Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has presecribed me Montek 10 mg to me for curing mild ventilatory defect. And the course duration is 3 months. I want to know what are the side effects of this medicine and secondly will my mucous problem be solved completely after this period ### REPLY: Hello, This medicine is used for allergy purposes mainly. Doctors usually weigh the risk and benefit ratio and then prescribe the medicine.  If he recommended this to you complete your due course and revisit him after 3 months. Common side effects are Stomach upset, diarrhea, earache and upper respiratory tract infections.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am student and i have not had my period for the past 2months ..i don t want to be pregnant.i am just 18 and just started my degree. please i won t be able to afford expensive medications,if any natural ways are there please help ...if there isn t any way i ll commit suicide ### REPLY: Hello dear, I understand your concern. In my opinion a urine pregnancy test need to be done to confirm the pregnancy. Then depending on the age of pregnancy the termination is planned. Early pregnancy up to 6-7 Weeks can be terminated by medical methods. After 7 Weeks surgical methods are successful. Iam sorry but there are no natural methods available for pregnancy termination.First I request you to avoid stress and don't get depressed. Mistakes happen but we will need to correct them.Don't think of ending life for this small matter which is correctable and reversible. I suggest you to consult doctor without delay and follow their instructions. Nothing to worry. Do not try the abortion medicines on own as they are associated witChatDoctorplications like heavy bleeding, incomplete abortion etc. So relax and consult doctor. Hope this helps. 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: I was diagnosed with a viral infection and given doxycycline. I was hospitalized three weeks ago for almost a week with a high fever, swollen eyelid, and I had two focal seizures. Could the viral infection have something to do with the hospitalization? ### REPLY: Hello, Very high fever can sometimes result in seizures, though this is more common in child .  It is possible that the infection was associated with the symptoms mentioned, but you would need to clarify this with your doctor. Your doctors may want to do an EEG (looks at brain waves), to further investigate your seizures. Imaging may also be suggested, such as a CT scan. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 27 years old, 162 cm, 53kgs. My boyfriend was diagnosed with hepa b last july 2010. Im worried that I also have so I got tested. These were  the results: HBsAg w/ titer (ECLIA) o.365 c.o.v. 1.000 non-reactive, Anti HBs(ECLIA) >1000 IU/L c.o.v. 10.000 reactive. My GP said that I dont have the virus and I am immuned to future infections. Its been one year and four months since I got tested, and we do have intercourse(unprotected) once in a while. Now, Im thinking of getting the same tests coz I wanna know if the results are still the same. Do i need to do that? ### REPLY: Hi thanks for asking question. You have negative Bag means you have no infection. You have positive anti HBS that is protective antibody against antigen. This antibody prevent protection for very long duration. Mostly you might have taken full doses of vaccine. If taken then no need of worry. Still you can estimate your antics title by ELISA for further confirmation of immunity against HBS AG... Wish you good health... Rake 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 stage 4 prostate cancer since Oct 2009. My testosterone is at 12. Recently, my hemoglobin fell to 8.5 and I received 2 units of blood which raised my Hb to 9.8. After a long dicussion with my Oncologist/ Urologist I stopped Lupron, Testosternone went up to 275 - feeling great. My urologists wanted me to start Zytiga but I had to go back on Lupron and drop my testosterone below 50 - it feel to 12. Four weeks later my Hb fell to 7.6 and I just received 2 more units of blood. Is there a correlation between low low testosterone and falling Hb. Also I am 65 ### REPLY: There is no known correlation between falling He and low testosterone. The falling He is probably related to your prostate cancer since it may have spread to your bone marrow (the place where all blood components are made). This is even more likely since you stopped Lu pron in between. I would strongly advise you to not discontinue Lu pron and to keep your testosterone levels as low as possible. That alone can keep your cancer in control. I would have liked to know your PSA level which I hope are being done regularly. They are a direct indicator of the level of your cancer. If your PSA is normal on Lu pron, you don't need to take Zynga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When I do exercise, I feel like there is a lump in my throat and the muscles up the side of my neck get really tight. I feel a little swollen around my neck and jaw but a doctor said my lymph nodes are not inflamed. I have been working a lot recently and am stressed so I feel like it could be that. ### REPLY: Hi, Dear thanks for the query to  Virtual Clinic. I studied your query in all the details given by you. I reviewed all the data and in my opinion I would advise you to Please check up with your doctor for thyroid swelling if any which might be compressing on your wind pipe. If there is no thyroid gland lump, then forget this fear, as your lymph nodes are normal, indicating normal tonsils. Hope this would satisfy your query. Write excellent reviews if you like this reply and find it helpful to you, as your comments and reviews would improve my rating for the visitors of the  clinic. Welcome for any further query in this regard to Me. I would love you to help out of this intricate problem of lump. Wishing you fast recovery. Have a good day. . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After unprotected sex on last September 8, my wife taking regularly Mala-d (a oral Contraceptive pill) on that day and every time i also ejaculate outside. does it prevent pregnancy? and when are we sure about that? my wife is taking mala-d first time. ### REPLY: Hello!  If your S having regular menstrual cycle(28 days) the safe period is from 5th to 9th day and 20 to 28 to day of menstrual cycle. Unsafe period is 10th to 19th day of menstrual cycle. So your wife started male d irrespective of safe and unsafe period. If its unsafe period d .  Chances S DAR to implant in Fallopian tube. Anyhow wait and watch don't get panic. If any missed period do UPT consult with OG. if its safe period don't worry your wife ll get menses. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: iam suffering from lax les. what is the treatment for this? plz tell me. is it dangerous? ### REPLY: Hi Deena, I Would like to know few things here?, so that I can suggest you better, 1.) What is your height and weight?2.) Do you have Burning sensation in your chest?3.) Do you have Difficulty swallowing?4.) Do you have chest pain?5.) Since how long do you have this? Lax LES is caused by a weak Lower Esophageal Sphincter which cause the Gastric Acid to return to the esophagus and cause burning sensation. You should be consulting a Gastroenterologist so that he can examine you and do an Endoscopy, Esophageal motility test, Chest or upper abdominal X-ray to confirm it. Once confirmed, the treatment will depend upon the cause.  In addition to this, you have to bring in some lifestyle changes,1.) If you are overweight, lose weight.2.) If you smoke and . 3.) Avoid hot spicy foods.3.) Eat healthy nutritious balanced diet which should include fresh fruits and Green Leafy Vegetables.4.) Avoid tight-fitting clothes.5.) Eat smaller meals, six times a day.6.)  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: two weeks before my wife went to Chicago to attend a 3 month nclex coaching class and since reached there she feels a shortness of breath every now and then. she doubts probably it happens because of the severe cold weather out there. when she was in texas she never had such problems. so appreciate your help find a solution for this problem. there is OTC inhaler available to help breath well while having such difficulties? ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to either Bronchial asthma or Allergic tracheo-bronchitis. Examination of the throat using a laryngoscope and X-ray of the chest will be helpful in clinching the diagnosis. Management includes:1. Stalin/Aeroflot inhaler-provide symptomatic relief by causing bronchodilator (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs)So, it can be used during an acute attack.2. Antihistamine preparations like Allegra & Cough expectorant syrup for symptomatic relief.3. Montelukast preparations- used as a maintenance therapy to relieve symptoms of seasonal allergies.4. A course of antibiotics may be taken to prevent secondary bacterial attack.5. Maintain adequate HY . 6. Also make sure that she is well protected from cold, dust & other allergens. Wishing her a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just discovered 2 olive size hard lumps on the top of my right collar bone, they do not hurt and my rom is fine, any ideas because this is scaring me. It almost feels like the bone has separated but I have not fell or had any injury to that area, I am a 38 yr old female ### REPLY: Welcome to  .1. It can be a lesion arising from the bone, a lymph node, a lipoma.2. I can be confirmed by getting an ultrasound soft tissue/lump.3. Ultrasound will help in identifying where it is arising from and what it contains.4. So. Take appointment with your doctor and get examined.5. Follow the needful investigations. 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 was diagnosed with kidney cancer this past spring and had a right radial nephrectomy- patho revealed clear margins. YAY! After my surgery I have been paying attention more to drinking lots of water, protecting the kidneys, signs of kidney failure. My shoes have been feeling tight, in particular, my right shoe. I ve even had to move up a size in shoes. No signs of swelling are present. However, tonight I realized that my right foot is now about 1 inch longer than my left foot!! This has never been like that before. I am 31 years old and have worn the same size shoes with no problems since the 7th grade. What s happening? ### REPLY: Thanks for your question on . There are few causes for unilateral (right) sided edema of lower limb in renal cancer patients (post neurectomy).1. Spread of tumor in right lower limb lymphatic s and cause obstruction and edema.2. Renal failure can also cause lower limb edema.3. If you sleep on right side than dependent edema can also occur.4. Hypoprotienemia and anemia can also cause lower limb edema.5. Thrombosis in veins and arteries of right lower limb due to tumor spread can also be the cause. So consult your oncologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 wondering how long liver enzymes might be elevated..( if at all) after one night of drinking at a reunion. I am otherwise health 50 yr old female that does not consume any alcohol except on very special occasions... 1-2 times a year. I likely had 16 oz of alcohol over 14 hours....maybe more. WHat do you think? ### REPLY: Dear Madam, Welcome to . I read your query and I understand your concern. I think that there is not any problem with your liver enzymes if you .  You do not mention what kind of alcoholic beverage did you take, since different beverages contain different percentage of alcohol. I ensure you that your liver enzymes are just slightly elevated or not elevated at all for the amount of alcohol you took just in one special occasion. Liver Enzymes are normally elevated in binge  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is 12, going thru Puberty, started menses 2 years ago.  In past 2 months, she has noticed heart palpatations at rest every 3-4 days. lasting just a few  moments at a time,  Should I be concerned & get it checked out or is it normal going thru Puberty?. ### REPLY: Hello, during puberty as she would have her first menses, the hormones and the pain because of menses, will release more a .  She needs to be reassured and if required analgesic like locally warm compress on lower abdomen or tab mesenteric acid according to her weight if pain accompanies palpitation.  However, if it persists more than 3 - 6 months till things normalize, a consult with the doctor is suggested particularly I'd there is any breathlessness associated.  Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lesion on the top of my hand. At first I thought it was a bug bite . It blistered up and the blister popped. Now it is an open sore with tiny pus bumps around it. It itches and the area is red and swollen. I have been putting cortizone cream on it. This has been going on for almost 3 weeks. I was hiking in the woods when I first noticed it as a scratch . ### REPLY: Hello, Thanks for the query, You might have developed a mixed fungal and bacterial infection. Please get a KOH mount done, This can confirm the fungal etiology. Also get a gram stain for finding out the bacterial etiology. Treatment can be with oral antifungals as well as with topical antifungals along with antibiotics. Please meet a dermatologist for exact diagnosis. Let me know if you have any other doubt. You can ask a direct question to me on this forum, following the below link.https://urldefense.com/v3/__http://www.ChatDoctor .com/doctors/ . 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 had my gall bladder removed 6years ago i ve been hrting off and on and lately a whole lot pressure around the area and unable to eat much with out hrting and had egd they said my pancrease is abnormal now cold that be from pullin from scar tissue he put me on creon pills to take when i eat they dont help then they did a swallow test see how my stomach empties and he said its takin me 1hour and 1/2 to empty so now he want s to try another pill that dont work he hasnt checked for scar tissue do u think it is help me plz ### REPLY: Hello, jacobsnurse, You mention that your gallbladder surgery was six years ago. I am assuming that the surgery was done through a laparoscopic approach. It is rather unusual to have problems with adhesions after this long interval. Now you mention the pancreas being abnormal. If your pancreas enzymes like Serum Amylase, Lipase were elevated, you may have pancreatitis. This can be confirmed by CT-Scan. Creon is a pancreatic enzyme supplement that is given for people who have deficiency due to repeated attacks of pancreatitis. The condition known as Chronic pancreatic insufficiency. This would make you to have fatty stools (Frothy and floats on the water and foamy as well). Hope this answers your concerns, and you can talk to your own doctor. I wish you well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI , I  AM SOMNATH GON FROM JAMTARA,JHARKHANDI AM SUFURRING FROM AUTO EMMUNE HEMOLITIC ANIMIA SCINCE 2003.AT THAT TIME BLOOD TRANFUTION HAD BEEN DONE OF 5 UNIT OF RED BLOOD.DOCTER PRESCRIBED ME STAROIED MEDICHINE AND TOLD WHEN EVER YOUR HEMOGLOBING WILL FALL DOWN TAKE THIS MEDICHINE SYSTAMATICALLY.FROM 2003 TO TILL NOW 2 OR 3 TIMES IN EVERY YEAR  HEMOGLOBING WILL FALL DOWN  AND I HAVE TO TAKE THIS COURSE.MY QUESTION IS THAT IS ANY PARMANENT REMEDY OR ANY SUGGETION FOR THIS PROBLEM.MY AGE IS 31, OCASIONALY SMOKER,NON DRINKER,MY HEMOGLOBIN RATING avg between 8.5 to9.5 mg ### REPLY: Hi, You need to be treated and followup regularly under a doctor with experience in treating blood disorders. Autoimmune hemolytic anemia maybe secondary to more serious underlying disorders like connective tissue disorders or lymphomas, etc. Hence, detailed investigation and also appropriate course of medicines is required. Steroids-usage by self without proper guidance can be dangerous. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, I have a fatty liver and distended bladder - my doc asked me to reduce weight immediately. I have the urge to reduce but how do I? Iam urinating every 10 mins and how would i go for a walk? Will I have hair loss problems at this time>? please tell me I have excess of sweat forming etc. ### REPLY: Hi thanks for asking question. Noted you have fatty liver with distended bladder.... Stress is avoided as it is related to over urination... Still for distended bladder consultation to urologist is necessary... It might be sphincter or neurological problem or prostate problem.... To lose weight you have to burn calories. Calorie intake restricted. Fruits more. Junk food, fried food taken less... Regular 1 hour active exercise done. Use only good oil in diet like sunflower oil. Alcohol avoid . ... Hope your concern solved.... Take care..... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello last night I woke up with severe dizziness which lasted a half hour. I called an ambulance and they did bloodwork which was fine. They said it was vertigo, is it possible I had a stroke. My speech was fine. Never been so terrified! Need reassurance!! ### REPLY: I read your question carefully, and I understand your concern. Vertigo is a symptom, unfortunately it doesn't say much about what the doctors thought to have been the cause. It would also have been useful to know some more details about your age, weight, lifestyle, prior medical history, family medical history to evaluate the likelihood of it being a stroke. Whether I can exclude with certainty for it to have been a transient ischemic attack, a subtype of stroke....no I can not do it with certainty. But I can say that if you are a young person, without any other medical condition, a stroke is little likely to be the cause of your vertigo episode, other causes such as inner ear issues are much more probable. Wishing you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was playing basketball and landed on the side of my foot, ankle is fine but foot hurts a lot, it s not swelling but can t really put pressure on it, I can move all my toes and the whole foot but motion is limited and there is some pain. Is this just a really bad sprain or a fracture a little worried because I can t really put any weight on it. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have pain due to sprain in ankle. Well there can be many reasons for symptoms you mention in query like soft tissue injury, fracture, inflammation or hematoma. I would suggest you to apply ice pack for first 48 hours and then apply warm compresses, keep your foot in hot water tub with Epsom salt for 15 minutest, take proper rest and take ibuprofen or acetaminophen for pain. Consult orthopedic surgeon for proper examination. Doctor may order CT scan along with physical examination. Doctor may prescribe muscle relaxant, anti-inflammatory, vitamin supplement for quick healing and recommend physical therapy. Doctor may also give later in case of fracture. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I seem to have a "swollen" joint at the ankle end of the 5th metatarsal. It is very painful, especially when walking, but it aches even when resting. I am a very well controlled insulin dependant diabetic. Could this be tumour, an ulcerated joint or arthritis? I would respect your views as to what I should do. ### REPLY: Thanks for your question, first If It is localized swelling You should do MRI ANKLE to know its and plain x-ray to exclude bony lesion and to know the nature and extent of any soft tissue lesion.diagnostic Aspiration may be helpful if it is localized tense swelling If it's diffuse swelling, so I will advise you to receive anti-oedematous medication and also receive NSAID for the pain .also elevate your limb all the time ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am suffering from liver problem since last 3 years and my main problem now is my tummy which is day by day coming out and giving sabby look to my body. My doctor has prescribed me UDILIV 300, SUPERIA L and Gelusil syp with LACTIFIBER for 2 months. Can you please suggest me better medicine which will cure me early as I am having Fatty Liver. ### REPLY: HelloFatty liver is due to deposition of fat within liver cells. It is a reversible condition. Fatty liver may be due to many causes like obesity, sedentary life, hepatitis,altered lipid profile, metabolic disorder etc. Thyroid hormone level should be estimated in your case. You may need few more investigations like routine hologram, liver function test, lipid profile, thyroid profile, urine RE/ME. Try to reduce your weight if BMI is high. Avoid alcohol if you take it. Go for brisk walk regularly and take the lot of fibers in your food. Avoid saturated fat and fried food. You have been prescribed right medicines, you should take it continuously. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear dr my father has bypass surgery last year at baroda heart institute at baroda. but he has no relief at all . he has experience  pain in heart which is gradually increasing . now dr suggest him angiography . my queries is that if in angiography there is a blockage and drs said that go through angioplasty then what is the guaranty that he got relief ### REPLY: Angioplasty results after bypass surgery varies from patient to patient. But in general several studies revealed that there is 65-80% success rate of angioplasty in post-CABG (Bypass) patients. When these patients were followed over a period of next 30 months then about 70% of them were pain-free and had an improvement in angina. However, around 27% required repeat angioplasty with about 80% success rate while 15-20% were complicated by re-infarction and only 4-6% with cardiac death. In my opinion proceed with angiography to help determine the extent of blockage and to decide about the options available. Make sure the medications' compliance post-procedure as this is crucial. Stay blessed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: when running my hand down the front of my throat, it feels like a lump at the base, as if my esophageous is pushed out almost...is this normal?  I am a 41yr old white woman, 160 pound, 57,no significant health problems.  No problems swallowing, no pain, except for a muscle pulled feel around my shoulder blades on occassion. ### REPLY: Hi there! When you look at yourself in the mirror can you see the lump also? Or do you just feel it as run your hand down in the front of your throat.  Then again if you keep your hand on the lump and perform the act of swallowing does the lump move during the swallow ? If it does, it is likely to be a swelling from the thyroid gland situated in the neck. An ultrasound examination of the neck should sort it out. All the best! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband is 77 years old. about ten years ago he litterly blew out the right side of his heart and never knew this until he had stint put in about 8 years ago.  than the following year he had a ballon added.  he has done well except that I am noticing that his left foot more than the right is quite swollen ### REPLY: Hi Sir, Welcome to , I understand your query and concern. Your symptoms are suggestive of Congestive cardiac failure. I advise you to get a 2 dimensional echo of your heart to confirm the diagnosis. . Report to an emergency if you have symptoms like chest pain or shortness of breath or dizziness. Monitor blood pressure and heart rate regularly. Consult your 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. My daughter has been out of school since Monday because she has constintally thrown up and had diarrhea. But today she is complaining about her throat hurting when she swallows and her throat is red for what I see. Can you help us with these problems so she can get better to go to school?!?  Thank you! ### REPLY: Thanks for putting up your query at . I understand the cause of your concern and have gone through the details carefully. Your daughter seems to have acute gastroenteritis or food poisoning. It generally occurs when some preformed bacterial toxin enters the body through some food item. It generally resolves on its own in a few days and the cause does not need to be treated. But the loss of salt and water from body may cause deny .  Give her frequent sips of ORS. You may give ODEM MD (ondansetron mouth dissolving) tablet 15-30 mins before taking food and that will reduce the throwing up. Giving curd/yogurt could be helpful. Gurgle with lukewarm water will give her throat some relief. It is probably caused due to erosion caused due the gastric acids during her throwing up. She may skip her school for a day or two till she is stable enough to attend her classes. I hope that helps. Feel free to revert with further queries if any. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a 58 year old female. Back in Aug,2011 I started having problems with imbalance, vigro. I have no dizzness. I have had two cat scans, MRI, spinal tap and multiple blood donations all with a negative result. My problem is I think I have a short circuit with the nerves in my back not telling my legs what to do. Thus, I stand still and move back and forth but cannot make my legs move. My husband has to push me to get started. Any idea as I am really becoming distrubed. Thanks ### REPLY: Hello, Your symptoms could be related to possible Parkinson Syn .  