Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 46 years old mother of 2, mamogram in Jun says normal. Basically healthy. Last night I noticed a painless bump in the right armpit. Squeezed and then white, cheese like, smelly discharge came out. It seems to be fine now. The armpit doesnt smell much unless rub the fingers on it. Do I still need to see a doctor? I have a high deductible insurance, i.e. pretty much everything come out my from pocket. Thanks. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have lump in armpit with white material. You may have sebaceous cyst or enlarged lymph node due to reactive hyperplasia or tuberculosis.  Yous should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Pain in left hip that comes and goes, but only lasts for about 10 seconds each time. It s such a immense pain, it literally takes my breath away and almost puts me on the floor! Colon cancer is in my family. I am worried this may be part of the problem. The pain feels as though a large butcher knife stabs me in the left hip, and is being twisted. But only for those few seconds, until the next one comes. I never know when it will come, so it catches me off guard every time. ### REPLY: Hello, The soreness in the hip that you have is likely to be due to a minor capsular inflammation - can be related to wrong posture or unexpected exercise. This is not related to the abdominal or digestive issues that you are having. This can improve with rest hot compress and mild painkillers. Taking joint lubricant supplements like glucosamine and Chen .  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: Which organ is located just under the left rib cage and toward the center of the abdomen? I have pain there that hurts mainly when I take a deep breath or have to sneeze. I don t believe it is my stomach. The pain comes nod goes....this time lasting for just over 3 days. ### REPLY: Hello! Welcome to . On left upper side of abdomen is the spleen. Did you have any trauma to abdomen or chest? This can cause splenic injury, if trauma is on left upper part of abdomen. Also, this can cause pain on tip of left shoulder which is referred pain. Pain can also be musculoskeletal or due to increased secretion of acid in stomach. For correct diagnosis, clinical examination of abdomen by your doctor is necessary. In my clinic, after clinical examination, I advise ultrasound abdomen & pelvis, CBC. Treatment is done accordingly. Till then avoid hot/spicy food, alcohol, smoking, late night meals, reduce stress if any with yoga & meditation. Hope this helps. Wish you speedy recovery. Thanks. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi sir, i am 23 years old, i have facing problem from past 7 years. 1. sperm leaking daily in my sleep and while urine. 2. if i stop one week i am getting pain in back bone. 3. my penis and testis are not developed properly, and i have marriage in next year, i feel very shame because my penis and testis are not developed, one time my fiance saw my testis and penis she told me that you are a child you need to improve, she want little bit more. one time i met one doctor (urologist) and he also told me that you have small penis and testis but he didn t tell solution. now i want improve. pls solve my problem. ### REPLY: Hii.welcome to our site. Ejaculating semen during sleep is a normal thing only.don't fear. Just take healthy foods. Avoid watching porn. Try to mingle more with friends. Avoid thinking about sex. If you want to increase penis size then you can try massaging the penis daily using oil. Stroke penis 20 to 50 times a day using oil. Each stroke should lose for 7 to 10 seconds. If you do daily then you can feel your increase in penis size. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 34 yrs old. I am female wieghing 77kg and height 165cm. I have had dry very itchy scalp extending to the back of ears and inside as well as forehead. All very flaky. I also have these patches on my back. feels like something is moving in my head. I am not on any medication and have no past health problems. I have tried ketaconazole shampoo, but it seems to be worse. My scalp getsbeven more tighter and dryer. ### REPLY: The fungal infections of skin can behave like this and fungus increases very fast in other areas due to touch if you have no allergies it is fungus take for can 150 mg once a wk for 6 week take basting 10 mg OD for 3wkuse in toxic soaps shampoo and creams on scalp use floor(antifungal lotion)on whole scalp at night and wash with candid TV shampoo in morning you can do day or thrice a wait will take 4-6 wk to go away apply candid on lesions of back ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir, I am an epileptic patient from the age of 3 years. Then started with treatment. It recurred on tapering the dose once and with same treatment once. I had my lost attack 14 years ago. Know, it was suggested do the MRI and EEG to taper the dose or change the medication as I am taking Phenytoin and Phenobarbitone currently. EEG was normal with no epliptic foci. MRI had two calcified granuloma with no edema or lesion around it. Does this Calcification still can trigger epilepsy in the future or can my seizures be stopped completely or cured. ### REPLY: Hi, epilepsy seizure can be caused by those granulators lesions. Childhood epilepsy sometimes difficult to be cured completely. It has guideline to taper and stop medication if you are seizure free. As mentioned you had recent episode of seizure episode then u ll be put on medication again for another five years of seizure free period.  Hope this would have cleared your query and fell free to contact me if you have any query Than n regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My right arm shakes alot that I cant write anymore head sometimes shakes and lower have been through a lot of tests and no one can tell me what is wrong with me they say I am disabled now it has been going on for about 3 years now had scans, mri, blood tests seen neurologists maybe you might have some ideas I am 54 years old on insulin overweight high blood pressure they say it is not a stroke because nothing shows on MRI and I loose my balance so if I go for a long walk I have to use a walker short walks I use a cane.  hope you can give me some ideas thank youShirley Miller ### REPLY: Hi, Thank you for posting your query. It is unfortunate that you are suffering on account of your neurological symptoms, and moreover, no diagnosis has been made. Normal MRI rules out stroke, as it would be clearly seen on the MRI. The possibilities include essential tremors, parkinsonism and cerebellar ataxia. If you can upload a copy of your MRI report, it would be useful. Also, if you can mention the abnormalities found by the neurologist on examination, it would be useful. For relief from tremors, you can use propranolol, a beta blocker. I hope it helps. Please get back if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 66 year old female , blood work showed my iron high? Why? I take synthroid some vitamins and suppliments none with iron. B 12 high, i was taking 500 units. Vit d low, i was taking 2,000 units. Now i am taking 50,000 units twice a week. I am comfused. ### REPLY: Hi and thank you so much for this query am so sorry to hear about this high iron level. High iron levels raise the suspicion of hemochromatosis. I will suggest that you get evaluated for this condition by your doctor. He would do other tests to show whether all other indicators of excess iron accumulation in the body do hold. Depending on the findings, further investigations or treatment options would be communicated to you. I hope this ad .  Thank you so much for patronizing our services, and please do feel free to ask for follow-up clarifications and information if need be. I wish you the best of health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a discectomy 4 weeks ago although my pain is better has not completley gone on my right side and i have a new problem on my left side since surgery . Sudden sharp pain in my left groin and my left foot the toes suddenly curl up in spasm ,very painful !   