Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my name is xxxx, I have pain in the lower left abdomen , and a purple blood blister the size of a peach below my navel and to the left. It started when I got my period three days ago. I have a doctors appointment tomorrow but it is getting worse and I feel lightheaded and lost my appetite . How urgent is this I am thinking I might need urgent medical attention. Thanks ### REPLY: Hi welcome to  forum.  Thanks for calling . F.  According to your description, it appears to be the boil with blood oozing in, due to pressure it is causing pain in the stomach. The period has nothing to do with the pain.  As you describe it may burst in about 3 or 4 days, anyhow you will be seeing your doctor tomorrow He will examine and may .  If at all it bursts in the meantime, you keep a wet cloth, or cotton and tie it with a cloth, to prevent spilling.  Wishing for a quick recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It has been discovered that the right transverse process (his right) of T8 has a break/crack in it... but is not displaced. My husband maintains that a visit to a chiropractor (who I have been to before successfully) is the culprit. He is currently dealing with awful back pain due to spasms, brought on by extened overhead scraping, painting of the soffit overhang on our home. Scaffolds are involved. It is high and scary, but he did not have any trauma associated with this activity other than an event... which he describes as warm tea being poured down his back ... which he ignored.. and worked thru for several days afterward. Q: Is it possible for a reputable chiropractor to break a transverse process? What ramifications does such a break exude on the body? the area around T8 does not hurt to the touch... so could it be causing any pain to my husband? OR is the pain still coming from spasms...(I think yes). He is taking 4mg Dilaudid and flexeril. pain returns when meds wear off. ### REPLY: Dear patient Any type of fracture can happen and caused by chiropractor. Since he is getting constant pain possibility of fracture is highly likely. I would advise visit to repute orthopedic surgeon and examination. X-ray of dorsal spine anteroposterior and lateral views to rule out bony abnormalities. If report shows fracture which is displaced recommended treatment is strict bed rest for one month and spinal brace for same period. Start tab diclofenac plus serratiopeptodase twice a day for 5 days. But bed rest is must. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffers from high bp he is on medication ,he takes enam 10 and eslo 5 regularly.he is non alcoholic ,works out daily and does not smoke too.his bp problem is hereditary,when he sneezes he feels a sharp pain in the chest. His age is 32,what should he do to further treat his problem. ### REPLY: Hello! Welcome and thank you for asking on ! Regarding your concern, I would explain that his symptoms do not seem to be cardiac related. They could be related to musculoskeletal pain or inflammation. You have nothing to worry about! I recommend consulting with his attending physician for a careful physical examination, a resting ECG, a chest X-ray study and some blood lab tests: - complete blood count- inflammation tests (PCR, sedimentation rate). You should discuss with his doctor on these issues and the proper treatment based on his test results. Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doc,My name is Daya 30 yrs old female.I was advised by my doctor to take yamini for 2 months to bring down my progesterone and testosterone levels which was a bit high.After this 2 mnths medication she has advised me to start with duphasthon 10mg and clomiphene.I also have PCOS .Am trying to get conceived.I have a doubt whether use of yamini will prolong my conception .Thank ub ### REPLY: Hi Day, Its true that Ya mini being contraceptive will prolong your conception, but it will prolong conception only till it is being taken. As you have finished (stopped) taking it, it won't prolong conception further. It's not correct to take Unfasten & Camphene blindly with monitoring ovulation, at least in first cycle. It's better to consult infertility specialist who can do ovulation induction properly to increase chances of conception. Wish you good health & quick pregnancy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 it possible for a 55 year old man to have a new tootChatDoctore in naturally Is it possible for a 55 year old man to have a new tootChatDoctore in naturally? I just had a back lower left tooth extracted 2 weeks ago. It appears that a tooth is trying to come in in the space in front of it where I had a tooth pulled a few years ago. It looks just like a tooth that is covered with gumline so far but it is protruding to a height of half a tooth so far. Am I seeing things? What else could it be? ### REPLY: Dear James, what you are seeing possibly could be a supernumerary tooth (an extra tooth int he mouths apart from 32 natural teeth), or it can a bony spicule, it could also be an anomalous tooth like structure (odontoid). You must see a dentist get your self examined, get an x-ray done. Rest will be fine. Do not worry. Once u get an x-ray if u wish u can send that to me on my mail- kakajuneja@yahoo.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lower back pain which may have been caused by heavy lifting for over 2 months now. It is getting more and more severe. It hurts to sit and to bend over. I also think it has caused constipation. I was prescribed Naproxen for the pain and cycloprine as a muscle relaxant. They only moderately help the pain and I wasnt satisfied with the doctors check-up. It seems to be getting worse still. It is making it very difficult for me to work let alone get in and out of the car. I am 20 years old, 6ft, 180lbs and I am very active and healthy otherwise. Any ideas would be greatly appreciated so that I could take some knowledge with me to the doctor next time. ### REPLY: In all probability we would suspect you to be having Spinal problem. It could be Muscular spasm or pull of muscles around the spine, Disc Prolapse, Discuss, Spondylosis. To confirm the same the doctors run few tests like X-ray or MRI of your spine. Most of the back pains fully recover witChatDoctorplete bed rest and later with appropriate physical therapy. Most of the patients doesn't recognize the importance of Complete Bed rest (ambulation only for nature calls) so we want to inform you that you may have to be prepared to take off from work for some days completely as recommended by your doctor. Any back pain not responding to usual treatment and rest needs to be intervened promptly. Moreover, not able to sit in the car, Constipation are not good signs to wait. We would suggest you to consult an Orthopedic immediately for further evaluation and management. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello without medicine just i hv done my follicular study no follicles were found on 10 th and12 day before this i hv my follicular study in january 2012 without medicine that time follicles were there after that again in sept 2012 my follicular study was done by giving the medicine than follicles were there what is the reason ### REPLY: HelloThanks for posting your Query. Follicles growth in your ovary goes with your regular periods. If you have irregular periods due to hormonal imbalance, you will not be producing follicle at all or at the least not every month. The fertility medications used commonly will make your periods regular and also helps in follicles growth by correcting your hormonal imbalance. I hope I answered your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am suffering from asthma and allergy.I am using a inhaler which is a composition of (budesonide and formeterol).and i am having a tablet montair(MONTELUCAST+LEVOCETRIZINE). My problem is that I am suffering from sneezing and mucosal fluid.When I am having montelucast I am okay but when I stop that i am suffering.My question is that for how many days i should have montelucast and if not then is there any alternative like nasal spray. ### REPLY: Hi, thanks for using  Sneezing and nasal discharge are normally related to allergies. Treatment would involve avoiding the allergens if they are known and the use of medication. Montelucast is effective for allergies and is also used in asthma. A topical nasal spray would also help to reduce your symptoms, examples are alone, escort, Flonase, avamysYou would need a prescription from your doctor. 