Anyway, vertigo is not typical of this disorder. For this reason, I would recommend consulting with a neurologist after 6 months for a physical exam in order to investigate for possible progression of your symptoms. I would also recommend checking vitamin B12 plasma levels for possible deficiency and vitamin E plasma levels. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last Wednesday I fell down with my back against a wall. My lower back has been a little sore since then but 2 days ago I had extreme pain all of a suddene. It hurt so bad that I cried. The same thing happened tonight. I take ibuprofen and tramadol for pain. I also take Valium. The pain tonight was severe. It lasted about a half hour. I am using a hot pack on it right now. The pain has subsided. ### REPLY: Trauma to lower back may cause pain due to local muscle injury and spasm or vertebral fracture depending upon the impact force and mode.  Absence of radiating pain to lower limbs, weakness in lower limb and non involvement of urinary symptoms are pointing towards inexactness of spinal cord. My advice will be to get a X-ray of lumbosacral region to rule out any fracture.  Diclofenac with muscle relaxant and rest may be helpful. Apply local ointment also. Wishing early recover and 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 baby has a hard lump at the back of her ear and it seems to be getting bigger iv been to hospital with her and they said its not a lingth nod and they will do an ultra sound scan it is hard and moves and it dosent seem to be bothering her but its worrieing me can you tell me what it might be to reasure me ### REPLY: Most common swelling is a lymph node which resolves gradually if there is no local infection. But as you've mentioned it's not a lymph node and that its hard and painless, its more likely a cyst, which is fluid filled balloon like sac. Other possibilities are fat or soft tissue. This can be differentiated with an ultrasound scan. Either of these is benign condition and needs conservative measures. Scan is to confirm the nature of the swelling and hence to manage appropriately ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dull pain in my lower back, somewhat of a upset stomach and generally don t feel well. I don t have a fever. I have been to the doctor and he said it was IBS. I am taking Metimucil twice a day along with chlordiazepoxide/clidinium caps 3 times a day. It does not hurt when I urinate nor do I urinate frequently. Could this be a sign of a kidney infection? ### REPLY: Hellman in lower abdomen and back may be due to many causes like genitourinary or pelvic problem, intestinal,musculoskeletal causes etc. You may need clinical correlation and further investigations. Investigation includes routine hologram, liver and renal function test, urine RE/ME, ultrasound of abdomen. Ultrasound of abdomen can exclude many conditions. CT scan of abdomen may be advised after evaluation. Proper treatment depend upon findings. Empirically you are taking right medicines. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a male age 23. I have been diagnosed with hypertension. The reading I was diagnosed with was around 160/80 when I was 21 years old. I was run through a series of tests which found nothing abnormal with me aside from elevated triglycerides which I was able to control after I took up exercise and reduced my weight by 16 lbs. I was put on Inderal 40mg b.i.d. This medication brought my bp down to 130/80 with a pulse of 72. However I suffered many side effects. Being a student I found it difficult to concentrate or sleep well, I also had nightmares,insomnia and memory loss. So I was switched to Atenolol 50mg which also caused me insomnia and memory loss but was not as bad as Inderal. Over a period of a few months of weight loss and exercise I came to 25mg of Atenolol at which time my Bp was 132/76. But due to the side effects I was switched to Diltiazem CD 120mg. This medication caused no side effects at first but over a period of a few weeks I developed negative moods, a severe headache similar to a migraine 24 by 7, rashes on my forehead, weakness and lethargy, flushing and feeling warm and a warm sensation in the chest area. So I switched back to 12.5mg atenolol. I have tried four drugs till now (propranolol, atenolol, amlodipine and diltiazem), all of which caused adverse effects in me. My doctor insists that these drugs are correct for me and I should make a choice between diltiazem or atenolol. So I stuck with Atenolol 12.5mg which still causes me embarrassing memory lapses and has reduced my academic performance greatly. My question is that since my diastolic bp has always remained normal and only my systolic Bp is elevated, does this mean I have the arteries of an old person? Is it absolutely necessary for a person my age to take medications and if so are there no alternatives with lesser side effects? ### REPLY: Since you are young, your BP can be well under control with diet weight loss and exercises. But since your doctor has started you on BP medications there must be some indications. You can try telmisartan 20 to 40 mg depending on your blood pressure. But still I would encourage you to concentrate on diet, lifestyle and weight loss. Also have u done a renal artery Doppler or CT abdomen for a . . Or get urine tested for VMA. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 6 weeks and 2 days pregnant. Last night i went to the er with bleeding and was told the baby looked good but the heartbeat was only 82 which they said was not good. I have been really sick, coughing A LOT hard and feeling terrible. Can the coughing cause the bleeding and the lower heart rate? ### REPLY: Hello, I have gone through the query and understood your concern. Cough can cause stress and pressure on the uterus and this exertion can lead to a possible hemophobia separation which may present as external bleeding. If this happens, and if this does not stop, the pregnancy is at risk. The lowered fetal heart rate is suggestive of a possible threat to the fetal blood supply. In the current scenario, you should take absolute bed rest, avoid all stressful activity, get immediate relief from the cough through medication or natural remedies and follow up regularly to assess the pregnancy status. Serial sonograms of the pelvis and serial beta-ChatDoctor titles help a lot. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: SIr, I m facing lever enlarge problem 16.5 according to altrasound report. And my doctor suggest me Ursodeoxycholic Acid (Ursodeoxycholic acid 300mg tablets) medicine. I m facing headache problem and negitive thinking comes in my mind. Please suggest me the Precautions. ### REPLY: HelloEnlarged liver may be due to many causes like hepatitis, obesity,alcoholism, metabolic disorder, tumour etc. I suspect you had elevated liver enzymes like SGPT, SGOT etc. and this may be the reason for prescribing ursodeoxycholic acid. Ursodeoxycholic acid tablet helps in regeneration of liver cells. Enlarged liver may reverse with treatment of underlying disease. Your current problem of headache is most likely not related to enlarged liver or ursodeoxycholic acid tablet. Headache is commonly due to tension, and you may take NSAIDs like paracetamol. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor from so many days I have pain in my finger bones actually I have a bad habit to press my fingers like (patakha nikalna) from my fingers n now by this habit my bones are damaged so please. Give me some medicine for this pain I had so much pain in my bones of fingers ### REPLY: Hello There is possibility of injury to ligament of metacarpal or flange joint. There can arthritis of hand joint in future de to such habit. Use ice packs to reduce swelling, inflammation and pain. Physiotherapy with ultrasound and Tens will help you, For early healing you can take Tab Colin [it C] and antioxidant with anti-inflammatory [Tab enzymic plus]. If there is no relief them you may need to do MRI. When such patients come to our hospital I advise them blood test like RA factor, CCP, ESR, complete blood count, HLA B27 to rule out polyarthritis. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother is having vertigo issue since last 20 days.. When she gets up from bed or turns towards the right side, her head spins and there is heaviness n headache in the right side of the head. Her eye no. has been changed and doctor said there is onset of cataract . She is on Vertin 16, twice a day. She has undergone the positional vertigo exercise too, but no relief from it. Please suggest any treatment. Thanks ### REPLY: Thanks for your query, Change your position slowly, especially when going from a lying or sitting position to a standing position. When you get out of bed, sit on the side of the bed for a few seconds to gain your orientation and allow your circulatory system to adjust. When walking, focus on distant objects. Do not look down at your feet. Avoid walking in dark areas or on unstable ground. Falls at home occur when the floor covering changes from carpet to tile or linoleum. When riding in a car, try to sit in the front seat. Look out the window at a fixed point. When going around curves, look at a distant object beyond the curve. Make certain eyeglass and hearing aid prescriptions are current. Use a cane, walking stick, or walker for support and to give additional pressure and touch (tactile) orientation. Avoid activities that move the head up and down repetitively. Try to avoid keeping the head tilted back for long periods of time, for example painting or dusting above your head. Be cautious when using medications that may cause balance problems as a side effect. If a person is having an episode of vertigo, he/she should not .  People who are subject to sudden instances of vertigo should also avoid climbing ladders or participate in other situations that may be dangerous to themselves or others (for example, hiking alone or taking care of child ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 atypical hyperplasia...it said within 0.2 cm of the lateral margin....is this alot of tissue?  Secondly my post op MRI one year later said it shows mild nonenhancing distortion posterior of my nipple.  I noticed it is very flat now.  What does these two things mean ### REPLY: Hello! I have read your concerns and will try to answer your questions thoroughly.  I assume you underwent lumpectomy for your tumor.  Atypical hyperplasia is not considered as cancer, so a 0.2 cm margin will suffice.  If it is carcinoma in-situ or invasive carcinoma, the margins should be clear in all dimensions.  In my practice, generally at least 0.5 cm to 1 cm margin is very good.  Your MRI result of a mild nonenhancing distortion posterior of the nipple is from the post-operative site, since a lumpectomy generally gets a chunk of tissues from the breast, hence, distortion of the tissues in that area are normally seen. I hope I alleviated your concerns.  Have a nice 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: my age is 41. i have high blood pressure and i am taking nebicard 2.5 daily. i started medicine one year ago.earlier without medicine my bp was reaching 150-100 once or twice  a month, i mean occasionally [not always] . after four month of starting , doctor stopped medicine. but due to gastric trouble and stress he started it again last month. i had chest pain sometimes since two month . all reports are normal. i want to get rid of medicine . help me.. ### REPLY: Hi, Welcome to  forum.  You got hypertension, using nebicard2.5. You are getting gastric trouble, stress, when stopped the .  Furthermore, you are getting chest pain while using the medicine as well.  It appears that the problem is due to the gastric irritation, and you should use medicine for that. So I advise you to consult a gastroenterologist.  To stop the antihypertensive may not be advisable.  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 I am a 31 year old female and have had chronic back pain now for 2 years, I had a Mri scan in november which gave the following results - consis L1 normal, dehydration of the two lower lumber discs is noted. disk protrusion L4/5 and L5/s1. central disc bulging noted L4/5 indenting the theca. loss of lordosis. Have had a course of physiotherapy and accupunture, gp thinks either spinal injections or surgery best way forward, though none of these findings have really been explained to myself ### REPLY: Surgical removal of disc (discectomy) and fusion are done if no response after epidural injections, physical therapy, radiation of pain limiting movement, bending and interfering with normal activity, not responding to medications. Subjectively, you may summarize your syptomsand its relation t following-- 1. Whether you can bend easily.2.does coughing/sneezing accelerates pain locally. 3. can you lift objects from ground?. 4.is the pain continuously there or comes on movement? 5. is your daily work, occupation hampered? If all these are positive then surgery is a solution. Some spine surgeons do laparoscopic removal of disc through a minute hole, while others do open surgery especially if fusion of adjacent vertebrae is necessary in view of foraminal pathology, nerve compression and rotatory spine movement bring on radiation of pain to lower limbs or to severity of back pain. Epidurals are tried for remission of pains if surgery is not yet possible/or indicated and normal daily activity is not . I hope this solves 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: i continously mastrubate past 3-4 years. now i were engaged and my marriage is on febraury 2016.so, i stopped mastrubate for the past one month for my future. now when i get tempered, i control myself. but ive  pain in my testis sometime in left and sometime in right. is there any problem in my sexual organs. give a way to stop the pain. and i want to recover my power and energy. is there any medicine to recover my energy. because i want to get a strong relationship with my gf for more years without any problem ### REPLY: Hi and thank you so much for trusting us with your health query. I am so sorry to hear about this testicular pain. There are a number of different reasons why you may have this pain which include infections, varicocele, mechanical pain, etc. However, the information you have provided is not enough to pinpoint the cause. I will suggest that you get examined to pick up more clues to direct investigations on the exact cause of this. Depending on findings, you shall be provided with measures and treatment options to help overcome this. I hope you find this helpful. Thank you so much for using our services, and please feel free to for more information or clarifications if need be. I wish you the best of health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am 31 Male. 92.3 Kgs. Today, I have been diagnosed with Grade 1Fatty liver. also, I am suffering from gastrointestinal gases. Over a span of 4 years, i have gaoned 25 kgs of weight. I am a teetolar and a veggie. T3, T4 TSH are normal. please suggest, what to do ### REPLY: Hi thanks for contacting . You might have high cholesterol level. So do your lipid profile. Let me know you fatty liver nowadays becoming common problem, and it can be reversible condition. Here are few suggestions for you. You have to lose weight. Regular 1 hour exercise done like swimming, running etc. Cutt of oil in diet. Use very less oil for cooking. Good oil like sunflower oil can be used. Fruits taken more. Green leafy veg useful. Avoid junk food and trans fat like butter, cheese, pastry, meat etc. Refined food avoided. Chamomile in tea can be taken. . If still constipation present laxative can take. With above measure you will benefit in fatty liver and constipation. If cholesterol level not controlled by above measures we will start  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 18, on birth control that s making me very nauseas. I ve also been sick lately but for the past couple of days I ve had a hard time breathing , pain under my lungs, blocked sinus and massive headaches with light headed feelings. Is it just an ear infection or should I be more concerned? The cramping feeling below my ribs is starting to scare me. ### REPLY: Hello, Thanks for the query to . Forum. Birth control usually develops nausea (in few patients vomiting just due to hormones and this is a natural phenomenon, not to worry). For this side effect you can take pantoprazole +risperidone tablet as when requires. Now main concern is difficulty in breathing, cramps, below ribs pain, blocked sinus. These symptoms may be due to allergic bronchitis with super added infection, in my opinion ear infection