Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, just had my second biggest tooth removed, it was a root canal as well...i did not take painkiller afterwards, and now its the 3rd day, the pain is almost gone, but i still feel very weak at times, is this considered normal reaction after tooth extraction? ### REPLY: Hello, Thanks for your query. In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on Coke, Sprite, Gatorade, or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had what I thought was an ingrown hair on my scrotum for about a week, today I took a really hot bath and when I went to dry the area I had a very tough core like thing come out and I have a very large hole with a hard outer area around it, is this normal? ### REPLY: HelloThanks for query, Based on what you have stated it appears that you have what is called as Sebaceous Cyst over scrotum. The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally it fades away without treatment however may need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. Take broad spectrum antibiotic like Čeferin along with anti-inflammatory . If persists may need to get excised in Toto (Completely along with the sac) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, recently I ve been having pokes or (stabs) on my upper left chest , I m getting scared because I ve never felt this before. It is persistent , I m 18 years old . I excersize a lot , i think it may help if you new that . Any comments or tips will help . Thank you ### REPLY: Thanks for your question on . In my opinion it is muscular pain mostly due to exercise.  But since it is left sided chest discomfort, we need to rule out cardiac cause first. So get done ECG. It will come normal mostly as you are too young for cardiac disease.  But better to rule out this by ECG. Try to follow these steps for better symptomatic relief. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 small lump between the base and middle of my neck on the left side. ENT said no need for biopsy and watch to make sure it doesnt change size. Is that okay? It moves around and doesnt hurt when you touch it but sometimes has pain around it. Just want to be assured, not in denial. ### REPLY: Welcome to  .1. Most possible cause is lipomatous lesion (fat containing) according to your description.2. But second possible cause will be infective etiology - thinking in terms of pain.3. In this case I would have done in this way - examine first, then ask for an ultrasound neck which will help me to know the nature of the lesion, its source and extensions.4. As it can be from thyroid, vascular and so on.5. Yes biopsy not needed but get the ultrasound done and depending on the nature of the lesion / lump keep followup. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. 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 problem. i get pains in the left side of my back but i am having to be very careful what i eat, if i eat a normal meal sometimes i get really bad pain in the left lest side of my chest and the pain in my back moves up higher. it lasts about 12 hours. sometimes i am really hungry but afraid to eat .whats wrong with me Im loosing weight. ### REPLY: HiT hank you for asking . I have gone through your query. Problems like peptic ulcers can give radiating pain towards back like you mentioned. Even colitis can give such symptoms. A physical examination is necessary and in case of gastric signs a consultation with a gastroenterologist is well appreciated. Fibrogastroduodenoscopy might be needed to rule out peptic ulcer in case of signs of that. Proton pump inhibitors like rabeperazole, mucosal protectors like sucralfate and diet will be helpful for you in such case. Hope this may help you. Let me know if you have any further queries. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello my 6 months old baby rolled of the bed and was crying for a while, he seems happy now but i have found a little purple bruise on his head does that mean he has hurt himself badly? He also has fell asleep it has been a couple of hours since the fall, is that ok . ### REPLY: Hi... Thank you for consulting in . I understand your concern. First be reassured that your kid is normal. I will suggest you danger signs of head injury -1. Vomiting continuously2. Seizures3. Watery of bloody discharge from ears and nose4. Unconsciousness5. Altered sensorial or behavior. If none of them are present, I don't think you should worry about his trivial head injury. For pain, you can give oral Paracetamol in the dose of 15 mg/kg/dose(max ceiling dose 500 mg) every 4-6th hourly.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It is not really painful. just a little discomfort. My back tooth bothers me a little and I constantly have a sore in the roof of the mouth . The sore is next to the bad tooth. It feels like a pimple and has a point or a head. ### REPLY: Hi, you did not tell that this is the last tooth or another tooth...........anyway discomfort and soreness is because of infection/caries in that tooth..............and if it is a wisdom tooth it may be because of infection in that area............so please go to your dentist and get the whole mouth examination done..........after examination follow all the instructions given and go for a proper treatment....nothing to get worried.........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 gums are really sore on both sides.  I doesnt feel like a toothache but it hurts on both sides of my mouth.  It changes sides all day long when I try to eat it hurts really bad.   I have a headache also and once in a while I have some dizziness.  Not that bad but once in a while ### REPLY: Hello, Welcome to  .com. I had gone through your question I can understand your concern about sore gums.  As per your history, it seems to me that there is no swelling or inflammation or ulcer. It can be because of periodontitis or gingivitis. If you have associated bad breath, bleeding while brushing or urge scratching the area then it may be periodontitis. But your history is not suggestive of particular medical condition because of lack of details. If you could provide certain more details like how many days it is there, is there any bleeding, any white painful ulcer, intensity of pain etc. we can provide you a better opinion. During mean time you must do CHLORHEXIDINE mouthwash twice daily, replace your toothpaste because certain ingredients of toothpaste may be allergic to you, brush your teeth twice daily. Hope the answer to your query, write to us in case further clarification is needed. Also provide your feedback too. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am a science girl, but for once I can t find the answer. I ve read others peoples similar problem but I can t find an accurate and we ll accustomed answer. On my right butt cheek right by the crack and inch below the start of my crack is a very painful lump that s red, hard, and rather swollen with shiny white blood mixed fluids. I have no idea how to ease the pain, and what it really is. I can t get to the doctors for awhile. Is there home remedies? And what is this lump? It would really help. ### REPLY: Respected Science girl His evaluated your query thoroughly.* Till your narration it is most probably perianal abscess likely, though require confirmation by physical examination.