Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hiI am a male 22 years. i have vericocele veins on my left side testicals. Few days before i started feeling extreme pain in my testies. When i Masturbrated sperm was low and yellowish. There was a drop of blood as well. I took antibiotics ( amoxycilin). So every time i Masturbrate it pains a alot. Any suggestions. ### REPLY: Thanks for contacting  with your medical questions. I am sorry to hear that you hare having pain on ejaculation and blood in your semen. These symptoms along with the pain in your scrotum usually indicate infection in the prostate gland. The antibiotic you took amoxicillin is not powerful enough to treat the prostate infection. I recommend that you seek medical attention to be treated for prostatitis which is an antibiotic for 4 weeks. In summary, I think you have prostatitis, and you need to seek medical attention for full treatment of your infection. I hope this answers your question. Please contact  again with any of your health care concerns ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 17 years girl.i didnt get periods naturally for 2 years.i have my t3,t4 normal but TSH high.my pelvic scan results are multiple tiny follicles in my ovaries and thickened endometrium upto 1.2cm.my gynocologist said that i am about to get my menses but i didnt get my menses even after 10 days of saying so.i am worried if i am having endometrium cancer. i have healthy eating habits and no family history of any disease.i am not overweight. please help me. ### REPLY: Hello, Thanks for writing to us. Looking at your USG report, you are having polycystic ovary which is a hormonal imbalance leading to irregular cycles. Your endometrium is thick, so your doctor thought that you might get your period soon. But, as you did not get your periods, you should consult gynecologist. You will need medicines for with . Also, you will need medications for thyroid. You will need to take tablets for regularizing your cycles. Hope I have cleared your queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sister baby male is 2 months and a few weeks old. belly button is pushing out like an outie. Poop is a little watery. the family is sick. Yellow color. she is no longer breast feeding for 2 weeks now. baby is on Enfamil newborn. She can not take the baby till Monday to the doctor to see if this is a hernia. Any thoughts? ### REPLY: Thanks for the query. You have not given cause for not feeding. It is although preferable to completely breastfeed the child till six months of age. Hernia of belly button is a very common condition and usually does not cause any problem. It gets resolved on its own by two years of age. As abdominal muscles grow. For lose motions check if utensils used for feeding are clean and sterile, which is a source of intestinal infection. If child is taking feeds, sleeping properly, passing urine and motion well then you need not worry. If lose motions are too watery and frequent then it is advisable to visit doctor 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: i am a 18 year old boy nd i m very about my sex organ and sex ...my penis has not growth with my age ...my penis is too small and thin ...and sperm also flows with urine...and my sex time is too shart mens  if i ever think about sex my sperm comes out and my testes have also not remain tight...SO,please help me ...i will be very greatful to you..thanking you ### REPLY: Hi, Thanks for writing in. Apprehension about the normal size of penis is a major concern for men. At 18 years age, you are too young to judge the size of your penis. It is made up of muscles and the growth at puberty and adolescent is under the influence of testosterone. A research study was done in healthy Indian males on penis size during flaccid and erect and the width of the penis. Mean flaccid length was found to be 8.21 cm, mean stretched length 10.88 cm and circumference 9.14 cm. Mean erected length was found to be 13.01 cm and erected circumference was 11.46 cm. If your penis measurements are at least as mentioned above then there is no need to worry. Semen flowing with urine is a misconception in most men at your age. If you feel it is present then it needs to be evaluated after clinical examination with the urologist. Any urine infection must also be ruled out. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has just got her TB reports that say IgM 0.8 OD (-ve) & IgG 1.22 (+ve)... she has been experiencing pain in her left eye - since the retina had swollen as the doctors found out.... could you pl. advise if she is suffeing from TB. all other reports have come clear ### REPLY: Hello, Thank you for contacting to . I read and understand your concern. I am  answering your concern. Immunological test for the TB is not recommended by the WHO. So based on the result of the immunology only it is not advisable to put any diagnosis. In country like India you will receive the infection even if you are not diseased by the TB. So in such a cases' antibody testing comes positive even though the patient is negative. I advise you to do more valuable test like Inexpert for the diagnosis of the TB. This test is not only gives you diagnosis but also provides the brief of the sensitivity report of the TB bacilli. In addition to treatment keeping the good hygiene can help you improve the infection fast. You can ask for your further query here, or you can ask me personally on bit.ly/ . Thank you, ChatDoctorInfectious Disease Specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My baby is 1.5 months old,she is cranky most of the times a day and does not sleep at all sometimes during all day long,my padiatrician has prescibed Phena kid(2.5 ml) thrice for her,docter says that since she has mild cold also the syrup will help in that also..plz advice ### REPLY: IIN my opinion fend kid is not a good choice for your child cranky nature. It has promethazine which cause excessive sleepiness and not safe for 1.5 month infant. Try to find out the cause of your babies cry. It might be insufficient feed, too much fore-milk due to hyper lactation leading to stomach distention, inappropriate environmental temperature, tight clothing or inadequate burping after feeds. These are very common reasons for a child to become cranky. Try to find the cause and treat it. If you need any further information on this then do call back ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 back has been hurting for as long as I can remember but I don t know what I can do about it or if I can do anything about it. At times it will start tingling and then go numb and then start tingling again as if it were asleep. Sometimes, (but not always) this is brought on by a charley horse on my upper back. I get spasms quite frequently too. For a couple of days now I have been getting sharp pain from the lower middle of my back and shoots all the way to my foot. What if anything can I do to relieve my back. Tried physical therapy for bout 2 months several different times, but it didn t help ### REPLY: I have gone through your question and appreciate Your concern. You should not ignore your health as you are Suffering from back pain. As it may be due to disc prolapse or spineTuberculosis. As u should rule out these conditions. By consulting orthopedic specialist. General measures to reduce back paranoid bending forward and lifting heavy Weights. Hot fomentation thrice a day. Muscle relaxants and analgesics to reduce Back pain. Local Analgesic gel for local application. Muscle strengthening exercises will Help you in long term to reduce pain. Thanks U can write me back for any query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: a week ago, I developed what I thought was an anxiety attack. I took a klonopin which didn;t help. about a half hour later I developed severe pain across my back. It felt like I was having a gall bladder attack. I went to the ER. they tested me for a pulmonary embolism, which was negative. they took an ekg which was negative. they kept me in the hospital overnight with iv fluids. over the following week, I had nausea, sore stomach (like somebody punched me), the back pain, some heart palpitations and wasnt able to get a full breath all the time over the next 6 days. then suddenly the 7th day, I was absolutely 100%. I had the h pylori test, which was negative. I had an ultrasound on the