Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 DOC IM LADYLIZ SILISILON 33 YEARS OLD FROM THE PHILIPPINES.LAST YEAR I SUFERRED HEART PALPITATIONS AND WAS DIAGNOSED TO BE HYPERTENSIVE,IVE UNDERGONE 2DECHO AND MY DOCTOR TOLD ME THAT MY HEART IS NORMAL.HE GAVE ME PRITOR 40MG AND NEBICAR 5MG AS MY DAILY MEDICATIONS AND LUCKILY THERE ARE SOME GOOD CHANGES IN MY HEALTH BUT LATER LAST YEAR  IM HAVING SLIGHT PALPITATIONS .DIZINESS SO MY DOCTOR GAVE ME ANOTHER MEDICINE THAT IS INDERAL 40 MG BUT UP TO NOW IM STILL EXPERINCING PALPITATIONS DIZZINESS AND MOST OFTEN MY EYES SEEMS TO BE HEAVY IN THE SENSE THAT IM ALWAYS FEELING SLEEPY EVEN IF IM ALWAYS SLEEPING ALMOST 8HOURS A DAY.KINDLY HELP ME BECAUSE I WANT TO BE NORMAL AGAIN A LOT OF THIONGS IVE SACRIFISE AND I QUIT MY JOB BECAUSE OF WHAT IM SUFFERING RIGHT NOW.THANS AND IM LOOKING FORWARD FOR YOUR ADVICE.CAN YOU RECOMEND ME ANOTHER MEDICATIONS.BY THE WAY I HAVE GALSTONES.GODBLESS ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should rule out hypotension in your case. You are taking three tablets for hypertension. So these might cause hypotension because hypotension can cause dizziness, tachycardia (palpitations) and heaviness in the eyes. So first get done blood pressure monitoring and if you have hypotension then you need to stop some .  If blood pressure is normal then get done ECG, 2d echo and Holder monitoring (24 hour continuous monitoring of ECG) to rule out arrhythmia (rhythm disturbances in heart) because arrhythmia can cause palpitations and dizziness. Sorry to say, but I can't prescribe medicine, it's not legal on this site. I can only give advice. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am an O.T. working with a 2year old girl dx with VACTERL...can you tell me what the eye problems are with this...I am wondering if she has some visual/ perceptual challenges as she is unable to place single puzzle pieces correctly...are there peripheral field deficits or convergence problems? ### REPLY: There are no specific described eye problems. Her vision will depend on the integrity of her eye structure. Hence, that should be checked out first. Does she have, for example, a cataract, or a retinal problem? Structure problems lead to function problems. Remember that! Of course, sometimes, especially when it comes to the brain and eye, the structure may be totally normal. Only way to make certain is by further tests and referral to her ophthalmologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently seperated from my husband.  I have been going through the motions of a break up.  for the first week I really didnt eat and and I m slowly trying to get my apetite back...but everytime I eat I become sick.  is this something I should worry about? ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. Reduced appetite and gastric disturbances are symptoms of stress reaction and can occur cause of the stressful moments with your husband and the separation incident thereafter. You need supportive psychotherapy from a professional and also need antidepressants such as fluoxetine or Escitalopram etc. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When I was a child I was tripped and fell on the back of my head on a gym floor. I recall there was nominal bleeding, which stopped with a moment of pressure. A knot remains, which is sometimes tender, with some neck tightness/tenderness. Is this anything that I should be concerned about? ### REPLY: Hello! Welcome to . Yes, your concern is very true. As the history of fall is in childhood, this can not be hematoma but more likely this can be due to fibrosis which is part of wound healing. Do you have fever? As then infection in it may cause pain. Consult your doctor once as local examination is necessary for diagnosis & treatment.FNAC - fine needle aspiration cytology may be advised for confirmation of diagnosis if in doubt clinically. Hope this information helps. Wish you healthy life. Thanks. 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 had two bottom teeth and one back top tooth taken out on wednesday, March 27. I am having mouth pain. Its a dull aching pain. When I eat/drinnk somethiung cold its fine. But at night when I sit down it hurts or when I lay down to bed it hurts. But when I stand up and take a cold drink i am fine. But I cant drink and eat Ice Cream all day long. WHat do I tell the Dentist to do? they never prescribed anything to      me. I am in so much pain I dont know what to do!!! ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have pain after removal of tooth, pain relief on taking cold water and ice cream, it can be due to your next tooth present to extraction socket may be carious or may abrasion is there.Don't worry about this you should consult dentist and go for radiograph x-ray if it is carious then go for treatment. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 50 years old had Ct scan and us found cyst in left kidney tingling and numbness in both legs down to toes weak tired cant even fold a load of clothes let alone walk without assistance. Please help getting no help from doctors. One says orthopedic another says endocrinoligst another says nephroligist ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Cyst size in left kidney is important for management. If small, it can be safely ignored.2. Tingling and numbness is possibly due to diabetic neuropathy or It B12 deficiency.3. Meet a neurologist to identify possible cause. If you have any back pain, Ct scan may be necessary. Continue treatment with It B12 and biopic acid. It could show improvement within two weeks. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have been having a swolen cheek (either right or left never both and just on the cheek bone) and lips (localised not the entire lip) frequently aand the situation is not geting any better as it occurs approx. 4 days a week with the sweling lasting upto 24 hours before subsiding on its own without taking any medicine. kindly assist as i end up looking as if i have been beaten.please help ### REPLY: Hello there, You seem to be having edema of the face which can be due to-1) Allergic reaction to any beauty products you may be using.2) Adverse effect of some medication that you are taking3) Reduced protein in your blood leading to accumulation of fluid in your face. A Liver function test of blood along with a TLC and DLC would help us establish if this is due to the above conditions. Hope this helps, Any further queries can be ad .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doc, May concern towards my health are having Shortness of Breathing(SOB), got nervous or feel dizzy sometimes or let may say my heart beat runs so fast everytime I laugh too much, just like my heart is sqeezing..When I was in high school I was exempted during our P.E. because many times I m collapsed at school. During that time I was taking a medicine as what the doctor s advice then if I should not becareful I might have hole in my heart. What I am afraid of is that last June I feel exhausted & hard to breath for an hour.Please can you help me Doc with regards to this concern?Thanks,Virginia T. Niez, 35yrs. old ### REPLY: Thanks for your question on . In my opinion we need to rule out1. Cardiac cause2. Respiratory causes first for your symptoms. So get done ECG and 2D Echo to rule out cardiac cause. Get done chest x-ray and PFT (PULMONARY FUNCTION TEST) to rule out pulmonary causes. If everything is normal than no need to worry much. Your symptoms may be due to anxiety. So avoid stress and tension. Be relax and calm. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband has been having tingling/numbness in his hands and feet .... and his arms....almost as if he has slept on them and you get that tingly feeling. he hasn t really felt right since June....very light headed....has had to pull over when driving... the right side of his face has now started getting prickly now. 2 weeks ago he went to the doctor and she thought the tingling/numbness and the light headedness/dizziness are not related. she ordered blood work but they called and said it all was normal. she ordered a neck xray (thinking maybe a pinched nerve)...we haven t gotten the results of that yet. the past 2 days he has felt worse.....nausiated and hot flashes... last night, he woke at 4am and said his heart was racing and he just didn t feel right - his left arm was tingly again. ### REPLY: Hello, In my opinion, neurological conditions such as Chiara malformation, peripheral neuropathy, etc. should be considered as possible conditions that may cause such symptoms. The first step in achieving a correct diagnosis is a careful neurological examination. Tests such brain and neck MRI, nerve conduction study, are also necessary. Discuss with your husbands Neurologist for these issues. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i woke up in the middle of the night needing a wee so i got up and went to the toilet by the time i had got to the bathroom my legs had gone wobbly, so i sat down on the toilet to have a wee, and started sweating and my eyes where going blurry, stood back up pulled my trousers up then i woke up layed on the floor not knowing where i was, with a headache, now i feel sick and still have a headache as i hit the back of my head, this is not the first time i have passed out ### REPLY: Hello, thank you for your question.I am very sure what your problem is with the detailed information you provided. You have Orthostatic Blood Hypotension. That is low blood pressure immediately after chancing position from laying Dow to standing. That cause rapid decrease of blood pressure that affects you brain, and you faint and lay down. Probably you hit the head on the floor and that is why you have headache. To avoid this problem you should not raise or stand immediately but first stay in sitting position for few minutes until your body adapts with this position, and then you can stand.Also, you should .  Coffee and cola have caffeine that helps to increase blood pressure.I hope with this new advice your problem will not occur again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son has a metabolic condition that is currently in the process of being diagnosed. He has a high ratio of sterified to free carnintine. He is on L-Carnitine 2x s a day. He has a sore throat today. Is there anything I need to be careful of when taking him to urgent care for his throat..for example I read that ids with some metabolic conditions should not take ibuprofen. What about anti-biotics? anything I should be careful of? ### REPLY: Hi, By what you quote I feel that your kid might be having a viral sore throat or a streptococcal infection. I suggest you see your pediatrician and get a rapid streptococcal antigen test done. If it is positive then she will require antibiotics. If it is negative then it might be a viral illness and doesn't require antibiotics at all. Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. 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: I got a tattoo a little over a year ago in the middle of my shoulders and the base of my neck.a lump as developed at the base of my neck and in the middle of my shoulders.there is no pain but some stiffness when I bend my head back.im making acdoctors appointment soon.just wondered your thoughts on this ### REPLY: Hi, Dear , thanks for the query to . I studied your query in-depth and I feel concerned about it. In my opinion-the lump with shoulder stiffness is due to mild infection-after the tatto-possibility of chronic infection is there. I would suggest consulting Surgeon who would treat it with antibiotics and NSAIDs-if it does not resolve, CBC,FBS, pps studies and excision of the chronic lump with chronic infection is needed. Hope This would solve your query. Wellcome again for any more 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: hi , dr prasad . i have  a question for u . i have some black spot on left portion os stomach . it does nt pain or anything . but sometime i feel like somebody just pinch me with a pin ,thts it . is there any thing tht i should be worried abt thnks ### REPLY: HI. Thanks for your query and an elucidated history. The lack spot on the abdomen on the left side with the feeling of pinching with a pin is suggestive of some sort of dermatitis. If this is long-standing Melanoma has to be ruled out. I would request to consult a dermatologist for a diagnosis and treatment, and if said, so you have to go for an excision biopsy for confirmation that this is not a Melanoma-Cancer can cause too much problem hence it is required to get a proper diagnosis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, recently i got my chest xray and esr done...where my esr count is 60, i am 25 years old. i have been healthy until last couple of months where i have had cold, cough, sneezing, running nose, constant headache and congestion. have recently also started suffering from shortness of breath and wheezing. my doctor has to say everything is perfect and i need to keep my haemoglobin levels constant. even my sister is been going through the same problem since last month. i want to know how to keep the ESR level to its lowest and how do i get rid of cold, cough, sneezing, running nose, constant headache and congestion ### REPLY: Hi. I can understand your concern. You are mostly suffering from allergic rhinitis and asthma. Asthma is most common allergic disease which is not a curable disease but definitely controllable, by controlling the same you can lead a symptom free life. Usually presents with cough, wheezing, difficulty breathing and chest tightness. If not treated appropriately can be life-threatening. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease. Allergic rhinitis is a due allergy to dust, pollen etc. Usually presents as running nose, excessive sneezing, blocked nose, headaches etc. It is ideally treated after consultation with a pulmonologist / allergist. Usually treated with intranasal steroids and anti leukotriens.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: earlies I  have sperm release after every 15 days during night while dreaming. ..I consult 2 the dr and take the med....but after some time nw again it start after releasing sperm after 15 days while morning sleep....and whn I ejaculate there is pain after that for sometime...how can I cure thz ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you are facing problem of night emission. Please note that it is very common to get night emission at the age of adolescence and there is nothing to be worried about it. It gets resolved without any treatment over a period of 1-2 years. As regards pain in penis after ejaculation, it is due to congestion of penis during erection and ejaculation. This fades away within 1 hour after ejaculation and does not need any treatment. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi sir .i get tensed when i get near to my exams.I am studying in sslc and i m very near to exams so what can i do sir.Now i practice yoga-ujjayi and basthrika.Many of the people avises me but i cant get out of these.Most of my teachers and parents say that the exams are nothing but i cant take in that way.What should i do? ### REPLY: Hi dear I understand your concern. Examination always bring stress and anxiety. But we have to handle it by making proper plan and schedule. Systematic reading with the help of your teacher will help. Proper sleep is must. Confidance and positive outlook help to reduce it. Exercise and meditation like yoga will help. Keep doing it regularly. Mild anxiolytic will help to reduce stress like Mizoram and propranolol.  But take acc. To doctors advise. If you require then consult psychiatrist and get positive motivational counselling. Still if you have a query then feel free to ask. Happy to help you further. 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: Yes. I am on oxygen 24/7 as it is and my husband has suffered a stroke. I don t know all the details yet but from what I have heard all he can do is lay in bed. I know Thai need to remain strong for him but I still need help. My husband is 69 years old and I am 68. Please help in any way you can ### REPLY: Hello, Unfortunately, the available treatments for stroke are only possible when administered in the first hours after a stroke at most in the first six hours after the onset of symptoms. After that period the damage due to the obstruction of the blood flow is established, there is no treatment to reverse that. At this stage, management consists of preventing other strokes from happening and in preventing complications (such as infections, deep vein thrombosis, hemorrhagic transformation etcetera). Gradually some (usually partial) improvement is expected, but that will be thanks to the unaffected areas of the brain compensating for the lost ones, not thanks to medication. The only treatment to help that process is physical therapy.  