* Need surgical evaluation as soon as possible till that time you can-manage to have soft stools with high fiber diet, plenty of liquids as hard stools will increase the agony- Site bath (sitting in a tub filled with lukewarm water for 10-10 minutes morning, evening & specially after passing stools) help a lot-avoid sitting on hard surface for prolong period of times - Local application of Xylocaine (5%) jelly give soothing action-refrain from any anal sex activities (if involved) - avoid smoking / alcohol if consuming - Systemic antibiotics & anti-inflammatory agents fasten the recovery as prescribed after in person evaluations- avoid oily / spicy / non-vegetarian stuffs - take analgesic tablets 3 times a day after meals for pain control Hope this helps you. Welcome for any further assistance. Thanks for using  .com & giving me an opportunity to assistWishing you fine recovery from the same. Regards dear take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i am about 31 weeks pregnant, i felt the baby move around a couple of hours ago and after that i felt a sharp stomachpain that worsened with in 10 mins now. its been about 3 hours now and it has not gone away. for a while my stomach was so tight and in pain that i could change positions from where i was layng. are these contractions? shpuld i be worried? ### REPLY: Hallow Dear, The fetal movements seem to be normal; however if your uterus is becoming tight, it means your uterus is contracting strongly. Please note the frequency of such contractions and whether you can indent the uterus with your finger during contractions. Also note whether it is uterus which is becoming firm or whole of the abdomen is getting tight. If it is uterus which is causing painful contractions, you will have to report to the Obstetrician ASAP since this is indicating premature labor contractions. You will be given some injections to relax your uterus; however at the same time you will be given steroid injections to make the lungs of the baby mature so that they will function well after the premature delivery. Please do not waste time and rush to the emergency room ASAP. Till that restrict yourself to the bed. Hope this gives you message.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 healthy 46 yo male. I started will chills Tuesday evening. Then it wasn t too bad during the day Wed. But I had a very slight headache but way worse when I coughed or sneezed. No head cold though. Started to get aches in back during the day. Now I have all symptoms but also have numbness in my hands ### REPLY: Greetings from . Thanks for posting your query.  Your symptoms are suggestive of Sinus Infection. Most of the time Sinus infections will subside in few days.  But numbness in hands has to be evaluated as it is not seen in Sinus Infection. It could be either a problem in Nerves or due to Calcium deficiency. For that I would advise you to get a Serum Calcium Ionized test done and revert to me.  As of your Sinus Infection is concerned I recommend you to do Steam Inhalation 3-4 times a 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: Hi I am a fit 49 yr woman . I got a nagging pain in the very center of my lower back app 30 hours ago, but now it has moved completely to my lower right side and seems to be over a bigger area and it is quite sharp and intense. I also feel a little sickish. Do u think it is just mussel damage. Thank you. ### REPLY: Hello, Thanks for your query. You might be suffering from Acute mechanical back pain.1. Hard bed rest for 2-3 days2. Take some muscle relaxants like moral 8 mg, etc., along with painkillers like diclofenac 50 mg. You can continue using voting spray.3. Hot water fomentation to back 2-3 times a day4. Physiotherapy - Inferential therapy (IT) to your back will help you relieve the pain5. Avoid .  These activities can increase your back pain. Even after a week if your pain doesn't gets relieved, better to get yourself examined by an orthopaedician. He might ask you to take a X-ray of your back do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi im a 22 year old women who recently just got on dialysis its been three months since i been on here. and the question i have is do the dialysis tech post to tell you about your kidneys progress? because they don t tell me nothing i have high blood pressure and we still trying get that down when i first went to the dialysis center my blood pressure was good then it turn around and shot high my doctor gave me some more medicine but the top number still high. how can i get a high risk doctor or a better doctor that can help me? ### REPLY: Relying on dialysis technician for blood pressure control is not a good idea. Experienced technician might have idea but better to consult in charge nephrologist. If you are not happy with your doctor consult other nephrologist.  Common causes for uncontrolled BP are excessive salt and water intake. Try to take BP medicines after dialysis finished. Regrading survival on HD is on average is 8 years. If possible go for transplant with which survival will be more than 30 years. All the best. If you have any questions feel free to consult me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 m a 30 yr old healthy male, I always have a yearly check up with all blood work and test etc.(last dr. visit about 3 months ago) and within the last year or so I ve noticed a discomfort in terms of the tightness of my foreskin which becomes even more painful when erect. My foreskin used to be very elastic and almost loose a few years ago, but now it feels like a tourniquet even when flaccid. Any advice would be greatly appreciated. ### REPLY: Thanks for asking in  forum. In short: Any infection of glans and prepuce can cause this. Explanation: As you told you were able to retract your foreskin previously but is difficult now. Any infection of glans and prepuce (balanoposthitis) can cause adherence of skin to glans and make it difficult to retract.  So, you can apply point clobetasol locally and try retracting it daily once for few days. If it subsides It's ok otherwise consult your doctor for this or for surgery(circumcision).  It is better to consult your doctor before taking any medication or treatment as it is a prescription medication.  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: Four months ago, I had radical surgery to remove 8 tumors, One was a pheochromacytoma on my left adrenal bed, the first pheo was removed two years previous, there were two tumors on my spleen, so they removed my whole spleen, there was a tumor on the tail of my pancreas, so they removed about a third of my pancreas and then there were two that were on my liver, so they removed them too. Since this surgery, I have been rehospitalized because of vomiting and diarrhea and severe abdominal pain. I was told that I have necrosis of the fatty tissue surrounding my liver, stomach and pancreas. Ok, I have been home from the hospital this time about two weeks and for the last week, I have developed a very rattly cough, and the vomiting and diarrhea has returned. The Diarrhea is constant and I don t always make it to the bathroom in time. It is orange with allot of mucus and very liquidy. Can you help me? ### REPLY: Hello! Thank you for the query. Your symptoms seem to be caused by chronic pancreatitis. Due to partial pancreas removal sometimes the pancreas enzymes are secreted outside the pancreas (to the fatty tissue). This is the most probable reason of necrosis. Diarrhea with lots of mucus is characteristic for pancreas insufficiency. Due to lack of enzymes which normally digest fat, diarrhea appears. That is why you should try pancreas enzymes supplementation with every meal along with special diet (low carboy . If it won't help, you may also have partial bowels' obstruction due to adhesions. To diagnose it, enterocolitis (abdominal CT with oral contrast) should be done. Cough can be caused by a connection between the abdominal and thoracic cavity or by metastases in the lungs. Please consult your doctor and consider chest CT. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 4yo daughter has been complaining of a sore tummy it seems to be worse at night, she can get teary at bedtime and complains that it is worse when she is lying down.... we have seen a dr a couple of time in last 6mths but they have said cut out dairy and see, this doesnt seem to be the problem... dont know if it is an attention thing or what,...?? ### REPLY: Hi.... the most common cause of pain in the abdomen in the scenario which you have just now explained is mesenteric amenities or swelling up of the lymph nodes in the abdomen. This is a self limiting disorder and the only thing which you need to do is give Paracetamol for pain relief at the appropriate dose. But if there is a family history of kidney stones are all gallbladder stones I suggest you go ahead with an ultrasound abdomen to rule out the same. 