upper abdomen including the pancreas (they suspected pancreatitis) which the ultrasound showed everything normal. I am 59 and my gall bladder was removed when I was 21. after seeing the dr today, she palpated my stomach and found a very sore spot in my stomach. since then today, I had a cup of coffee and had all the same symptoms as the week after my initial problem. I should also add that the sore spot in the week following my initial onset was at the area just right of the breastbone, which I understand is about where the pancreas is. I was taking Lasix, which the doctor advised me to immediately discontinue and thinks that could have been the cause of my problems. Do you have any ideas? ### REPLY: HIT hank for asking to ChatDoctorThese are the functional problems, you better see psychiatrist, before it is too late, you must be having elusiveness, obsessive, kind of attack if not treated in time then may lead to some kind of dangerous health problem, you are saying that you felt it could be gall bladder attack (Not the right term in any way, still I took it as granted) then at another incidence you are saying that your gall bladder was removed, just think it about that, what that is proved, have good day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my wife is diabetic, she also have ashma. prior to her knee replacement she suffer wound ulcer in her leg and took several months to heal before the surgery was performed. everything is okay now and her blood sugar is under control except for some occasional spike though she is taking insulin twice daily. The issue now is having burning foot pain, itchy and swelling find it hard to walk with out the aid of rollator. questions. how she can improve her blood circulation, prevent poor blood circulation, pain and neuropathy.another than these, her knee replacement is a success. she is 78 year old now, is her age a factor. ### REPLY: Hello, In a person with long-standing diabetes, peripheral neuropathy does set in, particularly if glycemic control is poor. But even with good control also neuropathy does develop giving rise to burning pain in feet, tingling and even numbness. Itchy feeling is due to improper blood circulation and affection of venous return. Strict blood glucose control is a necessity.  .  Strict dietary control, some amount of regular exercise along with glycemic control will help. Age is definitely a factor. Fasting blood glucose should be closer to 100 mg, PP 160 to 180 mg & HbA1c%<7.  Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 13 year old daughter has gastiritis.I think i have heard it also comes from stress.I think she is in stress mainly because i homeschooled her and she is missing alot people and friends.She never talks to anyone about this and tries to be happy.The only happiness for her is her cats.What can i do? ### REPLY: HelloGastritis can be due to so many causes, stress is one of them. If the condition persists endoscopy may be needed to rule out any ulcer. Although the main treatment is acid reducing agents like pantoprazole/omeprazole/omeprazole, but sometimes Helicobacter pylori(HP) kit may be needed if there is an HP infection. For stress counselling and antidepressant/antianxiety medication may be needed. Change in diet is also needed like avoid ens of spicy, oily foods with intake of plenty of water. I would suggest you to consult a physician for proper evaluation and management. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 age is 36yrs married but with no child at the moment and each time i make love with my wife i always release faster than i expected and more over my semen is too watery. what can likely be the cause and can this be the reason for my unable to impregnate my wife? please help. ### REPLY: Hello, welcome to . You seem to be suffering from premature ejaculation. You must learn the start and stop technique for prolonging sexual activity. Furthermore, you must visit a psychiatrist who would be able to help you in better way to deal with it in case you need some medicines. As far as you sperms are concerned you can undergo a sperm count and analysis which will be able to find out any abnormality in the. It is advisable to get your wife also checked up to rule out any pathology in her. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi ,my sister is 18years old ,she is suffering from low blood count about 5 years ago and it was diagnosed as thrombocytopenia ,in the last CBC the platelets was 60000 ,the WBC was normal ,the hemoglobin is low as well.so I am quite worry about her ,do u think thrombocytopenia may leads to leukemia . ### REPLY: Hi, dairy have gone through your question. I can understand your concern. No thrombocytopenia can not lead to leukemia. There are many causes of thrombocytopenia. Viral infection, malaria, dengue, immunothromocyopenia and many others. Leukemia also leads to thrombocytopenia. But your WBC count is normal, so leukemia is out of question. No need to worry about leukemia. Just be relaxed. 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: My husband was out in the wood a and came back with all kinds of bites on him....shortly after (2 days) he started sweating (im talking soaking the bedding) also had body aches namely back...and now I am suffering from the same symtyms is there a possiblity he has been bitten by a mosquito carring some kind of virus?? ### REPLY: Hi there! I am .  I am glad to answer you.First on the basis of short information you provided I can say that this could be vectored borne infection. You both may have been bitten by some ticks or mosquito. This depends on which place you visited & what kind of viruses/ bacteria are seen in that area. In this situation you should visit immediately to the nearest physician and go for blood tests for confirmation of infection. Then proceed for treatment accordingly. Wish you a rapid recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hai doctor,iam 30yrs old lady having pcod & last year we did IUI & the result is positive but after some days got miscarriage due to the blokage of fallopian tubes.After that we did laproscopy & pcod drilling.After that every thing is normal & ny periods was regular.Last month we had IUI & the test is negative.Please advice .And the same time I had fever while doing IUI ### REPLY: Hi, I think you can try 3 to 4 cycles of GUI. It will work out. Also do a thyroid profile and prolactin for yourself. May be due to fever implantation didn't happen this time. But it may work next time. Also, the chance of pregnancy is 10 to 15 % only in GUI even if everything is fine. If there is no success then you can go for IVF.  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: The results from an EKG I had done and I am not sure what it all means.  here is what the report says:Rate  70    Sinus RhythmPR    168   Probable Left Atrial AbnormalityQRSD  88  Low Voltage In Frontal LeadsQT   441   Borderline T Abnormalities, Inferior Leads-AXIS-P   73QRS   40T   -8 ### REPLY: Rate of beating of heart normal 60-100sinus rhythm-A sinus rhythm is any cardiac rhythm where depolarization of the cardiac muscle begins at the sinus node. It is characterized by the presence of correctly oriented P waves on the electrocardiogram (ECG). Sinus rhythm is necessary, but not sufficient, for normal electrical activity within the heart. Image result for pr interval In electrocardiography, the PR interval is the period, measured in milliseconds, that extends from the beginning of the P wave (the onset of atrial depolarisation) until the beginning of the QRS complex (the onset of ventricular depolarisation); it is normally between 120 and 200ms in duration. Axis is normal you have to study vectors for its inferior leads are leads representing inferior was of hear, borderline abnormality is not significant poor placement of leads can result in low voltage ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having severe pain in my pelvic are down to my groin and through back. Seems to get worse the more i move.I have had back problems osterosis, and kidney stones in the past. This feels like all the above. My sides are hurting as well. Ny idead? I have had several surgeries, could it be scar tissue been going on for almost week and not getting any better, only worse ### REPLY: Welcome to . You need to be examined by your doctor to rule out musculoskeletal and