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: Hi can anyone help I have suffered from lower right quadrant pain in tummy, chronic pelvic pain and lower back pain. I have a folic acid deficiency at the moment. The pain I suffer is about a 6/10. I take mini pill so no breaks or periods as was on decapeptyl prior to the mini pill. My bowels are changing now can be 5 times a day and can leak on to underware. Stools can be bloody( have internal haemorriods) but they also can feel like stuck and contain like bits of solid black bits looks like hard tar or plastic there can be lots through the stool. I really need some answers was checked for coeliac but I don t have that. Also I constantly show up as having blood and protein in urine yet no UTI and they checked my kidney from the urine and said that it s ok. Also suffer from hydradenitis supportiva not sure if important to know. Please help ### REPLY: Hi. Thanks for your query. You have right lower abdominal pain with pelvic and back pain; Folic acid deficiency, stopped Decadently; loose stools with may be leakage, with or without blood in stool, internal Hemorrhoids, bits of Galena the black stool, Checked for celiac and ruled out. Blood and Protein in urine. No UTI. Hy . . The cause of your symptoms can be due to intestinal infection called gastroenteritis or a specific reason like Typhoid or Tuberculosis. I would advise you to consult a Gastroenterologist as you have multiple problems and need correlation. Investigations needed are:Colonoscopy, Ultrasonography. Tests of blood, urine and stool. Get a course of an antibiotic, metronidazole, probiotic and review with your Gastroenterologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has developed several symptoms lately and I would like to know if they can be linked to any one specific disease. They include severe exzema, joint pain, reduced interest in sex, foul smelling semen, extreme tiredness, unable to sleep through out the night even with melatonin. ### REPLY: Eczema and joint pain are not related to sexual disinterest. However, continuous insomnia and severity of joint pains may be connected due to interfering each other. This may, in some cases, cause lack of sexual enjoyment, but it is not a rule. You should treat these separately in allopatry. However, in Ayurveda data humor vitiation theory fits insomnia, joint pains, impotency etc. but not skin as a general rule. In my own patients cases I would treat them with mild duration and Intestinal unctuousness, appetizers and nerving tonics like Ashwagandha herb and allied preparations. This would ad . When nerving tonics added with dhatupaushtik i.e. semen thickeners, the foul smell will go. For the time being a lot of water should be given along with Joshua and Pikachu herbal capsules of Himalaya co. If you agree, may write direct question for further guidance and treatment. Alternatively you may meet any Ayurveda specialist to look into the case for your husbands benefit. Hope it helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have Kidney stones and resently went to the hospital with alot of pain in my left testical but went away that evening and the doctor said I was passing a stone, It has been four days and no pain really and no stone has passed yet but one thing that has me worried i am not producing hardly any seman when I ejaculate is the stone blocking this? ### REPLY: Hi, No semen production doesn't get effected by kidney stone, Only just the pain of renal stones is referred to testicles they are not actually in the way of semen production and ejaculation, Renal stone occur far more away from testis and place of sperm production, so kidney stone cant be a cause, if you're really getting problem in production of semen then you should visit an ufologist. And get the cause evaluated. Hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir, I am very unhappy, because I have two kidney stones in the left and right kidney. In the left kidney there is 6mm size of calculli in the midle calyx. Yet Sir, In the Right kidney there is 12mm size of calcully in the Lower calyx. Actually Sir, I have found pain in the area of abdoment and upper chest of right side. Firstly I want take out the kidney stone from right kidney. problems in here, Please help me Sir , How to removed stone in this condition. Write me the nessecery process, God bless you sir. ### REPLY: Hello, You can consult a urologist and get the stones removed. You can go for ESL(Extra Corporal Short Wave Lithography) where the stones are removed using high frequency sound wave without making an incision. Sometimes pain related or kidney stones may radiate upwards due to common nerve supply. As of now you can take analgesics like paracetamol or Ibuprofen. 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: Barky cough for almost a year. Severe chest pain. Heartburn. Was admitted in children s hospital and diagnosed with a phyclogenic cough, but since i could at night they believe that isnt whats going on. Severe headaches. Taking Prednisone. Negative results on body. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes, it seems to be allergic cough and drugs provided to you is also a right . I advise you to look for the allergen causing allergy to you. Definitive treatment for the condition is to avoid exposure to allergen. Once allergen remains departed to you, there is no need to take the further treatment. Prednisolone is the steroid and suppress the allergic reaction. But it should not be used for long time. For long time it may cause variety of side effects and should be given short gap between the treatment. So in all avoid the allergic exposure and when needed to take the prednisolone. I will be happy to answer your further concern on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, I think I am suffering from a severe case of groin itch. The skin around the area has turned black. I drive my own cab the entire day & at times the itching becomes severe, especially at night while sleeping. I have applied Clotrimazole Cream IP & I do get some relief but it keeps coming back. Usually during severe itching, I feel small lumps which itch the most! It is really embarrassing especially when am with clients sitting in my cab, Please Help! ### REPLY: Hi. I have gone through your query. You are having a Fungal infection in the groin area. I would suggest the following: 1 Keep the groin area . 2 Take an Antifungal Fluconazole 200 mg once a week for 4 weeks.3 Take an Antihistamine Levocetrizine 5 mg at bedtime.4 Use a topical cream Antifungal, Antibiotic, Corticosteroid for local application. Use the cream for 2 weeks after becoming symptom free. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 year old just showed me a lump in is upper groin where is leg meets his trunk. He says he feels fine and he figured he must have banged it playing hockey this morning but cant remember doing so. Should I be concerned or do you think it is a swollen gland? ### REPLY: Hello and welcome to , A lump at the junction of leg and groin is most commonly due to lymph node enlargement. Trauma is less likely to cause a swelling at this site. An aspiration cytology of the lump is required. In aspiration cytology, cells are aspirated from the swelling using a needle, spread on a slide and stained with appropriate stain. The stained cells are studied microscopically to assess the site of origin and nature of the lesion. Management can be done after diagnosing the condition. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is Kimberly and lately I ve been very down, and I don t enjoy things I used to anymore. I also get irritated easily over small things everyday and I don t know why. Im also very fidgety and i have times when i cant breathe or just start cryig for no reason or all reasons, really. Can you please help me figure out what s wrong with me? ### REPLY: Dear Kimberly, I went through your query and can understand what you must be going through. Feeling sad and irritable, not able to enjoy things and anxiety are symptoms suggestive of a depressive episode. You should consult a psychiatrist for undergoing complete evaluation of your symptoms and initiating treatment. Treatment with anti-depressant .  