to provide help in your case.  That is not only because the site is registered in the US (there are doctors from all over the world here, maybe Canada as well, you may go through the doctors list), but mainly because we can't prescribe medication online, goes against the sites' policy.  It is a sensible rule in particular with medications acting on the nervous system which are a delicate issue. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my baby is 15 weeks old and eats cow and gate formula milk. for the last month he has been eating 8oz bottles which he finishs all of every fed. in the last to weeks i have started giving him stage 2 milk for hungrier babies but he is still eating the same amount. he is now at the point where he eats every 2 to 3 hours and is having a least seven bottles a day or more. he still seems to want more food. what do i do? ### REPLY: Hi, Do not upgrade formula milk just because baby is demanding more. If she is tolerating well then no need to get worried. Until you feel a rapid increase in weight gain, which is not in healthy limits. Secondly, correct your deletion. Sometimes the mother make too much diluted formulas that cause poor satisfaction of babies hunger. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello,Ive been experiencing abdominal pain all day, and a case of mild diarrhea. I have the urge to empty my bowels every hour, yet very little comes out. I assumed it was food poisoning, but I have not vomited. Ive been running a temperature for the whole day.When I need to make a bowel movement, I get excessive pain in my lower abdomen, and have to rush to the toilet. Can you confirm this is viral/food poisoning rather than anything else serious? Thanks! ### REPLY: HI. Thanks for your query and an elucidated history. The most probable cause of census - the painful feeling to visit a restroom is seen in meiosis with or without secondary infection of the intestines. Yes this is most likely to be enteritis due to waterborne infection or due to food poisoning as you are suspecting. Well., the treatment is almost same and contains :An antibiotic active against intestinal infection, metronidazole, probiotics, antispasmodic is the must and also a PPI / Reinitiating and symptomatic treatment for 5 days, and you will be intake home-made fresh food and avoid all the outside foods and beverages. Plenty of fluids. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sinus allergies year around, and recently been treated for silent reflux. I have this constant salty mouth for the past several month,  I also use nasal rinse (netpot with salty powder solution) for the last seven weeks (4 times/week). I am experience dizziness and little discomfort on my left year since last week. ### REPLY: HI, thanks for using  Reflux can result in an acid or bitter taste in the mouth and excess salivation. It may be contributing to the abnormal taste that you are experiencing. The history of sinus disease would, may contribute towards your dizziness and abnormal sensation in your ear. Sinus disease is most often related to allergies and would be treated with the following : (1) avoiding the allergen if possible(2) the use of topical nasal sprays such as alone, escort, rhinoceros, Flonase(3) the use of oral antihistamines would also healthier are also medications that can be used specifically to help with dizziness. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother is 86 years old and  needs open heart surgery.  She has 2 blockages is one artery 70%,   I am very concerned about the high risk of her dying having the  surgery, or also having a stroke.   She also  has a history of  dufficulty to stop bleeding. ### REPLY: Hello, I have gone through your query. At the age of 86 open-heart surgery definitely carries high risk.Therefore, you should opt for angioplasty instead of surgery, if lesions in artery are suitable for procedure.I also suggest that 70% block is borderline, so you must ask your treating doctor for increasing doses and optimizing medical management. Surgery should be last option that too if patient is willing. My best wishes .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got my wisdom teeth out about a week ago. Now Im eating regular food and everything is fine. When I put my tongue to the back of my mouth (near where my wisdom teeth were) i feel a hanging flap of something. What is this? As well, what are the thread like things between my teeth? ### REPLY: Helloo...read through your query...accordingly I can say that the flap of tissue hanging is the flap covering the wisdom tooth...and thread can be the suture material which might have dislodged from the site which might be making the flap hanging...noways don't worry.your not having any pain right.so it means the socket is healing...and I must say that u should not touch the area with tongue or fingers which might hamper