urological causes of the pain. Investigations by your doctor/surgeon/urologist will help reach the diagnosis. The chemical examination of a kidney stone and correction of the metabolic pathway of the substance found will be necessary to prevent recurrent formation of stones, similarly adequate therapy for the osteoporosis and back pain may be needed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a recurrent yeast infection lately each time I have been intimate with my husband. I have never had a yeast infection within my 47 years of life so I am very concerned about what is going on. Although we are separated I know that I have not been with anyone else and he says that he has not and I am believing him. So if multiple partners are not the case what else could it be? ### REPLY: Howell come to ChatDoctorI really appreciate your concern, yeast infection may not be due to coitus it is not the disease of STD, but it can be likely with poor hygiene, and with other sources, if it is being suspected due to intercourse then both the partner have to take the shot of the dose to eradicates the infection, although it is very common in females, hygiene have to be taken great care hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter went to the pediatrician last week with bumps on her body. He told us that it is a classic case of the chickenpox. However, 2 days later, in addition to the chickenpox, she started getting small, very very tiny bumps all over her body.Now she not only has the chickenpox, she also has about a million small bumps all over her chest, stomach, back and thighs....we dont have very reliable medical service in our neck of the woods. can you tell me what this could possibly be? ### REPLY: Like chicken pox which is a viral infection, there are many others which may cause rashes. The rash of most of such infections have specific characteristics and so it is really tough to comment without examining. Since, you do not have access to reliable medical services at the moment, you may upload an image on  and ask about it. Since there are several possibilities, I am not mentioning names to frighten you unnecessarily. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had right flank pain for at least three weeks. It keeps me awake at night. Aleve settles the pain for a couple of hours. I find it hard to reposition myself in bed. I have no fever, and no swelling in the extremities. Urination is regular, urine is straw colored. ### REPLY: Hi, Welcome to  forum.  The reason for the pain in the right flanks might be due to the gastric irritation, kidney infection, stone in the kidney, ureter, hepatitis, gallbladder infection, or stones, colitis, appendicitis.  I advise you to consult a surgeon for diagnosis and treatment. You may need to have gastrostomy, ultrasound, for confirmation.  Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to hasten the recovery.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am diagnosed with Hepatitis E  and taking udiliv 300. after the initial level of 2.8 , billirubin has gone to 9 . However, i am currently out of the vomitting and other symptoms. My appetite is much better. When the billirubin is likely to come down ? I am also very tired. Can i also take kizhanelli (phyllanthus nururui)  along side  Udiliv tablet ? Age 40 yrs. Weight 60 kg height 150 cm , Sex -female ### REPLY: Hi thanks for asking question. Noted you gave diagnosed with hepatitis E. It will take few days to bring your bilirubin normal.... Follow below instructions... No other specific treatment needed.... Continue using Adílio. Take low fat diet to rest liver. Non veg and junk food like trans fat diet avoided. Fruits taken more.... Avoid alcohol... One tsp licorice with honey can be taken... Garlic also good one.... Take one tsp cumin seed with water daily early in morning.... 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: Is dancing good for asthmatic person ? ### REPLY: Hi, Thanks for visiting . Asthma, if controlled, is not a contraindication for dancing. Whether it has got any positive effect on asthma course or symptoms has not been proven in randomized controlled studies. Some Indian studies have proven Panama to be beneficial to asthmatics. There is a special variant of asthma called exercise induced asthma, where any sort of exercise, even dancing too may lead to asthma attack. The mechanism is, increased airflow through airways lead to cooling effect and . If one has got this particular type of asthma, then better take your reliever inhaler before going for dance. 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 there, I am writing to ask about my daughter, she is eleven months old normal weight and height for her age. She is suffering from conjunctivitis, but also has a temperature of 38.8. We re worried it maybe something more! Hope you can help, Mark ### REPLY: Hi, welcome to . Can understand your concern. Conjunctivitis or inflammation and redness of the conjunctiva can be due to viral infection, bacterial infection or due to allergy to dust or other allergens.* in viral infection, there is clear discharge from both eyes, fever and nasal discharge can be present.* in bacterial infection, there is purulent discharge and usually one eye is involved. Fever can also be present.* in allergic conjunctivitis, there is history of contact with dust or other allergens in environment. Running nose is mostly present. An examination by ophthalmologist should be done so that proper diagnosis and treatment can be advised. I hope this will help you. Wishing your child good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI, i am chandan.Suffering from allergy for 3-4 yearsIn last november my condition was very bed for allergy.i was treated by Dr.V.N. Jha (M.B.B.S)He thout me that your allergy is on top.you have to take medicine withine 3 months.After taking medicine i was felling well.But now in these days i am felling same problem.my symtoms are:-1. sneezing in morning and evening time when taking water for being fresh.2. sneezing comes 20-40 times daily3. Diffculties in breathin in over night 4. cough                                So kindly please advice me what should i do.                      I will be very obliged of you ### REPLY: Hello ! Thanks for posting your query. Your symptoms are highly suggestive of Bronchial Asthma and allergic rhinitis.  With the right choice of medicines and avoidance of allergens like cold and dust, you can have your symptoms perfectly under control. I would prefer to start you on MDI (Formoterol + Budesonide), MDI (Levosalbutamol + Ipratropium)with valved spacer device, antihistamines.(MDI stands for Metered Dose Inhaler). These, in right dosing schedule, bring great relief.  Also, u should do steam inhalation and warm saline gargle to clear your nose and throat. Do consult a physician in person and get yourself examined and treated in the right way. Most importantly do learn the proper technique of using an MDI with spacer device from a qualified physician.  Hope you get better soon.  Do .  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am 36 years old and a mother of two daughters, I am trying to conceive since last four months but I am unable to, my ganache has suggested me to take Fertyl 50 mg from the 5th day for 5 days, EV Tab for 10 days and also use susten 100 mg twice a day. Along with Folnew tab will all this help me in conceiving ? ### REPLY: HelloAssumed that everything is all right, because you got two pregnancy before this. Now your gynecologist advise you to take clonidine or ferry 50 mg for s days from 5th day of menstruation, as this . While Austen (progesterone) will help in pregnancy maintenance (avoid miscarriage) . While E V and fol new will act as supplement for pregnancy. So, if everything will be in right direction, you will get pregnancy. 