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-----I have been suffering from cervical spondylosis since 15 years and also a hypertensive patient since 20 years or so---in winter times my neck region shows some mild tightness and alos my BP goes up in spite of 4 different types of antihypertensive drugs--i am 66 now . I read an article of close link between CS and sympathetic nerve system routed essential hypertension which can be cured by some suregry of the neck c1--c6 kind---and alos can be free from any hypertensive drugs---may be I can do with some exercise as well.Can you pl enlighten me about this topic and the experience of solved cases ???and if so how can go about solving my case. ### REPLY: Dear patient only relationship between cervical spondylitis and hypertension is that both occur in elderly. Treatment for both is different. For cervical spondylitis physiotherapy and medications is usually prescribed. Short wave diathermy, neck muscle strengthening and neck range of motion exercise are done by physiotherapist. For pain relief tab ibuprofen 4oo mg thrice a day is usually needed. For hypertension please continue your medications and regular check-ups with treating physics is 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: hello dr... i am 8 weeks pregnant... now i am suffering from severe sore throat, fever, malaise, dysphagia. consulted ENT surgeon - he said it is an attack of acute tonsilitis... he asked me to take augmentin, combiflam (paracetamol + ibuprofen)... is it safe in pregnancy... my pain is very severe... ### REPLY: Hallow Dear, If you are having acute tonsillitis, you have to take antibiotics to control the infection. You have been prescribed Augmenting. Augmenting contains a combination of amoxicillin and clavulanate potassium. Amoxicillin is an antibiotic in a group of .  Amoxicillin fights bacteria in the body. Clavulanate potassium is a form of clavulanic acid, which is similar to penicillin. Clavulanate potassium fights bacteria that is often resistant to penicillin and other antibiotics. Hence, it is safe to take in pregnancy. For pain and fever, I would advise you to take plain Paracetamol. Some researches have found that any NSAID like Ibuprofen may lead to miscarriage of pregnancy. I 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: I have a painful lump on the prepuce of my clitoris that appeared about 2 days ago and has got bigger. It is painful particularly when pressed and uncomfortable. I am a 17 year old female who is not sexually active and is generally healthy. What could it be? ### REPLY: Hi, If I were your treating Doctor for this case of clitoral lump, I would come up with three possibilities, these include: 1. Inflamed benign cyst like sebaceous cyst2. Folliculitis, infection at the base of a hair3. Benign tumor like conditions like papilloma, polyp or fibrous Nothing to worry about these also! Just take cold compress and local antibiotic lotion and wait for 1/2 days! Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes, my husband and I are trying to conceive. We conceived in 2008 & lost the baby at 14 weeks with a miscarriage. Since then, we have tried to get pregnant and learned April this year, I have premature ovarian failure with very little egg reserve left. Also, I just turned 40. All those factors are working against us.  Ive been on clomid for 3 cyles, and the last 2 months had mature follicles. Both times did not get pregnant. We decided to have my husband do a seamen analysis to see if things were ok in that area. He took 2 tests one month apart. There are 2 factors less than the desired level. My question is, could these 2 things be contributing to us not getting pregnant. His concentration was 6.2 out of desired 15 , and the motility was 33 out of desired 40. ### REPLY: Hallow Dear, At the age past 40, the fertility does go down; however, with proper monitoring and scientific approach, pregnancy is not impossible. Now let us start from the end of your query. Though a couple of parameters in your husbands' semen report are somewhat substandard, they do not rule out the possibility of conception. You may have to go for some assisted reproduction technology like intrauterine insemination of so. I am more concerned about your ovarian reserve. On what basis you have been declared a case of premature ovarian failure; and if so how is it that are responding to camphene citrate by ovulation? Anyway, your ovarian reserve seems to be very poor. Hence, I would advise you to monitor ovulation by ultrasonography. This will help to assess the endometrial growth also. Ovulation from the follicle between 18 mm to 21 mm gives best results. The endometrial thickness between 9 mm to 14 mm at the time of ovulation (thus indirectly conception and implantation) is very conducive for successful implantation and pregnancy. So at the time of ovulation with such conditions, you may get intrauterine insemination done to increase the possibility of pregnancy. You may try this for 3 months (considering your age and ovarian condition) after which you might seriously think of in vitro fertilization and embryo transfer. In this advice, I am presuming that you have tested the patency of your tubes, and they are patent. If you have not tested, please get Hysterosalpingography and/or Laparoscopy done for the tubal assessment before you take any active intervention step. I hope this clarifies your doubts.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a large swollen lymph node under left jaw for almost a month. It is painful to touch and I get a fever around 100.4 nightly. My family doctor had done blood tests and can t figure out what it is. It is now turning red. What kind of specialist should I see? Thanks ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  You may have some salivary gland pathology like siledenitis or some submental or submandibular lymph node enlargement due to some reactive hyperplasia or other Causes. You should consult physician and go for fine needle aspiration cytology according to his advice.  Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi I have had my implanon for over a year now and yesterday I noticed my arm started hurting when I woke up. This has never happened before and I m a little concerned. It s almost feels like my muscle is being stretched. And it still hurts today should I be concerned? Do I need to find an appointment? ### REPLY: Hello, As there doesn't seem to be worried. But in case you are having more trouble than an x-ray should be taken. If everything is fine and normal on the x-ray this pain can be muscular and with hot water fermentation and simple exercises you should do well.  In case this implant is of more than 2 years old and bone is healed completely then removal of the implant is always advised as it is a foreign material. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been bodybuilding since 14 and im 22 and ive never had a problem when lifting except 9 months ago i was working my biceps and i guess i used too much weight and a wrong position and my left testicle swole up and then it swells up and hurts every time i lift so i havent been able to lift comfortably ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you are getting pain and swelling of the left testicle while doing weight lifting exercises. This is due to increased intro abdominal pressure that causes varicocele. This can be confirmed by clinical examination by a qualified general surgeon and color Doppler study of scrotum, Please go ahead and get this done to confirm the diagnosis. Further treatment will be decided by him and will depend upon the final diagnosis and grade of Varicocele. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was cleaning out their water cooler and let bleach soak in it. I didn t know and drank from it. I swallowed three or four gulps before I felt it. I m pregnant and I was terrified. I immediately puked. What risks did it have to my baby. Is there anything else I can do ### REPLY: Hello, thanks for choosing  for your query... I understand your concern. By knowing your history you swallowed very small amount and diluted bleach. So it is most likely you will not have to face any serious complications. Most probably your baby will be completely safe. But bleach is corrosive.it can injure food pipe(esophagus) and airway pipe(trachea). IT IS HIGHLY RECOMMEND TO MEET DOCTOR IN PERSON IMMEDIATELY. I hope this helps. Feel free to ask any further queries. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my 6 1/2 month son had a fever and 1 convulsion on 24 august. He was immediately put on frisium 1/2 tablet once in d night and then after 12 hours d other half. We had given his urine and blood for testing and it showed that he had a urine infection. The doctor prescribed 4 ml of zifi 50 to be given to him 2 times a days for 5 days. The doctor had also asked me to do his chest xray. The conclusion mentioned in d report is bilateral basal patchy consolidation seen what does that mean?? I chked with d doctor and she said it is borderline pneumonia. She has asked me to continue zifi 50 4 ml 2 times a day and respira 1.5 ml 3 times a day for 7 days. Can u tell me if d diagnosis and the medication given is correct. ### REPLY: Hi welcome to  First coming to last question, by description provided it seems to be a case of Acute respiratory infection with wheeze with Febrile seizure with possible Urinary tract infection, but difficult to comment without examination and detailed history like duration of seizure, type of seizure, whether self aborted or not, is there respiratory distress , if there is significant respiratory distress seizure may be due to hypoxia. Regarding medicines given, treating doctor decides medicines considering a number of factors, he or she is right person to decide about them.2. Bilateral basal patchy consolidation means patchy areas of consolidation in lower lobes of both lung. (It is suggestive of pneumonia)Based on little information available, I have tried to answer your question to the best possible, but your primary physician may be in a better condition to elaborate more thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had lipo on my stomach around 2 weeks after having a hernia removed from my naval area.i kept the body wrap around my stomach and cleaned the area as directed. after 10 days a large bruise that was around this area has turned into a nasty looking scab. is this an infection or  can a bruise turn into a scab? ### REPLY: Hi, thanks for sharing your health concerns with !  If I were your treating Doctor for this case of infected wound, I would like to warn you regarding its bad consequences, and please urgently take it to nearby surgeon for a microbiological test and some broad-spectrum antibiotic medicines! The infection might come through your own hands also... I suggest you to go for local hygiene / . . Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife has tooth in back right upper mouth that is hurting badly she had X-rays and the dentist is sending her to an endodontist. After the X-rays her lower lip and chin on right side are numb and lower teeth hurt. Could it be the tooth that is infected causing this ### REPLY: Thanks for your query, I have gone through your query. The pain the upper tooth can be because of the tooth infection(acute apical periodontitis). Nothing to be panic, Consult an oral physician and get the tooth treated with root canal treatment or extraction of the tooth. Get a radiograph done to see the extent of the infection and suitability of the tooth for the treatment. If I am your treating doctor, I would have prescribed, a course of antibiotics like amoxicillin and metronidazole (if you are not allergic). Along with antibiotics, you can an analgesics like diclofenac for the pain. But these medicines will provide a temporary relief. Once you complete the course, try to get the tooth treated as early as possible. The numbness can be because of the pressure over the nerve by any cyst or tumor secondary to tooth infection. You need to take a radiograph like OPG to confirm the diagnosis. Meanwhile you can take a nerve regenerating .  Take care of the part which is numb from hot, cold and sharp objects, because you will not be able to make out the sensation. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor, i am 28 yrs female , married for last two and half years. i am diabetic from last two years. taking a lot of medication. i wanna have a kid now, and i am trying since long time but not succeed. Please can you help me in my problem, as in how can i conceive a baby, should i stop my medicines and start insulin ?? please let me know . Thanks . Dhanashree ### REPLY: Hi Dhanashree. Diabetes can cause a real hindrance with the whole process of conception, and more commonly the process of pregnancy itself. I would recommend working with your doctor to first control your blood sugar levels well enough. Insulin is a better choice during pregnancy as it does not cross the barrier reaching the fetus (seen with oral hypoglycemic . But before conception itself, good control of your blood sugar levels will be mandatory, and to keep it stable for a while. 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 daughter has a rare metabolic syndrome in which she can not absorb animal proteins, and fats.  She is also very sensitive to phyto estrogens. She takes Creon 5 (pancreatic enzyme).  Her skin is dry and has tiny bumps. She also has a chronic infection type rash on her nose that constantly peels, heals and reacts. She is afraid of using cortizones, and your average otc creams etc are not sufficient; any suggestions? We are from northern NJ NY metro area. ### REPLY: The condition sounds like seborrhea dermatitis, which is treated by proper skin hygiene (washing face twice daily) and with shampoo/soap containing one or more of these ingredients: Salicylic acid, Selenium sulfide, Coal tar, Ketoconazole, and Zinc parishioner. Other treatments include: Antifungal products, Corticosteroid lotions, Prescription-strength medicated shampoos, and Sulfur products. Make sure your daughter is not allergic to any of these ingredients by testing a small patch of skin on her arms (not face). She should be evaluated by a dermatologist, who can prescribe a stronger cream with an antibiotic to treat in case of infection and for proper diagnosis. In the meantime, there are also natural essential oils and emollients you can use like Need oil, which is naturally anti-microbial and soothing. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was diagnosed with depression and took deanxit for a period of 6 months and after that i was relatively better. Now after a period of 10 years i always feel tired and need a nap midday i either feel dizzy or fatigued or nauseated . I sleep a lot but always feel tired . i have frequent headaches . what i do is take a deanxit tablet from time to time but it makes me feel very sleepy. so i stop the next day. Please tell me what to do.Thank you ### REPLY: Dear user as per u, you had density 10 years back. U took for 6 month and u were well. Now you're feeling every time dizziness, are current symptom similar to previous which u experienced 10 year back.u should consult to your doctor. Might be suffering from similar illness .get complete examination .u may be anemic, go for CBC complete hectogram .go for thyroid profile to rule out hypothyroidism .hope this will help u. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a healthy history and have exercised briskly for years. I am now a 63 year old male who seems to have type 2 diabetes symptoms and when I walk or exercise after meals experience a RACING heart beat, clearly exceeding 175 to 200 beats per minute. Should I be concerned? ### REPLY: Hi Thereafter going through your query I understand your concern. I would like to tell you that people with diabetes are at more risk to develop heart disease than a normal individual and heart rate of 175-200 is really high and is a point to be concerned and need further evaluation.It's advisable for you to get an ECG, Echocardiography and a Treadmill test done and personally consult a cardiologist with reports for further management. Hopefully this has answered your query. Kind Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: On 23rd jan my period started which lasted 27th jan. On 29th jan I had an unprotected sex and next morning I took unwanted 72.  