Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been experiencing severe tightness and pain in my left arm and left breast for almost 8 yrs...the pain happens around my period either before or after. i have had 3 ecgs in this whole period and each was normal. during the attack my bp always comes normal and once was even low...i am at the end of my ether here as every time it happens i think its heart attack but now after all these years it seems like the boy calling wolf story...but i still worry as i dont want to die in my sleep...please help it just doesnt want to go away.... ### REPLY: Thanks for your question on . I can understand your concern. First no need to worry about heart diseases or death because your ECG s are normal at 3 different occasions. Your symptoms characteristically appear during periods. So possibility of stress and anxiety related symptoms is more likely. Periods are very stressful for some females. So consult psychiatrist and get done counselling sessions. Avoid stress and tension, be relaxed and calm. You may need anxiolytic .  Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am currently on birth control and have been for almost two years, once the birth control took affect I no longer had cycles, now I have spotting for a few days and then it goes away and my urine has an extreme odor, it smells up the whole bathroom and lingers for about 5-10 minutes. What could this be? ### REPLY: Hello, I read carefully your query and understand your concern. Your symptoms seem to be related to a urinary tract infection. I suggest doing a urine test to confirm the diagnosis. Meanwhile, I suggest using anti-inflammatory medications such as Acetaminophen to relieve the symptoms. I also suggest to .  Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What does it mean if I have an eating disorder and everytime I stand things go black and it becomes hard to stand only for a few seconds though ?Also my heart rate recently will be very rapid then all the sudden drop to th point where I can barely find it while checking my pulse? ### REPLY: Hello! Welcome and thank you for asking on ! I understand your concern and would explain that your symptoms may be related to orthostatic intolerance (orthostatic hypotension or postural tachycardia). Have you measured your blood pressure during these episodes? A head up tilt test is necessary to rule in/out this diagnosis. If these episodes occur only after eating, it may also be related to post radial hypotension (an autonomic reflex from the gastric distension). I recommend consulting with your GP for a careful physical examination, a resting ECG, a chest x-ray study and some blood lab tests (besides the head up tilt test): -complete blood count (for chronic anemia)-fasting glucose-blood electrolytes. Hope to have been helpful! Feel free to ask any other questions, whenever you need! 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: Hello Sir My Father has total left side Paralysis for last 6 years now he can able to walking with sticks  so I just wont to know my father has nothing any any improvement on his Left Hand so plz Guide me about this Matter and sir is there any possibility for surgery ya any thing else ### REPLY: Dear caring son your father must be suffering from post CVA left sided hemiparesis involving upper limb and lower limb. This happens due to uncontrolled hypertension. General progress is with physiotherapy and time lower limb recovers partially so that patient is able to walk. Upper limb especially hand recovers poorly. Since 6 years has passed and there is no recovery, chances of improvement is poor. You need to consult physiotherapist who can guide you better. Hope this is useful. Surgery is not helpful in any way. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 doc!! I am 25 year old suffering from acne .. I get them mostly around my nose and on my chin .. they start with a swelling and pain and finally turn into a huge boil .. I have been suffering from this problem from past 5 to 6 years.. Sometime my skin get s clear but sometimes there sre just too many of them on my face...I have tried homeopathy but it didnt work.. I am looking forward to some positive and effective reply from your side. ### REPLY: Hi, Acne is a common inflammatory disease of the Pilosebaceous follicles seen in adolescents.  The general health should be checked, anemia and hypothyroidism.  Avoid certain foods like pies, fried foods nuts etc. Wash the face frequently with soap. This reduces flora and removes the excessive oil.  I suggest that, Aloe vera is the best choice for acne, Aloe vera , acting as an anti-inflammatory and wound healing. Add Turmeric powder + Need leaf powder , make paste and apply on the face. Turmeric powder is an antiseptic and the need leaf is an antibacterial agents. It can also help to reduce acne. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Have been working in the garden today cutting back and dividing agapanthus plants.  Have just realised the sap they produce is poisonous and have now a red rash on my arms and legs where I came in contact with the sap.  What can I use to sooth the rash. ### REPLY: Hi, There is hypersensitivity reaction in your body due to allergen (sap). So don't waste time and immediately take pheniramine male ate tab (evil)stat along with anti-histaminic twice a day with raiding for 3 days.  If the symptom aggravates like generalized rashes, etching, breathing difficulty, sweating, palpitation, chest discomfort etc. then don't waste time and rush to emergency dept for injectable steroid, evil, beta 2 agonists if required and other supportive management.  Thanks n regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I hit my hand last Saturday and obviously broke a blood vessel. The whole top of my swelled immediately and cut a small spot. I iced it immediately and it s been getting better everyday. However, I spot I cut between my index finger and middle finger over the 2 knuckles are still swollen and sore. Should I be concerned? I feel if I broke or chipped a bone in my knuckle, nothing could be done anyway, is that correct? ### REPLY: Hi, thank you for providing the brief history of you. A thorough clinical examination is advised along with an x-ray. As you have injured your knuckles this could be a small hairline fracture or a chip fracture or a tendon injury. Post clinical examination and with the help of x-ray the diagnosis can be made, and the treatment plan will be initiated. As hand is an important structure in the human body, having a proper examination and treatment is of importance since these injuries responds long later in the life and give unnecessary troubles.in my clinical practice such cases we first take and x-ray and plan the treatment, so the damage to the joint is minimized, and the future complaints are reduced. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Had a bad fall on ice in 2007, MRI showed an annual rent or something like that and disc bludge on L4-5.Since 2008 to about 2012 I learned to live with a pain level of about 3-4 out of 10.  During 2012 I noticed the pain increasing in strength and coming on earlier and earlier in the day.   I had a colonoscopy last June 2013 a tumor was cut out in the anle area and tested positive for carcinoid.  It seems since this procedure my L5-4 pain has increased significantly.  I had an MRI in August 2013 with significant progression of the L5-4 and L5 sitting on the root nerve.  From June to now almost November the pain is unbearable.  