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 Evening, My question regards Kidney failure. Is there anything I can do to reverse the condition? Keep kidneys working longer with new diet or medication... I was told to wait and see what condition is in a couple of months b/c not sure what s triggering problem. Want to be pro-active & try to prevent damage if possible. ### REPLY: HelloThanks for query. You are suspected to have Chronic Parenchymal Kidney Disease (CPKD).However, it needs to be confirmed. Please consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis3) Renal function tests 4) Estimation of urinary excretion of protein in 24 hours sample of urine (Proteinuria). Please note that CPKD is a progressive and irreversible kidney disease and one needs to take treatment and dietary instructions as per guidance of Nephrologist to keep it under control, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 looking at having a knee replacement and my doctor is strongly urging me to wait as long as possible before getting it done. Why? At this point I am unable to do normal activities such as walking without pain. I cannot even stand for any length of time without pain. He wants me to lose some weight to help out the knee joint but I can t do that unless I can walk further or hike. Is it time for me to get the surgery? ### REPLY: For severe knee arthritis the surgery is must. But here your doctor is also right if you are very much over weight then post surgery the rehabilitation may become difficult. Here I suggest to start physiotherapy first and take a dietician consultation to plan your diet. Now here with physiotherapy treatment it will help to relax your soft tissue and knee inflammation. At the same time do take suggestion on how to reduce weight without doing weight-bearing exercises? One way is by cycling. Also take a complete exercise program on knee strengthening exercise and follow it. This will help you to recover fast after surgery. Follow this for some time and reduce your weight and strengthen your knee. I am sure with this your knee pain will also reduce as well for doctor also it will be easy to take a call on surgery. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering from mouth ulcers from last two months. These ulcers start automatically any time day / night and become big (inside mouth any part, not on single place). I am not sure the reason about this, i taken some medicine suggested by my doctor, i visited to 5 doctor, ENT Specialist too, but nothing works, neither mouth paint, cleanothrush, Tees, etc.I am worried why these coming, even nowadays there is no problem of stool etc, i left smoking two months back and also not taking any other things (Alcohol, Tobacco etc). Please suggest what i need to do or to whom i need to consult, is it Oral CA, but i also found on internet Oral CA Ulcer come on side not every where. ### REPLY: Hello, Mouth sores that reoccur are often viral.  Stress can bring on an episode and repeat. Have your mouth sores been tested? Simple swab, biopsy, etc.? See a specialist such as an oral surgeon. Visit a dental school or a dentist with a greater interest in oral pathology.  You seem to still need more diagnosis. Systemic conditions are known to be associated with mouth sores such as HIV/Aids.  Testing is critical to determine normal ranges and overall health. Your genetic history and family illness history may offer clues. Are you compromised? There are autoimmune disorders. Students stressed can have Mono. Travel lately? Unusual exposure or diet change? Keep asking many questions. A history of Measles can later appear as Shingles. Mouth sores can be included in Shingles. Virus exposure history helps diagnosis. Having an association with another carrier of a virus such as Herpes can cause repeat reactions. Changing routines, limiting exposure and getting rid of items that might carry a virus are all good actions. You seem to have tried many actions. One other consideration is an allergic reaction to your dental care products and make sure you have ruled this out. Try changing toothpaste or rinses. Flavorings and other ingredients are known to cause reactions. Symptomatic treatment with pain medication, rinsing warm salt water, avoid irritants and time passing is the best advice for now. I try to provide questions to help you think and you have the option to visit other doctors for continuing clinical evaluation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ocasionly smoke meth, when i do i get really sore joints, specially if i hav an injury in knees or shoulder it feels worst, just would like to know the reason why it makes joints worst, iv tryed finding answer on google but cant find much, has it got to do with smoke in general, i like use it once every month for one night so it happens of that little ### REPLY: Hello, I have studied your case with diligence. If not relieved then possibility of polyarthritis needs to be considered .  There is reduced chest function in this disease. Stiffness in spine is increased do you have such stiffness in spine? When such patients come to our hospital I advise them blood test like RA factor, CCP, ESR, complete blood count, HLA B27Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My temp is 96.7 I hv never really checked my temp but I went to er yesterday i was told i hv acute gingavities. Ima diabetic My daughter in law died do to infection spread to her blood stream I was told to tk my temp observe but dont no exactly what I m lookn 4 I was gvn zitromax 250 mg Im allergic to benzocaine all caine Im 55 yr female 5 3 212 lbs asthmatic, hv hyperthroidism, panic attack, hbp,diabetic, unable to get tooth extracted by reg dentist do to also suffering agoraphobia , ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You have acute gingivitis, You also have hyperthyroidism, panic attack, HBP, diabetes, and agoraphobia. You are 55 yr, female, 5.3, 212 lb, You are unable to extract the tooth.  You are asked to observe the temperature to find if the infection is spreading to the blood, If that happens, and neglected there is chance of septicemia and risk increases due to diabetes.  I advise you to consult a physician for diagnosis and treatment. You may need to get culture and sensitivity of pus of the oral cavity done besides other routine tests for confirmation of type of infection and sensitive .  You should be under control of diabetes, B. P, and hyperthyroidism for prompt cure of gingivitis. Under the supervision of a dentist you can have a relief after the control of the conditions.  Wishing for a quick and comfortable relief of the disease.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my 7 year old daughter has what looks like a red mottled rash on her arms and legs ,its not a constant rash as it comes and goes, it looks worse when she gets up in the mornings it doesnt seem to bother her and she hasnt been ill and no high fever ,what could it be ? ### REPLY: Hi, As per your query you have symptoms of red mottled rash in arms which seems to be due to contact dermatitis. Need not worry. You should apply only petroleum jelly and avoid touching or pricking rashes. I would suggest you to keep your skin clean and .  If condition doesn't get well then consult dermatologist for proper examination. Doctor may order certain test like skin patch test, blood test, allergy test and take history to rule out the side effects of certain  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 LOOKING FOR A LIST OF: THE BEST ONCOLOGIST DOCTORS IN THE EUGENE, OREGON AREA?, AND;  I WOULD LIKE TO MAKE A LIST OF THE 5 (FIVE), OR 10 (TEN) TOP ONCOLOGIST, WHO ARE PRESENTLY WORKING AT THERIVER BEND HOSPITAL IN SPRINGFIELD, OREGON?  ALSO, WAT IS THE NAME OF A OCOLOGIST WHO WILL BE ABLE TO TREAT BOTH A BRAIN TUMOR AND A TUMOR IN THE LUNG OF THE SAME PERSON? PREFERABLY, A DOCTOR WHO BELIEVES IN OUR LORD?  send a FREE ADVICE for this one? ### REPLY: Hi, Thank you for posting your query. If a person has tumors in both brain and lung, it is most probably starting in one of those areas, and spreading to the other area. In this case, the most likely possibility is a primary cancer of the lung, which has spread to the brain, a process called as metastases. You should consult a medical oncologist for this, as the treatment involves using chemotherapy. In some cases, radiation therapy may be required, for which he may be referred to radiation oncologist. This advice is absolutely free. I hope it helps. 