don't causes such type of symptoms. Consult a physician and get his opinion. Need not worry this is a common complaint just due to allergy. Hope I have answered your question. If further any question I will help. Good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell in the shower and hit my hip on the side of the tub. I already have a torn disc in that hip as well. It feels like my hip is on fire, and there was a bruise and swelling within minutes. This happened approximately 30 mins ago... should I see a doctor? ### REPLY: Hi, thanks for writing to .please take following treatment:1. Take rest2. Do minimal walking3.apply ice packs 5-6 times a day, each time for 15 minutes.4. Take anti-inflammatory like ibuprofen or naproxen. However if things are not improving in 2-3 days you might require a X-ray and further examination by an orthopedic surgeon. Hope I have answered your query. If satisfied, please rate my reply thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello i m 25 year old have pain in lower abdomen since 1 week before  doctor take urine test and blood test also dont know y this is urine resultquantity 60 ml colour yellow ph acidic sp.gravity QNS albumin nil sugar nil red cells 01-02 pus cells 04-06 epith cells positive amorphous urates positive so i want to know about problem please give detail about this test ### REPLY: Hello, Thanks for the query to . Forum. You are a 25 years old MALE or FEMALE ? This is important as few diseases in male & female are different as far as concerned about lower abdomen. Your urine report is normal and this cant be the reason of lower abdominal pain. Only amorphous rates are positive means may be stone or calculus in urinary tract system, so this may be the reason of pain. In my opinion write down complete history of illness as where is pain, left side, right side, below pubic area, burning micturition. Good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a month n a half old baby.. She is not latching on to my breast, initially I had a flat nipples so as per doc s advise I fed her with a help of nipple shield. Now when I try to feed her directly she s not accepting.. When I try it rigorously she cries a lot.. I feel so helpless n frustrated using this shield.. ### REPLY: Hi, Now she is used to of having feeding with nipple shield she may not like to feed with nipple directly as due to having flat nipple she feels inconvenience. Do not leave trying for nipple feeding. While feeding keep your two fingers around nipple and with fingers help put nipple in her mouth. Observe that her nostrils are not blocked due to breasts. Initially she will be hesitated, but gradually she will be used to it. Try to make nipple erupted with help of breast suction pump. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes i fell 7 days ago and landed on both knees really hard i weigh 240 lbs they were sore for a few days and turned black and purple last night my ankles started sewlling i elevated them and the swelling whent down some but not all the way had to work and the swelling started again i dont have insurance to go to a doctor is there anything i can do at home to get rid of this ### REPLY: Hello, Thanks for posting your query. Rest and protect an injured or sore area. When resting, place a small pillow under your knee. Ice will reduce pain and swelling. Apply ice or cold pack for 10 to 20 minutes,3 or more times a day. Compression, or wrapping the injured or sore area with an elastic bandage will help decrease swelling. Elevate the injured or sore area on pillows while applying ice and anytime you are sitting or lying down. There are many vitamins and natural supplements you can take to help rebuild cartilage and increase blood flow. Wishing you good health. Regards.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am on birth control and on may 31 i had unprotected sex. I usually take my pill around 12 and did take it that day. I had intercourse after the pill, but the next few days i did not take my pill. I just had intercourse only that day though. On june 4th i got my period. My question is, Is there still a possibility i could be pregnant? ### REPLY: HI, Thanks for the query. I understand your concern. Oral contraceptive pills are to be taken regularly at same time of a day, without missing a single pill.  You took the pill later than usual on the day of unprotected sex. That would have helped. Provided you had taken pills on following days regularly. You have missed the pills for few days following the sex.  This has increased chances of conception because- - Gap in pills induces ovulation - Sperms can survive in female genital tract for 3 days.  * So you should wait for your normal periods & go for home pregnancy test after 8 days delay in menses In case the test is +ve, & you are not prepared for a child, you should think of MTP.  Thanks.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am suffering from severe skin allergy ( rashes , hives for the past 6 months and have been diagonised Urticaire. I have taken Food Intolence test also which showed so many food items allergy. In spite of not taking these foods, still my allergy persists. I have been advised wysolone 10 mg , atarax 25mg. I am fed up. If i take wysolone 10 mg, my rashes reduced. Is there any other medicine for this? All other tests were normal only. ### REPLY: HI, thanks for using  Normally when the source of the allergy is eliminated, the allergy resolves. It is unusual for allergies to persist unless there is another source of the allergic response. You may want to consider repeating your allergy profile to determine if there is another allergen provoking this response. You may also want to visit an allergist, he or she may be better able to help you. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My gums are blood red but only the part on the top you have to strech the lips up to see there is deffinent straight line seperation the coulors also one tooth "roots" is hurting a biti think iv just popped a blood vessel and the blood is traveling around creating the coulor but im no doctor so ### REPLY: Hello! Welcome to . You seem to be having a poor gingival health. I do not understand what you mean by a tooth root hurts. If you mean it pains when you bite, then there must be an infection in the tooth also. I suggest you to see your dentist for a professional scaling session. Also rule out if any infection in the tooth you mentioned. Bad oral health is the most common cause of gingival infections. Maintain a good oral hygiene. See your dentist once every 6 months. Use a floss daily and mouth wash thrice a week. 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,I am a am of about 50 yrs. I have had 2 children before now. 5 yrs after my last child and after trying for almost 2 yrs to get my wife pregnant, i went for semen analysis and it was discovered that i have very low sperm count of 2million/ml. What couls be the cause and what is the type of treatment that will be most effective? ### REPLY: Hi ... Your sperm count is very low suffering from severe azospermia ... The cause has to be ruled out .... If you are taking antihypertensive, antidepressants, cytotoxic . . Excess radiation exposure can because . Smoking and alcohol can lead testicular dysfunction .... Rule out diabetic by random blood sugar. Rule out thyroid problem by serum TSH, t3 and t4 estimation... Excess stress, cocaine abuse, steroid can be causative .... Your testis also has to be examined for varicocele. Get your fructose test done that able to distinguish obstructive or less production from testis .... Obstructive cause include chlamydia or gonorrhea infection that lead obstruction by fibrosis.... If FSH, LH and Testosterone all low cause can be at hypothalamus and pituitary . For which CT scan can be done.... If all three normal obstructive cause there... Prostate examination also done .... You can give hey fort tablet and causative treatment done. ... With keeping these in mind consult surgeon or psychiatrist for that .... Take care .... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband s took his blood pressure 190/ 80, heart rate was down to 69. Last time was 180/80. Should we go to hospital? He had a heart attack last may and had two stints put in. Cardiologist was able to clean out veins. Healthy heart. ?????? Should I be concerned? ### REPLY: Hello! I would explain that his blood pressure values are really high and this could cause harm to his heart, considering the fact that he has cardiac stents. For this reason, I would recommend going to the ER for a physical exam, a resting ECG and cardiac enzymes and some blood lab tests (fasting glucose, blood electrolytes, kidney and liver function tests, etc.). Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am sufferring from low sperm count and we had 6 IUI and 1 IVF using my sperm which got unsuccessful. Now we are trying from donor sperm and my wife had gone 3 IUI but all are ended with negative results. As per doctors, she is perfectly fine and all test results are normal imcluding HSG. What may be the problem and what could be helpful in this case? ### REPLY: Hello, You have a history of low sperm count. Some food affect sperm quality like high fat dairy products (whole milk, cream, Cheese), Soy products, pesticides & BPA (present in soft .  Avoid them as they cause low sperm motility, decreased sperm count or abnormal sperm shape.  Avoid alcohol, smoking, caffeine or any other addiction. Snack on walnuts, eat fish, fruits & veggies. Take fenugreek supplements, vitamin C, D, zinc, ashwagandha is effective. Your treating doctor may give you multivitamin supplements & camphene citrate for better sperm count. Ge examined by a GP & get physically examined. If any pathology is detected, get it treated. Exercise regularly, stay away from stress, stress decreases sperm count, avoid negative people, take adequate sleep. Stay away from anxiety. After doing all this religiously you should get Sperm test done, your count should improve. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My father had an angioplasty in his RCA passage stenting two blocks. Just after the procedure his BP dropped and the doctors fought for almost 5 hours to make him survive the night of the evening. He was a diabetic with kidney issues (CKD 3 stage). The BP got controlled to some extent in the following morning but he started developing other symptoms everyday that started with high WBC count, lungs saturation came to a very low and then creatinine went to 5. He was on ventilattor and had to go through 48 hrs CRT dialysis. What do think go wrong with the procedure to start with? Btw, he came out of life support after almost 5 days and now recovering. ### REPLY: Hello and welcome to . As a Urologist, i must opine that, you're richly blessed by GOD almighty. The cardiologists and intensivists team, are to be congratulated for a remarkable resuscitation and successful effort. To begin with, your father had a diabetic nephropathy(Diabetes with CKD stg3), and injecting contrast, is potentially nephrotoxic. But, the only way to do angioplasty is, to do a contrast angiogram study, first. This can lead to acute kidney injury-ARF, where the creatinine goes up, with other side effects, like B.P.fall, and low oxygen saturation. Dialysis is imminent, when creatinine goes up. You may send any doubt, as a direct question to me, for an expert opinion. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor.am 21 years old and am doing masturbation .My penis is only 3" long in normal condition and when in mood my penis is nearly 5" longer.My masturbation time is max 10 mins.only.How to get longer time doctor..? weight-55 kg. Height-157cm. I was affected bu phnemonia when i was studying 8th standard. ### REPLY: Hello Thanks for writing to ChatDoctorYour problem is entirely psychological. Your ejaculation time is absolutely normal. You should avoid excessive masturbation and try to concentrate in your activities. You should avoid provocative literature and videos and try to keep busy yourself in your job. You should do exercise and take nutritious food. You are alright. Your problem is not related to history of pneumonia. Hope I have answered your 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: 23 year old female, experiencing lower back pain seems to be focused more toward my left side. When standing it hurts, sitting hurts even more and also causes my left hip to hurt. Laying down has become the worse of all pain. This has been going on almost a week lastnight it woke me out of my sleep and haven t been able to get back to sleep. No fever . I have tried tynol, ibprohen, heat and cool. What could it.be? Should I go on into the ER? ### REPLY: Hi, From your description seems to be lumbar discography or acute articular syn .  If pain radiate to left hip then probably sciatic nerve affected, compressed. In this situation you must seek specialist consultation with properly magnetic exam of your lumbar aria and injectable medication of course, PO medication alone will not help. Also, additionally after acute stage you need physiotherapy in specialized center twice a year to prevent recurrences.  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 ve had a silly cough (dry) with no other symptoms of a cold (like headache, pressure, aches, chest heaviness, etc.) for two weeks. I do; however, have a small lump near the center of my body in line with the clavicle bones (might also be described as at the base, base of my neck). Ideas? ### REPLY: Halloumi at the base of neck may be due to enlarged lymph nodes. There are many lymph nodes in this region for lymphatic . Generally lymph node are enlarged due to infection/inflammation in scalp, face,ear or throat.This region proper clinical examination to search for cause. Mostly these are due to benign reasons and disappear with treatment of underlying cause. So, you should consult your physician for proper evaluation. Your problem may be related to throat infection. Get well soon. Take Care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My father age 65 yrs has been diagonised of MSA similar to parkinson his legs only shake and not his hands he also has a low BP the major problem he is facing is that he is not having a proper balance while standing he goes back and falls down and does not know if he is falling whenever he tries to get up he sits down not able to stand uphe is on syndopa cr 250 mg roliten and lonazep he also has a prosterate problem one of the doctor has advise him to take vertin 8mg for 5 days and to have a collar around his neck also have told him to takerablet 20mg,mecgla tablet..i have also checked with the ENT he ADVISED THER IS NOTING FROM HIS END HE CAN DO SO Pls advice iam going in the right track of treatment and the can i go ahead with the tablets as iam not sure why do we ahve take these tablests will it really help him regarding the falling back plspls pls,pls advise my email address is ### REPLY: Hello! Welcome and thank you for asking on ! I carefully passed through your question and would explain that MSA is a progressive degenerative disorder of the central nervous system. It causes orthostatic hypotension, causing a decrease in blood pressure when standing up. This contributes to chronic fatigue and difficulty in the body balance. From the other hand it also affects the cerebellum, which is the posterior part of our brain, which is the main region of our brain to help maintain our body balance. So unsteady gait is another feature of this disorder. Unfortunately there is no cure to this disorder and no treatment is possible for these symptoms. Patients are not able to walk in the later stage of the disease. I recommend discussing with his doctor on these issues. Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi...I have a 13 going on 14month cld that is teething.his back teeth is coming in...one side looks normal but the other side is very rred and swollen and a thick piece of his gum is hanging.I noticed when I tried to brush his teeth and it start bleeding so I decided to take a look closer and seen the hanging gum and how big and swollen ### REPLY: Hello! Welcome to . This is eruption gingivitis common in kids. You can give your child a full course of antibiotics. Warm salt water gargle thrice daily. Brush twice daily.(don't worry even if it bleeds)If you think his oral hygiene is poor, you can take him to the hygienist. This will subside after the eruption. You must panic if the bleeding is profuse or if the selling increases in size. 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 8 year old has developed a lump above on her left side teeth, i went to dentist he drilled her teeth so if possible puss can be drained itself and prescribed antibiotic for two days, the same condition on next visit he added one more  oral medicine  after two days it is the same condition, now he is saying to see peadiatric dentist, what to do? what is this? ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as your small child has Carious tooth, Access formation is also there treatment Plan for that is if your child have Permanent tooth carious then go for Root canal treatment and if it is Primary tooth carious then go for Pulpotomy, or Lumpectomy, depends upon Investigations, So you go to Periodontist for your child treatment it will be good for your child, your Child will get proper treatment.  Hope this will help you.  Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i am 27 years old and i have been experiencing lower right abdominal pain for about half a year. The pain is constant and it becomes worse after i have any form of bowel movement or bending movements. I did an ultrasound scan and nothing wrong was found with my reproductive organs. Subsequently, i saw a colorectal specialist who initially thought that my constipation problem is causing the pain. However, after being on mild laxatives for 3 weeks, the pain did not improve of go away. The doctor says he is unsure of what is wrong with me. I have also sought help alternatively from Traditional Chinese Medicine who has diagnosed me with Chronic Appendicitis . Basically, he identified this condition by first pressing on the lower right quadrant of my abdomen (where the pain is). After which, he lifted up my right leg and pressed on the same spot again and that set me off into a yelping pain in which i literally jumped up a little from the bed. Hence, i will like to seek other opinions as to what can be causing this constant lower right abdominal pain. Is it indeed a condition of chronic appendicitis? This is bearing in mind that the pain intensifies after bowel movements or during any bending motions. Thank you very much for your kind help and time. ### REPLY: Hello. There is such a thing as chronic appendicitis. This usually occurs when xenoliths (small rock-hard pieces of stool) get inside the appendix stump and cause inflammation. The pain you described with right leg flexion is characteristic of a "sons sign" which helps support this diagnosis. In "chronic" appendicitis, the momentum (a curtain of fat overlying the gut) will usually start sticking to the inflamed portion of gut, causing more discomfort that can be constant. Alternative diagnosis would include diverticular disease, irritable bowel syn .  The most useful test in this case would be a Cat-Scan of the abdomen and pelvis with PO/Rectal and maybe IV contrast. If normal, I would then order a colonoscopy. If it is chronic appendicitis, this could be potentially dangerous. It usually responds to a long course of antibiotics, which can also be considered empirically if you don't have access to testing. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor, I am married 11/2 year back and wish to have children.But couldn t succed in our attempts.Formally,i have checked for RBS & SEMEN Aanlysis. My semen test analysis is like this: Physical examination: Abstinance : 3 days Quanity: 0.5ml Color : Whitish Viscocity: Normal Odour: SEMINAL Reaction :Alkaline Liquification time: 30 min Microscopic Examination : Sperm count : 190mill/ml Motility a) Active Motile : 35% b) Sluggish Motile: 10% c) Non Motile: 55% Morphology : Norml forms: 40% Abnormal Forms: 60% Pus cells: 12-14/HPF EPITHELIAL CELLS: 2-3/HPF RBC : 10-12/HPF In RBS Test, Random Glucose level : 119 It s being a big impact on my lifestyle.Hence,Can u plz suggest the detailed information & problems based on my report.Is there any abnormality? what could be the medication and treatment. Thanks. Rithwik ### REPLY: Hollowed this carefully and you will get the answer. Normal fertility is associated with sperm counts of> 48 million/mL (in your case it is 190 million/mL, but volume is only 0.5 ml (while normal quantity is 3-6-8 ml ),with a motility of >63 %(in your case total motility active and sluggish is 45 %)with >12 % exhibiting normal morphology (normal in your case). Normal pus cells are 2-5 (in your case it 12- 14) and RBC's 1-2 (in your case 10-12) . Glucose random is normal but upper limit, so for this I advise you get in blood for HBA 1 C examination and also repeat the blood sugar level for 3 consecutive day to rule out diabetes. Get in blood for sugar level first, thereafter consult infertility specialist. So in my opinion consult an INFERTILITY SPECIALIST and get his opinion. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doc,i have a 7 years old daughter and she s having a cough for 10 days now i gave her solmux and tempra forte because she had a fever 2 days ago.we went to her pedia today and he gave meptin and klaricid and she took it around 2:30 pm after 3 hours she vomitted she said she don t like the taste of klaricid is it okay to take the 2 med at the same time?r just need to change the med? ### REPLY: Hi... Thank you for consulting in . Cough and cold are viral 95% of the times in child . I DON'T THINK YOU NEED TO USE AZITHROMYCIN AN ANTIBIOTIC. YOU CAN STOP CLARIFIED. For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15 mg/kg/dose (max ceiling dose 500 mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetirizine at 0.25 mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 41 years old and have had trouble with intestinal adhesions and peforated bowels.  I am a runner and triathlete but lately have lost 26 lbs. lost appetite and now my red blood cells, hemoglobin, and hematacrit is low so Will bone cancer show up on a dexa scan? ### REPLY: Hi, Thanks for writing in. Perforated bowel and intestinal adhesion can be caused by benign and malignancy. It is usually seen in benign conditions and only few cases are malignancy related. It will help to know if there is any mass or infection on CT scan that might be the cause for such a problem. Lowering of hemoglobin and hematocrit is a concern. Please get a peripheral blood smear done and this is a simple test to know if you have anemia and what type it is.DEXA scan is a low intensity X-ray to measure bone density. When there is bone cancer, the density of bone in affected area changes as compared to surrounding bone. This difference is bone density can be appreciated. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Just received a report of my MRI.  MRI prescribed by my moms neurosurgeon because she had a small aneurysm near her pons area, her youngest brother had a massive basilar artery aneurysm, my maternal grandmother passed away from an aortic aneurysm, and my maternal great grandmother passed away from a cerebral aneurysm.  I had febrile seizures before the age of 3.  My MRI showed minimal scattered punctate foci of T2-hyperintense signal involving the subcortical white matter of both cerebral hemispheres.  Would like to know if I should be concerned. ### REPLY: Hi, Thank you for posting your query.First, I would like to reassure you that your MRI report of brain does not show any serious neurological problem, and there is no need to worry. Also, in view of a strong family history of aneurysms, it is good to note that there are no aneurysms reported in your MRI brain. Scattered hyperintense signals are most often seen in cases of migraine. Other cause could be ischemia (lack of blood flow) due to high BP or sugar. I hope it helps. Please get back if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes. I experienced a sudden sharp pain on the right side of my chest. It radiated up through my port and just below my collar bone. I also started having pain in my lower back and right arm. I am still in a lot of pain and discomfort. Slight arm movements causes the pain to swell. I do not feel well overall. Thank you, L. Roberson ### REPLY: Hi, welcome to  Thanks for your query. As you told pain increases after arm movement, Most commonly it is muscular pain, happens after strenuous exercises or running etc., It could be a pinched nerve. Then all you would need is some muscle relaxants and physiotherapy. If the pain is radiating to the back then it could be due to pancreatitis. You may have to then get pancreatic lipase and amylase estimation. Also, get an ultrasound to rule out pancreatitis. Pain due to infection or any sort of pathology in lungs will surely result in severe cough and breathing difficulties. Hope, I answered your query. ### END