Could the change be from the colonoscopy ? ### REPLY: Hi, Thank you for posting your query. The pain is neurogenic in nature and is related to the nerve compression due to disc prolapse at L4-5 level. The nerve compression can lead to pain in the back as well as radiating pain in the legs. This pan can get worse on exertion, walking, coughing, etc. Colonoscopy is unlikely to have aggravated this disc prolapse. In my opinion, the worsening of symptoms noted after the colonoscopy is coincidental. You would benefit from medications such as pregabalin or gabapentin capsules in relieving pain. If pain persists, please consult a neurosurgeon, who may plan for an epidural injection. I hope it helps. Please get back if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my grandfather is 97 yrs old and pretty healthy except for knee joint aches....we never took him to a doctor as he never falls sick and is very healthy otherwise no diseases or health issues....Although since last 8 or 9 years he s started to act strange we understand it s the age....my query is what can I do to help him with his forgetfulness and he doesn t keep himself clean....he can walk and talk and has no problems as such....He also calls women walking by and makes unwelcoming gestures....We are a family of five and we take good care of him....cleaning, feeding and talking with him but he still remains the same....Also should we be getting him checked by a doctor? ### REPLY: Hello, Thank you for the query Dealing and caring an older member in the family can be stressful and difficult. It is pretty normal to be forgetful at this age. As people get older, changes occur in all parts of the body, including the brain. As a result, some aged people don't remember information as well as what they did. They lose things and forget the usual norms. These are signs of mild forgetfulness, not serious memory problems. Serious memory problems which affect a persons personality and behavior like Dementia is when one cannot carry out his everyday activities. From your query I understand that he is able to do his daily activities. This is called Mild Cognitive Impairment. Trying to talk to your grandfather about his misbehavior could help him in understanding the trouble. A care takers assistance for him can make things simpler and easier especially for his forgetfulness. If it gets worsened, it is advised to take him to a euro psychologist. A euro psychologist is a licensed psychologist with specialized training in assessment and treatment of cognitive problems associated with dementia or other neurological conditions. Patience and sense of care is from the other family members, considering his old age will help him a lot. Stay Healthy! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: one month ago dentist cut my gums,scaling etc. Because my gums were in very bad condition.After this i got Braces on my teeth ,but still my gums are bleeding and in bad condition i am using Hi- Prodent tooth paste. Simply i wanna ask what i should do now. Am every time worry . am from Pakistan. am 23 years old, please....................................................... guide me. I will be very thankful to you. sir simply detist cut my gums.................... ### REPLY: Hi, Thank you for the query. According to the history it suggests of long-standing gingivitis. I would advise you to take an OPG and see your dentist . Because presence of infection in the gums will lead to repeated swelling and bleeding in the gums. This has to be treated by flap surgery and the x-ray will help you know the amount of infection and bone loss present. You have to concentrate on your oral hygiene and should maintain it by brushing twice and flossing and gargling thoroughly after every meal. A course of antibiotics is required to control the infection. See your dentist for clinical examination to rule out the exact cause. Hope this information helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi almost two months ago i caught in typhoid . My Dr. said that it was secondary typhoid. he gave me medicine but that antibiotics didnt work for me. My Dr , then changed my antibiotic, and advised me to take for next 14 days. i took, but still things are same for me. joints pain, headache , weakness, stomach problem and idleness. i need your advice. thanks ### REPLY: Hi, Welcome to ChatDoctorYou suffered Typhoid 2 month ago and took antibiotics for it. Joint pain, headache and weakness but no fever hence it may not be typhoid because simply typhoid improves in 2 to 3 week time maximum and if there is no infection even antibiotics do not work. It is advisable to visit a good Physician nearby and get complete focal examination and appropriate investigation would be done and once diagnosis is confirmed treatment can be given, and you will improve in few days time. It is not correct to take the lot of antibiotics without proper indications. Take care Good Luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 22 months girl has a black oval spot under her right foot. Just notice it 2 weeks ago. I am sure It is not a mole. I assumed it was a dry blood under skin from a pinch or something like that. After 2 weeks it haven t change at all, I am worry now. Can this be someting else? ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am a 42yr old female recently found out I have an enlarged heart. What s shocking is I have always exercised and worked out regularly from as early as age 16. I do not abuse alcohol nor have I ever abused drugs, in the past my blood pressure has always been on the lower side, also low blood count . I guess i am just confused as to how this is now my situation.I am sorry I really can t afford to pay at this time for the answer. I was mistaken, I thought it was free advice.Thank you for your time though.SC ### REPLY: Hello.First enlarge heart is a very vague terminology. Size of hear increases in two fashion. One is increase in thickness of wall called Hypertrophy and other is increase in cavity of heart called Dilatation. Again Hypertrophy is subdivided into two types inward enlargement called concentric hypertrophy of heart and another is outward enlargement of heart called eccentric hypertrophy. Whereas Dilatation of heart is called Cardiomyopathy. And Cardiomyopathy has various subtypes depending on etiology In short, the enlargement of heart including Hypertrophies and Cardiomyopathy; in both cases, the cause is not sure always. Any person at any age of life can be developed these disease. So in my opinion, better to go for diagnosis of which type of heart disease you are suffering and up to what extent having this disease then start the treatment that depends on condition and etiology. Thank You ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi. i suffer from constant and limiting back pain. i have been diagnosed with degenerative disc disease, syringomyelia, schmorels nodes, slight scoliosis and today was diagnosed with scheuermanns disease by a surgeon. can u tell me what scheuermanns disease is, i can only find info about the disease in children. im 41 yrs old, have had back pain here and there since my 20 s. in the last 8 yrs it has increased a little more frequently but manageable. in the last 1 to 2 yrs it has gotten so bad that i am unable to work. ### REPLY: Scheuermanns disease is a malformation of the backbones, commonly of the thoracic spine of the mid back. You should pursue a rigorous course of physical therapy, because while some with the condition benefit from surgery, it is very extensive and complicated and should be considered a last resort. Other options with this condition include local muscle trigger point injections, and acupuncture, not to mention medication 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: I have had brucellosis for over a year now ,since I realised I had the bacterial infection I have taken almost every antibacterial that kills brucella and completed all the dose but in vain, I tried chewing garlic for several weeks and got no results ,please advise me on the best way to combat this, Ali kafeero ousama from Uganda. ### REPLY: Hi, Welcome to , Brucellosis is easily treatable and does not have frequent relapses. I do not know the treatment you have been prescribed, but the .  Best regimen is consisting of doxycycline 100 mg orally bid for 6 weeks plus streptomycin 1g/day I'm for 2-3 weeks. If chronic case then vitamin can also be added. I suggest you get in touch with your treating doctor and discuss the suggested therapies. 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 m seven and a half months pregnant and I was just wondering how I could get rid of a yeast infection without harming the baby, I was told there s certain products that are safe and others to stay away from but it s driving me crazy I can t sleep because it affects me the most early morning or late night and I just really need to get rid of it please help! ### REPLY: Hi, I understand your concern.  - Oral . Application of ointment at time of excessive trouble will solve your problem.  - Use of loose fitting cotton clothes/ washing & mopping of genital area each after each visit to washroom or toilet./ avoid douching/ avoid sugar in diet/ use lac to bacillus contains curd in diet are some tips for personal care.  - avoid sex these days. Male partner can take both oral & local medication.  - It takes about 10- 12 days for total relief. After the relief personal care along with using antifungal dusting powder can prevent recurrence.  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 hit my head in the shower, and felt really weird and sick soo i got out and i have a lump and was bleeding , what should i do ? ### REPLY: Hello, Thanks for posting your query. First, you need .  Please consult Emergency Department in your locality. You may need an CT scan of brain to rule of internal brain injury, if you continue to feel dizzy or loose consciousness or omitting. They will keep you on observation for 24 hours. Do not worry. Most of the time it will be superficial injury. Get yourself evaluated. Wish you speedy recovery. Get back to me in case of follow-up 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: yesI had a situation sunday even where my normal blood pressure went up to a variety of numbers to include 197 over 133.  My l arm veins were pumping hard but my right side pretty normal.  I have a common birth condition where the blood flow in is great but out slow and narrowed.  Didnt go to the hospital  due to stress I believeIs this a sign of something to come?  Looking for a cardiologist ### REPLY: Hello dear user! Thank you for choosing . I have gone through your medical history and understand your concerns! I would like to know some more information to have a closer view of your situation.- What is your age?- Are you a regular smoker?- Are you overweight?- Have your parents or other familiars any history of hypertension? It is true that in women who take contraceptives for birth control may be affected by high blood pressure especially if they are overweight and smoker. If you have familiar history of high blood pressure this is more likely to happen to you. I would suggest you to quit contraceptive .  Having abnormal levels once or twice doesn't mean you have to take antihypertensive  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have just seen a specialist for high enzyme in my liver I had bloodwork done today. What other test should I get done? The doc s aid that after all tests are completed he said that if they are normal he said he will still take a biopsy of my liver Why? ### REPLY: Hi and thank you so much for this query am so sorry to hear about these high enzymes in your liver. The doctor would do a complete liver panel and also progressive tests like hepatitis serology, ultrasound, Antinuclear antibodies, etc. to establish the cause of this increased in liver enzymes for effective management. If no answer is gotten for the tests, then a biopsy would be needed as last resort to identify the cause. I think your doctor is on the right track, Work with him and get the problem looked into. I hope this ad .  Thank you so much for patronizing our services, and please do feel free to ask for follow-up clarifications and information if need be. I wish you the best of health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir, My SGPT 71 and Bilurubin 2.1 on 5/09/14 Test before that SGPT 65 and Bilurubin 1.9 on 28/08/14 . In Ultra Sound test Liver is midly enlarged and all other report is normal. Doctor Prescribed Urosol 300 and Pantodec L. Can I taken or other medicine are best? ### REPLY: HelloFindings indicate enlarged liver with increased SGPT and bilirubin level. Increased SGPT may indicate liver injury. It may be due to many reasons like hepatitis, alcohol intake, altered lipid profile, medicines,autoimmune causes etc. You may need few more investigations like routine hologram, random blood sugar, lipid profile, viral markers. Mild hepatomegaly often reverse with treatment of underlying cause. You have been prescribed right medicines. Ursodeoxycholic acid 300 mg helps in regeneration of liver cells. You should avoid saturated fat and go for brisk walk regularly. Get well soon. 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 have a raised esr level and have just had an ecg which showed some sbnormalities in the qrs reading , what does this mean for me i am female aged 59 had breast cancer 18 months ago stage 1 grade 1 no lymph nodes involved. i have had a pesistent cough for 1 year on and off. ### REPLY: Good Day, ESR is a very nonspecific reading. A great number of things can raise these values, and one large value does not necessarily represent any significant illness or issues; it will not be enough to say anything is wrong or right. What it can do is signify that your body is in a more inflammatory/reactionary state than usual; but as I stated before this can be due to a number of things (Stress, elevated BP, viral or bacterial illness (even simple colds that you don't realize you have). Are you suffering any other symptoms? I hope this has helped, I wouldn't place too much emphasis on your ESR by itself, but if there are any other symptoms, I'd be happy to discuss these with you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My name is Melissa and Got into 2 major car accidents and damaged my back...i have 2 herniated discs back spasms and some days it feels like electricity shooting down my legs. im in pain everyday and motrin doesnt work at all...what other pain reliever can i take to help me with this problem.???? ### REPLY: Hello, I have studied your case. Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor. You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case. I will advise checking your it B12 and it D3 level. As MRI shows disc compressing on nerve root then surgical decompression is permanent solution. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my dad passed yesterday, 16 days ago he survived open heart surgery which included a valve replacement quad bypass and aorta streghthening, he was released to a rehab facility and was doing well they took him to hospital for a chest x ray and blood work, he became unconsious and passed away from fluid in and aruond the lungs my question is could this have been prevented? ### REPLY: Hello derisory to listen about the loss of your dad, may his soul rest in peace. Warm welcome to .come have evaluated your query thoroughly.* The fluid around lungs may have different issues - fluid overload - lung infection - septicemia - cardiac issue with secondary event - others.* So far as the prevention question is concerned, it requires in depth case study with series of evaluation, one of which require postmortem. Hope this clears your query. 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 8 months old son has cough and wheezing for one week.this is second time in this month when he gets cough.He is taking Brace and Codelite cough syrup and he is on nabulization.Cough and wheezing Is not reduced.now doctor has proscribed Omnacortil and Antibiotic Synclar.Is it safe for him.Is there any alternative non steroidal medicine for this condition ? ### REPLY: Hello. I have gone through your question. Omnacortil contains prednisolone which is a steroid. If used in right doses for a short period of time it is safe and can work wonders for your son. Other non-steroidal alternative can be albuterol syrup. It can also help to get rid of wheezing. I hope this helps. If you have any other question/queries please feel free to ask. Thanks and wish you a healthy life. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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...im suffering from Esinophils from almost 3 years....it always attacks in winter.......my mother had Esinopheles long back...i have been suffering from fever from 3 days with severe cough,chest pain while coughing...yesterday i went to doctor then he has given Avil injection...immediately after that my hands became stiff...he has then immediately given decadron injection...and it got cured... ### REPLY: Hello, Your probable diagnosis: allergic bronchitis. Investigations needed.