Also I get a grinding pain in my lower spine after walking short distance! ### REPLY: Hi, It is too early to say anything about the healing process as everyone heals differently. You need to check back with the concerned doctor for the status of the spine post surgery. The nerve compression might be released, but the healing will take time. Lower limb exercises like bending your leg from hip and knee and straighten it, taking your leg outwards and inward sand walking will help you in relieving symptoms like tingling and numbness. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I went to the doctor yesterday to show him a rash on the back of my hands, but he didnt see the white lines and circles that show up and then go away. The redness also goes away then comes back and my feet and palms itch. The circles and lines look really scary, like crop circles or something ### REPLY: Hi. Welcome to ChatDoctorfrom what you described you seem to be having allergic reactions causing wheals or hives. Is this the first episode or do you have a previous history of allergies in the past. Try and recall any possible cause of the rash. Any history of outdoor activity, exposure to plants, dust, animals, chemicals, any medication, any particular food. Anything you have been allergic to in the past? Once you can narrow down the possible factor, you will have to avoid it, or you will keep having similar reactions. Seeing circles and lines, either white or reddish wherever you apply pressure, or scratch, is called demographic and is a sign of sensitivity and high allergy levels in blood. So do consult a doctor regarding tests for the blood levels of eosinophils, serum IGE etc., which can show allergy. Skin tests can also be done to check specific reactions. Very rarely this reaction can happen even in normal skin. Apply a menthol/calamine lotion for the itching, 2-3 times a day. Start an antihistamine daily for 5-7 days after consulting the dermatologist. They may advise a longer course after seeing your blood work. This can help bring the allergy levels in control. If it is severe or persistent, you may be advised a cortisone shot in the ER. Use a mild soap for washing, avoid harsh chemicals. In case you have severe swelling, puffiness of face, lips, difficulty breathing, etc. go to the ER immediately. Hope this helps guide you. Try to see the doctor as soon as the rashes appear. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i was wondering if it is normal to bleed for a week on the birth control pack? I had a normal period april 12th -19th then i started my second pack of pills april 21st then started bleeding april 28th and hasnt stopped yet :/, I had sex with my partner april 18th we didnt use a condom for maybe like two mins then we used a condom the rest of the time and finished with one. I am worrired that i could be pregnant. we also had sex on april 27th without he only stuck it in for a min or two and then next day i started bleeding. I am on my second pack of pills and just finshed the second week of active pills (28 pill regiman) gildess fe 1/20 is the one i am on now. So i have two more weeks till my next period. should i take a pregnancy test ### REPLY: Hello, Unprotected sex during period time is quite safe and chance of being pregnant is nil. In case of 2nd time sex on April 27th, you got bleeding on the next day, and it is not your conception or implantation bleeding. It may be due to local trauma during sex, hormonal imbalance by using birth control pill (quite common), cervical/ endometrial polyp, vaginal infection etc. Here, you need to get examined by your gynecologist to rule out underlying pathology if any. Take suggestive measures accordingly. It keeps you in safe place. Try to avoid stress, take healthy diet, .  Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello My two year old kid is having fever since last three days. Doctor told to give MeftalP for two days , but as the fever did not come on second day, i stopped giving it. Should i give this medicine as per prescription for two days even the fever has not come again?As the fever has again came today. He also has chest congestion. for chest congestion we are doing nebulisation. Pls suggest. ### REPLY: Hi, Meftal we can give on an SOS basis also (i.e. as and when required). But if the fever is not coming down after 72 hours, I recommend you to get back to doctor, as we may need an antibiotic too in case there are crepitations in chest (suggesting sputum) or other signs of bacterial infection. Meanwhile, you can continue nebulization. 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: I am 41years old my angioplasy was done on 24th April,2008, I take Tab.Ascard 75mg & Atarva 20mg I am feeling well my B.P usuall 80/120. I am warried about my healt in future please tell me about precaution about my health. Regards, Saleem Raza ### REPLY: Hi, Post-Angioplasty the precautions should be to take the blood thinning medication regularly (Aspirin), avoid junk food and fat-rich diet, do regular exercise.  You should also do a stress test every 2 years just to see everything is fine. The complications post Angioplasty is mainly because of blood thinner which can cause bleeding from any part of the body, but these are essential post Angioplasty, so any incidence of significant bleeding should be reported. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi.  My husband and I are leaving for Paris in a little over a week for a vacation that we have planned for a long time, and now my dentist advises me to have a broken wisdom tooth extracted right away.  The tooth does not hurt.  I was wondering how long it would take to heal and for the pain to go away. What about complications? (I am in my mid 60s.)  Would it be so terrible if I waited until we got back to have the tooth extracted? ### REPLY: Thank you for your query, The healing will take around 4 - 6 weeks to take place. The pain will go away within a week or two (assuming you are healthy, no medication)There are a number of complications that can happen namely .  But, if done with proper protocol the chances to these are negligible. If the broken tooth of yours involves pulp/ is very near to pulp, then waiting is not a good idea as it may flare up anytime. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 now 15.5 years old, since six months his behavior and attitude about family members became changed, and consciousness about the study also degraded. what we should do to move him in positive things, otherwise how much more time he will behave like this? ### REPLY: This is a tender age of psycho-physiological changes. There are quite a many possibilities of change in attitude and lower work performance in an adolescent. Most important and worrisome are . ) and mood swings (ups and downs). As a parent, you would have to be supportive and friendly towards him and at the same time give him his personal space because adolescents tend to trust their friends most in this age. Try to talk to his friends and gather information if anything is worrying him. And most importantly, never scold him. A more detailed description of his behavior would help in understanding his problem more. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had chronic lower back pain for about two weeks now. I thought I had possibly strained a muscle, but the pain has spread all acrossed my lower back. It is an aching feeling that at times feels internal. Can you tell me some possible causes? ### REPLY: Dear Sir/Madam, I thank you for having faith in  and for seeking help on your issue; I have gone through your symptoms, if a patient witChatDoctorplains similar to you come to my clinic I would advise, first that 2 weeks is not chronic backache. You need good physio and care of spine till then take tab Paracetamol 500 mg three times daily and consult a good physio hope I have been able to provide you with a satisfactory solution, if you want to clear any doubts about my opinion, feel free to contact. Special note-Any medication prescribed needs to be taken after consultation with your personal doctor only. 