These medications are slow to act, and you will have to be patient about the response which will need at least 2 weeks after starting the medications. In addition to medications, you should also start exercising daily. It will help you relax and feel better. I do hope I was able to help with your query. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My friend: Male, 44 yrs old, 6 2 , 185 lbs. normal BP & temp. smoker: pack.5/day. (I think he has rapid heartbeat but I m not in medical field.) Has rales and rhonchi. Problem: Has what appears to be pitting edema? in one mid-calf. Sudden onset 3 weeks ago as he was walking 5 miles and hadn t walked that much in a while. Had cramping at that time. Worse when he points his toes. Gets occassional cramping still. Swelling in ankle/calf/maybe upper foot. Swelling hasn t resided and I can see a small red spot with inconsistent edges that is warm but not hot to the touch. When he wears a sock the swelling is reduced within the sock area so then the calf hangs over where sock was. Has what I would call a cankle . He also has had for a long time small varicose veins, all little ones all over and around both ankles. Some blue but all small and skin a bit red poched on both ankles/lower calves. How does he get rid of swelling and is the red spot an infection? ### REPLY: Hi Thereafter reading the details provided by you, I understand your concern and I want to tell you that the condition of your friend doesn't seems to look good. The symptoms you are telling goes in favor of PAD (peripheral artery disease) he probably has developed Deep Vein Thrombosis (DVT) as he had a history of small varicose veins, and now he is having CLAUDICATIONS while walking. Now I would like to advice to consult personally a vascular surgeon as well as a cardiologist for BILATERAL LOWER LIMB DOPPLER and ECHOCARDIOGRAPHY, as smoking increases the risk of MYOCARDIAL INFARCTION also. Most Importantly he needs to STOP SMOKING IMMEDIATELY. He needs medical treatment to get rid of the swelling. No not an infection. I wish him 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 was coughing like a dry cough and one cough I made was strong and I felt a strong pain by my right temple and a little pop I happened this happened yesterday and now that spot has an irregular and irritating feeling ### REPLY: Hello dear, welcome to .come have evaluated your query thoroughly.* This seems respiratory infection with skin lesion over scalp.* Suggestions for better recovery-Gargles with salted lukewarm water added peppermint oil 3 times a day- Lesson pearls with mini OD will help.- Avoid smoking, exposure to dust, pollen containing atmospheres.- Consult later doctor if it requires.* Scalp lesion seems sebaceous cyst most likely, keep it clean with antiseptic liquids, .  Better if you attach a photo pic to evaluate it more precisely. Hope this will help you for sure. Wishing you fine health ahead. Welcome for any further guidance. Regards dear 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 had a blood test for liver function etc and it has come back with raised billirubin - so have repeated it but in a non urgent request from my surgery - i have been worried about my alcohol intake (female aged 55) but have since stopped drinking alcohol - could it be connected and if it was serious would my doctor have summoned me in to see him?  just a bit worried.Many thanks in advance for your adviceCordy ### REPLY: HelloThanks for writing to ChatDoctorYou need complete liver function test before starting any medicine.LFT includes GOT, SPOT, Total bilirubin, GGT, Total protein, Alkaline Phosphatase. Since you have alcohol history, this test is needed along with routine hologram. Ultrasound of abdomen should also be done. Urine RE/ME should also be done. Viral markers should also be done in altered LFT. 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 had lyme disease in June. Ever since then I ve had pain and burning under my right rib cage and pain around my back. My doctor thought it was gallbladder problems. I had a ct scan and it was negative. I have an appointment with a gastro doctor on the 16th. The pain is getting worse and is constant. Any ideas on what it could be? Nothing makes it worse or better ### REPLY: Hellos per your description of the clinical symptoms it seems that the followings can be probable reason for your discomfort- 1. As already described by your physician the most probable cause could be a pathology of the Gall bladder (cholecystitis or cholelithiasis).2 The second most probable cause could be a pathology of the liver or the hepato-biliary system. It should accompany certain other symptoms like nausea, vomiting, dyspepsia, flatulence etc.3. Any kind of muscle spasm or sprain.4. A Costco . A USG of the whole abdomen and blood tests (liver function test) may give you a diagnosis. Please visit your Gastroenterologist for further evaluation and man agent. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, this started about a couple of months ago but was starting to die down, its came back with a vengence today. Basically it started with chest and rib pain and within a day had moved into my arm. I went to the walk in centre and was told it was probably muscular despite having my blood pressure taken 3 times until the result was average. Being told this, I went home and just tried relaxing as much as I could. Unfortunately it got worse and worse and I would get dizzy spells and all sorts, after 3-4 months of pain it was starting to feel better and the fatigue I was also experiencing was starting to go away. With only a week of me feeling better it has came back and I feel rather unwell, my arms chest back and so on are very painful, Im feeling really dizzy also. My underarms are probably thew worst. Thankyou for reading x ### REPLY: Hello, High blood pressure stays high; it doesn't come down with rest and agitation and pain do. Cannot say in your particular case, but the only connection between chest and arm pain and dizziness would be a LOWERING of the blood pressure (or anxiety) which would be from a heart issue. But heart pain is not likely to be constant for weeks.  It is not elicitable by pressing on ribs and arms, and it is not both underarms. In theory serious lung disease could affect the torso, but nearly always people complain of lung/breathing in that context. 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: a couple of weeks ago i fell backwards on a big rock at the lake. a few days later other than back pain i noticed a lump in my adominal area above my penis in groin area. it has not gone away. should i worry or what could it be. doesnt look like any hernia pictures ive seen. ### REPLY: Hi thank you for trusting ChatDoctorI read your query and understand your concern I am sorry for the accident you habit is quit common that after physical stress or accidents inguinal hernia happens It isn't a risky situation You should avoid physical activity meantime It is recommended that you schedule an ultrasound to see the herniation dimension Anyway you don't have reason to worry too muchSometimes it does away itself can be more helpful if you upload a photo of herniationWish you good health and fast recovery Best regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, My ultrasound shows thickening of endometrium (day 10 the same is 10 mm). Also some polypoidal thickening. Can this be the reason for non implantation of embryo? Would this affect my chances of success in ivf? I have been trying to coceive naturally for last 5 years. Had conceived naturally once but suffered miscarriage. Would be really thankfull for your guidance. ### REPLY: HelloThanks for writing to us with your health concern. Proliferation and development of the endometrium (lining of the uterus) is normal during the cycle. 