-Auscultation -Chest x-ray -Spirometry if needed -AEC If your AEC more than 600 than start montelukast plus fexofenadine tablet course for 10-15 days. A decongestant like levocetirizine for five days can be prescribed. If bronchoconstriction present than bronchodilator needed. Consult pulmonologist for examination and get a prescription. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctors, This is Ahamed aged 31, Male, suffering from lower back pain. MRI shows Diffuse disk bulge at L4-L5 and L5-S1 levels mildly indenting the thecal sac with mild abutment of bilateral existing nerve roots. Doctor prescribed me tablets for 10 days and advised to take rest( Not to lift any weight or bending back) for 10 days. Can this issue be cured by medicine and exercise? Also Shall I have sex during these period of 10 days? Will sex affect my back by any chance? Thanks Ahamed ### REPLY: Dear; thanks for using our service, I read your question with care and will give you my advice. First, you have multilevel disc problem witChatDoctorpression of the canal. That is why you have back pain. The oral medication can help, but rest is very important too. Not only to avoid bending and lifting weight but also to avoid sexual activity during this time because it can aggravate the pain. There is no medicine to cure this, exercise can improve the strength of the back muscle but need to do it with care and supervision. You might need to have an evaluation with a pain management to consider epidural block. I hope that my advice has been helpful .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is a rash significant when a patient has hepatic encephalopathy? Would it be more related to the dx or more from adjustments of GI meds? The patient is a 72 year old male with hx of cirrhosis, ulcerative colitis, crohns disease, and his meds are Pentasa, Lactulose, Xifaxin, Uroxatrol, Propranolol, Omeprazole. The rash is present on upper arms, around neck, upper legs, and groin and it is pruritic. Thank you ### REPLY: Hi thanks for asking question. Noted you have cirrhosis and inflammatory bowel disease. In chronic liver disease yes itchy rash and purpura can occur... In cirrhosis hyperestrogen also lead Palmer erythemas.... Morever in ulcerative colitis like inflammatory bowel disease have extraintestinal manifestation like erythema marginate like skin condition... So you have to consult dermatologist for it. He may prescribe you antihistamines, anti-inflammatory . ... 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: 2 weeks ago I started having lower back pain just comes out of no where it hurt to move while I was having the pain but now its stronger pain and consistent it hurts bad an makes me fill like i gotta sick an making my stomach cramp an today I started having lose stools an blood in the stools It s like moving down into my legs ### REPLY: For severe lower back pain you can take some painkiller like ultracet-plus or zerodol-sp only when the pain is worse enough or disturbing your daily routine along with some calcium supplements like shackled or toscal-gem once daily. Take some multivitamin like spray or neurobian-plus once daily. Do some physiotherapy exercises after an expert opinion of physiotherapist. I will also advise you to sleep on a plain surface. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a c-section a month ago tomorrow and I ve had itchy bumps around vaginal opening for about a week now. I had a yeast infection and treated it with monistat but the outside bumps won t go away. When I walk and do activities that rub the Ares they itch really bad and hurt. ### REPLY: Hi, The itchy bump on your vagina could be due to yeast infection you had previously. I highly recommend you to consult with your gynecologist and run vaginal swab testing to confirm yeast infection.  For the moment, I advise you to keep good local hygiene. Avoid sexual intercourse until betterment. Apply Clotrimazole vaginal cream locally. Applying yogurt or vaginal probiotic cream can ease itching. 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: DEAR SIR, I GOT A PAIN IN RIGHT SIDE EAR WHILE CLEANING AND ALSO BACK SIDE BRAIN HEDACHE. AFTER 5 DAYS THEN A RED BLISTERS CAME ON EAR. RESULTING GETS EXCESS VOMMITING, WEAKNESS AND FEVER. SO I HAVE ADMITTED IN ENT SPECIALIST HOSPITAL AND GETTING A TREATMENT FROM OUR DOCTOR. THEY HAVE TOLD ME I GOT A HARPIES. SO THEY HAVE GIVEN ME TABS. - VALCIVIR - 1000 & DROXYL - 500. BUT TODAY I AM NOT ABLE TO PROPERLY STAND ON MY FEET. SOME CHAKKERS OCCURING. SO KINDLY SUGGEST WHAT TREATMENTS TO BE TAKE FOR 100 PERCENT CLEAR THE THAT TYPE HARPIES.  THANX. - RAVI. - 0000. ### REPLY: Hey. Welcome to . See dear, you can continue with the medicines which your doctor has prescribed you. It will take some time to get cured. So please be patient. And as you said that you are not able to stand properly on your feet, it may be due to weakness. I would suggest you to take a good multi-vitamin supplementation along with those medicines. Also concentrate on your diet, have healthy and nutritious diet. . Wish you good health.:)Hope I have answered your question. If you have any questions, then I will be happy to help you. Take care. Warm 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 just had my thyroid removed as it was cancerous. after 6 weeks, my tsh level is 8.61, my calcium is 2.23 and phosperous is 1.02. I have been stressed this past week and not taken my calcium pills which would explain the low level of calcium and phosperous. I am concerned about the TSH level being so high. I feel fine. I have not gained or lost any weight. the only abnormality is that my period has been spotty. What do you think? ### REPLY: It would have helped had you told me if your entire thyroid was removed or only half. Since it was cancerous it is more likely that the whole thyroid was removed. Normally, after removing the thyroid for cancer, a thyroid scan is done 6 weeks later to confirm that the entire cancer has been removed and if any is remaining to destroy it with medicines. It is only after this scan that Tab Thyroxine is started (the thyroid hormone that you will have to take for life) and the dose is titrated over a period of months to make the TSH normal. If you have not been given thyroxine because you are scheduled for a scan then the spotty periods and high TSH are normal as they are both features of a subnormal thyroid state. They are not related to your cancer and nothing to worry about. If you are not scheduled for a scan, talk to your doctor and get one. If you are already on thyroxine and the scan has been done, then the dose needs to be increased. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What can I do to decrease my SOB symptoms? I am pretty sure this stuff is going to kill me. COPD is apparently not my problem, as indicated by my near 100% O2 onboard level, consequently a canister of O2 will do me little good. I have identified various triggers of my gasp-attacks and most often head that mess off before it gets nasty. My fear is that something as mundane as choking on some water and then have this stuff kicks. in . I m dead-meat!! Please help. Does this make any sense? YYYY@YYYY . Ted Davis ### REPLY: Thanks for your question on . I can understand your concern. COPD is chronic progressive lung disease. COPD patients tend to develop psychological symptoms in their terminal life. So your current symptoms, fear of death, choking sensation, gasp attacks etc. are more suggestive of psychosis. So better to consult psychiatrist and get done counselling sessions. You will also need antipsychotic .  Don't worry, you will be alright with counselling sessions and antipsychotic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 applied parsley oil to my upper gum in my mouth to help sensitivity from tooth.  My left side of my mouth,top an bottom immediately went numb.  It has continued to get numb on and off as well as my tongue and my left hand from which I applied the oil.  