On 4th feb I got again periods for next 4 days.  Now yet I have not got my periods.  When will it come. Pls reply soon.Thanks. ### REPLY: Hiiii, You did sex on 29th Jan, just 2 days after your last period, and it is very much safe sex. You also took Unwanted 72 pill within 24hr, and it will give extra protection against unwanted pregnancy. Here, chance of pregnancy is almost nil. Your got period on 4th Feb due to with .  I suggest you to await for next coming period up to 4th March. Late period may be due to psychological upset, mental stress, altered eating habit, wt loss or gain, hormonal imbalance, thyroid disorder, ovarian cyst, high prolactin etc. I suggest consulting with your doctor and need to carry out some basic investigations (pelvic ultrasound scan and hormone profile) to evaluate underlying pathology if you don't get your period on expected date. Avoid stress by regular deep breathing, take healthy diet and proper sleep. Practice safe sex and good luck. Be well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Respected Sir, my father is diagnosed with severe pneumonia and was given injection Zeanam 500mg 4 times daily for 7 days and now still his total count is 28000. Doctors have prescribed injection magnex 3 grams 3 times a day now. Sir I am very worried now. Is this the right medicines. What should I do now? Please suggest me. ### REPLY: Hello dear, thanks for your question on . I can understand your fathers situation and problem. He is still having infection even after 7 days of injectable antibiotics.  This suggests that, this antibiotic is not working. In my opinion you should1. Get done repeat chest x ray2. Sputum culture and sensitivity. Repeat chest x-ray is needed to know whether pneumonia is worsening or not. And treatment of pneumonia should be guided on causative organism. So we need to first isolate the causative organism. So get done sputum culture and sensitivity to isolate the causative organism and guiding appropriate antibiotic treatment. Haphazard use of antibiotics should be avoided as it actually delays the recovery and increases the risk of .  So consult pulmonologist and discuss all these and start appropriate antibiotic according to sensitivity report. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently had my knee scoped. Today which is 4 weeks after my surgery I felt something like an asthma attack it came on fast and left me wheezy and a hoarse voice after. I am also experiencing tingling in my left hand. I am on a number of medications including fentanyl patch which is my newest medication update. Is this something to be worried about. Other than tingling in my hand and tired and now a sore throat as a result of my attack I feel better ### REPLY: Catching of infection may come from any source including nosocomial route. In such case it should be well managed. A doctor should advise patient for culture and sensitivity test in such condition. Asthma could be a result of infection in Respiratory tract or Allergy also in you case. If I were your doctor I would have advised you preventive measures to skip the possibility of such conditions. Hope this answers 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 had open heart surgery last Thursday. Is stomach is very distended (bloated) and causing him much discomfort. It will go down a bit during the day but not enough to make him comfortable. His weight is up 1.6 lbs today, though is his eating very little. ### REPLY: Hiafter open-heart surgery patient remain confined to bed for 2.3 days and after that he starts to ambulate slowly over weeks, There are a number of things that can cause stomach bloating following heart surgery. They include fluid build-up, constipation, limited moments, as he will start to ambulate bloating and fullness will go away . Constipation can be treated with laxatives like lactulose for the time being. Add fibers to his diet avoid oily and fatty food give him light food till he returns to normal activities thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello..I have done iui on 26th July and took duphaston for 14days but bad luck I got a negative result..my friends mother being a doctor she told me next time instead of duphaston I should b injected medicine,this is not clear to me..is she saying instead of duphaston there r medicine which can help me in implantation.. ### REPLY: Hi, Duphaston is given whenever progesterone deficiency is suspected or expected as in IVF and since you only had GUI, and it is not known if you had ovulation induction, it is difficult to comment on your need for progesterone supplements.  injections are sometimes given in the hope of sustaining the pregnancy if conception occurs. FSH injections are given to enhance egg release. Please clarify from your doctor what is it she meant by injections. Hope your query has been answered. 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 m 85 days late. Both blood and urine test show negative. I have all the symptoms i.e. Heart burn, extreme fatigue, slight pelvic pain, trouble sleeping, smells are bothering me, nausea, appetite has decreased. I m at a loss. I m 42-1/2 years old. No spotting. ### REPLY: Hello, I have gone through the query and understood your concern. As both the blood and urine tests have read negative for pregnancy, you cannot be pregnant. This delay in the menstrual period can be due to hormone imbalance and this is also likely to be the cause for the symptoms you are experiencing. Considering your age, hormone imbalance is more likely. This menstrual disturbance can also occur with sudden weight changes, stress, infection and use of certain medications. Please get a clinical assessment and a trans-vaginal sonogram to plan further management. 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: Hello, My husband is taking Oxycodone due to a broken leg/surgery. He has been taking this pain medication for one month. We are trying to conceive our second baby. Will this medication afect the fetus? Or the health of the baby? Or can it bring birth defects? Thank you. ### REPLY: Hello, and I hope I can help you today.First, there is no medication that can be taken by the father that has any way to get into your system or a baby if you conceive.  Medications can only affect a fetus if you take it while pregnant. The only issue is that certain medications may decrease a men sperm count and affect fertility, however pain medications like Oxycodone do not have this effect. So there is no reason for you to worry about conceiving while taking this medication.  The best way you can prepare for a healthy pregnancy is to follow a well-balanced diet, limit alcohol consumption and avoid cigarette smoke, and take a daily prenatal vitamin or folic acid, as folic acid supplements in early pregnancy helps to prevent certain types of birth defects. I hope this answers your question and best wishes for your upcoming 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: I am a newly diagnosed NHL patient receiving Rituxan Infusions. The first dose could not be completed because of severe chills, rigor, abdominal pain, fever and flushing. It was restarted after protocol medication. Again it had to be stopped for the same reasons. It was successful the next week with decadron 4m po the day before and the night before. The infusion went well with premedication of Tylenol, benadry. po and decadron and zantac IV. The next day I took post med of decadron 4 mg po the day and 4mg po again the night. However, the next day I went inot rigor and chills for two hours. Sent to ER and remained for 24 hour observation. Now the doctor is saying it was not a reaction to rituxan, but anxiety. I was NOT anxious because I had a great experience up unit the rigor returned full force when meds were stopped. I don t trust the judgements being made with my health. What to do? ### REPLY: Hi, Thanks for this question. As you have pointed out in your situation, your symptoms of rigors, chills etc. stopped during second time when you were premedicated with the list of medications mentioned in your vignette. But subsequently you again developed similar symptoms despite adequate premedication. Hence, there appears a scope for doubt that this time around your symptoms were Not due to Rituxan but those of anticipatory anxiety to medication infusion. This might happen some time & you should not fret over this too much. You have been diagnosed with a serious medical illness & are successfully coping with the same. Hence, I would suggest you should consult your doctor about SOS use of a benzodiazepine like clonazepam or Mizoram to help you cope up better with these manifestations. Wishing you good luck!