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: Hi i have a patch of rash on my left leg below the knee, it is verry itchy,i use a cream, it settles for a day or two then it flares up again and the itching is constant, sometimes on both legs and other spots other than where the rash is,what should i do? ### REPLY: Hello, Welcome to . I understand from your query that you are having itchy rashes on your knees. I would consider the possibilities of eczema and a fungal infection. You could get a confirmation done from your dermatologist/ GP. Eczema would clear by using a cream with 1% HY . For fungal infection, you could use a cream with 1 % clotrimazole twice a day for 2 weeks. Also take an antihistamine like 5 mg Levocetrizine at bedtime for 10 days. Hope this helps you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a hard painful lump under the skin of my left shoulder blade. It has appeared and gotten worse in the last two days. It oozes when I squeeze it every 5 hours or so. I have other lipomas ok my body but I don t know if this is one because I m able to drain it. It is very, very painful to lay on my back or even move my arm in certain ways. ### REPLY: Hi, If I were your treating Doctor for this case of such a lump, I would come up with only one and one possibility that is a sebaceous cyst! Nothing to worry about this and try not to get infected there! I suggest you to go for an FNAC test of the lump for confirmation and to relieve your concerns! Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My right side hurts, but not really low. Kinda in the middle. But it only hurts when I sit down, stand up, cough, any sudden movement like that. It feels like something s being jiggled out of place and the pain is a sharp twinge. It started as a normal stomachache then moved to my right side. ### REPLY: Hello, As the location of the pain isn't mentioned it is difficult to put a comment which is directed towards the pathology. As you mentioned the stomachache and pain moved, I suspect it to be the higher side of the lower back where you are getting pain. This can be due to organs compression over the muscular system. A diagnostic ultrasound scan will help to figure out the actual organ pathology and medicine will be prescribed based on that. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir, two times I had fainted and I had conselted a neurologist and he asked me to take EG & the clinical intetpretation :the record shows features suggestive of primery generalyzed epilepsy and the docter prescribed me epilex chrono 300 twice in a day. sir,what is my illness?is it curable and is there any side effects for this tablet? ### REPLY: Hello raze em.welcome to  History of fainting two times and EEG reports of primary generalized electrical discharge or generalized epilepsy suggest an epileptic disorder. Epilepsy is a disorder in which due to abnormal electrical discharge of brain, seizures or fits occurs and loss of consciousness is also seen in some people. Any single episode of epilepsy should not be ignored and treatment is to be started. It is treatable if medicines are taken properly and with advise of doctor. You have to take medicines for long at least 3 years, don't miss the doses of medicine. Epilex throne 300 is Valproate sodium, it is a good anti-epileptic .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello. i have a problem of hard to breath because of air in my stomach. I have to wonder is t cause by gastric? because lately i keep farting and quite every day releasing a gas in my body. Now, it s hard for me to breath because every time in going to take deep inhalation via my mouth its keep pressing my upper stomach and cause me a lot to yawning. ### REPLY: Thanks for your question on . In my opinion you are having HERD (Castro Esophageal Reflux Disease). It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Gaseous feeling and bloating are characteristics of HERD. Try to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and anxiety. 4. Start proton pump inhibitor. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in the bed. 7. Avoid habits like smoking and alcohol if you have. 8. Lose weight if you are obese. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doc. My mother has been diagnosed with right hemiparesis due to clot in the brain. It has been a month now. She is showing little improvement with physical therapy . My only question to you is that her affected right leg sometimes moves on its own, will turn in, or widen out. Is this normal ? Why does this happen ? ### REPLY: Hi, Thank you for posting your query. Brain stroke is a major cause of disability. However, your mother would show gradual improvement in her weakness over time, with good physiotherapy.  Spontaneous movements of the paralyzed side can occur due to what is called reflex movements. Sometimes, tone in the affected limb can increase, which can cause flexor spasms. Both these situations are normal and there is no need to worry. In rare cases, there could be focal fits in the affected side, where there would be jerky movements. This condition requires medications. Please talk to her neurologist, who would be able to sort this out. 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: Hey. I have had abdominal pains for over 2 years. Usually always locallized to a specific area and wierdly in 3 places. 1) just under my peft side rib cage. 2)under my right side rib cage. 3)in my lower left quadrant. Of recent ive encountered new symptoms. A jelly like feeling just behind my tongue. chest pains at onset moments. I cannot eat fried foods without feeling ill immediately after. More frequant bowel movements for 48 hours every time. Was given mebeverine 135mg for ibs but they did not work at all. was given lanzoprazole 30mg and after 13 months they finally stopped being helpful like they was. my gp asked me to do a colonoscopy but I refused because of how dreadful my abdominal pains can be and tje thought of a colonoscopy while awake to me, is extremely invasive. please help? My nights are restless from the pain that develops and worsens each day until I wake up the next morning. Then it repeats itself. I have lost an otherwise usually perfect sleeping pattern because of this. I need advise. I need a private doctor in the UK as the NHS service is terrible. is there any chance I could be leaded the right way, please? ### REPLY: HI. Undergone through your history and is quite interesting and typical brain-teaser. The spots/ area are fixed you say. It is wonderful that the Mebeverine did not help you nor Lansoprazole. See- if a particular medicine has not helped you for a clinical picture, we have to think in a different direction. What worried me is : see you have been suffering for such a long and yet not ready for Colonoscopy. This is a very simple procedure and if done by an expert - causes no pain at all. Another option is Virtual colonoscopy (done by a CT scan and no need to put any instrument in the colon other than air). You can opt for this. You have to have this as there may be strictures or some pathology that is causing pointed pain (fixed area)There can be a treatable cause which will be missed if you do not undergo further tests. A contrasts enhanced CT scan also can give some ideas. There has to be a cause that has to be found out so that further treatment can be guided to the cure. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pain in the left side of my stomach that goes to my lower back,it also radiates to my lower abdomen and my left leg sometimes. I also feel nausea,sudden weakness, im hardly eating what use to and im using the bathroom more than twice for num 2.I also feel an urge to do num 1, even if i just finished ### REPLY: Hi. Thanks for your query. From the careful evaluation of your history; I can think of an inflammatory process going on in the left lower abdomen. The causes can be an inflamed mass, lymph nodes or a mass or abscess of the deep muscles like sons or so. The best way to get a diagnosis is :-Blood tests to determine the hemoglobin, WBC count for infection, blood sugar to rule out diabetes.-Urine test: routine, microscopy, culture and sensitivity to determine whether there is an associated urinary tract infection as a basic cause or secondary to the problems I have enumerated.