the healing....do salt water gargling properly...twice daily...and be cool....socket is healing.hope your benefitted something with this reply.have a healthy 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 my feet hurt really bad . I work 11 hour days and after the 2nd day its almost unbearable to finish my nex 2 days. My heels are the worstm however it makes my whole foot hurt. They feel and look swollen after work everyday and it even hurts when U get up in the morning!! What can I do??? ### REPLY: Hello have studied your case. There is possibility of plantar fasciitis leading to pain in foot. Physiotherapy like ultrasound and Tens may give you relief. Another common possibility can be spinal disc bulge leading to nerve compression and foot pt. You can take analgesic and neurotrophic medication and calcium supplements. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer your question. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have problem from 2 days before... there very small pimples on cover skin of glans penis & also on glance, coronal ridge, inner foreskin. My wife were have fungal infection she dont know when we have intercourse. And the other day she realized and told me.... she got treatment and now she is ok... but i think i have the infection on my penis... please suggest me any medication for it. ### REPLY: Hello, Welcome to , The history and symptoms are suggesting me that you may be having Balanoposthitis. This type of infection are more common in patients with reduced immunity like diabetes. If you are uncircumcised you may have fibrosis which is a discharge from a fungal infection under the foreskin. This can be treated with good cleaning of the penis with a gentle soap and water as well as an antifungal powder. I would suggest you to follow1. Proper hygiene and regular washing of prepuce is useful for the prevention of balanoposthitis.2. Topical antibiotics like metronidazole cream and antifungals clotrimazole cream.3. Circumcision is helpful in recurrent cases like you. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, I discovered my babys stool was mucus and a few spots of blood when she was 1 month old. And the PD had switched her from cows milk formula to soy..since then her stool is look nice...and currently she is 3 months old, I have changed her to cow milk formula and alternate with soy formula...I discovered that her stool was consists of white sesame seeds...may I know what does this means? Shall I continue with the cows milk or use the HA milk for her? As I plan to stop her on soy formula. Thank you. ### REPLY: Thanks for asking I have gone through your question and I understand your concern. As you said that your child has blood in stool when she was on cow milk at the age of 1 month, cow milk should is to be avoided till the one-year due risk of cow milk protein allergy.  If was your treating pediatrician I would not advise you to start cow milk. If you want to start HA formula. You can start.thanks hope I answered your question ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After semen analysis, i am very dishaerded and depressed when i came to knw that my dead sperms are about 60%  and Active are just 25% and 15% are slugish one. now kindly tell what should i do. First of all i want to know that is there any possibility to activate them. ### REPLY: Dear patient! Don't be so depressed and disheartened. Please visit an infertility doctor to find the cause. As knowledge of the cause of dead sperms will help to ascertain a line of cure. If, it is due to an infection, it can be cured by using an antibiotic. Tab. Doxycycline 100 mg (1+1) for 14 days The following medicine will help in activating and increasing sperm counts once any underlying infection is taken care of. Tab. Fertile/Vertical/Fertile (2+2 - for 1 week) and then (1+1 - for 1 month)But, if you kindly send me your sperm count, it will give a better idea of your situation. Hope this will help your cause. Awaiting your precious feedback. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 aged about 52 yrs, had a heart attack on December 27, 2010. and angiography done in SGPGI, Lucknow. The report is critical stenosis in LAD. Normal LCX and RCA with right dominance. Apex dyskinectic with normal LV size and overall normal EF 53%. ECG shows AWMI. She is also having hypo thyroidism since 5 yrs on tab Eltroxin 150 mg OD. Is there any alternative treatment for the above mentioned disease except Angioplasty ### REPLY: HIA patient can be kept on medical management also but as lad is critically stenoses, angioplasty is a far better and safe option for increasing longevity of life. In general, the LAD artery and its branches supply most of the interventricular septum; the anterior, lateral, and apical wall of the left ventricle, most of the right and left bundle branches, and the anterior papillary muscle of the bicuspid valve (left ventricle). So in lay man language its he most important artery of the heart, medical treatment should be done only in case when financial problems are there otherwise go for stenting ASAP. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hey dr. this is anju gautam my father had a  sugery for tumur near his vocal  and in that surgery his vocal cord also got cut a little now again he has some problems after 15 years . he has to pressurise himself in the morning for his voice to come out . please suggest me something ### REPLY: Hiinjury or resection of the vocal cords, these are the problems more commonly encountered, please take him to a speech therapist, who make them get adapted to several self accommodating exercises for phonation & speech. He should be careful also during swallowing due to the risk of micro-aspiration, because of the inadequate closure of the vocal cords. Please go for repeat direct laryngoscope test, with an ENT specialist to find out for any newer problems on the vocal cords. 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: My husband is anemic. The dr. wants his number at 14 and it is 12 after taking iron pills and eating iron- rich foods. He is also dealing with siatica and a torn miniscus. He thinks he s falling apsrt at age 61. This is the first health issue he s had for any length of time. ### REPLY: hello level 12-15 is okay, yes iron rich green vegetables, banana,pomegranate, spinach will take care of mild borderline anemia....sciatica can be taken care by physical therapy, lumbo-sacral belt, back exercises, BD rest....torn meniscus can be treated with arthroscopic surgery by an arthroscopic by minimal invasive surgery consult an orthopedic surgeon for this. Torn meniscus is by abnormal stress or injury of knee usually twisting and shearing force, common with footballers.sciatica is caused by osteoarthritis in spine with bone spurs outgrowths impinging nerve roots at intervertebral foramina.cause is degenerative disease of spine with advancing age, increased occupational stress 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 2 weeks ago i had blood test gamma gt was 109 last month i tooked lot of paracetamol and codine is it affect my gamma gtlevel? gamma gt was 109 ### REPLY: Welcome to  Paracetamol overdose can cause rise in GGT but also causes rise in other liver function test parameters like GOT, SEPT, Prothrombin time. The GGT could be elevated due to alcohol intake. It is also seen in homeostatic disorders like hepatitis and gall stones. You will need to do other tests of liver function to help in the diagnosis. It is also seen in fatty liver. Avoid fatty food, oily food, fried food and junk food. Eat plenty of fresh fruits and green leafy vegetables. Exercise daily and stay fit. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i got married in 2008 oct. im trying to conceive but im not..i consulted one doctor. she told because of my weight im not getting conceived is that the reason my age is 23 and weight is 65. please do reply.actually wat my question is because of over weight also one cannot get pregnant ### REPLY: Hi, Thanks for the query. I understand your concern. Overweight could be due to two conditions of hormonal disturbance. Which in turn can lead to menstrual problems/ovulation problems(like pod or thyroid problems) You need to consult a gynecologist for normality of genital tract & endocrinologist to point out or exclude /confirm hormonal irregularity as a cause of lack of conception.  Both the problems are treatable & therefore conception is possible after specific treatment.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! I recently had a MRI of my brain. The findings state that there are small bilateral mastoid effusions. Mild ethmoid, right maxillary and frontal mucosal thickening, congestive or inflammatory. It also says a c4-c5 disc osteophyte complex partially effaces the ventral subarachnoid space. I also had a MRI of the cervical spine that states a mild reversal of the normal lordotic curve is seen either due to position and/or spasm. Can you please explain to me what this means and what symptoms would these cause. Thanks! ### REPLY: Hi, I am here with tried to give details in simple words-- Small bilateral mastoid effusions: It means there is mild fluid collection in mastoid air cells located within mastoid bone (prominent bone just behind ear) on both sides. It may be associated with infection.- Mild ethmoid, right maxillary and frontal mucosal thickening, congestive or inflammatory : Mucosa (layer or lining) of sinuses is thickened which may be due to infection (inflammatory) or allergic (congestion). Above findings may indicate infection that may present with fever, cough, cold, throat pain. - c4-c5 disc means layer in between cervical spine (bone) no 4 & 5. - osteophyte means bony spicules.- ventral: anterior or to the front.