Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just got braces maybe a week already. Before having the braces I have 2 extractions. After the extraction, my gums are really swollen and bruised. A week before putting my braces i got another tooth extraxtion for the last time, before putting the braces the gum of that extracted tooth was sort of healed but when i got my braces,after a day there is a small protruding gum on the space where my tootg was exrracted. It is not painful though but it kind of bothersome to see and touch. What should I do? ### REPLY: Hi, Thanks for asking the query, When you have braces on your teeth the Orthodontist will advise you to maintain a good oral hygiene to ensure that you keep your gums healthy. The best of brushing and flossing techniques when used along with the braces on will ensure that your gums are not swollen. Deep ultrasonic scaling followed by the course of antibiotics is required, use chlorhexidine mouthwash rinses twice daily. For gingival hyperplasia I would advise you to get an OPG done to rule out extent of infection or boneless if present and plan an appropriate treatment. Hope this helps out. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I fell out of a car almost 2 months ago. For 6 weeks I had half a skull because they took the other half because my head got so swollen. There was alott of blood from my brain an I am now home doing better every day. I was wondering if I could smoke healthily so I helps the pain. I did great in therapy and can do everything I used to do please answer this for me most doctors never give me a actual answer .. Thank you ### REPLY: Thank you for your query. No Smoking please! Smoking has harmful effects and more harmful effects. It does not cure the pain. It just masks it up. There are healthy option to relieve pain. Medications, yoga, meditation, and alternative medicine. If pain is severe/acute, non-addictive medications are advised for a long term use I additional to other methods mentioned above. All of it is worth trying as these are healthy and side effects free methods (except for pain medication). Smoking has a harmful effect and sometimes irreversible effect on many organs and body functions. I appreciate that you sought advice before acting on it.  I would greatly appreciate it if you sought other ways (as mentioned above) to get pain relief.  The fact that you almost back to your usual self is excellent news. That should encourage you to continue trying for a healthy solution. Hope Ive answered your query. Wish you good health. Please get back to us if you have further questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir/mam,My daughter is 3 years old.She was getting allergy Related wheezing once in 2 weeks.But now she has continous wheezing for past 1 week and doctor advised to go for an x-ray.X-ray report says Bilateral mild vascular congestion. Blood report says eosinophil is 540 Wbc 10800.Doctor said its pneumonia and advised for antibiotics through IVE. Since we requested an alternative method he is giving taxim injections  twice a day.My concern is so far we have given 5 injections  but our doctor says he will decide by tomorrow whether to withdraw injections and give syrups..We are concerned whether we can give so many injections for 3 year old....moreover she has lost weight also.....please advise Thank you Swetha ### REPLY: Hello Mam, I just read your query. As you have mentioned pneumonia and your physician has started antibiotic I/V treatment. Antibiotic treatment always has a schedule whether it is given orally or through I/V line. *So as per your question antibiotic through I/V line can be given to three years old as per diseases status and your treating doctor can decide it better because he is doing regular clinical examination.* The loss of weight might be due to improper feeding because during sickness babies have tendency to refuse diet, and they take less amount of food compare to normal.* So complete the treatment and try to give baby more semi-solid and liquid diet as it is easy to give and digest.* I hope you find my answer helpful. 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: My daughter had an induced labor 10 days early due to signs of preeclampsia. She arrived complaing of lowere back pain upon arrival. She was given an epidural which went well with no complications after 45 pushing and some tearing but with healthy delivery of 7lb. 11oz boy- but when it wore off post delivery, she again complained of lower back pain- after home from hospital - pain has worsened with pain behind knee and above buttocks. OB examined her and found definite weakness in left leg. He sent her for an ultrsound to rule out DVT which was negative and referred her for physical therapy appt. next week. She is having trouble walking. Is this the right step to take? ### REPLY: Cellophane You for contacting . Yes it takes a while to recover completely. Epidural can sometimes effect the nerves which in return causes pain. Following measures will reduce the pain:- take adequate rest-avoid lifting heavy weight-naproxen thrice a day for 5 days-take hot water in a rubber bottle and place it at the site of pain. It will give soothing effect-sweets like chocolate helps in reducing the pain as well.- physiotherapy will also help in improving the severity. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. 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: i  was  suffering  from  pcod  $  was  trying  to  concieve   for  the  past  4  years  i m  taking   metformin  but  now  doctor  was  said  that  it  doesnt  work  for  me  so  now  i m  taking  oosure   can  i  concieve  this  time  is  i  m  on  the  right  way ### REPLY: Hi, I think the medicines which you are taking now is fine and sure can also help, but the thing is that you need some medicines for growth of your eggs. Also, when egg becomes more than 17 mm one injection might be required for its rupture. After that you need to be in contact with your husband for next 2 to 3 days. Progesterone support may be needed for next 2 weeks. 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 have what seems to be heart pinches the way I would describe it. It hurts for a few good seconds an then releases and a few min later happen again - this will go on for about 30min. Than stop for a few weeks an than again. When I get nervous or stressed my hands shake and right after my heart pinches again...What am I expereienceing? ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion.It's difficult to tell what are these heart pinches. It is possible that they are related with a rhythm issue. An extra systolic beat or an arrhythmia might house premature or irregular heart contraction that gives palpitation, heart pinches or a kind of chest discomfort with anxiety, difficulties in breathing deeply. The houses of this rhythm issues might be different to simple emotional stress or different pathologies like anemia, hyperthyroidism, electrolyte imbalances, cardiovascular disease. Also pinches that come and go with seconds might have other houses like neurotic, musculoskeletal issues' ect. So, if I was your treating doctor I will recommend some examination like an electrocardiogram, a cardiac echo to evaluate heart function and walls, a full blood analyze, a holder rhythm monitoring to see your rhythm tendency and a street test if it is possible. After all this we can be sure if its is something that we should treat or not. Hope I was helpful. Best regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 6 and has cerebral palsy. I took him the walk in today has the school called me. It turns out he has got a throat infection and they gave me anti biotics. I told the nurse that he had nt eaten or drank anything all day and she told me to make sure when i got him home that he had a drink and then a big wee. When we got home he did have a little wee and then i managed to get him to have 4 sips of milk but he has nt had a wee since and he has been asleep for the past 2 and a half hours. Should i be worried ### REPLY: Hello, By what you have explained, I feel that your kid might be having a viral sore throat or a streptococcal infection. I suggest you to 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 viral illness and doesn't require antibiotics at all. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, I am 53 and am a smoker and a drinker as well. I do exercises but very limited based on Yoga..The last time I did a full check nothing serious was found but since recently am having a tickling or itchy feeling around the kidney are..I have been a lot of stress in the last 5 years and am only beginning to come out of them now..I started reducing the frequency and the volumes in the last few months but don t feel a great improvement. As a precaution what should the dosage be before i repeat my full tests..Thanking in advance. ### REPLY: Hi Welcome to  forum.  You are having tickling, and itchy sensation in the kidney area. If it is outside may be the skin infection. If from deep in side, it may be related to the ascending and descending colon irritation, lastly may be due to gastric irritation.  Stopping the alcohol and consulting the doctor are different things, so go on reducing the alcohol till you stop completely.  Besides, you can consult a surgeon for diagnosis and treatment. You may need to have M.R.I, for diagnosis.  Avoid taking milk, milk products, wheat, and barley.  Take more of green leafy vegetables, pulses, sprouts and protein rich food to support the medicines.  Wising for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a male of 56 years old and I believe I have genital warts that keep spreading. I have tried a perscribed gel before but all that did was burn and leave black and blue marks. What can I do? I don t have a family Dr but, I am covered under my county s medical assistance program. Can I get a perscription on line from a DR for something? ### REPLY: Hello, Thank you for posting on . Any lesion over genitals should be carefully examined by a dermatologist. Since definitive diagnosis rests upon actual examination, I would like to discuss treatment of genital warts with you. Genital warts are a kind of viral infection caused due to Human Papilloma Virus. They are usually transmitted through sexual route, thus mandating proper examination and investigation of your spouse/partner. Usually, I advise application of 20% podophyllotoxin over warts under supervision every week for 6-8weeks. Alternatively, 1%5-Fluorouracil gel can be applied at home on daily basis. Also, inquire about cryotherapy or radiocautery from your dermatologist. Use condom during intercourse while lesions are active to prevent transmission to your partner. Hope this will take care of your issue. Thank you .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, I am 32 year old man and having gastic and primary hypertention problem. whatever i take my stomuch is raised and i start passing the gas from mouth and anus. my doc says that my blood pressure is 145/90 is more than normal rang. so please tell me is there any relation between gastic problem and blood pressure. ### REPLY: Hi Thereafter going through your query I would like to tell you that the normal recommended range for normal blood pressure is up to 140/90 mmHg. So your BP is very slightly deranged which can very well be controlled just by following healthy lifestyle habits like:1. Start daily morning walks 45 mins a day for 5 days a week.2. Low dietary salt intake.3. Stop smoking completely (if you do). 4. Avoid junk food, canned food and deep-fried food items.5. Include good amount of fruits and vegetables in your daily routine diet.6. Avoid . For you stomach problem I would like to suggest you to start PROTON PUMP INHIBITORS like pantoprazole daily 20 mins before breakfast for 10 days. And avoid spicy and fried items.No, in your case there is no correlation between your blood pressure and hypertension. I wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Sir i am 31 years old male person. since past 3 years i am suffering from cold and also suffering from caugh since last6 months i have breathing problem also. especially this problem coming in winter season. I consulted the nearest physician (MD). he told that my disease is Allergic Bronchits. Which will get cure within one month after taking Criz-M, AB Phylline & Seriflow 250 inhaler medicine. But, this problem often repeats. Is this eosinophilia? Please suggest the medication as a permanent cure. Who is the best Eosiniphilia Doctor in Hyderabad city Andhra Pradesh state? Sir, also found some Dermit changes on my left leg at foot side ( small black shades are coming). And also i am suffering from insomnia ( no sleeping at night time) since 5 years. ### REPLY: Hello. Thank you for asking at . I went through your history. I conclude that you are having recurrent episodes of cold and cough for last 3 years and breathlessness for last 6 months, more in winters. Were I treating you, I would consider allergic disorder and would suggest you to take daily levocetirizine, montelukast and an inhaled corticosteroid. I also would suggest you regular nasal saline spray 3-4 times a day and steam inhalation. All these medicines control your symptoms, but they do not "cure" the allergic disease. Hence, I would suggest you to consult an Allergist-Immunolgist who will advise you allergy testing and may advise allergen immunotherapy based on results of allergy testing. Allergen immunotherapy will improve your immune system to reduce allergy symptoms. Allergy testing will also help you identify the substances you should avoid. I would also suggest you regular breathing exercises, Yoga & Panama, which will help you in a long run and improve your lung capacity. Also, please try to avoid dusts, smokes & air pollution as much as possible. Eosinophilia is not a disease. It is a finding in complete blood count testing. It may be due to allergic disorders, but there are other causes like parasitic infections, some .  If you have insomnia due to nasal obstruction, treatment of allergic rhinitis will help it. Also, both allergies and insomnia are aggravated by mental stress, so if stress is a factor for you, please try to manage it with meditation & relaxation. Otherwise, I would suggest you to consult a Neurologist for insomnia and a Dermatologist for skin changes. Hope this will be helpful to you. Wish you the best of the 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 a dark purple lump on my stomach and underarm, have had them in the groin area before. I am getting severe headaches and random pains in my arm, leg, knees. I am extremely tired and suffering night sweats thought I was getting the flu but this has been going on for over a month now. ### REPLY: Hi, I would need to know your age and sex to analyze the problem. You should see your Physician whenever possible. You should get evaluated for possible connective tissue disorders and get relevant investigations done like ESR, CRP, Complete blood count, etc. It could be one of many things, but it would be difficult to say without examining you. Take care and do let us know if we can help you further once you have had the investigations done. 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: Why am i getting excess hair loss after recovery from thyroid ?Hello ! Hairs from all over my head  are falling .. I was suffering from TYPHOID but at that time my hairs were OK ! After 1 month of getting rid of typhoid ,, my hairs Falls more and more ! Can you tell me WHY ?? I m in deep trouble ,,GIVE ME suggestions please i am 20 years old ### REPLY: Hello. Thank you for writing to us at  I will keep a possibility of halogen effluvium. Halogen is the resting phase of hair growth cycle after which the hair is usually shed. After any stressful event e.g. medical illness like dengue, typhoid etc., scalp hair may get shifted from growth phase (managed) to resting phase (halogen) which is manifested as increased hair shedding. Telogen usually begins 1-3 months after a stressful event and can last up to 6 months following which hair follicle re-enters the growing phase (managed). I suggest you to maintain a good healthy nutritious diet. You may add a multivitamin supplement to your diet. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! I m Lea and I m 16. This evening I had really intense pain in my lower left abdomen. It was the worst pain I had ever experienced. It got better with pressure but now it s getting worse again. The pain is now all over my stomach but its origin in my lower left side. I also feel cold and shakey and a little achy. I also have been urinating more than usual and there has been some yellow/green discharge in it. ### REPLY: Hi. Thanks for your query. Noted your history of more frequent urination with some yellow/green discharge in it. Intense pain in lower left abdomen, getting better with pressure. Now the pain is all over abdomen. I would advise you the following in such a situation. First send urine for tests of routine, microscopy, culture and sensitivity before antibiotic is started to get a proper reports which help in further treatment. Further, tests of blood, stool ultrasonography of the abdomen and so on. Clinical evaluation and examination by a General Surgeon to have a proper diagnosis and further proper treatment. I hope this answer helps you to get an early and proper diagnosis and 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: My Name is Jayme, I am 20 years old. I have been on the NuvaRing for about a year now, I have noticed loss of hair and bad blotchy rashes all over the inner parts of my arms. They itch so bad they bleed, and scar. Could this be a side effect from my birthcontrol ? ### REPLY: Hi, The symptoms you have mentioned do not appear as side effects or adverse reactions of the ring. If at all, you can suspect some allergic reaction but in view of the use being for the past year, this is no time for allergies to manifest. The symptoms may be unrelated, but, a clarification should be had from your consultant after a clinical evaluation. You should also see a dermatologist for proper evaluation and further management of your condition. Hope you find this information useful. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am a 15 year old boy, and i tend to masturbate quite a lot (once or twice a day, maybe more). Recently i have not felt the same feeling, when i masturbate. And my erections dont feel as har as they have been. i have been masturbating for 2 years. Have i dameged my penis? will i be able to recover if i stop masturbating? If yes, how long would it take to recover. I feel realy bad about this, so if you could help me i would be very grateful. thanks in advance ### REPLY: Degree understand your concerns went through your description. I suggest you not to worry much. Masturbation is not a sin. Every young men masturbate twice or more daily. Even animals masturbate and it is normal and natural. Masturbation habit cannot bring weakness in your body or penis. Weakness is in your thoughts. Negative thinking. You will be able to stop masturbating or reduce it when you grow up, when your priorities change to more important things like studies and career. Till then be happy. You might need psychological counseling., I am more than happy to provide telephone psychological counseling through . Contact me through customer care, www.ChatDoctor .com. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 58 years old and under medication for type II diabetes and hypertension. Both are under control. I have been experiencing higher right side back pain for last three weeks for which I took pain killers Aceclophenac 100 mg for around 15 days. The pain is still continuing and recent blood report has revealed normal blood sugar, normal lipid profile, haemogram  but elevated SGOT (46) and SGPT (66). I have been taking rabeprazole and domperidone everyday. Please advise. ### REPLY: Hello.GOT and GPT levels (indicators of destruction of liver cells) are slightly elevated, that's not worrying. If your back pain has not improved after taking Diclofenac for 15 days, I think it is necessary changing to another painkiller and to associate some other . In my opinion Tramadol 50 mg thrice a day + Diazepam 5 mg at night can be taken for treating your back pain. Please consult your local doctor for a prescription. Only if your back pain does not improve after 4-6 weeks of taking  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ege is 26 and i have regular nightfalls for last one month. these happened earlier also but rarely. i was in physically involved with my girlfriend but from last few monts back this was stoped because she is shifted with her family. now i feel very week after each night when i see there is nightfall.now we meet but i donot feel like before with her. im facing lack of interest in sexual acitivities because of this.and have burning urine also. i have started arurvedic medicine also but only burning of urine is ok not nightfall pls suggest what to do ### REPLY: Hello welcome to Ask A Doctor service. I have reviewed your query and here is my advice. Night fall is common problem if you do not masturbate. For burning micturition urinary tract infection has to be ruled out. For that urine routine microscopic examination has to be done. Meanwhile, take more fruits. Avoid excess spicy foods.  .  Cranberry juice extract tablet useful for your condition. You can consult psychiatrist for lack of sexual desire problem. Hope I have answered your question. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 7 month old son was diagnosed with an ear infection yesterday and was prescribed antibiotics. He s had 3 doses of Amoxicillin so far. Today he refuses to drink his bottles. He s had maybe 4-6 oz in 9 hours. What can I do to encourage him to eat and drink? ### REPLY: Welcome to the  I understand your concerns but don't worry. Antibiotics are usually associated with gastritis which leads to loss of appetite in infants at times. I would recommend you to start him on antacid such as Spy. Di gene for relief. This will improve his appetite. Hopefully this will be of help. I would be happy to help you with any further child health related questions. 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 im actually enquiring for a friend who is getting quite anxious and worried because he s had aching arms and legs and also a sore back (but he has had that a few times before!), he reckons his arm hurts even in bed, apparently he feels it started about 3 weeks ago and getting worse. he, by the way he explained it, went to the doctor for a check up and she did blood tests, (i think for basic cholesterol and stuff because it had been awhile) but from what i can gather this was about the time it started and im thinking she wasnt testing for these symtoms. He is actually my ex , but we are still a big part of each others life and have 2 grown up girls, and he may have forgotten but my daughter reminded me that he was actually whinging about sore muscle a few months ago, but not this bad. He is 55 very active but a drinker and heavy smoker, but when he has had check ups in the past has come through remarkably well, as far as heart, cholesterol and blood pressure. he has got himself thinking that somethings really wrong, i told him to go back to doctors asap and get more tests for these symptoms, he has had the same doctor for many years now! what do you think?? ### REPLY: Hi, I read carefully your question and would explain that his symptoms could be related to inflammation or articular pain from a bulging disc. That is why, I would recommend consulting with his doctor and performing some further tests:- complete blood count, PCR, sedimentation rate for inflammation- muscular enzymes (CPK) levels-blood electrolytes, for possible low calcium levels-vitamin D plasma levels - a nerve conduction study for possible neuropathy - a thoracic lumbar spine X-ray study. You should discuss with his doctor on these issues. Hope to have been 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: sir,my boy is 11 month old and he suffering from loose motions from the last three days and also he is quite dull,still he had not at cured from loose motions,i am very worried about him,can you please suggest me some better information to cure from loose motions ### REPLY: Hi.... By what you quote, your kid seems to be having a viral associated loose stools. Once it starts it will take 5-7 days to completely get better. Will tell you the danger signs when you need to worry... Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. If I were your treating pediatrician I would consider adding zinc supplements and Oral rely . 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: is it possible to have suffered a heart attack after being scared?  