10 mm on day 10 is slightly on the higher side. However, polypoid thickening is not normal. It can definitely impact the implantation of the embryo.However, it is not a total contraindication for pregnancy. It would slightly reduce your chances of conceiving from the IVF procedure. Since you are yet to go for the process, don't worry about what you cannot change right now. If the endometrium is not favorable, your doctor certainly won't go ahead with the pickup and transfer. Just don't stress out and stop worrying. A slightly more than normal thickened endometrium might sometimes be favorable for implantation - you never know !Just keep your fingers crossed. All the betake 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: For the past two days Ive woken with a rash that runs from the top of my knee to my hip, all the way around my right leg and it disappears about an hour after I wake up. No fever, my room stays about 65 degrees, I wore shorts to bed the first night and sweatpants last night. What is this and do I need to see a dr? ### REPLY: Hello, Thank you for posting on . The condition you have referred to is called Urticaria or hives. It's an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up. You may have to go for specific tests like patch test, food prick test, IGE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various antihistamines for long duration(at least 3 months) with or without oral corticosteroids. For non-responding cases there are many other .  Hope this will help you in resolving your query. Thank you  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor. I am worried for my mums health condition. Earlier today, I noticed a red lump On the left side of her head growing under her hair.It was the size of an eraser. When asked, she was secretive about and wouldnt want to tell me why..Do you have any explanation for it?Please help her. ### REPLY: HelloSubcutaneous lesion in head may be due to many causes like lipoma, dermoid cyst, epidermoid cyst, infective collection etc. These are generally due to benign causes. Need of treatment depend upon clinical evaluation and patient complain. She may need ultrasound of swelling. CT scan of head can be done after evaluation. Excision of lump can be done after evaluation. 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: I am concern about my TSH level. I am a diabetic and my level has always been very low. Last year it was 0.08 this year is it 0.005. My levels has always been very low but my family physician said it was ok. I am concern because I have discover that TSH is associated/indicator (possibly) for heart concern. Heart disease runs in my family so I would like to see should I take further steps. ### REPLY: Hello, Brief Answer: Low TSH is not a risk factor to develop heart disease. Explanation: My opinion is that low TSH or hyperthyroidism is an overproduction of thyroid hormones that manifest with symptoms and signs all over the body. Concerning the heart, you may experience palpitations and nothing more. If you have such a condition, you may need to do an EKG to make sure that your rate and rhythm is fine. I suggest my patients the following: Clinical examination and EKG if palpitations present. The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about the symptoms you have and if treatment is given. Conclusion: I suggest you check your treatment with your doctor. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my last visit to the doctor for sonography at 11weeks, it read Anterior uterine wall contraction noted. Could this cause any problem to my pregnancy? Now I am 15 weeks gone and I still get some pain on my lower abdomen when I seat on a low position. Could this cause a problem to my baby? ### REPLY: Hello, Occasional uterine contractions are common during pregnancy. It is nothing to be worried about.  The pain you are noticing while sitting down is likely due to the stretching of the ligaments around the uterus. Make sure to sir on a comfortable chair. Take breaks walking around whenever possible. If the pain worsens, or you develop bleeding, follow up with the urgent care. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 2 daughters woke up this morning with swollen eyes,swollen noses swollen face, red splotches here and there , one child had right foot swollen,right breast swollen, other child had a couple red splotches on back ,left cheek had red and purplish splotch. also had a white discoloration on shoulder . i gave both children benadryl and some symptoms went away but the swollen foot is still also the swollen breast the white patch on the shoulder and faces are still covered in red little bumps. after all this i notices nasal cavity was red and inflamed on both children. Could it be an allergic reaction or something more serious??!! How can both children have an allergic reaction at the same time when nothing new has been put into there daily life , also they have never had any type of allergies before please help me am still nervous my children are in danger!! ### REPLY: THINK SCABIES HISTORY PIN TOWARDS SCABIES IT SPREAD FROM ONE PERSON TO OTHER IF ONE HAS SCABIES OTHERS WILL LSO Have it spread from one to other immediately give fexofenadine for itching you need em scab lotion at night on full bodies and boils the clothes and bedsheets before reuse calamine or local antiallergic cream like COTOREP HC can be used brother members should also take care as it can speed to them also ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got married in the year 2004 and immediately i got one child and I have been trying to conceive for the second child for the past 4 years.  I had undergone HSG, diagnostic laproscopy, Ultra sonogram, thyroid, blood tests.  All the test results are normal.  During HSG they found the left overy is not free spilled but it is loculated. but after that by D.LAP they corrected.  But still I do not conceive.  My husbands sperm is also good.  I hv consulted many doctors. They said it is unexplained infertility.  I will be greatful if u give me solution for this. ### REPLY: Unexplained infertility though you're all investigations are normal there ought to be slight imbalance in your hormonal levels. Vaginal pH also matters here. This all needs proper showman of body. Again panchkarma showman is advised here, then proper medication like ashwagandha, gulvel, shatavari, shivlingi, putravanti in right combinations should be given. Market available preparations like ashwagadha vat, phala fruit, kumari Asama, shatavari kappa may be used. Refrain from having a wash immediately after coitus, just lie in head low position for some period of time.supra hardhat treatment for your husband is also advisable. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has been killed recently by a pulmonologist named Dr Vamsi Krishna from Siddhartha Hospital (kakinada) treating him in icu for bacterial and fungal pneumonia. I wanted to know is pneumonia that serious killer? First my dad was admitted into ICU on May 30, 2014 after seeing his lungs xray and he was put in ICU for 5 days then shifted to room then in 10 days he was discharged. After coming home we thought he was recovering well but on July 2 again he felt severe shortness in breath so when took to Siddhartha Hispital, Kakinad, Dr. Vamsi Krishna said that the lung infection came again and this time its fungal (previously he was treated for bacterial pneumonia) and so my dad was directly admitted into ICU with ventilators support. The ICU patient dies on july 12 and the reason Dr.Vamsi Krishna said is Sudden Cardiac Arrest and it can happen anytime. Other healtChatDoctorplications of my dad are diabetes and stints in chest. My question is if there is fungal infection that serious as to be admitted into ICU on July 2 why did the Dr fail to diagonise it when visited him on June 30 apart of weekly checkup? I felt the culture test for presense of fungal infection was done late and reports came very late on July 9. ### REPLY: Thanks for your question on . In my opinion cardiac arrest can happen anytime on ventilated patient with diabetes and cardiac stents. So your father was a high risk patient and pneumonia made him worse. Fungal pneumonia is not commonly seen. It is suspected only if typical x-ray findings are there, not responding with antibiotics. So I think doctor first gave him antibiotics, and he poorly responded to those antibiotics, so thought of fungal pneumonia. And all fungi are slow growing, so culture report comes very late. So fungal pneumonia can be the cause of death. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I feel a tightness in my upper chest when I bend over forward. There no intense pain just tightness. I notice it more after eating. Weight 210, height 5-10, age 57. I do mild exercise almost every day. I had a heart treadmill test 3 months ago and past with flying colors. ### REPLY: Thanks for your question on . In my opinion you are having HERD (gastroesophageal reflux disease), as you are having upper chest tightness more after eating meals. So chances of HERD are more. GERD is due to laxity of the sphincter. Due to this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Try to follow these for better control of HERD.1. Avoid heavy meals, instead take frequent small meals.2. Avoid hot and spicy food.3. Avoid stress and anxiety. 