-Ultrasonography of the abdomen to screen for the cause and -CT scan to confirm the diagnosis. The treatment will start as antibiotics and anti-inflammatory medicines. Surgery will be needed if their as an indication for diagnosis and/ or therapeutic importance. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 . m 48 yrs old female and  since  last week i have been having this uncomfortable feeling, .llike  a  mild pain in my chest,  and back side of my chest. There are times I  feel it a little bit hard to swallow. Sometimes I am  iimagining of a possible heart problem but  I cant feel any  an extreme  or strong pain  at all....Ive been depressed also for the past few weeks because of a family problem. Just a while ago I felt my heartbeat jumped a bit faster when I thought of a possible health problem. Sometimes the pain is below my chest  so I am thinking also of a hurtburn. I burp normal and dont feel any sour taste buds. ### REPLY: Hi thanks for your question. Most probably you are having acid peptic disease(APD).APD can lead to gastritis that is inflammation of stomach causing heart burns and HERD that is gastroesophageal reflux disorder, in which acid content from stomach pass into esophagus (food pipe) through a loose gastroesophageal junction and cause reflux esophagitis, which gives rise to pain in chest and difficulty in swallowing. Anxiety (tension) is the commonest cause for APD. Anxiety can also cause Palpitation that is fast heart beat. The second cause of difficulty in swallowing could be pharyngitis that is inflammation of pharynx. I would suggest you to consult a physician who may be able to evaluate you for your symptoms, and you may also need consultations with psychiatrist. Hope this answers your question ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Left Shoulder injury of a right handed person. An ultrasound has verified that I have severe diffuse subscapularis tendinopathy, however no significant partial or full thickness tear is evident. There is minor infraspinatus calcific tendonitis. There is moderate supraspinatus tendinopathy & a very small bursal surface anterior supraspinatus tendon tear immediately adjacent to the biceps interval, 9 x 5 x 3mm & mild thickening of the subacromial bursa, 2.2mm on abduction. I had a bursal injection & taken Celebrix & switched to Proxen. I have obtained no pain relief & becoming very frustrated at the lack of use of the shoulder & the extreme pain caused by some (normal) movements. I ride a road bike (upright - not racing) to & from work daily & doing it gently, to minimise bumps to the shoulder. If the anti inflammatory drugs are not working, is it because there is no inflammation but there is another problem. Could it be pinched nerve & if so, how is it corrected. I m seeing an Osteo who is massaging the muscles around the area & avoiding the shoulder itself. I welcome any ideas on what the problem may be & the appropriate course of action. thanks Peter ### REPLY: Thanks for the information. Depending on time since injury initial immobilization in a broad arm sling for 2-3 weeks is necessary to heal minor tears, bursitis,afterwards active shoulder exercises are begun very gently intermittently along-with oral anti-inflammatory for the period of pain. Gradually sling is discarded for longer periods of time intermittently. The process may take as long as 6 weeks to heal completely. After six weeks normal shoulder activity and muscle building exercises are indicated to bring back strength of shoulder.Also, any diabetes should be ruled out with blood and urine tests think it should heal with this regime ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sex: Male,age-29 Every 2 months once im getting mild whizzing and cough.After taking tablet it will go after one day.Normally it will start during evening time.Last 15 years im facing this problem. What may be the reason? How to prevent this? Can refer some good doctor in Bangalore? ### REPLY: Tehre is no treatment for allergy in any system of medicine, but what are allergens, should be known first, then if so, where did they come from?from food?environment?through skin?or else generated in our body only? Usually parasites were, though to cause allergy when absolute eosinophil count rises in asthma, may be, medical has been able to prove food allergy, autoimmunity nowadays.I hope i av given good enable you to understand the hidden mystery in body&envirnoment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently contracted influenza and am still recovering from it. Thank God for Tamiflu . Also had the stomach virus (throw up, head spins). I cannot have a flu shot because of a serious allergy to the preservative used in most shots. Is there a way I can get this without a shot? If so, would it be of help for me to get it now? ### REPLY: Hello, The serious allergy to preservative in most shots is not clear, and you may be referring to the egg protein if you have egg allergy. The influenza vaccine should be taken in the autumn before winter sets in for it to be effective. People with egg allergy can have the influenza vaccine provided the lowest cut off limit of egg protein in the vaccine is used. As there are many manufacturers, the egg protein in the vaccines vary and now the companies have to quantify the amount of egg protein for egg allergy patients. A 2-step approach is used (if the egg allergy is severe or anaphylaxis, and you definitely need the flu shots because of asthma, COPD etc.).10% of the vaccine is given s/c, then the patient is observed for 30 minutes, and if fine, the rest of the 90% of the vaccine is administered. I hope this was useful. 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: For the past 10 days, my husband has  been experiencing occasional dizziness.  The first time, he thought he might pass out and his face got very red.    It goes away after a short time.  He went to his doctor who gave him an antibiotic (z-pak) and  meclizine.   The meclizine gives some relief, but he is still having the dizzy spells sometimes with nausea. ### REPLY: HI, thanks for using  Dizziness and vertigo are some of the more common problems. The main causes are: (1) benign paroxysmal positional vertigo-in this case the vertigo only lasts a few seconds and comes on with certain head positions. This is treated by the doctor performing a specific maneuver (Ella or Lemont).(2) deniers disease-lasts minutes to hours, may be associated with ringing in the ears and hearing loss. This is treated by a low salt diet and diuretic medication.(3)vestibular neuritis- in this case the episode lasts for days at a time. Nausea occurs, may be related to a previous viral illness. There is medication that is used for a short time that would help his symptoms do not resolve, he should re visit his doctor for another evaluation. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have had a sore swollen patch on top of my right foot since last Thursday. I am a fitness instructor and haven t injured it at all it just started hurting after a class last Thursday. I have been to A&E and had an X-ray which showed nothing! I rested iced and elevated for a few days and swelling went down a bit. As soon as I have worked out on it again it has swollen up but now my vein across the top of my foot is huge and the sore patch throbs. Any working out is agony? Any ideas please? Not sure where to go from here. I am currently taking mynocycline for acne but no other medication ### REPLY: Hello, As I feel there will be ligament sprain which cannot be seen in the X-ray and needs an MRI intervention.  You need to use ankle brace and do some balance board rehabilitation for the stability of the ankle joint and also muscles supporting the ankle. Since you are a fitness instructor you need to be very careful as it may not be good for you to get injured. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i m 23 yrs. old, 48kgs. and 5 4 in height. my medical exam today shows that i have PTB left upper lobe, i was really shocked cause i don t have any history of it, actually last dec. 2013 i undergone chest x-ray and the result is clear, no findings. i really want to know all about it, the clinic advised me to consult a pulmonologist because i m unfit to work. how did it happen? why? what should i do? please, i really need your advice, thank you so much ### REPLY: Howell come to ChatDoctorPulmonary tuberculosis is geographically distributed according to incidence of infection to populations, in some part of the world it is common, say pan endemic while in some part of the world it is almost vanished, it is depends on where are you from? Or if you have visited such area where the chances of TB infection is likely, but with the proper treatment this cures completely only multi .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ,My baby was born on 28th November 2013 . On 12th , he was crying and he had fever of 101 F . we did not know know and by the time we reached hospital his fever has increased to 102.5 F . On reaching hospital he was given Crocin and with imeediate sponging his fever subsided and he did not have fever after that . However Doctor asked us to admin him to check if he had infection . They did urine culture , blood culture etc . urine culture showed he had some UTI infection . Initially he was given ampicilling and zentalycin . After urine culture was positive he was given Amikacyn ( once per day) and zosyn( three times per day ) for one week via canula . Now he has been asked to give Clamp(amoxicillin) 1.5ml/day for next thirty days . After that doc has ashed us to DTPA for baby .However with these antibiotics baby is passing continuous stool in small quantities somtime more than one hour continuously . While passing stool baby cries continuously :( . I feel so bad to see baby crying . Baby feeds well and when not having stool baby does very fine. We aksed doctor and they gave enterogerminal oral suspension twice per day (half ample) .Can someone help us if he is fine and medications are ok . We feel crying after seeing all this .REgards A ### REPLY: Hi, thanks for writing to us. Usually after taking amoxicillin one generally get loose stools due to the medicine effect. However, your doctor has prescribed enterogermina to reduce loose stools so continue it. But store enetrogermina in fridge for maximum efficacy. The kid may be crying because continuous loose stools may have caused inflammation of the skin around the anus, so go back to your doctor and get some soothing ointments to be prescribed. 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: Yesterday I have checked my blood, everything is ok, except sgpt level which is high 134.  My blood pressure also a concern which is 140-90.  Doctor advised me to stop alcohol consumption and start diet.  He prescribed me another test which is the abdomen upper test.  Pls advise me what has to be done to reduce sgpt? ### REPLY: Thank you for posting query.advice:abstinence from "Alcohol and .  - use lemon juice (lemonade) once in a day-walk 30 to 40 minutes every day.- or swimming is alternative to walking-NO sports and NO jogging-"recheck liver enzymes after 6 to 8 weeks".kindly rule out viral hepatitis / alcoholic hepatitis by getting results of following tests:1. Viral serology (Bag, anti HBS, anti HCV, Anti HAD)2. Lipid profile3. Ultrasound abdomen if any further questions, feel free to ask. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health. Regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello...have been havin yellowish clumpy vaginal discharge and was prescribed FAS 3kit for the same. I have started the dose today but even before i took my first tablet developed a low grade fever. My question is...can intake paracetemolnalong with the FAS 3 kit or do i need to call my doctor ### REPLY: Hi, Yes, Paracetamol can be taken safely while on FAS-3 kit. FAS-3 kit contains a combination of an antibiotic, antifungal and an amoebic commonly prescribed to treat mixed vaginal infections. There is no documented harmful interactions between Paracetamol and FAS-S kit, Paracetamol may be taken along with it for the symptomatic relief of pain. 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 4 1/2 year old daughter complaints of stomach pain daily, for the past 2 months. She also experiencing more than usual burping and gas. She has been on Miralax for 4 years for her constipation. Her diet is very simple, breakfast usually just gluten free cereal without milk, lunch includes crackers with cheese and either an apple or peach, then for dinner its usually hotdog, or mac and cheese. She is only 28lbs at 38 inches. she has always been tiny with very little to eat, but just few months ago started experiencing the symptoms of stomach ache daily, with gas and burping more than the usual. ### REPLY: Welcome to the ChatDoctorI understand your concerns. Many a time, by omitting a variety of food items in children diet due to fear of aches and bowel disturbances, we make them prone to malnutrition. Every child needs a proper balanced diet at this age in spite of allergies and diseases. It's not advisable to go for any special diet such as gluten-free without prior diagnostic tests which includes TTG antibodies and duodenal biopsy if required. Gassy tummy and stomachache in your child may be due to peptic ulcer disease, enzyme deficiencies, food allergies, infections or worm infestation such as guardians. So, to treat it I would recommend you to visit a gastroenterologist for complete examination and evaluation. Also, give your child normal healthy meals which include carboy .  You may consult a dietitian for help. Many a times vitamin deficiencies can cause such symptoms. Hopefully this will be helpful. 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 dry skin a the top of my butt crack.  It gets dry and irritated and I dont know what to do to make it go away.  It comes and it goes but its frequent.  Ive recently been tested for every single STD known to man by my family physician and Im clean as a whistle.  Any suggestions?  Oh, and how do you go about keeping your butt crack clean?  I just use soap and a wash cloth and figure thats the way to go.  Its important to wash down frequently there, right? ### REPLY: Hi thanks for writing here. . It has the number of underlying causes such as bacterial and fungal infections, worm infestations, eczema , stress released, etc. You may also get constant itching if you have piles or fissures as secretions oozing out irritate the skin., Ruling out underlying cause is important in such cases, so it will be better you consult a dermatologist. In any cases it is always important to keep area clean, wash with water and a toilet soap instead of cloth use running water after toilet, also keep area  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 bug bites on my legs and feet where some have swelled to the point where you can see a large lump and they also have a large patch of redness around them. Also, 2 bites on the outer part of my left foot have a red rash extending onto the top of my foot and when touched, it feels like a bunch of little needles pricking me. What can I do to reduce swelling, itch and redness? ### REPLY: Welcome to  I am  and I will help you with your query I have gone through your question. You had a bug bite and now facing with painful swelling of lower limb. To reduce swelling you need to apply ice, keep it elevated and have rest. For pain, you can take ibuprofen, apply some steroid ointment. Keep the skin clean to prevent any secondary infections.  In case the swelling is not settling in 2-3 days, there are skin changes like blackish discoloration, blister formation or increase in severity of pain. You need to consult nearby medical facility ASAP. I hope my answer will help. Do rate it, if you like it. 