I walked into a dark room during the night and a family member screamed as I turned on the light, scared me so badly Ive had a feeling on constriction thruout my chest and arm ever since. Should I be concerned?  I am a female, 48 yrs old, no other heart problems ### REPLY: Hia feeling of heaviness and constriction throughout chest can be a stable angina (not heart attack) or it can be because of panic attack also thorough history is neededlike do you have family h/o of cardiac ailment show long did the chest heaviness lasted did you ever felt any pain or heaviness in chest on walking which got relieved on resting I would suggest you to go for an ECG test which is a basic test most likely the episode was because of panic but yet we have to rule out cardiac disease if you are a smoker it has to be ruled out at the earliest thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 8 yr old has been running a fever for the last 16 days he has been to Dr. and hospital several times but this weekend my father-in-law was watching him he had a fever of 105.3 the only symptoms he has had have been Fever,tired and headache what would you suggest doing. his white blood count was 7.8 ### REPLY: Dear parent, The description u gave suggests the possibility of Pyrex of unknown origin. Please get the complete blood count, urine examination, blood culture, malaria TXT, dengue serology, widal test done. The most common cause of prolonged fever in India is enteric fever, viral fever and tuberculosis. There are other rare diseases also. Please get the basic investigation done before proceeding to further. Thanking 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: yesterday i had a n extremly bad toothache, and during the course of the day im would have condumed about 20-25 Nurofen Plus pain killers. This morning i went to the dentis, and had the tooth extracted, which was also painful. Now after working all day i feeel like i have been hit by a cement mixer..my whole body is aching, i have chills, and i just feel like getting into bed and sleeping. is this natural? and would the amount of pills consumed yesterday be conrtibuting to how i am feeling? ### REPLY: Thanks for your query, I have gone through your query. The pain and fever could be secondary to the infection. Do not take so many tablets it will result in adverse effects like nausea, omitting, restlessness, .  Without consulting the physician do not take any medicines. You should take a course of antibiotics like amoxicillin 500 mg TID and metronidazole 400 mg bid(if you are not allergic) for three days to control the infection along with a painkiller. The  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. Nice to see you. I am still a student right now(age 16). And I am facing 2 major problems (for me)... 1. I always felt tired and lazy. I do not know what is my problem. My neck and my back always felt hurt without any specific reasons. I never skipped my meals (I always eat vegetables and fruits) and I exercise regularly by dancing, cycling or playing ping pong. Can you tell me why? 2. As you can see from above statement, I think i am having a healthy lifestyle. But it is not what it is seem. Based on my BMI, I am an overweight person. Please help me. I have a low metabolisme rate, so is there any way to increase my metabolisme rate? Plus, I love ice cream and i do not know how to control eating it. Is there a way to control myself from eating unhealthy food? I am blank. Please help me ~ : ( ### REPLY: Hello, Thanks for your query. It seems that your increase in weight; wrong body posture; inadequate exercise and reduced muscle tone is taking a toll on your back. For pain to go, it takes not only rest (on a comfortable bed) but also avoidance of particular positions (during work, rest or recreation). During the day don't sit in one position for more than an hour and take frequent stretch breaks. Do not bend forward to lift things up, bend the knees and hips for that. Also discontinue any strenuous activity or exercises for some time. I suggest you to try back strengthening exercises by extension of the back muscles which can be taught by your Physiotherapist. This will help to relieve the possible muscle spasm which causes the pain. You may go for a physical examination by your Orthopedic to rule out any spine related pathology. You may be prescribed painkillers and/or muscle relaxants which should give you relief. Physiotherapy may also be advised if necessary. I would suggest you to try swimming as this will help most in back conditions. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I injected my self with Clexane a return from holiday 12 days ago. I had a P.E 6 years ago.I am having to have oral surgery shortly, would the effects,(blood thinning) have worn off by now? So would it be OK to go ahead with the surgery at this time? An early response would be greatly appreciated. ### REPLY: Welcome to . I am . Dear friend, Clean has half-life of approximately 4.4 hours for a dose of 40 mg.  Clean activity may persist in the plasma for 24 hours. After 12 days its level in blood is negligible. You have to do one blood test PT INR. This blood test will be very helpful for further management and plan for oral surgery. I suggest you to take Clean in proper doctor guidance with regular PT INR test. Thanx for 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 wife is undergoing lymphnode TB treatment since Aug 2009 & is now 6 month pregnant , she is having Oxfloxacin 400 mg , INH 300 mg , Ethambuntal 800 mg each 1 tablet per day . Is this drugs going to have any side effects on the foetus. Please let me know ### REPLY: HI, I understand your concern.  Both High doses of Oxacillin, INH & Ethambutal are placed in category c for their use in pregnancy. Though there are no sufficient evidences about their teratogenicity, they are to be used with precautions in pregnancy when the benefits over weigh the side effects & they are essential for control of Tuberculosis in pregnant woman.  The doses offered to you are in normal range. & I feel you should believe your treating doctor & continue taking it as per the advice, while regular pregnancy check-ups are done.  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: Dear sirs, I have a baby boy of 04(four) months old. Some white soft things are seeing during he pee. He has fever also. An antibiotic zithiumO & crocin is prescribed by the physician. Is this antibiotic is correct for such type of UTI ? please reply at the earliest. ### REPLY: Hi. Thank you for posting your question. The diagnosis of UTI (urinary tract infection) in any child especially a 4-month-old should not be based on merely the presence of whitish discharge in urine and fever. It should be confirmed by getting a urine culture done and only then appropriate treatment initiated. Even if UTI has been confirmed, azithromycin (lithium o) is not the .  Also, UTI in a 4-month-old child needs to be investigated further in lines of any structural abnormality of the urinary tract. This is usually done by an ultrasound scan, a maturating cystourethrography and a DMS renal scan. However, your first approach should be to confirm whether it is the UTI that is causing this fever. In the meantime keeping his fever under control by Cronin  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 13 month old son has a hard bump on his buttocks.  I thought it was a flea bite or a regular oil bump because pus came out of it and than some blood, but the area is very hard.  Is there something I can use over the counter to "draw the pus out" if it is that?  He has had it for a week . Thanks for your help. ### REPLY: Hi ! Good evening. I am  answering your query. Even though from your history, your son seems to have developed some kind of infection of the tissues (cellulitis) over his buttocks, I would strongly advise you to get it clinically examined by a general surgeon of your area for a proper diagnosis and management. Till then, you can apply a myself . I hope this information would help you in discussing with your family physician/treating doctor in further management of your sons' problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello , im am 14 years old and is having sharp chest pains on my heart about 3 times a week and they last about 15-20 seconds long but sometimes they last 1 minute , im and not over weight i weigh 103.5 pounds and is 5 2. Do you have any idea what this could be? its been going on since i was about 12 or 13 ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you are mostly having anxiety and related symptoms. At your age(14) cardiac disease is extremely uncommon. But better to rule out cardiac cause first for your chest pain. So get done ECG.  