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: wife (68) has stage 4 kidney failure-taking nefedipine-colodine*sodium bicarbonate-calcium acitate- 22 units of insulin once a day and 50000unite vit d every two weeks- is time she is sick and wants to vomit with back pain and chills-what is going on-what does this mean? ### REPLY: Hi thanks for writings you have said your wife has CKD 4. The symptoms such as nausea, omitting, poor appetite, muscle aches may be symptoms of advance kidney dysfunction. The renal function should be checked and if creatinine is high patient might need dialysis. Meanwhile, symptomatic treatment for omitting should be offered. I will be glad to answer any queries. Ply attach recent labs when you communicate next time. Tx ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 injured my wrist about two weeks ago. It was swollen for about a week and I could barely move it. After the first week, the swelling went away and I regained some movement. Now it hurts whenever I put a lot of weight on it, bend it too far, or it moves suddenly. I initially injured it playing basketball. ### REPLY: Hi, Thanks for your query. From description, it seems you might develop muscular or ligamentous strain. Now after 2 weeks if pain is severe, I would suggest getting this evaluated by an orthopedic for an accurate diagnosis and appropriate management. You may get the x-ray/ MRI of the area affected under his/her guidance 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, I have 2 bumps in the gum of my mouth on each side, they dont hurt, bleed, and I cant really feel them unless I touch them with my tongue or finger. Are they dangerous? What could they be? Ive had them for a LONG time (A year or two, perhaps.) and Ive always wondered what they are.I believe I got them when my dentist injected anesthetic into my gum. ### REPLY: Hi, Thanks for asking the query, Lump on the gum which is painless can be a due to inflammation and swelling at the time of administration of LA, injury by food products, cracked tooth, vitamin B12 deficiency, tobacco use, smoking, low immunity. Stress and hormonal changes may also lead to such lesions. So I would suggest you to consult to an oral surgeon get the clinical examination and evacuation done, take necessary x-rays. If annoying can be removed surgically. Hope you find this as helpful, Regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son is tube fed, this past week he had an ear infection so doctor put him on antibotics, his but got very sore (diaper rash) soon as the 10 days was done of antibotics his rash went away, but now im noticing a red dry feeling circle around his tube, should i take him to be seen or just continue to put some oniment on it? ### REPLY: I didn't clearly understand what you meant. Do you mean there is a red circle around where his feeding tube is, or do you mean there is a red circle around his anus? If it is the feeding tube, then it needs to be checked, and perhaps changed, by a registered trained nurse or doctor. If, however, the redness is around his anus, you can apply an antifungal cream on it for a week before worrying about it. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Its been six years since I broke my back  L1 bursted lately I have been having more pain a mri is being done on Monday or maybe tlhis is just living with a broken back we will see on Monday. Is there a book out how to live with a broken back some days my pain is more severe. I dont know if I  am doing too much or is this part of it. ### REPLY: Hello, Thanks for your query. After going through your query I came to know that you are suffering from post dramatic chronic backache after L1 burst. Trust fracture occurred 6 years back, so it is unlikely to be directly related to it. It may be due to weakness of bone and muscles and vitamin and trace element deficiencies specially vitamin D and vitamin B 12. Back exercises, neurotrophic such as mecobalamine and analgesics (DICLOFENAC 100 MG SLOW RELEASE TABLETS) give relief. Sometimes vitamin D deficiency can aggravate this so serum vitamin D test is advised if it is lower than vitamin D supplementation will be required. Avoid long continuous standing. Sit in a straight posture. Eat milk, fruits and green leafy vegetables daily. You need to do MRI TO RULE OUT other causes. You can discuss with your treating Doctor about it. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was eating an orange and it went down the wrong pipe. It took my breath away and I struggled for a while and continued to cough. I thought it had cleared but the next day it seems like there is something in my lungs and I keep coughing to try and get it out but nothing is happening. ### REPLY: Thanks for your question on . I have gone through the question and understand your concern. I see similar kind of cases in my clinic. In first meeting, I advise them not to worry about aspiration in lungs and ask them to visit again after 1 week. If they still have same feeling of something stuck in the lungs then I post them for bronchoscopic evaluation to rule out foreign body aspiration in the lungs. So you can discuss this with your doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is getting bruises on her legs bach of knees and inside of her elbows. These are appearing without injury she is also complaining  of icy skin. She is going to get a blood test this week but is concerned because it has gotten visibly worse in the past 24 hours. She is 20 years old. ### REPLY: Hi I do care for your concern. Your history suggest more of blood disorder than to allergy. It is advisable to take the blood test prescribed by your doctor and to follow up with him. In most cases the substances called as clotting factors are found to be deficient and causing the disease, and It's advisable to rule out the same. Hope I have answered your question, if you have more feel free to ask. 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: suffering chronic and often acute back pain from neck to foot on back left side with radiculopothy of left leg for six months.   Assuming its a herniated disc in the lumbar region, do the nerves radiate to the lower rib cage of the back? The rib seems to have a very sensative point that will hurt to the touch. ### REPLY: Hi, thanks for posting your concern in the . A herniated disc in the lumbar region will not cause pain in the ribs. The dermatome distribution is different. Neither will it cause any pain in the neck. Radiating pain in the lower extremity may come from a pathology in the lumbar spine. . I think you should have clinical examination of entire spine. Cervical spondylosis or any other abnormality in the C spine may produce radiating neck and/or upper back pain. Rib tenderness may occur due to several conditions including diseases in the lung, mediastinum or pleura. Bony pathology and fibromyalgia should also be ruled out. You should consult your local orthopedic surgeon or local physician for further clinical examination and evaluation. Tests including that of blood and imaging of the spine and chest may be needed. For any further query please write back to us. Regards.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 59 year old white male with lung disease. Asbestos plaques and now bronchiectasis. Mild emphysema I m told. Here is the problem though, with this diagnosis, what is causing me to have shortness of breath when I walk, excer t (mildly) and cause me to break out in a sweat, get light headed and dizzy, near passing out? ### REPLY: Thanks for your question on . Since you are a diagnosed case of bronchiectasis and chronic bronchitis, your shortness of breath can be explained by these.1. Both of these are obstructive airway diseases. Which causes bronchospasm and thus lungs are not properly oxygenated. 2. Both of these can cause structural changes in lung, thus decreasing total lung surface and thus causing poor lung function.3. Infections are easily occurred in diseased lung. This will further hamper lung functions. So your these diseases makes you breathless. Better to consult pulmonologist and get done PFT (Pulmonary Function Test) to know about your lung function. Start treatment and repeat the PFT and see for improvement. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 too, i took one tab cerophen from 2nd day of my cycle (50mg) on dec 2012. i started bleeding on 22nd jan 2013.than, i took again double dose 100mg from 2nd day of my periods. but now i had to start on 22nd feb but i didnot start , i got my urine tested , it is negative i m so confused what should i do .... if i m pregrant so how come i know if i m not pregnant so what should i do for starting periods my age is 27th years old ### REPLY: Hello, I would like to know whether the cycles were monitored by follicular study that is by serial ultrasound scan for seeing the growth of the follicles. If ovulation was confirmed, then the possibility of pregnancy is high, you should repeat urine pregnancy test or directly get blood levels of b . If the ovulation was not confirmed, then there is a possibility that you might not respond to this medication and if repeat pregnancy test negative, you should consult doctor for giving you medication for with . Also, other factors for infertility including semen analysis for husband should be done. 