4. Take proton pump inhibitors. 5. Go for walk after meals.6. Keep 2-3 pillows under head in bed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doc,Ive been sweating excessively (on the sides and back of my head) when I sleep at night, so much so that i wake up with my pillow soaked (a large, very damp patch) every morning.I do not remember dreams/nightmares and I do not wake up in the middle of the night.Im a 26 y.o male. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Sweating is a body mechanism with which body temperature is regulated according to the outside temperature. Body temperature is maintained at a particular level throughout. Sweat also remove toxins from our body. Exessive sweating or hyperhi .  Anxiety or apprehension is another cause. Excess sweating is also possible on hot weather. Ask yourself. Is the weather hot? Am I anxious? If the answer to these questions are NO, then consult a physician for further diagnosis and treatment. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my partner thinks his wisdom teeth are coming through, he has swollen gums , inflamed glands on both sides, pain in his ears, tonsils and his head and agonising pain down the left sideof his face. this is constant agonising pain he is unable to sleep. the doctor suggesting taking ibruprofen and that is all. the pain is now becoming unbearable. ### REPLY: Hello and welcome to  forum, as you stated that there is persistent pain on the left side, radiating to the head and neck, also gums are swollen, it seems to be a case of acute infection, which may or may not be associated with erupting wisdom tooth, to clear out the diagnosis kindly get him checked clinically by a dentist. I would recommend, warm saline rinses or Betadine mouth gargles(3-4times/day), a complete course of antibiotic and anti-inflammatory is also required. It is highly recommended to visit your dentist. I wish you good health, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, 3 days ago i got all 4 wisdom teeth removed as 3/4 of them where impacted. If it matters i am 18 and the surgeon stitched the sickets with dissovable stitches. They are healing well but since yesterday i noticed a small flap of gum on 3 of the areas where my wisdom teeth where removed. Each flap has gotten bigger today (its possible that theyre just swollen though). The problem with this is each flap has grown over the tooth next to them, so im basically chewing on them throughout the day. Will this cause any problems? What should i do? And why are those flaps there? They seem to be mostly secured by the stitches ### REPLY: Hi, Thanks for asking the query, A complete healing after wisdom tooth removal occurs up to 3 months, whereas pain swelling subside in 10-15 days. According to your symptoms I suppose that you have developed inflammation and swelling around the healing socket. You just follow the post-operative instructions given by the Dentist properly. Take complete course of antibiotics and analgesics. Take lukewarm saline and antiseptic mouthwash rinses. Avoid eating of hot and spicy foodstuffs. Avoid smoking and alcohol consumption as this may worsen the condition. Hope this helps out, Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been having heart palpitations for about 3 weeks. I have had them before but just for a day or so and it goes away. I thought it was just due to the stress of the holidays but this last week it s gotten worse. Every single day and all day long intermitantly. I had a really bad day a couple nights ago where it did really big flips like my heart was going to jump right out of my chest , I had tingling sensations down my arms. It seems to have improved now but still going on. And I m having shortness of breath also. I ve made a doctors appt, but it s not for 4 more days. What is going on? Will this go away? ### REPLY: Hello, Thanks for choosing  for posting your query. A lot can be answered in a better way IFI knew your age. But the kind of problems that you have described doesn't appear to be physical in nature. It is more so ever appears to be psychological. You should get an ECG done and get a consultation from a cardiologist. If he says it is fine, which mostly is what he will say, then you should visit a psychiatrist who can train you with some relaxation techniques and also help you with CBT. He may use some . All said it is not something big you need to worry about. Hope I have answered your query. I will be more than happy to help you if you need any further clarifications. In case if you want to discuss with me directly you can use the link:http://www.ChatDoctor .com/Funnel?page=askDoctorDirectly&docId=64634Wish you a good health! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I started an exercise program about two months ago that uses resistance bands for arm and bicep strengthening I seem to have injured my thumb. I thought it would go away but has been six weeks now and I still have pain when doing certain things like lifting and pouring a coffee pain or lifting a heavy book. The pain runs up the top of the thumb into the hand above the joint. What would be the cause and do I need to do anything about it? ### REPLY: Hello, One possibility may be that you have developed a tendinitis.  There is a form of tendinitis in the thumb area called de Quarries Tenosynovitis. Without examining you it is difficult to tell, but certainly this could be a possibility. In the first instance, I would ice the area for about 5-10 min, 6 times a day. Taking over-the-counter medications such as ibuprofen would certainly help.  Sometimes in the case of tendinitis we would prescribe a wrist and thumb brace.  This is sometimes called a thumbs pica splint.  Occasionally for persistent tenosynovitis I will insert a small cortisone injection into the tendon sheath, which can give significant relief. I would suggest seeing your primary care physician or an orthopedic specialist, for a further consultation. I hope this helps.  Please message me back if you have any further questions. A . D. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yesterday, my 14-month granddaughter fell on her sidewalk and got a bad sidewalk burn on her nose and a small on her forehead.Her nose is swollen some.Her Mom is putting children s neosporin on it and I told her to be sure and 100% sunblock to keep from tanning.Are these correct and what would you recommend to speed healing and to prevent scarring?My son and wife are so worried about scarring.It s really burned badly on her nose.Thanks, Janet Steele ### REPLY: Hi....USUALLY THE BLOOD SUPPLY TO THE FACIAL REGION IS VERY RICH AND THE HEALING WITHOUT MUCH SCARRING CAN BE EXPECTED. But.... Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i used benzoyl peroxide gel 2.5 and took doxybest tablets.It caused burning effect and swelling.Plz tell me some home remedies as i am a working women and i dnt have any time to go to a dermatologist.I used ice and fuller s earth to cool my skin down. ### REPLY: The benzoyl peroxide has probably caused a chemical irritation or burn and is the cause of your problem. You have done the right thing by applying ice. Also use some emollient like aloe vera lotion over the area, and you will get some relief. Please be patient as it may take a few days to heal up. Taking some antiallergic tablet like levocetirizine once a day for three or four days should be helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My child is 8 months and is milk and soya intolerant, he has had green stools since being on nutramigen aa which I am told is normal, but when changing his nappy today his stool was greeny/pale grey colour and looked a little mucusy is this something i should be concerned about? ### REPLY: Hi, Can understand your concerns. Green color stools are normal in babies, it occurs because of decreased transit time of food in intestine of babies. Due to decrease transit time, the bile is not separated from food. Due to this the color of stools appear green. Sometimes the child can also pass Golden and yellow color stools, both of these colors are also normal. At this age, Semi solid food should be started.  