If ECG is normal then no need to worry much for cardiac cause. You are having anxiety mostly. Better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Avoid stress and tension. Be relax and calm. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Thanks doctor actually I m verymuch about my hair bladness so I want to know that can I use nisim hair solution which is canadian product , secondly I already used minxodil and rogain but I feel itching after tbat and seconly can I use rigix tablet for bladness ### REPLY: Hi, You can apply minoxidil cream (Romaine) directly on your scalp, it helps hair re-generation. To avoid itching you can take non-sedating antihistamine (Levocetrizine), one SOS before application. Finasteride (Alopecia) is a daily pill that you should take under a consultant. It slows down hair loss while promoting new hair growth. Yes, Ni sim gives hair regrowth solutions to both men & women. It neutralizes DHT (dishy .  Take adequate mineral, protein & vitamin. Autoimmune condition, Alopecia create has no cure, it causes rapid hair loss.  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: MRI results with mild disc desiccation c5-6 and C6-7. It says annular bulge and bony encroachment on right side of right neural foramen at c5-6. I had Chiari decompression, craniectomy and duraplasty 2008 and took out bottom part skull and c1/2. Now have terrible headache and neck pain. Brain MRI shows mildly predominant cisterns magna, mild amount of T2 signal of periventricukat and corona radiate white matter , tiny pineal cyst but no other mass. Focus of low gradient echo signal along posterior fall to right of midline likely benign calcification. Left more than right ethmoid sinus mucosal disease without acute sinus mastoid effusion. Small cyst found on sphenoid sinus.What does all this really mean? Is it related to my Chiari? ### REPLY: Hello! Welcome on  ! These MRI findings are not related to the chary surgery (besides predominant cisterna magma). The cervical spine changes are chronic changes which may explain the neck pain. The cysts are incidental findings, which are not related to the pain. I would just recommend follow up after 6 months with brain gadolinium enhanced MRI in order to monitor the pineal cyst for any possible progression. In my opinion the headache could be related to occipital neuralgia. But I would like to know more about your headache: - the location?- The duration?- Does coughing or physical exercise trigger the headache?- like pressure or throbbing type? I remain at your disposal for any further questions. 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 age is 29 (My weight is 66KG and my height is 174cm) ... i did blood test (14/4/2012) SGPT was 84 and GGT is 67 the doctor said i should go on a diet and eat healthy food and that what i did and asked me for Hepatitis test after (17/4/2012), i did the test again the results was SGPT: 111 and GGT is 61 Hepatitis is Negative.. so he asked me again to do an ultrasound for liver ..kidney.. pancreas .. Result:the liver is in normal size and homogeneous in echo pattern apart from small sub-capsular calcification in the right hepatic lobe, which mostly represtent and old granuloma .and everthing regarding others is normal.. i repeated the test after (21/4/2012) my SGPT reduced to 90 and GGT to 56 knowing that the before (5/4/2012 till 10/4/2012) i drunk like 5 liters of alcohol and i took 1 gram of cocaine ( itake this drug once each 2 years... im not that much alcoholic i drink like that each 3 month because i work abroad... how can i lower my SGPT and how long it will take i want to lower it to 60 or less in 10 days because i have to present them to the embassy.. im on stirct diet.. ### REPLY: Hi welcome to , Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses, referred to as types A, B, C, D and E. These five types are of the greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in Hun .  Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact. Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.  Hepatitis & alcoholism can not go hand by hand, as reported by you heavy alcohol cocaine needs addiction and proper treatment as both as hepato-toxic, visiting a psychiatric treatment center you would be advised .to lower s.g.p.t unlit 150 o.d is advised in interim.  Thanks for your query Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had unprotected sex with my boyfriend on the 4th day of my cycle. He did not ejaculate in me. But i was worried and took unwanted 72 on the 5th day of my cycle, and within 24 hours of unprotected sex. I had a bleeding 6 days after taking the pill. My periods was due on 1st may but i still have not had my periods. What could have happened? Because i do think i could be pregnant. ### REPLY: Hello welcome to  Generally in a regular cycle ovulation occurs on 14th day of menstrual cycle.sperms cal have their in vagina up to 3-4 days,You have no chances of being pregnant,that too he didn't ejaculate in you. If you are still worrying about pregnancy go for pregnancy conformation test.it will tell you. Regarding your delayed cycle this month,this is because you have taken the unwanted 72,it contains progestins which alter the cycle. Hope you understand my answer. 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 Dr. Grief. I would like to ask about my problem on fertility. I am worried if I can have a baby with my wife, because I experienced electrical shock 7 years ago at 440 volts and I was unconscious for 15 minutes that time, there was no burn noted all over my body. Thank you ### REPLY: Degree understand your concerns went through your details. There is no chance of that sort. Electric shock do not have any direct impact on your reproduction ability. You may check yourself. Consult a specialist and get your semen analyzed to be yourself sure. Don't worry unnecessarily and don't be obsessive and anxious. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. 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: Iam scared that i had unprotected sex with a promiscious female, after intercourse, i had a difficult sleep overnite with severe knee pain and pain in the neck, after then i got a shot from the doctor, i sleep well but the knee pain still persists and i have never got to fully recover from nose blocking, ### REPLY: Hello, I read carefully your query and understand your concern. The symptoms seem to be related to muscle pain due to a viral infection. I suggest doing the STD tests for further evaluation. Meanwhile, I suggest using anti-inflammatory medications such as Acetaminophen to relieve the knee and neck pain. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards!  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a lump on my left forearm last month. it was there for about 2 weeks. I thought it as a spider bite, it went away. now I have a hard lump on my right upper arm and it itches and its on my muscle and it aches and another little one close to the bend of my arm on the same arm. the one at the top is warm to the touch. it showed up this morning as a little lump now it is about an inch and a half oval shape ### REPLY: Hi, Good Morning, Thanks for your query to  online Clinic. I have read your query in details.-Dear In My opinion, the lump on forearm, is mostly a ? Spider bite again ? Or mostly due to the URTICARIA.-This is what I could advise from the data of your query.-It needs further detailed study, and so I would advise you to consult an ER Doctor, who would fix the cause for it and would treat it appropriately.-Don't worry.-Remedy-Take Care with your doctor, and it would go off. Treatment -Tb antihistamines, Tb-Steroid.-and investigate to avoid its recurrence by proper treatment.