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: What causes me to feel slightly breathless, momentarily when I lie down on my right or change sleeping positions in bed or if I walk too fast or much, like climbing stairs. Also there is a pain in my right rib cage when I try to breath more deeply.  BUT all these symptoms only last a minute or two, not longer.  As long as I am not exerting myself, I seem to breathe normally, . . . ### REPLY: Hi thanks for contacting ... Noted here pain and dyspnea mainly on exertion that you are mentioning. First get your total hemoglobin estimation with peripheral smear examination... If anemia is present corrected with iron or vitamin B12 and folic acid tablet whichever requires. As anemia can lead dyspnea... If you are having cardiac history then dyspnea can occur... For that ECG or ECHO done... Measure your blood pressure also... If you are taking excess stress then also slight dyspnea can occur... As far as rib pain is concerned, if ribs are tender to touch it could be Costco . .Here is no need for worry. Consult physician. If needed after examination then for respiratory causes x-ray or PFT useful. Take care.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a sharp pain in my right side, for three days. I feel bloated, and the pain is worse after I have eaten, but is there most of the time. When i lie on my left side it makes the pain worse  on the right side. When I laid on my stomach every time I breath in and out it felt as if liquid or something was sqeezing out of something in my right side. I have had a headache on and off for the last three days. When Im walking I sometimes get sudden stabbing pain in my right side and have to bend over with pain . ### REPLY: Hi ! Good morning. I am  answering your query. From you history of pain on the right side of abdomen specially after food accompanied by bloating sensation, the diagnosis goes more in favor of gall stones with infection of the gall bladder (Cholecystitis). Whenever there is intro abdominal infection, there will be pain which may be severe on movement due to inflammation of the local parietal peritoneum. That is why you have got pain on movements. Apart from the cholecystitis, there are a few other conditions which can give rise to similar symptoms, but I do not want to confuse you by just telling you the names. If I had been your doctor, I would first examine your abdomen followed by investigations like CBC, Blood sugar, LFT, S Amylase and Lipase, followed by an ultrasound abdomen to confirm my diagnosis. In such a provisional diagnosis of cholecystitis, you should avoid fatty food which may aggravate your pain, and you can go for an anti-spasmodic for an immediate relief. But you have to consult a general surgeon to diagnose the condition by physical examination and investigations for further management. Thank you for using  forum for your health query. I wish you an early recovery. Thanks 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: I had three wisdom teeth extracted alittle over a week ago. And it hurts to open my mouth and on my lower left side of my mouth i have stabbing aching pain in my jaw that goes up into my ear and also is causing me to have tension in my neck. Pain meds are not helping they just make me sleepy but the pain stays. I went back to the dentist to have them look at it and they took an xray of my lower left side where they extracted the tooth and they said that it doesn t look like i have a infection or dry socket. So what could be causing such horrible pain in my jaw? ### REPLY: Hello, It is normal to experience severe pain even after a couple of days of surgery. Sometimes, one has to take off a bit of bone during extraction of the tooth because the tooth can be impacted and deep-seated within the jaw. In these cases, there can be severe pain especially with chewing. Go on taking the analgesics on a regular basis, the pain would take some time in coming down in intensity. If there is no other problem like infection then there is no need for worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: good afternoon my question is regarding lump in armpit, i have had for several years, i did not think much of it.  I think it started after my first pregnancy.  whenever i wear a sleeveless shirt it can be noticed and, it does not hurt, but i just wanted to know if there is a solution to this problem ### REPLY: Hi, Good Morning-from INDIA. I am . N.here to take of your health query from  virtual Clinic. Thanks for your Health-query to  Clinic.-I studied your query in-depth and I understood your concerns.-It's a Normal -Breast Tissue -in Axilla-also known as -Axillary Tail of the Breast Tissue and is the normal extension of the Breast tissue.-The prominence after the pregnancy is -due to the Spent in Hormonal activity after Pregnancy, which is a normal hormonal response. This starts from Puberty, increases after delivery-for lactation, and reduces after menopause-along with the normal recession of the other breast tissue-pectoral part.-So don't worry -this axillary breast is NORMAL.-Still if it worries you, Consult your family doctor or Surgeon which would re-assure you of the Normal Breast. Hope this would help you recover fast out of the Breast Lump anxiety. Wellcome to  again for better Health and Living. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 think I may have a kidney infection . The only symptom I ve had is a dull pain in my back on the right side, sort of by my bottom rib. It only hurts when I cough or take a deep breath, though. I had two UTI s in 2012, one in November and one in October, but none recently. I ve had no fever, no fatigue , and no burning sensation during urination . I am getting over the flu which has been going around my dorm which involved a nasty sore throat , coughing, and loss of voice. My mother who is a doctor told me it s nothing and I m being paranoid. So, do I have a kidney infection? ### REPLY: HiT hanks for the query. Your symptoms do not suggest the possibility of a kidney infection. However, you should do urinalysis and urine culture and an ultrasound of the kidneys and bladder. These tests will help us confirm or refute the diagnosis. I would also recommend an X-Ray of the chest. Please see a physician with the above tests who can then examine you and prescribe appropriate medications. Hope this helps Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir,i am pregnant for five weeks and whenever i have sex i bleed for that period,the ultrasound result shows am having an early intrauterine cyesis but suggest to repeat scan in two weeks to ascertain fetal viability.am i at the risk of loosing my baby.i really want to have my baby cos i have lost two pregnancies before this one. ### REPLY: Hi dear, I have gone through your question and understand your concerns. Spotting after intercourse in early pregnancy can be due to threatened abortion, or some local lesions in cervix or vagina. I would suggest you to consult an ORGAN specialist to get properly examined, and if there is no local lesions, then you should try to abstain from intercourse till the fetal cardiac activity appears. Hope you found the answer helpful. 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 gave up smoking 4 weeks ago after being a heavy smoker for 30 years. I am currently experiencing physical pain in my right upper arm only in the early morning (around 4am) but once I get up it goes away after about 1 hour.  Could this be anything to do with quitting smoking?? ### REPLY: No it is not connected with smoke with .  