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband was recently diagnose with eccrine carcinoma. It grew around his scrotum and between the cheeks of his buttocks. They also associated this with colon cancer. We have had 8 wks of chemo and radiation, waited another 8wks for surgery. They removed the tumor, and now he has a permanent colostomy. We herd today that our radiation Dr was not optimistic of how the tumor responded to treatment . Also during surgery they found nodules on his liver. My questions are whats our prognosis, and can this type of cancer spread to the liver this quickly? ### REPLY: Hi and welcome to . Thanks for the query. This is very rare tumor, and it should be always confirmed by biopsy. I presume it is confirmed. Usually it spread to local lymph nodes and infiltrate surrounding tissue. Distal metastases are possible but rare. I wouldn't say was early phase considering that it infiltrated colon. So metastases should not be ruled out but as I said this is rare and there are various liver lesions which may be considered in the differential diagnosis of metastases.  Wish you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been taking diovan and inderal for HBP. Occassionaly my readings spike into the danger zone. 188+/110+. This weekend it spiked to 220/120 but I had no symptoms, felt good. For the past six months I have been walking 2 1/2 miles every day, eat healthy, am not overweight, I am a 55 year old female. I have been tested for adrenal insufficency and that is okay. I do have a couple of drinks every day and am wondering if this is causing the sometime spikes. Any other possible reason why you might think this is happpening? ### REPLY: Hello, I passed carefully through your question and would explain that these spikes could be related to different possible causes: anxiety, physical activity, thyroid gland dysfunction, caffeine intake, etc. For this reason, I would recommend avoiding caffeine intake and checking thyroid hormone levels.  Regular physical activity and a maximal reduction in salt intake would help avoid these spikes in blood pressure values.  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 Doctor, My 7.5 month old baby has got loose motion and also red rashes on her bottom. For the loose motion, we are controlling her diet . But the rashes are bothering her a lot. She cries everytime she has a motion or urinates. I am also avoiding diaper and keeping her in loose nappies only. Please suggest how to make sure that rashes go away soon. Also suggest if I need to do something for more for her loose motion. Thanks, Harveen. ### REPLY: HelloWelcome! I would be pleased to answer your question. From the description of the lesions they seem to be either an eczema or irritant contact dermatitis.  The Allergy can be due to external or internal allergic agent.  Here is what will help: 1. Clobetasol propionate cream + Mupirocin cream: Mix and apply over the affected area on the right shoulder twice a day for 5 days then switch to Fluticasone propionate cream once at night for 2-4 weeks. In the groin/upper inner thigh use Fluticasone in place of Clobetasol from the beginning. The specialist to see will be a dermatologist and he or she can prescribe these for you. Nothing over the counter will help much, the only product with some benefit is 1% Cortisone cream. 2. Syrup Clarity twice a day for 5 days to get relief in itching. 3. Sara sensitive lotion can be used 2-3 times a day to give further relief from itching. This can be continued even when the above creams have been stopped. 4. Avoid scratching the affected areas as much as possible. This is most important. Whenever it is not bearable soak a towel in ice-cold water and keep it on the affected areas or apply the Sara sensitive lotion. Lastly keep the affected areas as well moisturized as possible with a moisturizer of your choice. NOTE: 1% Cortisone cream, Clarity and Sara lotion can be bought without a prescription. Please feel free to ask if you have any queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had some sites of pus accumulation in my anterior side. Among those were my both thighs,areas just above penis,and below the politeal area. all of them i ve got rid off by pressing and getting the pus out and filling it with betadene and bandaging,now all of them are gone but now a similar kind of thing have aroused in my hip s medial side. what should i do now ? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have pustules or abscess formation. You should take a course of antibiotics. If it does not respond to treatment then go for culture and sensitivity test and then take antibiotics accordingly. You should check your blood sugar level. If you have diabetes then you should take treatment of that also. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am the mother of a five year old, when my son was born he had a small lump on his stomach the doctor said it was a grease bump and that in time it would go away. Today he is 5 and the bump still exists it is about the size of my thumbnail the doctor says there is no need to worry should i take him to a dermatologist?? No pain and never fuses about his bump but to me it seems abnormal for him to have this ### REPLY: Hi. Thanks for your query. I can understand the anxiety a Mother can have with any problem for her son. Grease bump is one thing that should not be worried about. Just to reduce your anxiety, it would be better to have a consultation with the Dermatologist, get the bump removed and investigated by histopathology examination and you both will be happy and tension-free. Why to keep something lingering that bothers you the most. I hope this answer helps you in proper decision-making. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: S.C.Khare Hatta,M.P.I am a patient of CRF be adviced with you for best tretment without dylisisus. my blood urea report is 108.7 mg, SR.Creatinine 8.7mg on 03.03.2010 now i am feeling weekness, Hediace, Low Appitute, My blood prasure is 70-160 and rendom sugur is 210 plz Advice me for best tretment without dylesis. Now be take EIDOFE, FOLI-12, NEPHCELOL, ZATOR 20mg, S-NUMOLO 2.5, PANTODOM all these medicine take once time in a day be take Inj - TRANSFER-4000 Weekly My H.B. is 8.10 plz advice me what can i do?? Sir if you advice me I will thankfull to you  My E-mail ID is -  YYYY@YYYY ,  YYYY@YYYY ### REPLY: Hello Their and welcome to . As a Urologist and kidney transplant surgeon, i understand your anxiety.You've CKD, diabetes(uncontrolled), and anemia. You should write your age. Cause of the CKD, would most probably be diabetic nephropathy. There are only two options in management in your case :1. Maintainence dialysis.2. Kidney transplant. The second option is the best of the two, if you're below 70 years age. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was in an auto accident over six weeks ago and got beaten up by some hoodlums about 3 years ago. Both Have caused me to have terribly swollen feet. As if I have serious neuropathy which is very painful. What would be solutions to my problem. Bob ### REPLY: Hello, As per your clinical history is concerned, please follow like this:1) Do a clinical examination by your treating Doctor [Or tho] and to confirm exact cause do [X-ray and an MRI scan].2) Do take OTC painkiller like [Ibuprofen + Paracetamol] for pain and swelling.3) Your Doctor will decide treatment plan after investigation reports only, and normally it is [Reduction, Immobilization, and Surgery] which your Doctor will decide.4) After healing consult with your physio for a specific exercise plan. Do follow few lifestyle modifications like this:1) Try to wear proper shoes. Use hiking shoes on rough terrain. Wear steel-toed boots in your work environment if necessary. Choose appropriate athletic shoes for your sport.2) Replace athletic shoes regularly. Discard sneakers as soon as the tread or heel wears out or if the shoes are wearing unevenly.3) Try to build bone strength. Calcium-rich foods, such as milk, yogurt, and cheese, really can do your body good. Taking vitamin D supplements also can help.4) Try to strengthen your ankle muscles. If you are prone to twisting your ankle, ask your physio for exercises to help strengthen the supporting muscles of your ankle. 