-Hope this would resolve your query. Wellcome for many more queries to  from your friends and you in time to come. Have a Good Day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been diagnosed with a 6mm kidney stone - lower pole. First presented last June with gross hematuria but no pain. Told to wait and see. Now 6mo later another episode of gross hematuria AND flank/groin, abdomen pain. Latest CT w/o contrast reveals same 6mm only slightly moved (likely cause of latest bleed). Its being suggested it may not leave on its own. I hear good/bad about the blasting with sound waves. What else might be considered. Im still having intermixed abdomen pain no longer bleeding. ### REPLY: Hi. 6 mm stone in kidney normally pass out of urinary tract. But there is always a chance to get it stuck along the way. Lithography is a good solution unless and until it is on the transverse process of spine. The Doctor doing Lithography knows this. If he feels OK, please go ahead as the stones causing bleeding are better be removed as they are the source of infection and recurrent bleeding and cause obstructive symptoms. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 this feeling in my chest like something is in there and its kind of difficult for me to breath, it has me coughing but nothings coming up, i am 6 months pregnant, so what should i do? the doctor gave me a chest xray lastnight but couldnt  see nothing, what other test shuld i do, they gave me rocephen saying that its a upper respirtory infection, but when i jump out of my sleep i feel numb all over until my blood catches up i guess ### REPLY: Thanks for your question on . I can understand your concern. Coughing, chest congestion, tightness with normal chest x-ray are commonly seen with bronchitis. So better to consult pulmonologist and get done PFT (Pulmonary Function Test).PFT will tell you about severity of the disease and treatment is based on severity only. You will need inhaled bronchodilators (formoterol or albuterol) and N acetyl cysteine (NAC) (bucolic and expectorant . Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Since the last week in Feb, I have had abdominal pain. Started with the upper left quadroon, and causes back pain. My belly is swollen or distended, it becomes worse when I eat. Bowels vary from, normal to diarrhea, very foul smelling. I have been to the ER twice, been to Primary multiple times (who has now dropped me as patient, because I keep asking for pain meds) Pain is pretty much constant and intolerable. Right now i am taking one tramadol with two tylenol every four hours. This helps a little but not much. My white blood count is high (although I dont have #s, I was told this by PCP. CAT SCAN with contrast dye, did not show any problems with organs. However i do not know it the intestines or colon was looked at. I think the ER is also thinking I may be looking for drugs now too, but I could be just paranoid. I do have Alpha 1 Anti Trypsin and Factor V Leiden. Blood pressure has  been high for me since this has started. Normally blood pressure is on good low side, no cholestrol problems, never had any stomach issues in the past. They did find a small Kidney stone on right side, but pain is primarily on above left and center. ### REPLY: Hello ! We can not ignore this kind of chronic abdominal pain which requires medications every four hours. Some history if you consume any alcoholic beverages had been helpful. However, the site of your pain points more towards pathology in the stomach/duodenum like hyperacidity causing ulceration, which has penetrated and might be causing inflammation of organs in the back like pancreas. However, even though all these points to an abdominal problem, you should also get your cardiovascular status checked by a cardiologist specially when your blood pressure has gone up. Also, you should go for Serum Amylase and Serum Lipase. The finding of a small kidney stone on the right may be a coincidental. 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: Dear Sir My semen analysis report is as follows... volume 4.0ml lequefication time 30 minute ph alkaline total count 70 millions/ml active motility 60% sluggish motility 20% non motility 20% morphology normal forms 75% morphology abnormal forms 25% pus cells 2-4/hpf SEMEN CULTURE AND SENSIVITY REPORT... STERILE FOR AEROBIC ORGANISUM AFTER 48 HOURS INCUBATION PLEASE SUGGEST if report is not good. ### REPLY: HelloVolume 4.0 ml (Normal 3-6 ml) . Liquefaction time 30 minute (Total count 70 million /ml (normal 60-120 million /ml normal)Motility 60 % (normal motility for successful conception require > 63 %)in your case it is low, but conception can take. Morphology 75 % (>13 % is associated for normal fertility, so in your case this is very good). Pus cells 2-4 normal Sterile semen, this is very nice i.e. no bacteria. Studies suggests that normal fertility is associated with sperm counts of 48 million /ml, with motility >63 % with >13 % exhibiting normal morphology. Approximately your semen is normal for NORMAL FERTILITY. 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: Hi there, my daughter (11) has got serious lower back pain which occured about one week sgo. I massaged it and it went away but it has returned with a vengance. She cant tuoch her toes or pin point where exatly the pain is comming from just the area. She did  slip and land on her bottom when she went ice skating but that was the last week of April and like I said her first complaint was about one week ago. Do you think she has a serious problem? ### REPLY: Hello, I have studied your case. Due to trauma to back there can be injury to vertebra or sacrum, you may need to do X-ray spine and MRI spine. Due to compression of this nerve root there is back pain. 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. Core stabilizing spine exercises will help. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doc, i m 29, married, want to coceive, but failed. i already taken treatment of micribillium genus last year. ive both ovaries polycystic and atrophic endometreium. already taken premarin .625 mg. now i am taking folvite 5 mg.  ve any chance to conceive? weigh is 58kg. ### REPLY: Hi, I think you can conceive, but you will need some medicines apart from folic acid for that. You can take some medicines like camphene for the growth of your follicles and track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband every 2 to 3 days after your periods stop.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 months. Discuss with your doctor regarding this.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im a dentist married eight months back but im in relationship with my hubby for past 2mnths only becoz of my studies...i hav shorter cycles having mild pco in left ovary my lh also high.........is follicular study needed for me nw or shd i wait?i want to conceive soon ### REPLY: Hi, if periods are regular then you can try naturally for 6 months. Don't rush. If it doesn't work then you can go for follicular monitoring and be in contact with your husband every 2 to 3 days.  If ovulation is not occurring, then you can take some medicines like camphene for the growth of your follicles.  Track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days.  Take progesterone for next 2 weeks.  Do a urine pregnancy test after that.  You can try like that for 3 to 6 cycles.  Get a thyroid profile done.  Hope I have answered your question.  If you have any other query I will be happy to help. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a 26 year old female and I returned from my holiday 8 days ago. Since then, I have been developing red spots over my body which I initially thought were heatspots. I have been getting around 3 each day. All really itchy. Do you have any ideas what this could be? I don t have any rashes , feel fine otherwise. Not able to get a doctors appointment until at least tomorrow, Thanks ### REPLY: Hello Dear.... Thanks for your query. Well first I must mention that there might be many reasons for such eruptions. So a proper history and follow up is needed. Where did the spots develop? How they appear as? Are they just spots, nodules or pustules? Is there any pain associated? Keep informing here how the condition progresses. One of the possible cause might be bite by parasitic insect Timex lectularius commonly known as bed bug. When bed bugs bite, they inject an anesthetic and an anticoagulant that prevents a person from realizing they are being bitten. Most people do not realize they have been bitten until bite marks appear anywhere from one to several days and sometimes even up to 14 days after the initial bite. Now for relief from the itch take Levocetrizine 5 mg tablets thrice daily for 5 days [it may make u feel a bit sleepy which is side effect of levocetrizine, but don't worry]Keep your skin clean and don't stretch the red spots as it may cause secondary infection. It would be better to consult a Dermatologist. Take care and keep informing here how it progresses.