It is connected with cervical disc problem which has just started. When there is no pain, do Yoga postures for neck (no jerks please), do deep breathing and avoid high pillows. You may apply some muscle relaxant gel on back and sides of neck and the portion of arm that pains, preferably after hot fomentation on these parts. This will relax muscles and pressure on nerve will release. If pain is much any anti-inflammatory 1 s.o.s. may be taken but don't make it a habit please. To my own patients I start Turmeric powder 1/2 tsp with warm milk or water for natural anti-inflammatory effect besides yoga postures for neck. Physio is also an option. Hope it 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 one or two red blisters on my inner butt cheek, I wasn t ichy before my bath, the tub was cleaned yesterday... We do live in the country so there s are spiders and ear wigs sometimes found in the bathroom. The blister opened when I iched it, now it hurts when I sit. Burning feeling. It s not small either just under the size of a dime. I just want to know I m ok. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Spiders don't reach up to but Creek to bite. So in my opinion it sounds like some kind of infections. Diagnosis is important in treating this condition. But till you visit the doctor and get yourself diagnosed I suggest you to take the antibiotics like definite to control the infection. Local application of the ointment like polypoid can also be helpful. Please maintain good local hygiene as it can be helpful in occurrence of the infections. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 in the lymph node on the side of my neck. Went to dr and blood work is normal other than thyroid level is elevated. He does not think the lump has anything to do with the tsh. Is there something to worry about further. I am a 46yr old female with no other medical issues. I am concerned of lymphoma. ### REPLY: Hall lymph node swellings are not Lymphoma. In my opinion, you should get an FNAC (Fine Needle aspiration Cytology) of the lymph node first. If it is inconclusive, then the entire Lymph node has to be removed surgically and send it for histopathological examination (Biopsy). Exact diagnosis will be confirmed. It could be a simple Non-specific lymphadenitis. If you come back after reports, I will clarify further. Wish you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hii..doctor I m 19 years old. I dont able to sleep without masturbating. .I had this habit from 3 yrs early. I enjoy masturbating. ..and feel excited by releasing sperm. .too quickly. .I use to masturbate 3 times a day..not even a single day I live without masturbating. .plz tell me if it will affect my future sexual life... ### REPLY: Hello,Based on the facts that you have posted it appears that You have been indulged in masturbation since many years and fear yourself to get into problem of infertility in the future.First there is myth in a mind of common man that excessive masturbation is the reason of all sexual problems. But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body. So do not worry at all.However, it is advisable to get addicted to it. 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: sir i hv missed my regular periods by 7 days, im 24 yrs old, last time had unprotected sex with partner was 2 weeks ago, from last 3 days feeling uneasy,hv frequent cramps in left lower portion of stomach, last night was feeling nauseatic, tell me what should i do, i dont want a child rt nw as i m working, if im pregnant tell me the soltion to get out of it. ### REPLY: Hello dear, Welcome to . I understand your concern. If a regularly menstruating sexually active woman complains of missed period then the pregnancy is the first thing to rule out. As your period is 7 days delayed I suggest you to consider doing a urine pregnancy test. The urine pregnancy test gives accurate results a week after missed period. In case if the test is positive the pregnancy can be terminated in two ways depending on the age of pregnancy. The medical termination of pregnancy is possible up to 7 weeks. After 7 weeks surgical procedure like D&C is required. So as it early pregnancy the medical termination can be tried. It is effective up to 95%. The medical termination of pregnancy includes usage of mifepristone and bisoprolol tablets. The bleeding usually starts after a few hours of taking bisoprolol. A ultrasound need to be done 14 days after to check for complete abortion. But these medicines are associated witChatDoctorplications like heavy bleeding, incomplete abortion etc. So they need to be taken under strict medical supervision to avoid complications. In case if the test is negative I suggest you to repeat the test after a week. If the repeat test is also negative then the pregnancy is ruled out and the delay is attributed to stress induced hormonal imbalance. So relax and consider doing the urine pregnancy test. Hope this satisfies your query. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 34 year old female that stands at 56 and is considered obese. I weigh about 260. I smoke cigarettes, marijuana and crack.  Lately, Ive been noticing black spots in my saliva when I cough. The sailva is thick as well.  I currently have no health insurance. What do you recommend.  I know #1 recommendation stop smoking everything but what else can I do? ### REPLY: With you query, it is mandatory to clinically and microscopically examine your saliva to know what it is. IT IS STRONGLY RECOMMENDED TO STOP SMOKING OR CONSUMPTION OF NICOTINE O NARCOTICS IN ANY FORM MAY RESULT IN CAUSING CANCER. I assume dark spots what you see in your saliva might be blood fragments you also mentioned that saliva is thick so I would suggest you to visit your dentist for further diagnosis and treatment. Maintain good oral hygiene ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 work as a cashier in a very busy travel stop. At times giving out the change is so very painful I can barely tolerate the pain. The pain also slows me down. At times bleeding occurs. Also am constantly wiping down & cleaning may counters and things of that nature. Also my fingernails are breaking down and I don t have a clue for what to do about any of this. Any insight or suggestions would be extremely appreciated. ### REPLY: Welcome to  Forum should moisture your hand always. Every night before going to bed wash your both hand with warm water and apply a thick layer of petroleum jelly over it and keep it open throughout the night. In the daytime when you are in house you can repeat this too. You can apply little petroleum jelly just to moisturize your fingers when you are working at daytime. You can dip your fingers tips in olive oil for 5 to 10 minutes daily when you have leisure. Take more natural proteins diet and mineral rich diet. Hope this will be helpfulTake 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 think I have cold ulticaria. I did the ice cube test and got a positive result. I put an ice cube on my arm for about 3 minutes and it started burning and itching and little tiny hive broke out and formed the shape of the ice cube and look like a welt. And it took only a couple mins to form into a welt. Also I think I might have strep throat. And my ear hurts and a swollen lymph node on the left side ### REPLY: HI, thanks for using  Sore throat is more commonly viral than bacterial, so it is possible that your sore throat is due to a viral infection unless the pain is severe, lasting more than a few days and associated with persistent fever. Using pain medication may help. The ear pain may be related to the sore throat or problem with the ear itself. If it continues then you may need to be seen to rule out ear infection. Cold urticaria can be treated with anti histamines 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 periods last date was 16 may and it should come in 13 or 14 in this month but it doesn t i also took two time i pill in that month i want to know about irregulation of my periods and its cure can i use ovral g for this purpose and how can iuse this ### REPLY: Welcome to  Good Dayton should avoid taking I-pill more than what it is prescribed for. The side effects of I-pill Levonorgestrel is delayed periods with heavy bleeding, weight gain, migraine attacks. You need to consult with a Gynecologist who will help put you on regular combined OC pills, 3 monthly Progesterone injections or IRENA IUD for contraception among various options available for contraception, but none of these prevent from STDs like a Condom. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 father is 67 yrs old with creatinine 5.38 he is taking homeopathy treatment but now seems to be no improvement further. and we want to avoid dialysis pls help,he has no other problem other than this. Can his kidney get improved to 30 or 40%. please do help. ### REPLY: Hi, welcome to our site. I am . Read your query. That is a very significant question and I appreciate your problem. I will try my best to answer your query am not sure what is the cause of kidney dysfunction. But we do need to take a look at that. In causes like diabetes, tight control may help. Avoiding painkillers and other nephrotoxic . Besides, I understand that he may not want to do hemodialysis. Its uncomfortable and inconvenient. However have you discussed the possibility of CARD, or peritoneal dialysis with your doctor?once he is trained at it, he can do it at home, and be mobile and everything can be done normally I think that may be a good option hope this helps you. Inform the reports mentioned above so I can be of help further. Best of luck. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Looking forward to your return query with the details asked so that I can help you further.(If the answer has helped you, please indicate this) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 m 25yrs old female, from India....suffering from hair loss.....I have very less hair left on my scalp, more specifically hair are not sufficient enough to cover the scalp entirely....scalp is visible from every where....and because of this my confidence is reducing day by day.....and I am scared what if one day I become bald....I have researched a lot on the internet and I think I am suffering from telogen effluvium....please guide me what to do about this problem and also how can I confirm whether it is telogen effluvium or sum kind of alopecia....pls doc tell me which test I should undergo in order to know the problem and the treatment to reduce the frequency of hair loss....I m supposed to get married after 9 months I m really worried please help. ### REPLY: Hi Dear, Understanding your concern. As per your query you have symptoms of hair loss which seems to be due to compromised immunity of body, stress, systemic conditions, improper hygiene, fungal infection and hormonal changes. Need not worry. I would suggest you to - Avoid covering your hairs with cap/hat or longer duration.- Take diet rich in supplements like vitamin A, Omega-3 and vitamin E.- You should avoid using shampoos that contain excessive chemicals. - Take protein rich diet and healthy food intake on daily basis. - Do massage of hair scalp on daily basis. If symptoms keeps on persisting visit dermatologist once and get it examined and start treatment with antifungal medication and shampoo. Go for blood tests to check any underlying systemic pathology. Hope your concern has been resolved. 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 have 4 rotten wisdom teeth that gave me n infection in my mouth. I think i might have a gum disease also and im really afraid my teeth will fall out.I work a full time for $8 hr,no insurence, and have bad credit and no cosigner Can i get help? ### REPLY: Hello, thank you for consulting with . When there is infection in any tooth you have to get it either removed or get it root canal treated, as infection can spread to the apex and cause an abscess or cyst, which will be very painful, so better you should get it treated as just taking medication can not solve the problem, so you have to make time for appointment of dentist. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been having severe occasional mid upper abdominal pain , sometimes it last seconds to minutes. doctors have tested me and they say they dont see any problems. the pain is almost like a squezing to similar feeling of a pulmonary embolism . i had mult. pulmonary emboli 1 1/2 yrs ago due to blood clotting disorder. they are gone and my coumadin is checked weekly. but this pain in my middle upper abdomen chest area is concerning due to when it happens it takes my breath away and i break out into a cold sweat. i am very scared and i know something is not right, i am 30 yrs old and want to get to bottom of this. i never know when it is gonna happen and it makes me freeze so when driving i am scared i might wreck. any help will be greatly appreciated. sometimes it seems soda brings it on but i drink more water than soda. pleaseeeee help i am scared ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You have got pain in the upper middle region of the abdomen. It is squeezing in nature.it is so severe that you get sweating during pain. You had pulmonary embolism 2 1/2 years back.  The site and nature of the pain suggest it may be peptic ulcer, gallbladder pain, or liver pain due to hepatitis.  It could be due to recurrence of embolism also. I advise you to consult a physician for diagnosis and treatment. You may have to go for gastrostomy, M.R.I. besides other routine tests for confirmation.  Wishing for a quick and complete recovery.  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: For a few months now, Ive been getting tiny itchy red bumps on my labia majora. Im not sexually active but I was a couple months before it started happening. I went to the doctor a few times. The first time they said it was a bacteria infection. The symptoms came back and I went back a second time about two months later. The gave me the same treatment. About three months later, the itchy red bumps were back again. I went to a different doctor and got check again. I got a pap smear and blood drawn. Everything came back negative so the doctor gave my a jock itch cream. I was wondering if you could give me any answers because I dont think they know. Can you please help? ### REPLY: Hi there, Thank you for reaching us. I understand your problem. Though you are not sexually active now, but you might have acquired a sexually transmitted disease(through oral, vaginal, and anal sex), when you were active. This most probably is due to a virus named Herpes simplex, for this you need antiviral treatment. Secondly it might be due to sensitivity to chemicals or irritants(contact dermatitis), or caused by allergies (atomic dermatitis). You should visit a gynecologist for this. In the meantime avoid known irritants, such as abrasive soaps or strong fragrances. You may find some relief through a site bath. This helps to relieve any pain and discomfort associated with the sores. This can be done at home by filling the bathtub with warm water that goes up to your hips. You may add a mild saline solution or baking soda to the water. While you can purchase small basins for site baths from a . Hope it helped. 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 started having really bad stomach pains yesterday. The pain is in my lower left abdomen in my ovary area and goes up to the bottom of my rib cage. The entire area is very tender to the touch. I ve taken pain pills and muscle relaxers to ease the pain but its not helping. Any idea of what it may be or any suggestions on what I should do? Thanks! ### REPLY: Hi. Thanks for your query. He pains on the left side of the abdomen lower ovary area to the bottom of the ribs is suggestive of the following things:-Colitis of the left side of the colon, the large bowel.-Left Kidney and / or ureter stone or infection. I would advise the following:Examination of the stool, urine and blood. Ultrasonography of the abdomen. This will five idea of the problems and guide for further investigations and treatment as per the cause. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 have had pains in my heart and tightning chest  and very fast heartbeat went to my docters and she said I was haveing panic attacks and I have blood taken and a ecg test done it was going very fast but wasnt missing beats but my heart still hurts sum time is it normal when u just had a panic attack as they come on all the time? ### REPLY: Hello.... You did not mention your age. There are two things... Sometimes Panic attack per se can cause chest pain and palpitation. But sometimes if anyone having some previous heart pathology then sudden mental stress can cause chest pain due to vasospasm of coronary artery disease called Unstable angina. As you said, your doctored one your ECG and blood test that came negative for any heart pathology. So it may be due to panic attack you are feeling chest pain. In that case, nothing to worry about your chest pain regarding your heart, but you have to control your anxiety and do some lifestyle modification with some yoga for piece of mind. 