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: HiMy father lives in India and he met with an accident in 1997 and had a clot in brain, doctors in India have operated him and then after coma and long time he slowly recovered but now also he doesnt think like normal adult and sometimes behave kiddish and he has to take medicines daily that is Tegretal 200, Eption etc. otherwise he gets fits, So I wanna ask here in UK Is there any sugery with lower risk to operate him and remove his clot so that he can be a normal and independent person?? ### REPLY: Hi, Thank you for posting your query. The abnormal behavior in your father is related to old head injury and blood clot in brain. These lead to permanent damage in different parts of brain, leading to different symptoms. If you can send a copy of recent MRI brain report, I would be able to tell the different problems that he may face. The current medications such as digital (carbamazepine) and option (phenytoin) are given to prevent seizures (fits), which can occur in a person with severe brain injury in the past (post-traumatic epilepsy). I hope it helps. Please get back if you require any further information. Best wishes, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI I WAS JUST WONDERING I HAVE HAD THIS BURNING SENSATION IN MY VAGINAL AREA FOR 6 DAYS, I THINK ITS A YEAST INFECTION GETTING WORSE, I AM TRYING TO GET AN ORDER FOR A URINALYSIS, WILL THAT TELL ANY BACTERIA EVEN IF ITS SOMETHING OTHER THEN A YEAST INFECTION? I HAVE CAME UP WITH IT BEING A POSSIBLE BV. ### REPLY: Hello, Welcome to , There are many conditions which can present with these symptoms, they are bacterial vaginosis, fungal infection, genital herpes infection, chlamydia infection, trachomas and gonorrhea infections. Yeast infections can also present with these symptoms, yeast and certain bacteria are normal comedians of the genitals, and they are kept under control by useful bacteria, whenever there is a change in environment they get activated and produces the symptoms. Physical examination and lab investigations will help us to confirm the diagnosis and to prescribe proper medications. 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 a bullet that is very close to my spine.. It has been a year since I got shot. The doctors did not want to remove due to more complications. I have started to have trouble with my arms and fingers. Constatntly getting numbness and tingling. I do not know what do do an more or what should I tell doctor ### REPLY: Hi, I'm imagining that this bullet is up in the neck somewhere, right? That is the only place that a lodged bullet or piece of shrapnel can be to be affecting both arms and legs.  You'll probably want to get more specifics as to exactly HOW close the bullet is to a critical structure and what sort of chances there are of having a bad complication.  Maybe a 2nd opinion from another surgeon in a different hospital or group of surgeons would be another alternative to consider. 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: my 13yr old daughter has had a fever of 104 for 3 days now. We have been giving here Motrin every 6 hours and Tyenol every 4 hours. Her temp goes down to 100.5 but does not stay down for very long. She started vomiting this morning, she now has a stuffy nose and cough on top of the fever and vomiting. Is it time to take her to the Dr. Most times I take her in they tell me to wait longer to see if it goes away so I waited this time but getting worried now on Day 3 of fever ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query your daughter is having fever, nausea along with cough and stuffy noise is because your child is suffering from viral infection. It could be due to bacterial infection / upper respiratory tract infection as well. I would suggest you to visit pediatrician once and get complete examination done. You should go for blood and sputum tests. You should give antipyretic to your daughter for fever relief such as cal pol, paracetamol or Adolf suppositories acetaminophen. Gargle with saline water. Give steam inhalation to child. Use mist humidifiers in room. If fever increases do tepid sponging as well with cold water. Give throat lozenges as well. I would suggest you to consult ENT specialist as well if symptoms keep son persisting. Doctor may prescribe antibiotics along with decongestants. Give child multivitamin tablets. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 50 years old and have had asthma for about 15 years now - or at least finally diagnosed 15 years ago.  My doctor has put me on Symicort.  My throat was hurting so I stopped using it for a few days.  It seemed as though my asthma fought with a vengeance.  I now have the worst cough and wheezing ever.  I have since (for 2 weeks) been back on it but am still suffering.  What should I do? ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. In my opinion, inhalers such as Symbicort should not be stopped without doctors advice. Stopping controller inhalers can cause return or exaggeration of symptoms. Please make sure that your technique of using inhaler is perfect, and you are rinsing mouth after each use, this will reduce deposition of . 2. In such patients, I usually suggest continuing original inhaler (Symbicort) in the same dose as they had been using previously. In addition, I would suggest them to use inhaler like levosalbutamol or albuterol 3-6 times a day and also to take montelukast regularly. Please discuss these possibilities with your doctor.3. For long term management of persistent asthma, I would suggest you allergy testing, which will help you identify the substance causing symptoms to you as well as to know the measures to avoid them. Based on allergy testing, an Allergist-Immunologist may prescribe you allergy specific immunotherapy which works on immune system to gradually improve allergy symptoms over long time.4. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution.5. I would also suggest you regular breathing exercises, plenty of oral fluids and a healthy diet rich in vitamins & minerals. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health and a quick recovery. Thank you & 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 would like to know what is the main problem of my husbands semen analysis and what would be the solution. we are trying to conceive for the past 2 years.. here are the results:Volume - 3mlReaction - alkalineViscosity - hyperviscousTotal Count/ejaculation - 55,200,000Liquefaction - >180minSperm Vitality - 35%Motility:     after 30mins (PR+NP) - 30%     after 1 hour                 - 25%     after 2 hours               - 20%     after 3 hours               - 15%Sperm Type of Motility:1. Immotile - 0% 2. Total Motility (PR+NP) - 5%     Progressive motility - 25%     Non progressive motility - 70%Total Abnormal Forms (Krugers Clasification) - 30%     a. Abnormal Head forms - 15%     b. Mid-portion abnormalities - 10%     c. Tail Abnormalities - 5%Spermatogenic cells - 1-2/mlPus cells - 1-2/mlRBC - 3-4/hpf ### REPLY: Hi greetings. Mainly 3 important parameters. 1. sperm density is normal .we need only 16million /ml2. Motility. Rapid progressive motility is below normal, but moderate is ok3.morphology of sperms seems to be normal. Another findings are prolonged liquefaction. I suggest your husband to consult an .  If so treatment can be taken SND motility and liquefaction might improve. Need not worry about single report. There will be variations always. A repeat analysis after 2 months can be done. Hope my answer helps you. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having this sever neck pain, back pain,pain in my inner thighs...also I feel like my head is spinning and I might fall if I dnt get the support of something.also I fail to hold even a cup of tea and plates irrespective of the temp and weight and it feels it will fall down from my hand. my age is 26 I am male and my weight is 58kgs and blood group is O+. I dont have Migrane problem only ### REPLY: Hello, Medical conditions causing such symptoms are commonly slipped disc, cervical spondylitis & vertigo. Get physically examined by a GP. Get blood & Imaging tests done to detect the pathology causing you such discomfort. You are suggested to get Blood tests, X-Ray & MRI done to rule out arthritis, inflammations, ligaments, tendons & blood vessels, tumors, degenerative disc disease, slipped disc, spinal stenosis, cervical spondylitis, etc. Your treatment will depend upon the pathology detected. In the meantime take NSAIDs for pain relieve. Since you are having dizziness do not .  