- subarachnoid space: it is a fluid filled space surrounding the spinal cord.- c4-c5 disc osteophyte complex partially effaces the ventral subarachnoid space: It means bony spicules causes compression of subarachnoid space anteriorly.- mild reversal of the normal lordosis curve is seen either due to position and/or spasm: It means loss of normal curvature of cervical spine (convex anteriorly) i.e. loss of curve and spine become straight which may be due to position (position of head and neck while doing MRI) or spasm (muscle spasm)Above findings may present with neck pain with stiffness, pain radiating from neck to shoulder or arms. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, for a while now i have been feeling like something is pressing against my ribs from the inside on the left lower side of my chest, when i lie on my front i can t feeling it and when i sit in certain positions also. recently i have been getting shortness of breathe when walking, doctors cant see me for a week but i am really worried. ### REPLY: Thanks for your question on . I can understand your concern. Chest pressure, breathlessness are more suggestive of heart diseases. So better to consult cardiologist and get done blood pressure monitoring, ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry about heart diseases. Sometimes stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, suffering from aching back and neck, headache all over, sinusitis symptoms....hard to breathe especially at night.....2nd bout in 2 months.....debilitating because of tiredness .......I have been swimming in chlorinated indoor pool for 5 consecutive days leading up to this bout......would this trigger the bout and would antibiotics work? ### REPLY: Hi, From history it seems that you might be having acute respiratory tract infection giving rise generalized body ache, malaise, headache, fatigue. Swimming in chlorinated water might have precipitated the infection. A course of antibiotic for 5 days will give good relief from your all symptoms as it will clear the infection.Meanwhile, take Ibuprofen, paracetamol combination and decongestant to give you symptomatic relief from all symptoms. Take plenty of water. Take complete rest. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My name is Bela. In the middle of the cycle , I had cramps for two days, and right after the cramps stopped I felt pressure , which I still feel today in the lower part of the abdominal. Is this a sign of pregnancy? My period is supposed to come next Saturday . Do u think if it is appropriate to take a test today?Thank you ### REPLY: Hi and thanks for the query, From what you describe, it is more probable that this should be ovulation bleeding or what is called the Metameric. If you do not have irregular periods in the past, and you think your period is overdue, it is safe and reasonable to do a pregnancy test. However, taking the test too early might proof negative, and maybe retaking the test 2 weeks later might be more appropriate. Thanks and best regards, Luchuo, MD. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is abusive when I do not do as he says or if he has stress, I am blamed for most of our problems, He runs to his parents cuts off everything, won t answer the phone till he feels I am broken enough, then it it terrible abusive phone calls. He says he loves me when he has his way, if not he is cruel and abusive to the point I cannot sleep I cannot eat, the fear and anbondment completely destroys my life, I am distressed for a week or months depending on how long he want to hurt me. I cannot function I am so tired and weak. He threatens divorce if I do not do what he demands and accept all the blame. He has done terrible thing to me though he says get over it. When I have gotten a little strength to stand up for myself and stood up to him he leaves and emptys the joint account and leaves me with so much fear. This has been going on for one year and six months, my health is suffering. I smoke so much as my nerves are finished, can t hardly eat cannot sleep. I am sorry my husband has left me with no money. ### REPLY: Hi, sorry to hear about what is going on in your life. In my opinion you should first get yourself a job which will make you financially independent. You need to talk to your husband about all this and stand up for yourself. If this does not work then you may reconsider the status of your relationship with him. Smoking will only do you more harm. I suggest you do yoga and meditation to keep your self calm. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 4 episodes of attack (heavy pain in middle of the chest and right side of the chest that radiates to the back). I have gallstones (confirmed through ultrasound). 