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: Hey. I m 17 years old. I m 6 ft 3 inches and I m currently 120 kg. I look awkward, fat and tall. Whenever I do a hardjob, like just climbing the stairs or just running a bit my heart Starts beating very fast. I feel very tense. I m always low, I get fatigued so much, usually I really don t do anything but if I do so like visit someone I become so low. My brain just stops working. I usually take coffee and tea alot. I also suffer from trichotilomania and I really fear of losing my hair day by day. The pulling starts when I get tensed, excited or Anyother anxiety. I ll be really thanksfuk for your help. ### REPLY: Hi, I read your query can understand what you would be going through. Going by what you have mentioned, you seem to be suffering from depressive as well as anxiety symptoms in addition to trichotillomania. I would suggest you to consult a psychiatrist for your symptoms. Had I been your psychiatrist, I would have treated you with a combination of medications and cognitive behavior therapy. Medications will include selective serotonin reuptake inhibitors which will help take care of anxiety and depressive symptoms. Cognitive behavior therapy in form of habit reversal therapy would be recommended for trichotillomania. You also need to start exercising daily as it will help you relax as well as lose some weight. Hope this information was 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 my friend is applying overseas but there is a problem on her xray.last 2010 the result of chest PA was suspicious thickened linear densities, right upper lobe. and chest pa and lordotic view was band of fibrotic scarring right suprahilar. region, whats the difference? she took for a second opinion ang undergo for ct scan but is negative,, aftr 3 yrs staying abroad for work she want to comeback and nw took again for an xray and rhe result was a linear fibrotic density and a small nodular opacity are seen in theright suprahilar region.consider kochs etiology.the heart and rest of the chest structures are remarkable? what is the difference of the 2010 result on hr result nw? is there any cure or preventions? coz she was never diagnosed of having a ptb.she sometimes had cough...but maybe its the result of changed weather, now she was given a medicine to take clarithromycin for 7 days, coz the findings of the doctor was pneumonia vs ptb (undetermined activity) right suprahilar area, the doctor said if she comply to the medication after 7 days she will having an xray if its the findings was gone then its pneumonia and if its not it is a ptb?can you pls help me to understand what is the real condition of my friend coz she is now hopeless..and thinking she she can never go abroad for work, being jobless here in philippines is difficult...the future of her family is at stak.thanks... ### REPLY: Thanks for your question on . I can understand your friends situation and problem. Current x-ray findings and previous findings are almost same. This suggests that your friend is having old, healed, inactive scar tissue. To solve visa problem, I advise her to consult pulmonologist and get done 1. CT thorax with Contrast. 2. Bronchoscopic evaluation and BAD (bronchoalveolar lavage) analysis. CT thorax is superior to chest x-ray in diagnosis of old scar lesions. Bronchoscopy and BAD are also more diagnostic in diagnosis of active infection. If both of these are negative for active tuberculosis than, she can argue with visa authority about not having active, infectious disease and the lesions seen on chest x-ray are old, healed, inactive, fibrotic lesions. So ask her to consult pulmonologist and discuss all these. Hope I have solved your query. Wishing good health to your friend. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi - I have had a large bony lump at the back of my head slightly above the ear on the right side. It is about an inch round and 1/2 inch deep. I noticed it at least a couple of years ago though it may have been there longer. I have now started to get swimmy sensations in the same area. Should I get this checked out? ### REPLY: Hello! Thank you for the query. Such lump can be a lymph node, lipoma or sebaceous cyst. Lymph node can be present in this area due to some inflammation in close neighborhood like ear infection, tooth infection. Lymph node is usually soft, hard and movable structure located under the skin. It does not cause pain. Lipoma or sebaceous cyst should be also considered. Both are benign lesions which does not increase cancer risk. To determine what you are dealing with, I suggest you to have an ultrasound of this area done. In case of enlarged lymph node, hematologist should be consulted. Lipoma or sebaceous cyst can be removed by a surgeon. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my nephew ,he is 13 years old, for the past 2and half month he is suffering from  dry gaugh,we visited so many docteurs, and we admitted in clinic also , but after 3 days he started to caugh, docteurs are saying its a type of asma.but he had this problem only in night till morning non stop with out sleeping. please advice me what do. ### REPLY: Hello. Thank you for asking at . I went through your nephews' history. I assume that apart from this, he does not have any other healtChatDoctorplaints. Were I treating him, I would suggest taking a combination of montelukast & levocetirizine daily at evening for 14 days. If he has any of the complaints like regurgitation, nausea, vomiting or burning in chest, especially after spicy meals, I would also suggest antacid like omeprazole before meals for 14 days. I would suggest you to make sure that there are no cold air currents directed at his nose/face (such as air conditioner, open window, etc.) in to be .  Cold,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having discomfort in my lower back on both sides.  I have increased my water consumption and havew also been drinking cranberry juice.  My son had kidney surgery 35 yrs ago and they discovered a horseshoe kidy.  I was told this was hereditary but have never had any problems until now. ### REPLY: HiT hanks for your query. After going through your query I came to know that you are suffering from chronic backache. It may be due to vitamin and trace element deficiencies specially vitamin D and vitamin B 12. You can get vitamin D and vitamin B12 levels and if found low you can take its supplements of vitamin B12 and D3. You need to do MRI to rule out other causes. Back exercises, neurotrophic such as mecobalamine and analgesics such as Ibuprofen give relief. Avoid long continuous standing. As you are worried about kidney disease is also advised to exclude kidney related causes by ultrasound of kidney and abdomen. You can discuss with your treating Doctor about it. I do hope that you have found something helpful, and I will be glad to answer any further query. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor. I am 34 years old , i have a 6 year old daughter. I am planning for the next child. After delivery since 6 years i am having back pain while doing any work for which i have to bend forward. Hence i used to just avoid to bend forward. But since last 5 days i am having extremely seviour lower back pain, i can t able to move also . I have to take pain killer pills to do my day to day work. Doctors prescribe me to do x-ray . But i have a doubt of pregnancy, so avoiding the x-ray and having the pain killer pills. My question is if i got +ve pregnancy, then how could i diagnosed my lower back pain , as i cannt do x-ray. please advice me. thanks minakshi ### REPLY: Hi Deena, first thing you need to do is confirm your pregnancy with urinary pregnancy test kit which is available over the counter on the pharmacy. Both x-rays and painkillers could be harmful in pregnancy, so you need to confirm the test before going for the same. In case if it is positive, and you still want to continue it there investigation like MRI and little blood test like CBC, ESR, Sr calcium, Sr it d, to rule out significant causes of back which could affect you in the pregnancy. If your pregnancy test is negative then you can go through all investigations as advice by your orthopedic doctor before planning a 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: Hello, I am 29 years old and have a illness as too much cough and acne on my back. Cough gets up to the extent of Vomit feeling and really terrible. Few days back, I had a medical test and found some allergy in blood. I was having homeopatChatDoctoredicines but cough was increasing. When I take Citrazine (Anti Allergic), Cough and Acne fades away for a week or so. But seems not a permanent cure. And My homeopathic Doc is also confused. Kindly suggest.Regards, Ankur Jain ### REPLY: Cough is allergic as your blood work tells as you take medicine for cough it suppresses but involve skin in the form of acne you might be allergic to any substance anything can start giving allergy at any time at any age you may be allergic to foods pollen cloth medicine for body application materials anti allergic tab and spy will decrease the allergies acne can be decreased by application of clindamycin need to get allergy tests by consulting allergy doctor to find the cause and treat it ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Please write your question here hello doctor me & my wife have same blood group b+ve.is it a problem for pregnancy.?last time my wife have a pragancy bt we have to abbort our child due to baby suffering from cystic hygroma.is  due to same blood group?pls give me ans with clear reasons.. ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  You and your wife both have same blooded group.  It doesn't cause any problems in pregnancy or childbirth.  Cystic aroma can be due to congenital developmental defect.  It has no relation with blood group. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I woke up this morning with knee pain. I haven t knocked, banged or twisted it and found it painful to get out of bed and weight bear. It was sore to touch and got more swollen throughout the day. Little bit warm to touch. Do you think it could be gout or bursitis? ### REPLY: Hi, I appreciate your concern. Painful and swollen knee, without any injury or twist, appears strongly a case of GOUT, or its variants.I always investigate my such patients for blood test, joint fluid aspiration and testing, to confirm the desease.in the meantime, immobilization of knee in splint, ice therapy, and safe painkiller may make u comfortable, as per advice of your family doctor.thanks. Iwill be happy to answer any further quarry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 have elder brother and he had obstruction problem in one kidney. We had consult regarding this problem to PGI Lucknow. We did some test according to Doctors instruction and after the report result, Doctors advised for the operation. They asked,  some pus has been stored in one kidney so finally we have to removed through operation. We had no option and thought we should follow instruction of doctors advised. We are in hurry about kidney issues. Is one kidney lead a normal life for anyone ? ### REPLY: Good day, and thank you for being with  ! Yes there are numerous studies that living with a solitary kidney still leads to a normal life as long as the patient would live a healthy life with adequate exercise and proper nutrition. In my opinion since the affected kidney is full of pus and may lead to life-threatening infections, it is better to heed your doctors advise and have our removed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What should be the ratio of calcium, potassium, magnesium for a heart patient taking Amiodarone, furosemide,irbesartan, warfarin. Also type 1 diabetic. Experiencing low BP in am that weakens me and increases my heart rate. Since water with a little salt in it seems to revive me, I thought my electrolites might be out of balance. ### REPLY: Welcome at  I have gone through your query and being your doctor I completely understand your health concerns.  The calcium potassium and magnesium levels need to be in normal range for the proper functioning of the human body.  Now coming towards the medicine you are taking.....furosemide and irbesartan are antihypertensive medications. They lower the blood pressure by increasing the urine output. In some instances the dose become relatively high causing low blood pressure along with electrolyte imbalance. You need to consult your doctor so that your medicines can be optimized to prevent these side effects... As far as warfarin is concerned the only related thing is PT INR, your doctor will decide how much anticoagulation is required for you. Normally INR is required at value of 2 to 3. Amiodarone is concerned, it is antiarrhythmic . .  Last but not the least is insulin you should be cautious regarding hypoglycemia. So use frequent small meals and keep sweet candies in your pocket to prevent hypoglycemia... Your doctor will educate you about hypoglycemia and ways to prevent it.  In short, you need to decrease your antihypertensive medications dose and also look carefully whether you are developing hypoglycemia or not.?  Do consult your doctor immediately.  Hope your query is adequately ad ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 18 Years old. on 29th March the Bilirubin leven in blood we have found 2.8 and just after 3 days later on 02.04.10 the same has been reduced to 1.9. there is no any sign of Juandice, all blood reports are normal including CBC, ESR, ceroplassim etc.. etc.. we hav adopting only home remedies, can we will able to take it normal range after 3 / 4 days pls advice......... Rgds / Umesh ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your son is suffering from some liver disease. So his bilirubin is high and fluctuating.  He should go for complete liver function test. Find out the cause and then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had severe neck pain but also affecting my collarbone and neck where it joins the collarbone. an xray shows loss of normal lordosis and spondylotic chnages at c5/6 and c6/7 - doc says i have what is called anxlyosing spondolitis however i know my own body and i am sure that the collar bone issue is totally unrelated and may be something to do with lymph nodes ### REPLY: Hello, I have studied your case. Due to compression of this nerve root there is tingling numbness in your arm and fingers and collar bone pain associated with it. I will advise you to MRI cervical spine for better diagnosis. It can be due to various causes like sudden jerk to spine, due to facet arthritis, degenerative. For these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Lymphangiography may help. 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. If you are satisfied with answer do not hesitate to rate this answer at end of discussion. Wishing 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: my husband had liver Hepp atitis c and was treated twice.  the first time it didnt work but the second did after 15months of treatement. In oct he was diagnosed with liver cancer and advised he needed a liver transplant.  it was not eligible at first to go on the list as he had 4 tumer and one was two big. after two treatments of y-90, two of the tumors shrunk enough to make him eligible to go on the list.  Now however we found out that his afp number have been rising so they want more test .  it was reading 148 but last month went o 268.  this month it is 378.  what are some reason that the afp might go up other than that the cansor may have spread.  he has had mri every 4 months ### REPLY: Welcome to  Hope you are doing good. Moderate levels of AFP (even almost up to 500 NG/ml) can be seen in patients with chronic hepatitis. High blood levels (over 500 nanograms/milliliter) of AFP are seen in only three situations HCC (Hepatocellular Carcinoma) Germ cell tumors (cancer of the testes and ovaries) Metastatic cancer in the liver (originating in other organs) I Hope had answered your Query.  Regards ### END