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 FATHER AGE 60 YEAR. HE FEEL BACKSIDE PAIN AFTER 15 DAS , AFTER HE DID MRI , THIS REPORT METASTIC DEPOSITS IN D9,D10, D12, LI,L3,L4,AND L5 VERTEBRAE. MINIMAL POSTERIOR DISC BUIGE IS SEEN AT L4-5 AND L5-S1 LEVELS. MY QUESTION IS THIS CONDITION IS CANCER ? OR VERRYBED ? ### REPLY: Sorry to say that your father has metastatic disease to spine .your father must be having primary cancer somewhere in body and what are MRI showing only secondary seedlings ....sometimes cancer first seen in bones and then primary searched out ...please take your father to general practitioner.he will examine your father and run tests like PBA ...ultrasound abdomen ...chest X-ray etc ...when the primary will be found then treatment will be started ...let's hope for 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 showed none of the symptoms of having any blood clots but I have them in my lungs and it s not hereditary so how did i get ot doctor couldn t give me an answer I wasn t driving long distance wasn t on a plane and didn t have no surgery I also played basketball that same day and didn t have no shortness of breath worked out 3 days that same week can you give me an answer ### REPLY: Thanks for your question on . I can understand your concern. You are having Pulmonary embolism (PE). Other causes (other than you mentioned in the question) for PE are 1.  Cigarette smoking 2. Diabetes 3. Hypertension 4. Dyslipidemia (high cholesterol and triglycerides) 5. Protein C deficiency, protein S deficiency 6. Homocysteine (high levels of homocysteine) 7. Factor V deficiency. So better to consult pulmonologist and discuss these causes. You need different investigations for the diagnosis of these conditions. If you are smoker then this is the most likely cause. So quit smoking as soon as possible if you are smoker. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, thank you for your help. I got a bad cold and the mucus increased to such a level that its causing me almost to chock. I suffer of asthma for many years, close to 30. Now I am under this cold and desperate, I havent been able to lay down for about 2 weeks. Would cortizone help me clear while under this condition? ### REPLY: Hi, Welcome to , Asthma is an allergic disease occurs as a result of exposure to cold, dust,smoke, pollens or grass. Here, treatment is mainly symptomatic which includes inhalation steroids which actually causes bronchodilatation and relives from the symptoms of acute breathing difficulty. Also, corticosteroids tend to decrease the inflammation of bronchi and bronchioles with other . So, by this means cortisone will certainly go to help to relieve from asthmatic attacks and will also reduce mucus by causing bronchodilatation. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor. Im 19 yrs old, female, weight 75kgs, height 160cms. Ive been having staph infections regularly for the past two months wwhich started off as an eye stye, ive had 7 of them in two months time. I visited an opthamologist who prescribed antibiotics n opthalmic solutions, which helped me get back to normanl but lately ive had a swelling near my abdomen similar to the stye. It started as a pimple and later becam big like the size of a coin or much bigger filled with pus. The doctor again prescribed me anti inflammatory medicined to heal but of no use. Last night, blood clotted and started too ooze out blood and pus, but still it didnt come out fully, and the area where the infection is, has big red swellings. Is it normal for a staph infection or is it something else? ### REPLY: Hi, welcome to . Staphylococcal infection usually subside by medicines in initial stages but if pus has formed adequate incision and .  Also, please get the culture and sensitivity done for the same because a resistant species called MRSA is there which does not gets eradicated by conventional antibiotics and require ninefold and rifampicin for 15 days. So, just see if your pus culture grows MRSA. Hope you 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: hi im haveing abdominal pain in the epiggastric region ... it happens once every few months its a dull pain that gets worse and worse i can feel it in my mid back then after 10 min it gose away for like i said weeks or months ...  and its only in my uper abdominal ..  im M/26 ### REPLY: Hi. Thanks for your query. You are a young male of 26 years. The probable cause of intermittent sudden pain in the epigastric region, with pain in the mid-back can be due to the following reasons. -Gastric ulcer / cancer with involvement of the posterior (back part) of the stomach wall. -Pancreatitis, may be with stones in the pancreatic ducts. I would suggest in such a patient the following:Upper GI Endoscopy and CT can of the abdomen. MRCP if required. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 2 Back teeth pulled a week and a half ago. Over one, where it was pulled, the is something that is white and mussy. Half of it seems to be comming loose like it will come off.. There is nothing over the other. What is this? What do I do if it comes off? How long will it be there? My gums are still really sore, is this normal?   How long will my gums be this sore?  Thank you ### REPLY: Hi! Welcome to .  You have mentioned that there is something white and mussy over the area of extraction of one tooth. You need not worry about this as could be the debris accumulated as a result of poor oral hygiene. Take precautions so that your mouth is clean and use a warm salt water gargle daily after every meal.  With regard to the healing it usually takes 3 to 4 weeks to heal completely. But I think by 2 weeks at least you should be relieved of your soreness. From the two complaints you have given that is a white mussy area over the wound and soreness. It could be due to poor oral hygiene so take care and rinse.  If the pain persists you can visit your doctor.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my 19 month old has this red rash on the bottom of his feet for the last week.  Hes acting normal eating well, no fever and no sign of rash or sores anywhere else. I noticed today that his pinky toes are dry and hard almost like a calus. What could this be? ### REPLY: Hi... I feel by what you quote he should be having a - Hand Foot Mouth disease. This is one viral illness among all other anthems which can cause fever followed by rash over palms and soles. It is a self-limiting disorder and itching can be really worrisome. I suggest you use any over the counter antihistamine if you have one with you now. You can use HY .  This can even cause some peeling of skin in the next 4-6 weeks and do not worry about it. 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 believe my five month old may have a milk allergy (female, 13lbs, 28inches) She has severe reflux and the pediatrician recommended we change her formula to Enfamil AR...but still has reflux...she also has really bad eczema and I just noticed ridges in her nail beds.  She had some yogurt the other night and spit it up within five minutes.  Does this warrant a call to her peditrician or can we wait until next months check up?  She has been seen for a weight check and the doc is aware of these symptoms just never discussed possible allergy. ### REPLY: HI, thanks for using  You may want to take her to see her doctor sooner so that she would not have to continue the milk if she is reacting negatively to it. There are other milks that can be helpful with reflux or her doctor may recommend a normal milk with added cereal (to increase thickness) since she is 5 months old. It is important to remember when you start introducing her to other foods to introduce them one at a time. Each food should be used for 3 to 4 days before starting another. 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: The main symptom is moderate abdominal pain/discomfort for nearly 3 weeks.  It started off as minimal but has increased of late.  At times it feels near bottom of sternum but other times more into the abdomen.  Eating or not eating does not seem to make a difference.  Seems to be more noticeable when sitting at desk or in car.  Lately have slight feeling or tendency for shallow cough.  Other symptoms include pain emanating to lower back and dull in ache in right arm.  No heartburn, acid issues, or other digestive complaints.  Doctor did bloodwork and everything appears normal.  Endoscopy scheduled in 3 days.  