3/4 attacks happened around evening/night (4 hours after dinner) . But I don t have tenderness /pain when I touch the gall bladder area. 1 week after my recent attack , I m having stabbing pain in the left side of my chest. I also have nausea, loss of appetite, diarrhea, joint pain in the leg area, dull body pain, headache and fatigue. Are my symptoms due to gallstones or is there any possibility of IBS/gastritis ? ### REPLY: Hello Welcome to Ask a Doctor service I have reviewed your query and here is my advice. Presence of gall stone may cause the pain that is resemblance to cardiac pain it is advisable to remove the gall bladder, and to rule out the angina or ischemic pain EKG is the best option, abdomen pain have numbers of causes including IBS and gastritis and other, clinical history investigations finding can differentiate them. Hope I have answered your query, let me know for further assistance. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 primary immunology deficiency with the main problem being hemolytic anemia,i do weekly plasma infusions but my problem is everytime im taking off my steroids i turn yellow .the doctor has now introduced new drug to help wean me off steroids and will i be on this treatment for life ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Primary immunological deficiency or primary immunodeficiency disorder being you are genetically having a weak immune system. At present, it seems you have more of an autoimmune disorder.2. Do this autoimmune disorder, antigen antibody reaction and complement activation and hemolysis is occurring.3. Cause of hemolysis needs to assessed and particular antibody needs to be removed through apheresis. 4. steroids or other immune suppressants are necessary to reduce further antibody production. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 68 years old and have a lump in my right testicle and it got smaller in time and somewhat hard to the touch.I think it started due to my BPH .    I work out with weights and may caused the urine to flow into tube going to the testicle.   Is there a medication  I can take.  I have tried cyprl and it didnt work.thanksCarl ### REPLY: HelloThanks for query. Based on the facts that you have described the lump in Try testicle can not be due to reverse flow of urine in Va's difference due to BPH but could be either of the two 1) Benign Cyst of the epididymis (Spermatocyte)2) Infection of the epididymis (Epididymitis)It needs to be confirmed by a clinical examination in person by a qualified Urologist and doing following basic tests 1) Urine routine and culture 2) Ultrasound scanning of scrotum If turns out to be an Epididymis cyst, no treatment is required as it is benign in nature. If turns out to be Epididymitis you will need to take appropriate antibiotic as per culture report along with ant inflammatory medication for 2 weeks.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my daughter had the implanon removed on March 4, 2013 and began Orthotriclo on March 7, 2013. She forgot to take the pill on March 12, then took it as soon as she remembered on March 13. She again forgot to take the pill on March 16 and had unprotected sex on March 17. Her cycles were every 28 days prior to the implanon insertion. What are the chances of her being pregnant? ### REPLY: Hello. Thanks for writing to us. Since your daughter forgot to take the pill on 16th March and had an unprotected sex on the next day, the chances of pregnancy are there. Although the chances in such cases are not more than 5% still she needs to check her urine for pregnancy if her periods are overdue. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently have had an MRI of my brain because I was diagnosed with central sleep apnea. I was told that I have a lot of white matter on my brain, everything else was ok except of some age related issues. I am very fatigued always, hard to stay awake. I m a nurse, working full time. I have been on antidepressants for 3 years (Effexor) and also aderall for depression (loss of daughter, Son with TBI after Iraq deployment). My question is, about this MRI white matter disease, could this be caused by antidepressants, should I see a neurologist? I do not have hi BP or diabetes but my family has had autoimmune issues. Carol Chiesa So surprised that I have to pay for an answer! Not told of this before. Web MD is not being honest about this service, therefore I will go to a neurologist, in person, to answer my questions. ### REPLY: Most likely you have been told finding "white matter changes" in your MRI Brain report. White matter and gray matter are normal parts of the brain. Few CNS diseases involve specifically white matter like desalinating daises (e.g. Acute disseminating encephalomyelitis, Multiple sclerosis, Leukoencephalopathy). Also, white matter ischemic changes can be found in patients suffering from Hypertension, DM)You must go to neurologist to decide nature of your white matter lesions and to correlate clinically too. ### END