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father in law is 74 yrs old,his blood pressure are normally high..he has sudden attack with blood vomitting and he was not at all in conscious form..we have admitted in hospital immediately..after we came to know he is having blood clot in brain..pls advise if it is curable and how long it takes to cure...also which hospital is best in delhi /ncr and reasonable as we r middle class people...pls advise it is emergency ### REPLY: Thanks, It appears that Your father has suffered a CVA(Cerebra Vascular accident), It can be a bleed in the brain or an infarct(an area of brain without blood supply). Both the lesions are treatable provided the size of infarction or bleed is small and there are no associated secondary damage to the brain or lungs. It's very difficult to give you the time he will take to recover as it depends on several factors. Please contact a neurologist at the earliest. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father died of a cardiac arrest. However, he had an abdominal aortic dissection that was detected on the last day. his intestines, gall bladder and part of the liver were removed. BP and pulse were high during the operation. later stabilised. then at 1.20 am, he had a cardiac arrest and passed away. He had no history of blood pressure, or heart disease.He first reported stomach, back n chest pain on 7th december, 2010. Also fainted and vomitted. However, doctors suspected food poisoning, colitus and later gall bladder inflammation. the actual problem was discover on 23rd Decemeber, he died later the same night.(24th december) I need to know how and why this happened ### REPLY: Hello, Cardiac arrest is usually the mode of death in the majority of the cases. Whenever any disease becomes severe, it ultimately leads to cardiac arrest and death. In his case, it is aortic aneurysm. I don't know entire scenario here, but just considering the information you have provided, it may be possible that aneurysm might have ruptured leading to blood loss, low BP and leading to cardiac arrest. Did he have any infection or sepsis which can also cause low BP and cardiac arrest which ultimately leads to death?  Hope this helps you and get back if you have any doubts. Take Care 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: 9 year old son just came home from first day of school complaining of sore throat, low grade fever (99) red bumps on inner knees, lower legs, some on his arms and on the palms of his hands... he said they are pretty itchy, they almost look like puss filled pimples. he looks run down ### REPLY: Thank you for asking on . Most of the sore throat in child .  Both of these infections are self limiting and recovery occurs spontaneously in 5-7 days irrespective of the use of antibiotics. It is often associated with fever or pus over tonsils. Your child probably has such a condition. I am assuming that the child has been immunized properly and hence am not considering diphtheria which could also have been a cause. Gurgling with lukewarm water will give him relief. Hope that helps. Feel free to revert in case of further queries if any. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 m from , I have had vitiligo in my face in 2008, I had white patches on the left si de of my face. In 2010 the patches started to disappear, until there were only 2 small patches left. 2 weeks ago, the patches started to appear again. I dont know what to do. A friend advised me Meladinine tablet . Could you please give me an explanation? And, can I try the Meladinine ? Thank you in advance ### REPLY: HelloThanks for using  . I would be pleased to answer your question Firstly, The Medicine can be taken but only under the observation and guidance of the doctor as it can have its own set of side effects.  If the spots are spreading it means the condition is unstable, and it needs to be stabilized with certain medication after a dermatology examination.  Topical application of a steroid cream or a tacrolimus ointment on the spots will help stop the activity as bellcranks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: THank you! My daughter is 18 years old & healthy. She was in a car accident last March & suffered a concussion . We just found out she has elevated liver enzymes . Unfortunately the tests were run last August & we just received the results today. She does not drink alcohol or take drugs she was not on prescription meds when the tests were run. She is of normal weight. She takes minimal over the counter pain meds. I am wondering what could be causing this & what other tests her doctor should run. Mean plt volume is 12.0 Bicarbonate is 21, AST ( SGOT ) is 45 & ALT/ SGPT is 68 ### REPLY: Hello, The most likely cause for rise in liver enzymes of your daughter seems to be the use of painkillers. These painkillers in general can cause liver injury even when given in recommended dose. One should try to avoid painkillers as far as possible. There is no medicine which can reduce the enzyme levels in blood except removing the offending agent from your diet list. I don't think there is any need for any test regarding the rise of liver enzymes are concerned. 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: Hello. Last thurs and fri I felt sick. Friday I felt a mump on the back of my neck. Went to doc theysaid it was a lymph node. My skull is hurting though everytime I bend my neck from the lymph node up to maybe the middle of my head. Very tender and sore. I have been pressing it and making it worse. Is this normal? ### REPLY: Hello, Well, it is not normal to have this type of head pain BUT it is normal to have a head pain from an inflamed lump that you keep pressing which is likely overriding a cervical-cranial nerve traveling up the head to light it up. Yes, that's NORMALLY what happens when you press on those things.  Therefore, please resist the urge to HURT yourself anymore and instead. Treat that lump with care! By continuing to press on it, you just keep irritating the nerve.  You may gain some benefit from an ICE PACK over that lymph node or inflamed gland.  After a few days, you may switch to a warm pack or heating pad. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am swastik. am from lucknow . in the last week of jan. and feb. there is this allergy to me in which i get pinning sansations whenever there is transition from cold to higher temperatures.the sympotms are so strong that instantaneously i feel as if thousands of needles are being pricked in my body . it reaches its peak value and then subsides. then again after 3-4 min. starts again .have had methyl predinosolone tablets called nucort m4 , and nelora and septilin . i have been taking this medication for about now 4 yrs. but now my body has become slightly immune to this drugs. can i get any treatment for it ### REPLY: I had the same condition for the longest time and wasn't able to figure it out. Finally, I found a doctor who diagnosed me with cholinergic urticaria, or urticaria type cholinergic. While there is no real cure, as in my case it sometimes goes away on it own. Treatment includes exercise to bring your body temperature up, so you first experience it, and then it subsides. I also found antihistamines such as Ben .  Hope this helps! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a dry cough and cold on my stomach it chokes me when i try to get it out and it feels like somethings blocking my throuth its sometimes difficult to breathe when this happens and the cold comes out thick and yellow.I am using histatussin for it but its still the same.Can you be of any help to me please? ### REPLY: Cellophane You for contacting . You did not mention you age. Is there any history of fever? I would suggest you following things:> Take Defense . > Take hot water in a cup, add 1 tablespoon salt in it. Perform gargles (mouth wash) with it three times a day for at least 3 days. It will give soothing effect.