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: Sir, Since last one year I am suffering from fatty liver problem. My  total bilrubin was 1.3 and direct bilrubin was 0.5 and ALT was 63.  I have under gone treatment and I have taken Udiliv 300 twice and vitamin e (NE) twice. After one month in blood report Total bilrubin found   was 1.03 Direct bilrubin was 0.5 ALT-36. However I was continuing the same medicine for another two months. At present my recent blood report says Total bilrubin is 2.2 where,   direct bilrubin is 0.49, AST-25, ALT-19. I am 21 year old I have reduced my weight from 70 kg to 65 kg in last three months. My Physician suspects that the cause of higher bilrubin is Hemolytic Anemia  and prescribedt same medicine with Iron supplement for another three months and ask for blood test for Hemolytic Anemia. Please advise. My height is 172.2 c.m  XXXXXXkolkata ### REPLY: Hi, Thanks for writing in. Udiliv is not the medication of choice for fatty liver. The best combination would be sorbitol, trampoline citrate and orbiting for a period of 6 months. This will help reduce or normalize the liver function tests. To rule out a hemolytic anemia you need to undergo proper clinical examination and hematological work up including peripheral smear and bone marrow studies. 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 started having numbness in my forehead and both forearms about 9-10 weeks ago. I now have some numbness in both feet around my toes ( feels like walking on cotton) Now I have slight numbness on my tongue. Had bloodwork done. Blood sugar was a little high. 6.7 but everything else was good. I went to a chiropractor for about 6 visits. Nothing has helped. Just saw a neurologist and she doesn t think its neuropathy because it didn t start in my feet and I don t have any pain. I just had an MRI and haven t had the results as yet. I ve completely changed my diet. I m following the Paleo plan. Any idea what this might be? I m thinking of going to an acupuncturist next. Thank-you ### REPLY: Maybe you have to consult an endocrinologist too regarding your high blood sugar. Polyneuropathy can in some cases start from the upper extremities. But the numbness in the forehead and tongue doesn't comply with neuropathy diagnosis. Did the neurologist recommend the MRI and what region? Do you have any other symptoms or did the doctor found any other sign during the physical examination? I will be interested to know the MRI result or any other test that you've taken. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My father is suffering from DVT and before 2 days his INR was 1.14, so doctor changed his medicine form Acitrom 3 mg to 2mg and for your kind information before 5 days his INR was 6.31 So is it the right dose is he taking right now or should he consult doctor again? ### REPLY: Hello. Thank you for using . I carefully read your concern. Acenocoumarol is an oral anticoagulant, which takes effect on the body after 48-72 hours. Therefore, the opposite is also true - if you discontinue it, you should wait 48-72 hours for the effect to wear off. Now, every time that INR goes off the range, various methods and dosages can be used to maintain it within range, depending on how high or how low it is. In this scenario, I would recommend a more often measurement of the INR, and consulting the doctor for the dosage of acenocoumarol, on a daily basis, until a more equilibrated dosage can be instituted. I hope I was helpful. 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: Last week I was taken to the ER because of severe vertigo, nausea and headache. During the evaluation a blood test was administered. The test came back positive for the ChatDoctor hormone. An OBGYN was consulted and was given the okay to administer Phenegren. After an MRI I was diagnosed with an inner ear virus. I am a 52 year old woman and have not had a regular period in 6 months, what could be the cause of the ChatDoctor levels in by blood? ### REPLY: Hi, Welcome to  forum.  The reason for the vertigo is nausea, and headache may be due to the infection of the internal ear, and confirmed by the C.T. scan.  Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to have good health and resistance.  I advise you to consult an E.N.T. surgeon for diagnosis and treatment of vertigo.  Regarding the  positive in a woman of 52 years may be due to the Gestational triploblastic disease.  It is a term used for a group of pregnancy-related tumors. These tumors are rare, and they appear when cells in the womb start to proliferate uncontrollably.  I advise you to consult a gynecologist for diagnosis and treatment.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: how long can you live with one severely leaking heart valve and another moderately leaking heart valve? 86 year old woman strong heart muscle over all good health. she has been in the hospital twice in the last  2 months with fluid build up. thank you for your input. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Valve leakage on heart depends on the which valve it is affected and how much is the severity. Depending on the above factors we can decide the management. But overall with mild leakage on right side of the heart valves patient survives better. Some swelling and edema of the body is common, but this will be corrected medicinally. You can take some home physiotherapy exercise it will help correct the edema. Avoid excessive salt intake, this will compromise the edema further. Rest all the medication needs to be taken on the time. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr. I m post Kidney transplanet(mar-2009), from past 4 months, creatine leave has been increaed from 1.3 to 1.7, i m on pangraph 0.5 mg on night,720mg & 540 mg of myfortic, wyslone 10 mg, with BP tables, Can u please help y these creatine may go up..? and chance to bring it down to 1.3.? ### REPLY: Hello. Thanks for writing to us. The cause of rise of creatinine needs to be seen. Please visit your physician to undergo physical check up and also to undergo relevant investigations required in your case. If the medicines you are taking already are not effective, increase in dosage may be required after consulting your physician. Try to avoid having pulses. I hope this information has been both informative and helpful for 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: why do i get a really bad stomach ache, start sweating, feel dizzy, blurry vision and my ears feel cloaged. . it feels like im going to faint, i actually have fainted about 4 times in my 19yrs of life and when i do its usually these symptoms that i get. . can you give me an answer as to what it can posibly be? ### REPLY: These symptoms are quite alarming. Have you got any investigations done? Do you get heart burn or pain in upper abdomen? Where is the pain most often - Which area of abdomen? You could be having an ulcer in your stomach or duodenum(small intestine) or it could also be due to low sugar levels or inflammation of the Pancreas. I would suggest you get your liver function tests done as well as an Ultrasound abdomen and if they are normal then an Upper GI Endoscopy. But before that please reply with your sex, weight and location of pain and also whether you have ever had vomiting with or without blood or have had black tarry stools? Will wait to hear from you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my younger brother has stones of 10 mm in left kidny and this kidney is horse shoe shape both the kidny is connected with a minner block. he has got his treatment from cmc vellore, doctors removed some stone by making a small hole in waist and suggested for 14 times  lithotripsy as 1 lithotripsy per week. ### REPLY: Hi, Thanks for writing in. Stones of size 10 mm are large and cannot be eliminated by medicines. The approach by doctors suggesting 14 sessions of lithography is among the best solutions. Lithography is a safe procedure with the least complications. Your brother has a horse shoe kidney and therefore there is a higher tendency of stone formations. Lithography is done session wise and all the stones cannot be targeted at a single session. Your brother must .  This way his kidneys will be regularly flushed and any smaller stones and fragments will be washed out through the normal passage with urine. ### END