I hope this will help you. Wishing your child could help. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 40 yr old women i have been suffering with sever anemia and have had several blood transfusions and Recently had a iron transfusion and had a sever reaction and had to be given Benadryl and cortisone  . i do not know where to turn i have lost a lot of my hair and my body hurts most of the time . It is frustrating that the specialist that im seeing dont seem to know what is wrong with me. ### REPLY: Hithanks for your query can feel your concerns lethargy, weakness and aches & pains in body are feature of anemia advice you to consult your hematologist to establish the cause of anemia and then treat accordingly if it is iron deficiency anemia, you can use oral iron preparations and need to improve your diet you seems to have vitamin deficiency as well. You should use multivitamin tablet after consulting your doctor hope it helps regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have outbursts of anger.  i cant control myself and i just want to know if theres a name for it. i dont know how to explain to my personal doctor. it scares me how bad it gets sometimes but when im upset my anger feels justified but afterwords i feel embarrassed and sad. what is wrong with me? ### REPLY: Hello Sudden anger outburst is common finding in a number of individuals. But if the outbursts cause significant dysfunction in social and occupational functioning then it needs attention. Such symptoms can occur due to Impulse Control Disorder. This is a type of disorder in which significant anger outbursts and episodes of violence occur in individual. There is no need to hesitate to consult a psychiatrist. Visit a psychiatrist and explain your symptoms. Medicines like mood stabilizers as Sodium valproate are used to calm down the individual. Psychological treatment for anger management is also useful. Thanks, hope this helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,i am  male ,aged 45 years. height is 165 cm and weight 85 kgs . i am suffering from high uric acid which is 9.9 having swelling in both the feet and joint pains. my BP is 130/90. using Arbitel40 for BP one tablet a day and Feburic40 for high uric acid one tablet day.kindly advice to bring down uric acid levels .Are the medicines using are right one or needs to change ### REPLY: Hi Venkatesh, Thanks for writing your query. Arbiter contains Telmisartan, which helps in control of blood pressure. Feb uric Eurostat which lowers high uric acid. Both these medicines are helpful in control of blood pressure and uric acid respectively. One common factor for development of increased blood pressure and high uric acid is obesity. Your weight is in excess as compared to your height. You should plan for gradual and slow weight loss as quick weight loss may increase uric acid and can cause kidney stone. You should limit your salt intake and avoid purine rich foods, organ meat, .  I think you should continue with the medicines and take precautions as advice. If you have any further doubts, I will be happy to help. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been experiencing sensations as if my brain is shaking inside. When this happens, I ve noticed that my vision is clearly moving in a rapid up and down motion. I had an MRI and CT and EEG, an there were no adnormalities. I have also been diagnosed with Vertigo resulting from the inner ear. ### REPLY: Hello, You may have a condition known as OSCILLOPSIA which refers to fields of vision that are in motion with head movements.  The underlying pathological mechanism involves a loss of image stabilization by loss of reflex control of eye muscle control when a person has their gaze fixated.  Things such as toxicity, infection (most importantly meningitis) or side effects from antibiotics can cause the condition.  Desalinating disease such as MS can also cause this condition, as well as abnormal movements of the eyes referred to as nystagmus. I recommend you seek an opinion from a NEURO-OPHTHALMOLOGIST.  Vertigo from inner ear problems will not produce this phenomenon. 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: Hello! I have a question about a possible heart problem. As a teenager I was diagnosed with mitral (?) valve prolapse, which was causing some discomfort. I was told I would outgrow it and it never bothered me much. I am a 30 year old, generally healthy woman, my lifestyle is rather stressful (due to job). In the last year I have been getting episodes of heart palpitations (heart rate drastically increases for no apparent reason, feeling very tired and also having a tired feeling in the chest/heart area - I guess it could be pressure, its just a feeling of tiredness, also in the left arm). 2 months ago I had a surgery due to rapture in which I lost 400ml of blood. I am taking Iron as a supplement and still feeling very tired most days. Could this be a heart problem that needs immediate attention? ### REPLY: Mitral valve prolapse is known to cause to palpitations. But the feeling of tiredness and weakness may be due to some other reason like low He! So please get yourself checked by a physician as you need certain blood tests like complete bleed counts, thyroid function test. Also, an echocardiography to see the status of mitral valve prolapse as this can lead to leakage in the mitral valve in some people over a period of time. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Dr. Manjunath, I m at the day of 12th of taking Jasmin and I know that I will have my period 7 days after finishing the last one , in 9 days. I need to advance my period for 5-6 days due to my vacation. I would appreciate it if you could help my with it. Best regards Neda Jonson ### REPLY: Hallow NEA, If you want to extend your period for next 15 days or so, you need to continue the tablets for next 12 days at least, or may be for 15 days till you do not want the menses to appear. Jasmin tablets are Estrogen + Progesterone tablets. These hormones grow and maintain the lining of the uterus (Endometrium). When the tablets are discontinued, the levels of the hormones start falling down and thus the grown endometrium cannot be supported. It then starts breaking down and is thrown out along with some blood after about 4-6 days. This is menstruation. Now you can plan when to discontinue the tablets. Continue taking the hormone tablets as per your requirement. I hope this solves your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has unrespectable pancreatic cancer...his wbc is 4.4, his lymphocytes are 0.4, his granulocytes% is 86.0, his RBC is4.04, his hgb is 11.0, hct is 35.3 and mchc is 31.2....I m very concerned...his nurse practitioner did not explain these to me...any help will be appreciated...my emails is angelicgaston @yahoo.com...thanks ### REPLY: Thanks for your question on . I want to ask you few questions first.1. Does your husband on chemotherapy? 2. Does your husband have fever? His total WBC count is on slightly lower side. And this is seen when patient is taking chemotherapy.  As chemotherapy .  His neutrophils are very high, so of he is having fever than chances of bacterial infection are high.Otherwise, report is good. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 woke up early this morning with piercing pains on the right side of my upper chest to the right of my sternum and underneath my rib cage. The pain is worst when lying down and breathing deeply, though has been there all day. I can feel slight vibrations whilst breathing in. Over the last week, I have felt slight pains in the same area but barely noticeable until today. I m not sure if it s linked but my stool has traces of blood in it too, and my visits to the toilet have either had symptoms of diarrhoea, when blood has been sprayed, or being hard and black. Thanks ### REPLY: Thanks for your question on . I advise you to get done chest x-ray first to rule out lung infection as cause for your right sided chest discomfort. If x-ray is normal than you may have gastric ulcer related disease. In this due ulcer pain in chest is felt, it is burning like sensation. And ulcer causes slow continuous bleeding from the vessel and this blood appear in the stool as black colored. Blood is actually changed its color due to gastric acid and turns black. So black colored stool is suggestive of gastric bleed. So better to consult gastroenterologist and discuss all these. You may need upper GIs copy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello dr . my age is 25 . i have PCOD issue . before marriage my dr  suggested  to take orgamed i took for 7 year till now its not regular . after marriage she asked me to take rubella vaccine   and contraceptive pills for 3 months again i had cysts .dr suggested me to take clome , duphaston ,glycomet . will it successfully to get pregnant ? ### REPLY: Hi, PCOD is complex disease and treatment response is variable. Once your period become regular chance of pregnancy is high. You are on correct treatment. Come, Phaeton and Comet will help you to become pregnant. Clonidine citrate: increase maturation of follicle and ovulation by increasing FSH & LH. Dupahston should be taken in second half of period to regularize luteal phase abnormality. It helps in implantation and pregnancy. Glycomet: again induce ovulation and decrease insulin resistance. You should take above medicine under advise of gynecologist and monitored by USG scan and ovarian follicle study. If .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 worried becoz I felt a hard thing on my areola a pea size, I notice this for about a week now. a bit sore when touch. Do I have to remove it? I am 44 from the philippines. My doctor gave me antibiotic and anti inflammatory upon my request, bec. I dont want to remove it rightaway. ### REPLY: Hi, Good Morning-from INDIA. I am . N.here to take of your health query from  virtual Clinic. Thanks for your Health-query to  Clinic.-I studied your query in-depth and I understood your concerns.-My opinion-this requires clinical exam as there are many reasons. But from the facts of your query-it appears to be infected Montgomerries glands of the nipple areola. Other possibilities could be-?galactose?fibrotic adenoid?perirectal adenoid -benign or malignant?-I would advise you as you don't want to remove it immediately- as follows-a-If after the antibiotics the pain/soreness goes and lump vanishes or becomes supple, then it would go of its own in 1-2 was time-as the infection of the Montgomery glands of areola subsides by that time.-b-If hardness of lump-does not reduce-You consult a Surgeon-c-who would do-CBC and would review treatment by -EXCISION BIOPSY-which would take care of the cause of it and would remove the lump itself. Advise-So if surgeon feels -Surgery may be needed. But as told above it could be treated patiently -with-a-Tb NSAIDsb-Antibiotics for infection control.c-Tb Serropeptidase-if harness takes time to recover -this may be tried for 5 days timed-If still it remains-this may need surgical excision ONLY-if it TROUBLES YOU.-e-If it does not, then you still could avoid Surgery and keep watch on it with advise from Surgeon.-Hope this would help you recover fast out of the Lump anxiety. Wellcome to  again for better Health and Living. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi Ive had rheumatoid nodules on my elbow for several years know , after each operation to remove them they regrow , the doctor says that I do not have the artheritis though.for the past 12 months I have been having allergy attacks and itching on my hands between the fingers and eyes this usually goes within 24hrs of starting.I have tried antihistimenes but these dont work I also get very tired during the day could this all be related and what should I do Iam 44 not overweight walk every morning with the dog the problem with the elbow started about 8 years ago and to date it has been operated on 4 times and Iam waiting to see a surgeon again ### REPLY: All that I can convey to you on the basis of my three decades old clinical experience is that you must get support of Ayurveda treatment. While surgery can remove nodules, it cannot prevent regrowing. Here Ayurveda can help you in a safe n side effect less way.Similarly, anti Pittman regime in Ayurveda can effectively manage allergic conditions and common herbs can be used to ad . No interaction of any Ayurveda med. With any other  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had bladder cancer (inside) about 4 years ago. It was removed gets checked ever 6 months along with Psa test. Went to doctor for blood work now has elevated white blood cells, has to go back in two weeks for recheck. If still elevated has to go to oncologist. No symptoms except for losing weight. Could this be some form of cancer? ### REPLY: Hi Welcome to ChatDoctorI have gone through your query. I can understand your concern regarding elevated BCI would like to know what is the WBC count ? Any medication going on ? Elevation of white blood cells is caused by many factors :--Immune system targets the thyroid gland causing hormonal changes that affect the levels of white blood cells Reactions to certain types of medications may result in an increased white blood cell count. These include .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having a lot of bleeding from my gums at several different times since last summer. As of last april I went on a particular diet or "eating plan" that I use a lot of herbs and spices. I am wondering if this is causing this crazy gum bleeding. I take really good care of my gums and teeth on a regular basis. Also my hot flashes/ night sweats seem to have returned and gotten out of control. ### REPLY: Hello, Thanks for your query. Going through your symptoms I diagnosed that you are anemic....increase your iron intake, take fresh fruits especially apple, banana and oranges....as oranges are rich source of vitamin C, so it will help to cure bleeding gums...keep good oral hygiene and go for scaling too. For one month take folic acid 5 mg per day. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am having a problem with mouth ulcers, I get one after another, not all the time but once I get one then several others follow.  I have quite a painful one at the moment( had two or three a week ago) and despite trying many products this one is still causing a problem.  Many thanks Chrissie ### REPLY: Hi. Thanks for the query. As per your complaint and presentation of symptoms you are suffering from RECURRENT AUTHORS ULCERS / RECURRENT CANKER SORES. It can occur due to a number of conditions like Nutritional deficiencies, hormonal fluctuations, acid reflux, stress, etc. At times, it can occur without any underlying cause as the exact cause of authors ulcers is still unknown. In case if the ulcers does not respond to any other Medication or remedy then Steroid therapy is the ultimate treatment. You should consult a dentist and get evaluated. He can start with a loading dose of steroid followed by tapering the same. Gargle with 1:1solution of water and HY . . You can apply milk of magnesia two to three times a day on the ulcers. In case of pain lidocaine gel can be applied over ulcers for relief.OTC painkillers like Advil can be taken to relieve pain. Avoid hot, spicy and citrus foods as they can cause irritation. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Im 24 years old and female been feeling short of breath mild chest pains similar to those you may have In your lungs after running if your outta shape. Night sweats. I wake up every three hours at night while trying to sleep. Often I wake up frustrated and want to cry. I have been dizzy tired and my muscles feel weak. I am also always thirsty. Been to the doc had an irregular holter monitor result with my heart rate increasing thru the day up to 175bpm. Went for chest X-ray was fine, EKG normal.  Echocardiogram results not on yet. Blood tests normal no signs of thyroid problem. Im tired of feeling like crap everyday. My job is very stressful which adds to my symptoms. What can I do to feel better. Im already on a lopresser and i havent noticed any differences. ### REPLY: Hi thanks for contacting ... Noted you have done echo for your condition. Let see what is the report... But if it comes normal then your condition is most likely related to stress taking.... By stress, you can have panic attack and so it can lead dizziness, sweating, chest pantry to avoid stress. Yoga and daily exercise useful. If possible job can be changed...or solve the problem with discussing to your cooker if you can't find solution... You can consult psychiatrist for behavioral therapy session ..... Anxiolytic . If still problem pulmonary function test done. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 accidentally kicked my toe on some furniture about a month ago. It bruised really bad, and a lump/knot appeared where I kicked it (in front of my toe nail). The bruising has gone away but the knot is still there. Is that normal or should I have it check out? ### REPLY: Hi, Dear,Welcome to . Based on the facts of your query, You seem to suffer from-POst-traumatic Scleroses / fibrosis Hematoma, which is causing the knot/lump in front of your toenail. X-ray-Toe would fix the cause of the fibrosis hematoma in front of the toenail. Remedy - would be -Hot fomentation Coquitlam 1 two times a data Chymotrypsin 1 three times a with Point Tomophobe point. Locally Needle Aspiration if -its liquid trouble some by its size, Surgical Evacuation and primary suturing would help Hope this reply would help you to plan further treatment with your doctors. Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Good Day!!  . S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my molar tooth pulled 2 months ago and now it  feels like the whole side of my mouth has changedMy teeth feel bigger my gums are tender and I keep rubbing my tounge against the side of me teethI went to my dentist and he said everything looked good and he did take a sharp edge off one of my teethbut I my mouth still feels like i described in the first part of my letter. I do have OCD and anxiety attacksI am on a zanax and prozac. Do you have any suggestions on what I can do to make feel like it did before he pulled my Molar?Thanks ### REPLY: Hello, I can understand your concern about your pain and numbness of your tongue. As per your history, it seems to me that you are having post extraction nerve injury. This happens when the lower second or third molar is removed. You do not need to worry, it usually heals in two to three months after the expiration. One thing you need to keep in mind is, do not rub your tongue against the teeth or do not bite on it. Because of the reduced nerve supply, there are more chances of traumatic tongue ulcers. Also, take vitamin B complex supplements at least for a month once daily. Keep your mouth clean and examine your tongue daily for any traumatic ulcer. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my daughter is almost three weeks old, and this morning I noticed she has developed a red rash around her cheeks and neck! little red bumps that look like they have a white head, can you tell me what this is or if there is something I can use to get rid of it? thanks for your help!! ### REPLY: Hi... I sympathize with the kid and understand your concern. The trick of the management is keeping the skin moist and never allowing it to be .  For this oil massage and lotions like Hiatus will help. Regarding cure options - eczema is a sort of allergy...allergies can only be controlled and can never be cured. But usually kids grow out of it...that is as the age progresses, they become better starting from 6 months. 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: My 6 year old son has several bug bites around the inside of his legs, buttocks, & testicles from playing outside. Despite putting medicine on the bites & giving him an oral antihistamine medication, he is still scratching. I noticed tonight that his testicles are now bruised. Could this be caused from him scratching that area so much? Thanks! ### REPLY: Hi, Thank you for asking question on . As the skin over the testes is thin with rich blood supply severe scratching for a log time leads to bruising. Continue antihistamine to reduce itching and an antibiotic to prevent infection. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi..I am 27 years old weight 67 and no medical history as such . I am O negative blood group. Married to O positive. My mensus are not regular and if i get it , its so less which is equal to no. only some strains in my panty. not required pad. its since was in teens i have irregualr periods. I have consulted doctors many times, but every time they prescribe some medicine ..i got it that time then after some times its the same. Now wheni want to conceive and trying since 6 months no result. is it because of the mensus problem or something else. is been 2-3 month I didn t have mensus. ### REPLY: There can be several reasons for not conceiving, most common cause in your case seems to be ovulatory factor, you should go for follicular study on 11th and 13th day of cycle to see the maturity of ova under USG after consulting a GAEC. If the size of ova is less than 19 mm your doctor will give you some injections like FSH but do not take them without proper guidance, before that your husband should go for the semen analysis. You should get your Endometrial biopsy done before your spotting to see the secretory phase. You have to take progesterone for luteal support.HSG is another test to see the tubal patency. Then there are certain immunological tests also. Best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i have been using skin lite from 1 year. i had a drastic change in my face color but the thing is that if i stop using skinlite for 1 week then again my face is becoming darker. May i have any other alternative for that? and can you please suggest me some other cream which gives me permanent solution? ### REPLY: Hi, There are two important factors involved in the dark skin :the one is Genetic and the other due to sunlight. The darkness is due to the activity of melanocytes in the skin. These melanocytes are the cells which regularly produces color/pigment known as melanin in the skin. These are superficially present in the upper skin known as epidermis. This is a tendency in us to get higher activity of these melanocytes at the facial area according to our genetic make up. It is seen on higher side in people of Asiatic origin than in white population. I prefer to use a cream containing Comic acid with albumin and mulberry extract in it. I suggest you to meet a dermatologist and go for best treatment under his/her guidance. Take care. Wish you glowing skin, With regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, I have been having a fluttering in my chest (seems like my heart, just left of my breastbone), since last night and throughout the whole day.It feels like bubbles, not painful, just uncomfortable. It is driving me crazy. It happens about every 5-10 minutes, sometimes more often...is it my heart or esophagus?Kind regards ### REPLY: Hello! Thank you for asking on ! I understand your concern and would like to explain that it is not very easy to differentiate between different causes of this symptomatology, just referring to your complaints. It may be related to a cardiac arrhythmia or gastroesophageal reflux, or esophageal spasms. I recommend performing some tests besides a careful physical examination: - a resting ECG - a chest x-ray- complete blood count-kidney and liver function tests-blood electrolytes-amylasemia (for the pancreas)- inflammation tests (PCR, sedimentation, fibrinogen), to exclude possible cost Chen .  - a fibrogastroscopy to exclude possible esophageal disorders should consult with your GP on the above-mentioned possibilities. Hope to have been of help! 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: Hi, my son 11 years old was playing basketball and injured his ring finger. Theres is a bruising seen between 3rd and 4th phalanges. I applied cold compress and bandaged together, but he is still complaining of pain. Today is 3rd day, bruising going away, theres no sweeling, should I still X-ray him? ### REPLY: Hello First I will advise doing x-ray and rule out any unicortical fracture in your finger. According to your history it looks that there is possibility of injury to soft tissue due to injury. If you are having swelling and pain you can strap your finger to get proper rest to joint. And apply crêpe bandage for support and compression. Use ice packs to reduce swelling, inflammation and pain. Physiotherapy with ultrasound and Tens will help you, For early healing you can take Tab Colin [it C] and antioxidant with anti-inflammatory [Tab enzymic plus]. If there is no relief them you may need to consult doctor again. 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. Wishing you good health. Take care ### END