I am applying heat to the area an it helps the numbness go away.  Should I go to Dr. ### REPLY: Thanks for your query, I have gone through your query. The parsley oil will not help you to reduce the sensitivity in the teeth. The numbness can be secondary to allergic reaction to the oil. Nothing to be panic, consult an oral physician and get it evaluated. For the sensitivity, you can use desensitizing toothpaste like strontium chloride, potassium chloride(sensor toothpaste) or fluoride containing toothpastes. If it is secondary to the decayed teeth then the teeth has to be restored with a cement material. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What can I do. I had a stent put in after kidney stone surgery. It hurts in my lower back very bad when I feel the fluids leave my kidney into to stent. But once it leaves my body the pressure subsides and not as painful . But my lower back is in so much discomfort afterwards. Only thing that helps with pain afterwards is a hot bath. Anything else I can do relieve the pain . ### REPLY: Hello, Welcome to ChatDoctorI am  answering your query. I can understand your concern. The pain you are experiencing may be 1.post-operative and 2.back muscle spasm pain. Hot water bag or heating pad will be very useful for constant use. If you are passing urine without any pain and obstruction, then it is all right, if not, please see your doctor. Do mention your pain to the doctor during your follow-up visit. Hope this suggestion will help you. Good Luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am being treated for some type of allergic reaction since Monday with prednisone 5 mg 4 times a day.  Sarted with itchy palms and soles of feet, now I itch all over.  I am today having trouble swallowing my food, I called my Doctor and he said give it a few more days.  It is really scary when you feel like something is stuck in your throat. Should I call another doctor? ### REPLY: HI, thanks for using  In most persons' prednisone is given as a single dose in the morning to correspond with your own bodies release of steroids, with adults taking 40 mg maximally at one time. The body releases steroids in the morning in everyone. It is possible that if used in this way that you may have improvement, but you should speak to your doctor to find out if this is an option for you. There may be a particular reason that you may need to take it in this way. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am pregnent of 26 weeks, i have one issue..i dnt like milk at all does my baby bone are fine becoz i am not consuming milk i like more salty things instaed of sweet do i have any other option to consume calcium so that my baby will not suffer from calcium deficiency. looking forward for ur rep. ### REPLY: Hi there,From 28 weeks of pregnancy extra calcium is required as that is the period when maximum development of fetal bones occurs. If you are unable to take dietary calcium in the form of milk, then it would be wise to take Calcium supplements. About 1 gm of calcium in divided doses of 500 mg twice a day can be taken. Any brand of calcium will do, you could try a few, see which one suits you the best, as some calcium tablets can be quite large and women find them difficult to swallow. Also do not take iron and calcium at the same time as they can hamper each others absorption. Hope this help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: after i walked 1 mile or so blood pressure is 144/84 heart rate 124 taking meds lisinopril 10 mg , simvastatin 10mg and fenofibrate,54mg metformin 500mg 2 day weight was 252 now 238 on diet how long do i need to been on meds if i keep diet and lose weight. ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain and give you my opinion. Hypertension is divided in two groups: essential or idiopathic hypertension without an identifiable cause and secondary hypertension, usually in young ages, meaning that is a secondary cause of it. This cause might be a renal disease, an endocrine problem, a cardiovascular pathology. I suppose in your case we are dealing with essential hypertension. It is a chronic disease. It has not a definite cure, but it should be treated life longs you are diabetic, and you have cholesterol problems under treatment we have blood pressure target for you bellow 120/80 mmHg. Diabetes and lipid disorders are cardiovascular risk factors, so we have to be much aggressive with our mean blood pressure values. It is normal to have blood pressure values above 140/80 mmHg soon after walking and fast heart beats. It is mandatory to have lower mean values during the day. Physical activity, losing weight and diet will help you to better control high pressure, diabetes and lipid disorder but this doesn't mean that you will stop your medications. Hypertension and diabetes will be treated medically livelong. Keeping on with your diet will help you to stay on lower dosage of medication as long as possible, but you should never stop your blood pressure, cholesterol and diabetes medicine. Stopping them will rise all your values again because these are chronic disease. So, my opinion is to keep on with your physical activity and diet, continue your medicine and after two months discus with your doctors for your medicine dosage after measuring once a wile your blood pressure and your diabetes. Hope I was helpful. Wish you good health. Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have come off the pill after being on it for 8 years. i have been off it now for about 8 weeks because my partner and i are wanting a baby but i have still not had a period but i have never had regular periods but i was wondering can you still ovulate without a period? ### REPLY: Hi, I think you can ovulate without periods, but it is rare. So, you will need some medicines for ovulation.  You can take some medicines like camphene for the growth of your follicles and track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your partner 2 to 3 days after injection.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I had capsuotomy for contracture and Duvries surgery. Five weeks later, it hurts somewhat. What bothers most is a funny cracking sensation of the joint (big toe). Should I worry? I m exercising, as recommended, by crunching my toes and trying to lift (my heels off the floor). Thanks. Rosie ### REPLY: Hello, Cracking of toes is not a matter of concern. Your history is quite insufficient as you didn't mentioned in which you have duties surgery. Also, you didn't told about any other disease that you are suffering from. If that cracking sound is from the toe which had undergone duties it is not a concern as the sole purpose of duties is to correct deformity and not provide a normal toe, due to lack of proper joint toe may produce cracking sound. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering from what my gp says is anxiety and am pretty much paralyzed from it. I have been on cipralex for a week at 5 mg a day. I am constantly dizzy and vision has decreased. Also I am tired all the time. I was tired all the time Aswell befor the cipralex but it seems to be worse. It is Christmas break at my dr office and I am not sure what to do. Should I continue with my dose today? I herd the symptoms would go away but I feel like I m just getting much worse. Please help. Thanks ### REPLY: Hello....... Thanks for your query. Circle (Escitalopram) is an effective anti-depressant/antianxiety agent. However, the dosage of 5 mg is only starting dosage and can be gradually escalated till 20 mg/day. In addition, psychotherapy (e.g. cognitive behavioral therapy) are available for depression and other effective antianxiety medication are also available. Hence, it is premature to lose hope. Hope you found the information useful. 