Get your ears clinically examined. Get audiometry test done, if pathology is detected you will be treated with medicines or surgery. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my name is debra .i went to the dentist a week ago and find a dark spot on the upper roof of my mouth. can this be due tomedication that i am on or something i need to be concern .at the time i was on two blood pressure medicine and one has a fluid pill with it. My doctor just taken me off the blood pressure because my legs became very dark. can this be a symstom from my blood pressure medicine. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have symptoms of dark spot on the roof of mouth which could be because of allergic reaction due to any food product, any medication side effects and could be due to excessive cigarette smoking leads to formation of spots known as nicotine palatines. I would suggest you to visit your nearby dentist and general physician just to make sure that these areas are not because of any serious mouth pathology rather just because of effect of medication side effect. Maintain hygiene of oral cavity to prevent bacterial growth. Keep using antimicrobial mouthwash. Your doctor will take a sample from these dark spots and can go for biopsy for the same to find exact diagnosis and then treatment can be done accordingly. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello  i am a 29 year old woman i just had gallbladder surgery to remove my gallbladder 12 days ago today my husband and i had sex but had discomfort due to a IUD i had inserted a month ago so we decided to try to have anal sex everything was going great but then i started feeling pain on my  right-side of my abdomen shortly after that it also started on my left  i felt as if my intestine was going to explode i had a lot of pain wear  my gallbladder was b4 , can you tell me if i might have caused something to go wrong with my intestine or something around that area ? ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. No, it can't because any disorders related to gallbladder site, so pain is caused by colon irritation, and it should subside in few days, so you should not worry. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. 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 have a severe needle like pain at the left side of my lower back. I visited a doctor recently and he suspects that there might be a cyst at the L4 L5 region. He has asked me to get an ultrasound done and an x-ray. What kind of a cyst can this be. I have been having this pain for about 4 years now. and never bothered. Only now as the pain increased, i thought i must visit a doctor. since then i am  extremely worried. ### REPLY: Dear patient First according to me cyst is very rare condition and your symptoms do not justify that diagnosis. Also, ultrasound is not sufficient to diagnose l45 cyst. So I think possibility may be 1. Disc prolapse with nerve compression 2. Muscular pain.  So you need to be investigated with MRI of lumbosacral spine with screening of whole spine.  It gives detail of nerves, disc and bones. So visit radiology center nearby you and get it done.  Take expert spine surgeon opinion with report. Meanwhile, start tab attract one at bedtime and take tab regain plus vitamin B12 combination at bedtime for 10 days. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 31 year old male I smoke about a pack of menthol cigarettes a day. I noticed a lump under my tongue towards the back of my mouth it is painful and has been there for about a month now. and also it tends to hurt slightly when I swallow recently.cancer does run in my family my mother and father have both had forms of it. what should I do? And how long do people usually live with oral cancer? ### REPLY: HI, Dear,Thanks for the query to .1-I have studied your query in depth.2-IN my opinion, this lump on the back of your mouth-floor which has become painful recently was present for a month, with swallowing hurt from the lump, is cause to worry, though the only pacifying fact is that its painful or this may be a danger signal of invading lump in to nerve fibers around.3-With a pack of cigarettes a day, this could be a -painful lump on the mouth floor with ulceration not noted by you, or it could be a lump with invasion in surrounding tissue.3-a-I would advise you to show your doctor -surgeon, as it hurts you and the lump was there for a month-or could be for more time.5-Dear, I would advise you to URGENTLY-consult an ER Surgeon-doctor, who would rule out the medical causes, and would excise the tumor if the FNAC indicates that its cancerous.6-Hope this would solve you query to your satisfaction.7-Wellcome for more queries to me On . Thnks once again for your inquisitive query. 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: I had never had a problem with high blood pressure it always ran about 120/80 .About 2 weeks ago ,I got really bad headaches and just felt bad in general so I went to the Dr. it was 188/94 . She put me on a water pill , after about 4 days it started messing with my bladder because of my IC. She did an EKG she said it looked good except that my heart rate was to high.It was 125. She then put me on an ace inhibitor.I quit all caffeine and cut way back on my smoking.                  After I was on it a few days I started getting a feeling in the right side of my chest that felt like electric shocks. They were so bad that I couldnt sleep.I called her , she put me on a beta blocker, they helped bring the heart rate down and reduced the number of electric shock episodes. should I see a cardiologist to make sure my heart is okay? I feel some pressure in my chest ,mainly at night when I lay down. ### REPLY: Hi, Do you have chest pain or heaviness on exertion or just chest pain only. It doesn't look like pain, and it seems gastritis and reflux disease. Surely BP should be controlled, and you can visit to get routine test done like lipid profile, sugar and echo. You should follow healthy lifestyle avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity at least 30 minutes a day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, and avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Also avoid spicy and fatty foods and maintain sleep habits regular and also do regular exercises. Have some walk after meals instead of taking rest immediately. You can take acid suppressant like tab pander. 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: MY LEGS HAVE GONE INTO ACHING SPASMS WITH NO POSITION BEING COMFORTABLE. i AM NOT OVERWEIGHT BUT WORE HIGH SHOES YESTERDAY WHICH WERE COMFORTABLE BUT NEVERTHELESS THE STRAPS ROUND MY FEET WERE TIGHT AS THE AFTERNOON PROGRESSED. i SLEPT WITH MY FEET RAISED BUT HAVENT TAKEN ANY PAIN RELIEF SO FAR, AND THEY FEEL A LITTLE EASIER BUT STILL ACHE. i HAD PHLEBITIS MANY YEARS AGO, AND THERE ARE MANY VEINS PROMINENT BUT I AM TOLD NOT DANGEROUS. I AM FLYING ON THURSDAY. IS IT SAFE AND WHAT SHOULD I DO? ### REPLY: Hi, Thanks for your query. After going through your suffering, it seems you have developed muscle spasm (cramp). The cramps are caused by hyper excitability of the nerves that stimulate the muscles.  .  A simple way to prevent cramp is-1. Warm up and stretch your calf muscles before running stretch your calf muscle before going to field 3-4 times and each time holding for 10-15 seconds. 2. Talk to qualified trainer for proper running form and footwear.3. You may run in a heel-toe pattern and avoid letting the balls of your feet hit the ground first.4. Stay properly HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 40 years old and believe I have ADD. All of my siblings are nurses and they tell me I have all the signs of it. I have taken quizzes and they said that I have ADD. My question is how do I start the process of seeing a doctor about it. It is very embarrassing for me, but it is really starting to hurt my life on several levels. ### REPLY: Degree understand your concerns went through your details. You did take quizzes. You did go through the details regarding to ADD. Furthermore, you are almost sure that you are showing signs of ADD. But let me tell you an intricate opinion. The more you dwell into ADD information (in the beginning) the more you will find the symptoms of ADD in you. That is called internship syn .  