> Take boiling water in a pot, put your head over the steam and cover whole with a sheet. Take deep breaths in it.(Avoid getting closer else it might cause burn). Do this twice a day.AVOID:> Chilled water>  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im a 16 year old girl in recovery from anorexia and recently my mum told me Ive become a completely different person since having the disease. Is it normal for the illness to change your personality? Will I go back to the person I was once Im better? Also, Ive missed roughly 6 or 7 of my periods now. When will they come back and am I at risk of infertility? Thanks. ### REPLY: HelloAnorexia nervosa is one of common psychiatric disorder seen in teenage girls. Chronically decreased nutrition status in body results in a number of serious complications and amenorrhea is one of them. Treatment consist of long term use of anti-depressant .  The complications improve with improvement in nutritional status. You are on treatment, and you have missed 6-7 cycles. See this will take time to get your menstrual cycle normal. Wait for nutritional status to come in normal range, and you will see improvement. For change in mood and personality issues you should be given anti-depressants. Consult a psychiatrist for proper management and evaluation of personality traits if any. Most of the individuals improve without any serious complications, so there is no need to worry. Thanks, wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a scary episode while driving the car on Saturday. I had a couple painful heart beats then my peripheral vision got cloudy and heard a loud rushing noise in my ears. It lasted 10 seconds or so and then my vision and hearing were fine. I was having an occasional flutter in my heart beat but after resting a few minutes, I was okay. I have no history of heart issues though my doctor told me I have an RBB (she called it rabbit ). ### REPLY: Hello... You did not mention your age. You also did not mention smoking. Generally, RBBB is a cause of Right heart pathology, and sometimes it is totally physiological. In your case, it is very unclear on the basis of ECG. So kindly go for Echocardiography. If ECHO is normal, then it is likely to be Panic attack. So take some Antianxiety . If ECHO suggestive of right heart pathology then consult a Physician to find out the exact etiology and treatment is according to that. Thank You ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I am 35 years old and slipped and fell getting out of bathtub. Banged and scraped my leg. Had bruise from calf to ankle. This was about 6 weeks ago. about a month ago which was two weeks after it happened, had it checked by urgent care. They said warm compresses and advil as needed. My question is that I get stingy feelings in my calf and the spot on my leg is still tight and sensitive to touch. Is this normal? ### REPLY: Hi, thank you for providing a brief history of you. Since you have visited an urgent care it played an important role as your injury got assessed. The medicine was fine as well, as to what the physician prescribed.let's go closer to what you are feeling is a tight muscle. Well its normal that you will have a spot on leg, sensitivity and tightness. Try doing some hot water fermentation and post that do some ankle toe movements along with straight leg raise exercises to get strength in your leg muscles. Meeting up a physical therapist should give an addition to your improvements. With the grace of God I wish you a speedy recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My name is Bobby Joe Billy, and I m the best deer hunter and skinner in all of Loganville. Last night my head fely like it got hit by a two by four, and my stomach wouldn t hold down my food. When i got up, I had to sit back down cause the world kept on spinning, and I got this red spot on my leg that won t go away, and these theses tic bites are freaking annoying! ### REPLY: Hello, Blood blisters are collection of blood underneath the skin due to rupture of small blood vessels. They occur due to friction, tight clothing, heavy rubbing, pinching, sometimes due to infection. Usually blood blisters go on their own, no remedy is needed. But if the blister is large or bursts there is a chance of it getting infected, then you have to have antibiotics. Clod compression on blood blister is a good mode of relieving pain and reduce size of blood blister at acute stage. Hope this helps. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have gynecomastia from puberty just found letrozole is too effective so what may i do? take it or drop it if yes i need information related to dosage & after that if my sex drive goes zero what should i take to recover it back or i want to know the cure for gyno without surgery.... ### REPLY: Hi, It is less likely to affect the sex .  Gynecomastia occurs due to an imbalance between the sex hormones testosterone and estrogen. Estrogen causes breast tissue to grow. Metronome acts by decreasing the formation of estrogen from testosterone, and thus it is used to treat gynecomastia. Since metronome does not reduce the levels of testosterone, so it is less likely to affect the sex  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: mys sister is down with arnold chiari malformation type 1 with syringomyelia she has undergone two surgery  2003 and 2005 respectively. recently she was diagonised with respiratory type II failure now she is bedridden is there any scope of improving her health ? ### REPLY: Thanks for your question on . I can understand your concern. Type 2 respiratory failure means hyperbaric (high carbon dioxide) respiratory failure. This means she is not exhaling carbon dioxide out of the body effectively. It is commonly seen with brain diseases and neurosurgery patients. Brain controls respiration (inspiration as well as expiration). So when diseases of brain progress, respiration is also affected, specifically expiration. Since her brain condition is irreversible and not improving, her type 2 respiratory failure will also worsen and not improve. So prognosis in her case is very poor. Hope I have solved your query. I will be happy to help you further. Wishing good health to your sister. 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 found a pea sized lump on our 2 year old sons abdomen above the navel. Our pediatrician. Said it was a hematoma from an minor injury. That was 2 weeks ago. It is now visible and the size of a Lima bean. Should I take him back to the dr. He was one month and a week premature. ### REPLY: Hi ! Good morning. I am  answering your query. If there is a history of trauma at this site, it could be a hematoma. Otherwise, it could be a small era umbilical hernia as well. However, this could be diagnosed by a clinical examination by your treating doctor. A hematoma would resolve of its own in three to four weeks time, whereas a hernia won't, and this could come and go at intervals. I hope this information would help you in discussing with your family physician/treating doctor in further management of your sons' problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I been taking citalopram 20mg about one month. Last Thursday I started having pain in my left arm and shoulder, it feels like muscle spasms. I been taking over the counter pain reliever and using icy hot . The pain hasn t eased up. What should I do now? ### REPLY: Hello! I understand your concern and would explain that the pain is the arm is not a common adverse effect of citalopram. For this reason, I would recommend consulting with your GP for a physical exam and performing some tests to investigate for the possible causes underlying your complaints: -a resting ECG and cardiac enzymes-a shoulder and cervical spine X-ray study-complete blood count, PCR for inflammation- muscular enzyme levels-vitamin D plasma levels and blood electrolytes. You should discuss with your doctor on the above tests.  Hope I have answered your query. Let me know if I can assist you further. ### END