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 the past few days there has been a lump, or maybe like a underground one right above my anus. Each day, the pain from it has been getting worse. Now its been 3-4 days, its hurts to lay down, it hurts to sit, and its even getting uncomfortable to walk. And just today a little while ago, now there is a clear sticky substance coming out of my anus..whats going on... ### REPLY: Hi ! Good morning. I am  answering your query. The condition you have just described seems like a perianal abscess which has burst now due to neglecting treatment. This could also form a fistula in ANO. Therefore, I would advise you to report to a general surgeon in your area for proper management as it might not be possible to advise you properly on net without clinically examining it. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My pluse is 73 and I m 23 years old I have a head and for Luke a few mins my vision was blurry I do have bloodpersure what could be my issue some one said some kind of anal problem someone else told me a mingrain what do you think it it is please help and what should I do ### REPLY: It can be a condition called PRESYNCOPE.where u don't lose your consciousness but blurring of vision and a feeling as if you will fall will be there for few seconds as you have problem with blood pressure, if you are on medication it can be because of your medicines also migraine without headache is a possibility, but rare things are rare so firstly rule out presyncopeadvisedHUTT test2D echo carotid Doppler(to rule out that blood flow to brain is normal or not) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has had upper left chest pain for weeks. He s had a ct scan with contrast of lower pelvis nd abdomen and checked for kidney stones. They said he had lots of stool backed up. He has taken magnesium citrate twice and still has the pain. Any advice on what specialist to see next? YYYY@YYYY ### REPLY: Thanks for your question on . I can understand your concern. Constipation (stool backed up) can not because upper chest pain. Upper left chest pain is mostly due to heart and lung diseases. So consult internal medicine doctor and get done ECG and chest x-ray. If both these are normal then no need to worry about heart and lung diseases. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. 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: hey, i was feeding my dog when he jumped and i scratched the skin just below the nail of my hand finger, it bled a little but i pushed more blood out then cleansed it with perfume for any bacteria, its just a little minor rip size of a fullstop, do i need some kind of medication ? ### REPLY: Definitely any dog related injury whether it may be minor or major must be reported to the doctor. If you are the owner of dog, and you are sure about the vaccination schedule of the dog (if it is properly & timely administered) the can observe the dog for next ten days from the day of occurrence of injury. If the dog is as normal as previous no need to do anything but if the dog has got change in behavior or if it is irritable you must rush the doctors. If the dog is not pet, or it is wild or rod dog on which you can't keep a watch it's better to see a doctor and according to his opinion go for a post exposure prophylaxis of rabies. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 grandad is 82 and has metastaic liver cancer which has spread from his prostate he is back home now but he wont eat anything or drink the energy drinks. he has a small amount of tea - i am his full time carer and its worrying me that the doctor knows more than hes telling me? Is my Grandad dying? and will it be soon? ### REPLY: Hi, Thanks for writing in. Please see that your grandfather gets 1800 kcal food energy daily and most of this might be given as fluids and a nasogastric tube might have to be inserted for better acceptance and energy utilization. Generalized weakness might be due to malnutrition and combined vitamin and mineral deficiency. His general condition requires to be improved and this can be done by providing him minimum daily nutritional and fluid requirements. You can include protein and vitamin supplements to give him extra energy. Unfortunately the life expectancy in stage 4 cancer prostate is between 6 months to two years. Please encourage him to eat and .  Give him maximum support and care. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 57 yrs old and I was climbing down off ladder and lost my balance and missed the last step on the ladder and landed on the hard floor with all my weight on my right knee I heard a loud pop but i still walked on it for about 2 hours then it hurt to bad to keep walking. I was a doctor at a clinic and she put me on light rest walking 2 hours a day. My knee is still hurting and it has been 4 weeks now. What do I do? ### REPLY: Hi, thank-you for providing the brief history of you. A thorough musculoskeletal assessment is advised. As I have gone through the history I feel you should consult an orthopedic and get the knee assessed. As the pain is still not reduced. Also, by understanding your mechanism of injury I feel you must have injured your ligament. As you are 57, the degenerative changes in the knee must have been present and can damage any soft tissue with smallest or hardest impact. Also, your or tho may recommend you an MRI of knee to see the soft tissues within the joint. Post which the treatment will be planned. With proper medication and a combination of physical therapy you will have better strength and your mobility will also improve.in my clinical practice such cases of ligament injuries are always delayed to undergo physical therapy and the recovery time is delayed. So I advise you to take up at the earliest and make a rehabilitation process start soon. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. Im 17 years old and on July 28th I ended my period. On August 3rd I had unprotected sex. he didnt finish inside me but we wanted to be sure no babies came from this experience. The next morning (14 hours later) I got plan b and took it immediately. I felt sick throughout the day and then was spotting a lot. About two weeks later on august 17th I got a heavy period that only lasted a couple days. Now its September 15th and I havent had another period? I havent had any morning sickness or bloating or any symptoms of pregnancy but Im worried I missed a period. If I was bleeding heavy two weeks after taking plan b would that be my period? I wouldnt be pregnant right? Im only about 110 pounds and 54 so I know my hormones can act up from plan b but Im just worried something went wrong. What should I do? ### REPLY: HelloThanks for your query. The spotting and sickness was most definitely due to Plan B. Plan B is notorious for altering the pattern of your normal menstrual cycles. It can advance or postpone your periods by a week or more. Hence, the heavy bleeding you experienced COULD be an early period, brought on by Plan B. As you have missed your period now, take a pregnancy test to be sure. Have protected sex in the future. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 30. over weight. Friday night she was having numbness in her left arem down to her elbow. Hier bloodpressure was 190 over something, she had a low grade fever and kept saying she didnt feel "right". The Er did a chest x-ray and they did an ekg but the dr said it was nothing. what do you think? ### REPLY: Hi,190 BP is very high and you being a young hypertensive you will first need evaluation for cause of blood pressure. She should undergo test like kidney function test, renal artery Doppler, Sr cortisol and 24 hr Urinary metanephrines. Also get lipid profile and sugars tested once.  She should monitor blood pressure thrice a day, for a week followed by once or twice a week. She should be started on medicine like tab Amlodipine, Telmisartan. Blood pressure should stay below 140/90.  She should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet. Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once. 