No problems. You should consult a psychologist who assess you impartially with his own assessment tools, and then he will give you your diagnosis. If you are confirmed ADD you should request his advice. He may ask you to consult a psychiatrist or to take his psychotherapy treatment. Do as he tells you. God bless you. 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. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my boyfriend has been "passing out". it has been 3 times this year. he has complained of chest tightness and unable to breathe sometimes for about 2 1/2 years now. he went to the ER and he was diagnosed with epilespy and he has cardiomegaly. how is that possible? can one cause the other? ### REPLY: Thanks for your question on . I can understand your concern. Epilepsy is the disease of brain. It can not cause cardiomegaly. Similarly, cardiomegaly also can not cause epilepsy. Both are separate entities and can present simultaneously. His chest tightness and breathlessness are due to cardiomegaly. Common causes for cardiomegaly are heart failure, valvular heart disease and cardiomyopathy. So get done ECG and 2d echo for the diagnosis of heart disease. He will need diuretics and other cardiac supportive .  Don't worry, he will be alright with appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your boyfriend. 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 have a very large painful bruise on my inner part of lower leg. The bruising is spreading down to my ankle and to the front of my ankle in the front. Also out of nowhere I get blood just running out of my nostrils. Is this anything to cause me to be seen by a doctor? ### REPLY: Thankyou for choosing . I understand your concern. The blue spots on your legs are representing the bleeding under your skin you need to urgently contact doctor in your vicinity to get treated as it may have serious consequences. You did not mentioned your age and also did not mentioned whether you are taking any medicines or not. I need you to follow up with doctor to rule out the bleeding disorder due to low vitamin K levels or due to deranged PT/APT as well as to rule out DVT if any before thinking of minor conditions to be considered. Do tell your doctor in detail the medicines you are taking at present and immediately stop medicines having anticoagulant therapy if you are using like warfarin, aspirin etc. I hope you will understand the risk and see your doctor urgently. Get well soon ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 several lumps under the skin of my lower right leg. I had ultrasound to rule out DVT. Lumps are tender to touch, anywhere from nickle to quarter sized. No skin discoloration with exception of nickle sized dry patch just above ankle.  Also recurrent nausea. ### REPLY: Hi, Dear,Good Evening from INDIA. Thanks for the query to . I went through all the details of your query. On the details given by your query, In my opinion you suffer mostly from-on the facts there in-mostly you suffer from-a-Varicose vein with multiple lumpsb-with Venous eczema above the ankle. Recurrent cause with it is serious indication and indicates some infection with it. Consult ER doctor. Hope this would resolve your query. Welcome for any more query to  and ME, in this regard. Wishing you fast recovery. Write review ASAP with strong recommendations for  and for ME, for the benefit of other new and old patients. Have A Good Day. With . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi - my stepdad has stage 5-6 dementia , CPOD, emphysema, and lung cancer . He recently was undergoing SBRT for the tumor (stage 1) and after three treatments was in the hospital with pneumonia - two weeks later he seems better - a little unsteady on his feet but doctor says he needs 24/7 babysitting or go to nursing home coz mom can t care for him at home with what he needs. we are confused doesn t seem bad enough for 24/7 - he was on level 2 oxygen and went up to 3, now trying him on 1.5 should he go back for the rest of treatments - it isn t seen as a cure ### REPLY: COPD, Empysema of the lung are chronic diseases and super added with pneumonia, in cancer lung after radiation therapy, I think he is in critical period. To overcome these problems, he needs medical supervision, may not be available in the home. He can shift to home, once his condition is stabilized means he requires only oxygen and able to breath normally on oxygen. Going for further cancer treatment is, in my view, not give any positive results. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been in and out of the ER and doctors offices no one can tell me what is wrong i have had really bad pelvic pain for the past year i have had sugery and they thought i had Endometriosis but when they went in found nothing noone can give my answers please help me ### REPLY: Hi. Thanks for your query. This becomes very tricky if on surgery for pelvic pain finds no endometriosis. I would suggest the following :Get an MRI of the thoracolumbar spine and the pelvis with specific reference to the deep pelvic pain, that the Radiologist can coordinate with ... This may find the lesion and help you to get a treatment. Till then, you can be started on empirical basis with Gabapentin and see the results. If everything is normal, you can get an appointment with a Psychologist or a Psychiatrist and a Neurologist to find or rule out sensory nerves problems. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, if you have been to the doctors before to get something checked out and they tell you that you have something similar to acne what can you ask for to get rid of them ? ### REPLY: Hi, thanks for query. Acne is very common problem of growing age. The reasons are hormonal changes, oily skin and environmental effect. Please avoid too much of junk food, take good care of your skin after coming from outside. In case of infected acne you need to take a course of antibiotics to get rid of it. Some local creams also help. In case of severe problem, get in touch with a dermatologist. 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: Sir, Im 30 yrs,5height and 55kg, thyroid patient from 1996 after operation of Thyroglossal ceasts in my throat and beta thalassemia carrier from 2008 after ceaser. How can I manage my good health and is there any risk involved? If any, what can I do? My only son aged 3 yrs also beta thalassemia carrier. What can I do for him? Please detail inform me. I shall gratefull to you forever. My problems are 1. My leg and hand fingers are quite swelling very often, 2. My hb is at present 11.8, 3. Monthly periodical flow and quantity is too much heavy, I cant stand up from my bed. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. No need to big worry.  Person with beta thalassemia trait can lead to normal healthy life. You should regularly check your hemoglobin level.  Because any inter current illness leads to fall in your hemoglobin.  You can take blood transfusion as and when required.  And your son should not marry the girl with beta thalassemia trait. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor,For the last few months I have been getting as tingling feeling in my lower left arm as well as an ache in my left arm pit. There is no pattern towards the sensation yet but I do notice that it comes more when i am feeling stressed or anxious. ### REPLY: Hello! Welcome and thank you for asking on ! Regarding your concern, I would explain that your symptoms seem to be related to anxiety. But a nerve compression can not be excluded either (considering the fact that the feeling is radiating in a nerve trajectory). So, I would recommend performing a nerve conduction study and a cervical spine X-ray study (to exclude possible bulging disk). But, I don't think that your symptoms are related to any cardiac disorders. So relax and don't worry about it! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been having the smell of blood in my nose and the taste of blood in the back of my mouth. Sometimes when I blow my nose, the mucous is bloody. This worries me. Besides that, it seems like I have other constant sinus problems; sneezing, coughing, headaches, burning eyes, irritated throat, lack of smell and taste, and fatigue. I don t necessarily eat unhealthy or have unhealthy habits, but I never feel any better. What should I do? ### REPLY: Hi, thanks for using  The bloody discharge would be related to the inflammation in the nose and sinus passages. This inflammation may be due to allergies and/or infection. You need to consider treatment with antihistamines, decongestants, a topical steroid nasal spray. You would also need pain medication to help with any discomfort (e.g. paracetamol or ibuprofen). These, with the possible exception of the topical steroid nasal spray, should be available over the counter at your local pharmacy. If there is a bacterial infection then you would need antibiotics. If you use the above meds and do not notice any improvement, then you should visit your doctor to find out if you have bacterial sinusitis. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother is having a severe cold which looks as a TB and she is taking prescribed medicine for a severe cold for a more than 4 months but still is result is not satisfactory.The cold and cough is developed in a serious stage for her and she can t able to sleep well at night.She is getting more salaiva out which is in greenish colour and it s still coming when she is gets a cough again and again.I doubt it should a TB deficiency.I am really scare of my mom s health.Would you please give suggestions for it for treatment & medicines & food habit which has to follow ? Here:these are the prescribed medication by a Doctor for my mom-Celin,Levoflox-250,Ebastine and Piriton Tonic which are taking for more than 30 months. ### REPLY: Hi Dear !! Thanks for your query to . Read and reviewed your query and health concerns. IN the given situation of Yours, You seem to suffer from-Chronic Productive Cough-from Bronchiectasis. The greenish sputum is indicative of bronchiectasis and the history of copious secretions for 4 myths chronicity, leads one investigate case with Chest Physician. Other causes like TB bronchitis with pneumonia, necrotic tumor in lungs need to be ruled out by CT Chest and flexible bronchoscopy. This plan would reduce your dilemma from chronic copious cough. Hope this would help you to plan further of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following  link-Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at  services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi...am bind...my son goes to the gym everyday...he is 20 years old...he developed some red rashes on the chin ...is it because of the protein shake that he takes or the eggs ..he tAkes two eggs a day...he only eats chicken everyday with fruits of course...how to avoid the red rashes..he has a very good complexion actually..except for the red rashes...if u puts cold compress is also help...we tried calosoft wch is calamine, aloe era gel n light liquid paraffin..he helps but if he stops he appears again..pls advise...thank you...sooooo..muchhhhhhhhh.. ### REPLY: Hi there, First question I would have asked from you would be is there a rash anywhere else on the body?if NOT then I would suggest that it's a simple case of Contact Allergic Eczema. I think he needs to apply 1% HY . 3: Observe the rash, if the above medications don't help in 3-5 days then you need to see your GP or dermatologist of course.I think I can not help more than that with such a brief history, so please bear with that, thankyou and all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had abdominal pains for a couple weeks now. The pain is fairly sharp but not overwhelming. I have also felt sick (but not as though I will actually be physically sick) and have felt sort of dizzy and tired too. I have been irritable as well. Also, during and after sex it feels like my gut has been squashed up and the abdominal pain intensifies. Also I dont know if its relevant but I had black, tarry stools a couple months ago now. ### REPLY: Hi. Thanks for your query. Read your history and understood your problems. To recapitulate- pain in abdomen for a couple of weeks-feeling sick, dizzy and tired. - had black tarry stools a couple of months ago. I would advise you the following :-Blood tests particularly for Typhoid, sugar and thyroid function tests, Kidney function tests and liver function tests. -Urine-Stool routine, microscopy and for occult blood tests. -Ultrasonography of the abdomen particularly to see for PID-Pelvic Inflammatory Disease, condition of the Fallopian tubes and Ovaries. Any fluid in the pelvis. -Gynecologists opinion, internal examination will help to localize the problem. -Get a course of 5 to 7 days of an antibiotic, metronidazole, symptomatic and supportive medicines like probiotics and multivitamins. If Tidal is positive you have to take an additional treatment of 3 weeks. Get a proper clinical examination, investigation to get a 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: I have had a dull pain since Friday (sudden onset) on right side waist high in abdomen, radiates to back right and a bit tender to touch there. Gallbladder? Kidney...not constipated but feel bloated. Seems worse at night. ### REPLY: Hello, The mentioned symptoms point towards either gall bladder infection or kidney infection. However, in kidney infection burning micturition, blood in urine, etc. can be present.  So these symptoms have to be ruled out. I suggest you investigate with urine routine microscopic examination and USG scan for further work up.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 16 months old. Every night she wakes up from her sleep crying and screaming. She cannot be consoled and at times we end up awake all night. She gets into such a state and is very distressed. what can I do? My cousin is epileptic and takes seizures in her sleep I am worried this is what is happening ### REPLY: Hello, What is her sleep routine? If she is sleeping in the day, then she will be awake at night. Check for any abdominal pain or ear infection. If the baby is having colic, give her colic .  Try to give Paradox in that case. If she is wet in diapers, or it is too cold, or too hot, or she sleeps hungry, figure out among all these problems. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi sir , i m a stammerer i face many problems in speaking . i usually stammer when i am speaking to new persons i m not stammering while singing i m feeling shy to give seminars in college due to this stammering what should i do is there any medicine for stammering ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. For stammering, you will require relaxation therapy to reduce your stammering. Biofeedback therapy will also help. Medicines generally do not help in stammering. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 31 weeks pregnant and haven t had any problems with nausea or vomiting for atleast a month now, well I just threw up and noticed it had a little bit of a pinkish tint to it and thought it might just be from some candy I ate earlier. But at the very end I threw up something dark red, I think it might be blood. But twice today I had pieces of cake and there was a little bit of dark red in the cakes. So I wonder if it could just be from that. I feel okay and the baby has moved a little since then so I feel like there s nothing wrong with her. What do you think? ### REPLY: Hello, I have gone through the query and understood your concern. Your description suggests fresh bleeding. This is likely to have originated either in the esophagus or the oropharynx as the mucus membrane may have got eroded due to retching. If the blood is from the stomach, it will have altered color. Please inform your consultant and get properly managed. If you have any indigestion, you need to attend to it. Any gastritis also should be treated simultaneously. Please do not worry and continue taking adequate rest and monitoring fetal movements. Wish you safe motherhood. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i.ve got knots in left armpit they hurt really bad ,left rib cage severe pain , weight loss ,fatigue weak ,blood work is fine ,mammogram ok ,ultrasound tomorrow ,5 lymphnodes removed left side of neck years ago .why am i having so much pain ? and small knots are popping up up allover i,m 48 ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have multiple enlarged lymph nodes.  It can be due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma.  You should go for ultrasound study and if needed to go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I want to seek treatment for add. I and a 62 year old male who has suffered from being unable to focus in sports activities. For many years I ve tried every supplement I could find and have been unable to find anything that helps. Do you know of any doctor in the Sacrament are that specializes in this area ? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Attention Deficit Disorder is a disorder and not a disease. Disorder becomes health or life problems if you take them seriously. Ignore them and be aware of them. Find your attention deficit areas and be aware. Never try to overpower them. Ignore them. Think that they are normal and are causing no problems to you. Slowly and steadily the effect on life reduces. You learn to live with it effectively.  If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. 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: Hi I have a lump about the size of a nickel at the base of my skull on the left side of my spine. It is compleatly hard and unmoveable. Iv had it for 5-6 months and I thought it couldnt be anything at first but It has been causing pressure behind my left eye numbmess and tingling in my left hand and toes. I have really bad headaches everyday and they come on and off throughout the day but I cant get rid of them. Its been everyday for three months. Im nautious everyday on and off and Iv tried everything to stop it, that has been going on for two months. I feel like I cant remember things that I need to and Im somewhat confused sometimes. Iv been thinking it could be a tumor but didnt want to do resurch online because I thought I might scar myself. Any advise or insight would be greatly appericated. Thank you! ### REPLY: Hi, Thank you for posting your query. A clinical examination would be useful in confirming the nature of lump. In addition, a scan (MRI or ultrasound) would help in diagnosis. At the moment, if you can upload a photograph of the lump, it would be helpful. There is no need to worry, as proper diagnosis and treatment would help you get better. Please get back if you require any additional information. Best wishes, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 yr. old daughter has a rash that just appeared over night. It s on her lower back, bottom and upper legs. They are red bumps with a head on them and they itch really bad. She has never had chicken pox but I can t figure this out. 4 nights ago she dumped my husbands shampoo in the bath to make bubbles but the spots just showed up today. Other than that there have been no changes in her diet or soaps. ### REPLY: Hi, Welcome to , The rashes can be due to allergy as she used the shampoo that she should not have used. Child .  Antihistamine Syrup and mild medicated lotion/cream can be of help. Do not let her scratch. It is important to rule out any fungal infection, viral infection. Get her examined clinically by a doc. Diagnosis should be made early to start the treatment, she will need antibiotics and ointment surfeit to be applied locally if ring worm infection is detected. If it is measles, symptomatic treatment should get started as it is a highly contagious disease. Maintain hygiene, get her treated, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having right sided chest pain for the past three months every time I eat or drink. I have had a chest x-ray which was normal and have seen my GP who has advised me to try an anti-inflammatory gel and also gave me a months supply of Lansoprazole. Neither of these have helped. Please can you advise what this may be? ### REPLY: Thanks for your question on . I can understand your concern. Since your chest x-ray is normal, no need to worry about Pulmonary causes for your chest pain. In my opinion, you are mostly having stress induced HERD (gastroesophageal reflux disease). You need to follow these lifestyle modifications along with lansoprazole for better symptomatic relief. 1. Avoid stress and tension. 2. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. 3. Go for walk after meals. 4. Keep 2-3 pillows under head in the bed to prevent reflux. 5. Lose weight if you are obese. Avoid smoking and alcohol if you are having these habits. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 54 year old male. I am experiencing a buzzing in my groin that feels like it is happening near my testicles. I cannot feel it with my hand though its strong enough it feels like I should be able to fell it. It is a very light buzzing sensation that happens when Im sitting or laying down. My physical condition is pretty relaxed having worked in a deskjob for the last few decades. The periods of buzzing would be described as prolonged. I am on one BP med (coversilplus) and currently stressed looking for work in a new career. The sensation is very annoying anytime I am stationary. Please advise! ### REPLY: Hi and welcome to . Thank you for your query. Well this buzzing is nontypical sign, and it may indicate certain issues such as epididymitis, small inguinal hernia or genital neuropathy. Epididymitis is inflammation of part of testicle and this not uncommon in males especially in young age. This is usually treated with 10 days of antibiotics, usually ciprofloxacin and there are no permanent consequences, but it should be confirmed with Doppler ultrasound first. . Masturbation and intercourse should be avoided till pain persist, if possible since it may prolong inflammation course.  You should take B12 vitamin supplements and see if this will stop, since in this case it would be neuropathy. Hernias can be detected with ultrasound, so I recommend it if symptoms persist. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. 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: My Mother has been diagnosed with a large kidney stone which has resulting in years of painful urine infections. She has private health insurance and, living near Bath, her only treatment service which has been offered to her is a mobile unit which visits the RUH once a month with a waiting list. Are there Kidney stone clinics nationally? I am having difficulty in finding information. ### REPLY: Hello and welcome to . As a Urologist, a large kidney stone must be removed. The stone is the focus of infections. Once cleared, the pain also will be relieved. Leaving it, will cause pain, recurrent infections and increase in size of stone.There are stone clinics nationally. Stones can be treated in many ways. You should send details of your reports, scans, age,and medication. You can send them as a direct question, to me, for my expert opinion. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yesterday I was biking and took a turn too tightly and I couldn t stop the bike so I hit a tree head on. The bike hit the tree first and then the right side of my head hit the tree. I didn t lose consciousness. I remember exactly what happened. I felt a little nauseous afterwards and have been having dizzy spells all day whenever I change directions, like turn my head fast or get up or lie down. I don t have any other symptoms for a concussion. Should I still get checked out? My head is still swollen and hurts. ### REPLY: Hello! Welcome on ! Regarding your concern, I would explain that your symptoms are related to a head concussion. But the dizzy spells can also be caused by positional paroxysmal vertigo. This is a benign disorder affecting the inner ear, caused by trauma. So, I would recommend having some rest for some days. If the problem persists, I would recommend consulting with an ENT specialist and performing labyrinthine tests. Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Nine year old nephew, who is extremely fair complected, has recently developed l blood blister on his lower lip. It continues to enlarge and is now purple in color. He bumped it a few days ago,  he bumped it and it bled profusely. He was taken to the local ER, and was told it was from biting his lip (which he doesnt do) and it should dissipate in time. Despite the physicians prognosis, it has continued to grow in size and has begun to take on an irregular shape.It may be of importance to note that skin cancer is prevalent on his mothers side, and his father passed away at 31 of lymphoma. Could this lump be cancerous? He did spend a great deal of time in the sun this summer. Should I suggest they take him to a dermatologist? Can it be removed? ### REPLY: Biting is one of the differential diagnosis for a blister on lip in a 9yr child.it should heal in a matter of 1-2 weeks completely. As u said it started as an enlarging blister with bleeding and grown in size in an irregular shape, so the child should undergo biopsy to rule out malignancy. As family history also suggestive of cancer in the mother, you need to consult dermatologist or pediatric surgeon for biopsy and to proceed 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 husband s feet, ankles, and bottom part of his legs have been extremely swollen for over two weeks now. This happened when he flew to a business meeting. Swelling has never gone down. Skin on legs are tight and shiny. Over the past week they are becoming red. (started lower leg around ankles but it is now up to his knees. Tonight, he had to take his pants off as they seemed to be getting wet. He thinks fluid is seeping through the skin. He thinks it is his gout acting up but I don t think it is. I might add, he drinks alcohol accsessively. Please advise. He refuses to see a doctor. ### REPLY: Dear madam, chronic alcoholic are at a great risk of both chronic liver disease and cirrhosis. This causes edema of the feet, moreover the potential of getting infection and cellulitis with cirrhosis is also very high, in my opinion you should consult your doctor, and get him treated early, because these signs are not good and may be even life-threatening. Hope you convince him to take medical heptanes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had four of my wisdom teeth extracted a week ago and my throat and left bottom side still hurts.  he said that was the hardest one to do and my throat pain didnt start until after the extraction.  it hurts to swallow and i still cant open my mouth very far because of the pain on the left side ### REPLY: Hello, Welcome Thanks for consulting  I have gone through your query, as you have mentioned that you have wisdom tooth extraction now swelling is there and painful throat, after extraction of wisdom tooth swelling occurs for week also, don't worry consult your dentist for check up again and Examination of socket Do warm saline gargle two - three times a day it will help you in healing of socket and painful throat also Hope this will help you.  Wishing you good health Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good Day - I HAVE I THINK CHRONIC CONDITION WITH MY SKIN ESPECIALLY ON HOT DAYS MY SKIN GETS A FINE RASH - FLAIRS UP WITH RED PATCHES ALSO AROUND THE NECK , EAR AREA ,BECOMING DRY AT TIMES . IM CURRENTLY USING DAZIT FOR THE LAST 1YR AND 3 MNTHS , THE BIODERMA FACIAL WASH AND HYDRACRYSTAL URIAGE , BIODERMA SUNBLOCK WORKED LIKE MAGIC UNTIL THEY DISCONTINUED IT, SO NOW IM BACK AT STAGE ONE USING ADVANTAN CREAM INBETWEEN PLS HELP ESTELLE ### REPLY: Good Day to You too Estelle. To the best of my knowledge, Bioderma products are still very much in the market & I prescribe them on a daily basis & have been over the last decade! If you do not get the sunscreen in your parts, might I recommend a Bioderma product called Modern PO Zinc cream that can act as a sunscreen & a skin Southerner & usually recommended for babies who ail from diaper rash. It is safe & works like a charm save for the noticeability factor. Please do continue with the other Bioderma products in the interim. Good Luck & here swishing you a safe & radiant complexion always!! Cheers!  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 from cardiogenic shock in July. I was wondering could there have been something I couldve done to prevent this? I am living with a lot of guilt bec I went to nursing school and never saw this coming. His ejection fraction was only 15 % ### REPLY: Hi welcome to . I understand your query and concern. Your father symptoms are suggestive of Congestive cardiac failure leading to pulmonary edema and cardiogenic shock thereby death. Congestive heart failure has poor prognosis in all cases if the ejection fraction is under 30%. If he had got urgent hospitalization he would have recovered.It's always advisable to keep the blood pressure under 130/80 mm of Hg. I advise my patients to have a baseline 2 dimensional echocardiography, ECG,HS CRP and lipid profile to assess the basic cardiac reserve of your heart to avoid these complications. Restrict the intake of salt to less than 6gm/day. . Semiannual follow-ups are advisable on maintenance for people who have crossed 40s is helpful. Once the above measures are carried out, good survival can be expected. Consult a Cardiologist for further expert management. Post your further queries if any. 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 Please find attached LFT of one of my clients. Please advise the possible diseases Regards Patient Name: IRFAN Consultant: FARISHTAH PIR Hb 11.3BILLIRUBIN TOTAL mg/dl 13.5 S.G.P.T (A.L.T) U/L 1244 S.G.O.T (A.S.T) U/L 2198 ALKALINE PHOSPHATASE U/L 408 GAMMA G.T U/L 134 TOTAL PROTEIN G/dl 8.2 ALBUMIN G/dl 2.7 GLOBULINS G/dl 5.5 A/G RATIO 0.5 YYYY@YYYY ### REPLY: Hello Tapir and thanks for the querulous clients Liver function test are highly disturbed. He needs immediate hospitalization and to be investigated for the cause of such a high liver function test. Certain causes are: Hepatitis, Obstructive Jaundice and Liver Cirrhosis. Stop smoking and alcohol, avoid all kind of fatty and oily food. Take plenty of water. If you provide me some detailed history like what symptoms are present, general condition and any history of liver disease etc., than I will be able to give you a proper and detailed answer. Best Wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been told that I have orthostatic Blood Pressure.  I have been having a series of dizziness and black outs. I stumble and fall a lot.  I can be walking and be unstable in my gait. Do any or all of these symptoms come from orthosatic bp?  What is a definition of orthostatic bp, and why does it hapen? ### REPLY: Hi! I had gone through your question and I understand your concern. Yes these symptoms are caused by orthostatic or postural hypotension (orthostatic blood pressure)It happens when you stand up - gravity makes the blood to pool in your legs so the heart has less blood to pump - low blood pressure (means less blood will go in your brain and the other part of the body) . Normally our body has natural process to fix the hypotension problems in these process (in heart, nervous system, metabolic problem) cause orthostatic hypotension. The important thing is to find the main cause of the orthostatic hypotension here are some that may cause : - Deny .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 its been 9months since Ive had any sexual activity, however three months ago, I noticed some small pimple like bumps under my shaft, they didnt hurt but itched a little, until I seen them so I burst them and it healed up and went away, so this month I felt the same sensation and it was two bumps. What do I do? ### REPLY: HelloThanks for query, Based on your statement I would say that you have recurrent Sebaceous Cyst over shaft of the penis. The penile skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Take antibiotics like Doxycycline twice daily for a week.If it does not subside within a week consult qualified General Surgeon for clinical evaluation and further treatment. If needed is it is bigger may need to get excised in Toto (Completely along with the sac) .  ### END