Possible causes? ### REPLY: Hi. Thanks for your query. Possible causes : of the pain in abdomen in the upper area spreading to the other area, without any other symptoms of heartburn, acidity or digestive problems is suggestive that the pain may be of the origin of the lower lungs or pleura, or a local problem of the abdominal wall like epigastric hernia. I would advise you to get the X-ray of the chest, ultrasonography of the abdomen, Physical examination by a General Surgeon. This will help to get a proper diagnosis and proper 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: Hello Dr.Samuel N.Grief,i want to know what it means when you feel like there is like a knot feeling in your heart and it feels like its twisting its a bit painful and happens to me almost ever other day and on those days i have it continuously throughout that day? ### REPLY: Hi Welcome to , I understand your concern. Your symptoms could be related to underlying pathology in the heart. So I advise you to get an ECG,2D Echo, lipid profile immediately. Monitor blood pressure and heart rate immediately. . Exercise daily for 30 min. Avoid smoking and alcohol if any. Consult cardiologist for 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: Hi what is treatment of betching stoppage in the throat,severe stomach acidity and intestine n stomach pain? My mom has dis severe problem n medicines r not affecting good in sense. Plz guide. She cant eat anything except porridge.age 52years.all is bcoz of stress.plz reply.... ### REPLY: Hi. Thanks for your query and an elucidated history. Since you have already written about one of the most common causes of such problems as stress; the ultimate treatment will depend upon the combination of prescription based medicines:: Medicines for stress. Ranitidine /Antacid gel at 3 hourly intervalDomperodine 8 hourlySoft bland diet. To take her to the place as a change of atmosphere, away from home and such situations which cause or increase her stress. She will be fine. Once you follow the proper guidelines. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 rosalynn i am a 49 female.  ruptured my appendix 18months ago, after surgery i had an illius,  since have had cronic abdo pain, mix of toileting issues,  no appetie tireness, bone pain losted over 8kg in weight, had all sorts of test,  last being a test pill cam which broke up and cause my stomach to distend and my bowl to dilate, have maroon cloured stools,  all my gp will do is give ensure plus,  and told me its in head, its ruining my life cant work i am so week. ### REPLY: Hi Rosalynn. Thanks for your query. Read and understood your history. To recapitulate:Female 49 - ruptured appendix 18 months ago - Claus - develop[ed chronic pain in abdomen since then. Changed bowel habits, no appetite - bone pain - lost 8 kg - maroon colored stools - tests done including the camera pill - starts the distension - bowel get dilated - GP gives ensure - feels it is in your head - can not work - weakness - ruining the life. I would advise you the following:First get an Enterocolitis (barium studies)done under fluoroscopy control to see the actual movement of the intestines, any obstruction, fistula formation, kinking and so on. The best way in such situation is to go for diagnostic Laparoscopy which will help in diagnosis and therapeutic work as it will be easy to cut the bands or release adhesions or releasing the kink and so on. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: gd mng sir,  medical admin by profession,having dull pain in lower abdomen ,sometimes colicky in nature 3-4 motions /day,for last 15 days. not responding to antibiotics , USG -WNL, blood picture N , Colonoscopy done till hepatic flexure-WNL, further abandoned due to non tolerable pain. my doc is not ready to do procedure under GA due to fear of perforation. what should i do ? i am much worried . thanks ### REPLY: Hi It seems your worry is the main cause of your symptoms as all the investigations are WNL.what is the color and consistency of stools?3 motions per day is normal. But if the stools are watery or mucous is there then you need to worry. You can fry some(spoonful) poppy seeds and grind it to paste and can have with food which is helpful if loose motions are there and if mucous is there it s/o Amoebas and you have to have home cooked food and avoid outside food and have to take antibiotics. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 try to lay down to sleep i  my hearts starts paining and i stop breathing or cant take air inside i am smoker i did have heart palpations before but it seems this only when i laydown on bed i become normal once i get back up fast i also have lower back pain but i doubt its my kidneys or something seriouse since i checked recently ### REPLY: Thanks for your question on . I can understand your concern. Since you are a active smoker, we should definitely rule out heart and lung diseases for your symptoms. So consult cardiologist and get done ECG, 2d echo and stress test (trade mill test) to rule out heart diseases. Get done chest x-ray and PFT (Pulmonary Function Test) to rule out lung diseases. If all these are normal then no need to worry about major heart and lung diseases. Sometimes stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relaxed and calm. And please quit smoking as soon as possible because it is not a good habit. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr. Samuel My doctor has adviced some medicine for the pain at the back they had my X-Ray and finally given me the medicine which i have to start taking the medicine are following 1)Patova 40 2)Cholecalciferol soft gelatin 3) Egact 90 4) Methylcobalamin 5) Pregabalin Sr Request you suggest me if i can go ahead with the medicine and also,let me know if there is any side-effects of any of the above mdecine and there intensity Regards Shashank Shekhar ### REPLY: Dear patient Every medicine has side effects and so has the medication u have been prescribed.  But they are not significant. Of all of them pregabalin should be taken only at bedtime as it leads to giddiness and headache if taken in daytime. Cholecalciferol is vitamin d3 and methylcobalamin is vitamin B12 which has no side effects if taken in recommended dosage. Tab pat ova is antacid and tab exact is painkiller and has minimal side effects.  So do not worry and start taking your medication. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, My MRI on Lumbar Spine revealed the following findings can you guide and tell me the seriouness of this. At L5/S1 1.diffuse posterior disc bulge intending the thecal sac slightly touching the traversing nerve roots at lateral recess . 2.left foraminal disc bulge slightly touching the exiting root at left neural. Kindly advice regards Kaleem YYYY@YYYY ### REPLY: Dear Concerned, Thanks for writing to us. There is an evidence of radiculopathy. Therefore, the aim has to be to reduce the neural root compression. The diffuse posterior bulge and also left foraminal disc bulge also touching the nerve roots. There are two ways of treating this condition, (A)Conservative/medical line of management;- Complete Bed Rest for 08 weeks with Lumbosacral Belt for support/Opioid Analgesics/ muscle relaxants/ Physiotherapy-Traction and SWD.(B)Minimal Access Euro Endoscopic Discectomy by an experienced Spinal /Euro Surgeon in a Tertiary care Center.(C)Conventional Euro Surgery;-Laminectomy/Discectomy with Posterior Fusion and Rib Grafting. Kindly have an early consultation with a Euro Surgeon, depending upon the nearness to Hospital/Financial viability/Insurance-Mediclaim coverage etc. you may decide and go ahead with treatment protocol. Wishing you a speedy recovery, Best regards., .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi Dr Justin Glaister ,i would like to ask u , i have a problem i have smaaall black dots on my teeth and i removed them for a couple of times before but they keee on comming backhow can i remove them once and for all are they a kind of bacteria ? or maybe a deficiency in something and thats y they come bkthankxx... ### REPLY: Thanks for your query, I have gone through your query. The stains can be because of the habits like coffee, tea, or smoking. The other possible cause of black stains can be because of the chromogenic bacteria, or it can be secondary to the use of mouth wash also. Consult an oral physician and get it evaluated. If it is because of the coffee or tea or smoking, get the teeth cleaned and avoid the habits and rinse your mouth soon after eating anything. If it is chromogenic bacterial infection you need to consult an oral physician and take a course of antibiotics and get scaling done. I hope my answer will help you, take care. ### END