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: Gregor, who works at a pesticide factory, comes to the clinic complaining of muscle spasms that interfere wit his movement and breathing. A blood test shows that he has been contaminated with organophosphate pesticide, which is an acetylcholinesterase inhibitor. How would you explain to Gregor what this means? ### REPLY: Hi Dear !! Thanks for your query to . Read and reviewed your query and health concerns. IN the given situation, You seem to suffer from-Chronic OP(Organo-Phosphorous)-poisoning, as Gregor is working in pesticide factory. Central paralysis affecting respiratory skeletal muscles. Intermediate type-II paralysis-effects seem to be more in his case. Evaluation of dermal contamination /or ingested contamination to plan rightful treatment, would need Consults with ER expert in dealing with OP poisoning cases. Explanation-Gregor seem to have contamination exposure for 1-4 days and seems to be a low dose -long period contamination in his case. This would persist for 4-18 days if not aggressively treated. Consults with Physician-Specialist doctor/ and few investigations like -RBC and plasma cholinesterase/ Chest -X-ray for pulmonary edema, would fix diagnosis/Watch on 6-hr-post-admission lactate blood levels is needed. And blood and urine would fix cause of your ID. Remedy-Decontamination with removal / and disposal of his clothes is a must before starting any treatment. Treatment is mainly based on-Atropine with Low does Pralidoxime(1-2gm) continuous slow infusion with / Intubation and Oxygenation/ with Diazepam to control seizures/ with Magnesium infusions to control CNS convulsions and seizures. Decision of need and planing of above treatment is left to attending Physician, who would treat Gregor, depending on his condition and its assessment with various test -lab and clinical. This would give him relief from the bronchospasm after inhaling pesticides. Hope this would help you to plan further of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following  link-http://doctor. .com/Funnel?page=askDoctorDirectly&docId=70229Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at  services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctors, I have a kid of 8 months age, he is continuing to stool green colored with watery consistency, i contacted a pediatrician locally as my regular pediatrician is abroad for a conference, and he said it is normal, but i am worried as he has been stool since a week like this now and the frequency is about 6 to 9 times ### REPLY: Let me assure you that green stools are extremely normal in child .  It is not a cause of concern. It occurs due to rapid transit of the fecal matter through the large intestines and so the bile pigments do not get the time to get converted to the yellow pigment of stool. Furthermore, passing stool 10 times a day is as normal as passing stool once in 10 days in a child of this age and both are to be considered normal so long as the child is passing adequate amount of urine. If the child passes urine more than times in 24 hours, you need not worry. No remedial measures suggested so long as the child is active and feeding fine. Just continue breastfeeding as usual. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 havnt been able to produce a bowel movment in going on 9 days..iv tried magnesium citrait and enemas im on miralax now since my doc told me this would wrk but still nothing... i had been diagnosed with HPV 9 days ago as well and am curious if this has anything to do with it but before i couldnt go bc it hurt and now that the sores r gone i still cant go?? i have shooting pain going though my lower back as well as cramping and my legs also start to shake involuntarily..i am afraid to eat anything bc it has no place to go..and when i do eat something it comes back up so lets go ahead and add nausea and vomiting on the list.. im very scared and my doc dosnt seem to be helping and i cant just change doctors bc my husband is military...so i have to see the ones on base...i will try anything at this point.. can u please help me? ### REPLY: Hello, Welcome to , Your history and the clinical symptoms are suggestive of fungal infection over the face and chin along with Wart or Condyloid Alumina over your hands. Wart which is painless and itching are the classical of Wart which is caused by Human Papillomavirus (HPV). Human Papillomavirus (HPV) infection can be transmitted to the partner as this is a sexually transmitted disease. This should be diagnosed by physical examination and confirmed by Polymerase Chain Reaction (PCR). The treatment for this condition includesCryotherapy- which should be done in the hospital.local application of 0.5% solution of podophyllin, which should be applied twice daily for 3 days and nothing should be applied for next 4 days (7 days cycle). This cycle should be continued for 4 weeks.local application of 5% Imiquimod cream for 3 times in a week for 16 weeks (4 months). For fungal infection you can use topical clotrimazole cream over the lesion. If it is not improving you need to undergo lab investigations like KOH mount. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi- question regarding 23 year old 6 5 male with prior history of childhood exercise induced asthma (much resolved in late-teens according to pulmonologist). Recently having on/off symptoms of sharp pain under armpit area, down side and occasionally upper abdomen area. Does not take any meds. ### REPLY: Hi. I can understand your concern. Possibility that it is asthma again is there. Will also need a detailed examination to look for any local cause. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of asthma. It will also tell you about severity of the disease and treatment is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My son is diagonised with Typhoid. In widal tests Typhi H were 1:160. Today is 21 day, He has gone through antibiotic course of oflamac 300 mg daily for 2 weeks. Still he gets fever approx 99.5. Intilayy temperatures has gone high constantly upto 103 to 104. Now all medicines has been stopped. Still he gets fever around 99.5 in nights. ### REPLY: Hi. I have gone through your question and I understand your concerns. I see such kind of cases in my clinical practice. I would recommend them to undergo urine culture as it has been 21 days, so typhoid bacilli would be present in urine at this stage. Additionally, I would recommend them to start Tablet Azithromycin 1 gm OD for 5 days in order to kill . I strongly suggest you to undergo CBC, Peripheral Smear for Malarial Parasite and Liver function tests to rule out other causes of Feverish you healthy life 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 underwent external beam radiation for prostate cancer. Last treatment was in February 2014. My PSA was 13 before treatment. As of my last exam it was 4. I was on daily Cialis for a month. It helped some but not much. About three weeks ago I began noticing blood in my ejaculate. Is that cause for concern or to be expected after radiation? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have Hesperia.  It means bleeding in semen.  Italy be due to radiation injury.  Most of the time it is temporary condition. And it becomes normal within few days.  So just wait for few days.  If it remains persistent then further investigations are needed to search the cause.  Trauma, tuberculosis or tumor in genital tract can cause this.  So wait for few days. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My husband is 35 and has recently started haveing health problems. He has rapid heart beat, a gland in his left armpit that swells off and on, muscle spasms in the chest and his primary doc said his liver enzyme is slightly elevated. He has seen a cardiologist which told him that he has artierial flutter/fibralation. They sent him to a sleep study for sleep apnea and told him that he had such a mild case of sleep apnea that it was his choice weather he wanted the cpap. This has all happened in the past three months. The cardiologist has put him on heart meds which worked for a short period of time but doesnt seem to be helping. He says that his heart does this off and on through out the day. The gland in his armpit if pushed on radiates pain through his left arm, down his back and across his chest. He has had an X-ray and no lumps were found but the his primary doc did feel something small a month ago and agian yesterday but he said that it hasnt increased in size so he does not think its cancer. His primary doc is doing an ultrasound on his stomach next week due to the elevated liver. My question is do you think this could still be arterial flutter/fibralation or could all these symptoms be linked to something else? Any advice would be greatly appreciated.Thank you for your timeTheresa king ### REPLY: Hi Mam Thank for choosing , you have described three problems altogether which are co-related with each others, Arterial fibrillation/flutter required echo study, and for liver the MRI study would be the best choice instead of sonography, the lymph also needs biopsy study, you have not told anything about your husbands habits, we always ask for complete medical history, for provisional diagnosis and better advise, take good care of your husband, and be in touch with . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Sir , My brother has a special symptoms, He is always saying one of the bollywood actor is controling him using some device like remote and what ever the actor is saying my brother can able to listen .We are not able to follow whats going with him.I have taken him to many Psychiatrist .All are giving medicine mostly like sleeping pills but am not sure what to do .its been more than 10 years please advice.How we can bring that thaught from his mind that no one is controlling him. ### REPLY: The problem you mention is a really important issue. It could be dangerous for him or other people if he thinks that anybody is ordering him something because he may act on those commands. This problem is defined probably as psychosis and first episode of psychosis should be investigated for many things like hormonal problems, like hypothyroidism or a .  If all the possible medical problems are ruled out, he should take an antipsychotic medication, not just merely sleeping pills and the symptoms will subside. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good morning sir, I am 47 years old men. My right leg is only 30 percentage affected by polio. Only problem is leg length is only 0.5 inch lesser than the other leg. Now it is very difficult for me to walk for long distance. Is there any minor surgery is required for me to increase my leg length with modern technology? ### REPLY: Welcome to  I have gone through your query and understand your concern. There is no minor surgery, but there is major surgery called limb lengthening surgery (by illizarov technique) but this surgery is not indicated as you have only.05 inch shortening which is covered by shoe raise. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i shave my pubic area and recently noticed a few flat, red blotches just above my penis .they seem to be somewhat circular. i have only had sex with my girlfriend for the last 2 years and she is clean plus we use condoms . any idea what this is? ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have shaved your private parts recently and have noticed red circular spots on pubic area . Most likely this is due to allergic reaction to the chemical or soap used while shaving. Do not worry just wash your genitals and private part with warm water twice daily and apply anti-allergic steroid cream. This should get cured within a week. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i m concerned for my brother. he has an intermittent low-grade fever, left lower quadrant pain, had a granuloma show up on on his lung xray, and also has elevated liver enzymes from recent bloodwork. our mother is convinced it is cancer. he is being treated for diverticulitis as a result of fever , constipation, pain. the enzymes and nodule showed up during his workup. ### REPLY: Hello and welcome to , Thank you for your query. First, as he is being treated for diverticulitis, this must mean a diagnosis was made. Let us talk about a granuloma. A granuloma is the bodies response to a foreign substance which it could not eliminate, or throw out, thus a collection of immune cells over this substance takes place, resulting in granuloma formation. The foreign substance could be bacteria, fungus, tumor, etc. This doesn't necessarily mean that this is cancer. Although a granuloma can be seen even with malignant tumors, this is not always so. Further investigation of the granuloma will be required to be able to tell what it is for sure. The liver enzymes are usually elevated during the presence of some abnormality. And again, an elaborate work-up would be required to find the cause for this elevation. As your brother is under a doctors' supervision, it would be best to conduct all the investigations under his care at this moment, and rule out the worst. I hope I have succeeded in answering your questions, you could write back to us anytime for further clarifications. 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 been struggling with pneumonia for about nine days with a fever that jumps to 102-103 unless I use Advil. I am on z-PAC and penicillin and a nubulizer. I had blood work, a chest X-ray and a cat scan.  At what point do you predict my doc will put me in the hospital? I am a  60 yr old white female, 155#, 5 5. ### REPLY: Hello, nine days with high fever that won't respond to antibiotics suggests either a viral infection or an infection by a pathogen, which is resistant to the antibiotics you take. If you had uploaded the lab test and X-ray report and particularly the CT scan, it would have been very helpful. A very high C-reactive protein for example is a sign of ongoing bacterial infection that hasn't been treated properly. Other signs that may predict a bad outcome include a low oxygen saturation, increased number of breaths per minute (particularly when they are more than 30), more than one site of infection on the CT or X-ray, comorbidities, a very fast heart rate, etc you understand that a lot of important data are lacking for me to give you a more specific answer. I'll be glad to do so, if you'd like to provide the data. Best wishes for a speedy recovery! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I ve been feeling really down lately. I can barely get through a days work. I m self destructive and am ruining my relationships. I think I ve always had mental health issues but everything has escalated lately and I feel terrible. I haven t told anyone because I think I feel ashamed. ### REPLY: Hello thanks for asking symptoms like low mood, self-destructive behavior, sedentary lifestyle, impairment in social relationships and functioning etc. could be occurring due to depressive disorder and should be diagnosed properly. Please don't feel ashamed for the symptoms. Depression is a mental disorder like any other medical disorder and with medicines this can be treated properly.  .  The  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 27 years old. During night time I will have pain in my legs.. What may be the reason for this??? ### REPLY: 1. rule out diabetes, calcium and salt deficiency, any relation of pain with numbness, burning, positional??2. Doing too much of aerobic exercises or standing/sitting for long hours causes calf muscles to get fatigued, which cannot clear the build up lactic acid, resulting in pain while retiring into bed.3. If your doctor see no problem of muscle fatigue, it could be circulatory problem, under active thyroid.4. Could be nocturnal cramps.5.  Advise of Physiotherapist and Ayurveda Buying (leg massage) are also useful clinical procedures.6. Start taking omega 3 fatty acids, and It. E long term therapy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am concerned about soreness/pain in the muscle of my right arm. It hurts if I try to open my arm from a bent position all of the way. I notice that it gets worse with any activity - this past weekend my arm was extended to hold my 2 yr old s hand as we walked through a park. After that, the muscle still hurts, is sore, and I have to open my arm slowely to avoid pain. What should I do? ### REPLY: Hi there. You could be suffering from Tennis elbow or elbow joint arthritis. Apply warm compress or hot water bottle to the painful region. Take painkiller and muscle relaxant like Diclofenac and Thiocolchicoside for relief from the pain and muscle spasm. Avoid lifting weights or performing any wringing activities. Consult your Orthopedic surgeon to get a proper physical to find out what's the problem. ### END