Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The doctor injected histamine on my left arm. Pain developed on my left shoulder radiating to my neck. Then, pain radiated to my left elbow down to my hand. In addition, I felt a moderate numbness on my left arm.  Is it possible to be allergic to histamine injections, and if so, are these symptoms common? ### REPLY: Hi... Welcome to  . I have gone through your query and can understand your concerns... As per your complaint it seems that there has been nerve injury caused by picking needle leading to nerve damage and causing destruction to the myelin sheath that is a protective covering over the nerve. Du to nerve injury there have been irregular firing of nerve impulses leading to pain and the pain over the shoulder and neck is radiating pain from the injection site over the course of nerve. You should consult a Neurophysician and get evaluated, and a thorough clinical evaluation can help in diagnosis. As of now you can take painkillers, vitamin B complex supplements and do warm compresses over the painful areas. Hope this information helps. Thanks and regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my husband has had a blisery rash for a while now - the doctor gave him cream and it cleared up and then re apeared on his head - it has now appeared on his chest.  they are dark red patches which blister. ### REPLY: Hello. Thanks for writing to us at  Fluid filled lesions on the body, that are persisting as well as new ones reappearing at places like head and chest, needs to be clinically examined and if required to be biopsied as well. It could be an immunoblots disorder e.g. Memphis vulgarism or bulbous pemphigoid. In each of these disorders, there are well-formed ballad. While Memphis vulgarism presents with fragile ballad that rupture easily and leave behind painful erosion, bulbous pemphigoid on the other hand presents with tense ballad along with itching and urticaria.Therefore, a thorough clinical examination, supported by appropriate investigations like skin biopsy, is a must to arrive at a diagnosis. I would suggest him to visit to a nearby dermatologist for the same. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my dad was diagnosed two years ago with the colorectal cancer and he has an issue with Peeing very frequently he feels the sensation to P but no time to actually go to the bathroom it s a feeling and then he just goes ...does this have anything to do with the sickness ### REPLY: Thanks for your question on . I can understand your fathers situation and problem. He is having urgency, and it is a classical symptom of prostates (involvement of prostate). In his case following are the possible causes for prostates. 1. BPH (Benign prostatic hypertrophy). 2.  Prostate infection 3. Spread of colorectal cancer in prostate. So better to consult urologist and discuss all these possible causes. He may need urine microscopic examination, urine culture to rule out infection. Abdominal ultrasound and transrectal ultrasound are also needed to rule out BPH and malignant spread. So consult urologist 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 ve been having chest pains for a couple of hours now. I am 30 and I ve had some issues with chest tightness due to psoriatic arthritis. I did start synthroids 50 mg today. My blood pressure is normal 126/76 Are there any signs I should look for about this pain to know if its not just the arthritis? ### REPLY: Thanks for your question on . I can understand your concern. Psoriasis arthritis can cause lung complications like bronchitis and lung fibrosis. Both these cause chest tightness and chest pain. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x-ray and PFT (Pulmonary Function Test). Chest x-ray is screening tool for lung fibrosis. PFT is must for the diagnosis of bronchitis. If both these are normal then no need to worry about major lung diseases. Take simple painkiller and muscle relaxant .  Apply warm water pad on affected areas. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Gud evening sir/madam i am 24 years old man before 1 years back my right side chest paining i took Xray, Echo,Ecg, nothing is there but in this winter season my ride side chest is paining when i deep breathing most of time happening in when i cold body temp. what is reason its happening.....plz give ans. ### REPLY: Hi thanks for asking question in . You have chest pain while breathing mainly. First auscultation done for whether any rhonchi or crepitation heard or not... Chest x-ray done to rule out bronchitis or asthma or pneumonic consolidation.... For interstitial lung disease or fibrosis disease spirometry also useful. This is to be ruled out if smoking habit.... If no respiratory cause present then only muscle tear or strain might be the cause. Rest done. Analgesic taken.... If ribs tender to touch then Costco . .... 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 hyperthyroid patient aged 42 male, who has been advised thyronorm 50 mg and inderal 10..today i had rapid palpitations and the doctor added two more meds like migrabita tr 20 and nexito 10..wish to know whether these medz are safe and habit forming.. ### REPLY: Hello, hyperthyroidism per se will cause palpation and increased heart rate.  Thyroxine itself it is thyroid hormone and is used for treatment of hypothyroidism and not hyperthyroidism.  There is some mistake in your understanding.  If you have hyperthyroidism, adding only thyroxine will worsen all symptoms.  Federal and migrated are same .  It will help in controlling palpation and is used for treatment of hyperthyroidism. It has no habit-forming properties and It's safe to use Next is a medication used in your case as antianxiety pill.  Yes it has addictive property and I would recommend that you avoid it as much as possible, till a proper diagnosis is reached upload the thyroid profile report, so I can guide you and help you clarify about the condition and the treatment. 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 Doctor the case is about My wife , she has asthma from time to time , but that happens only if her nose nasal passage are blocked , some time both passages some time only one . And her asthma gets worse and worse if it is both . She used a lot of sprays but no great affect until lately she used ... , and it made a different by reducing the mucus in her nose and thus breathing normally most of the time. I read a lot lately about deviated spetrum surgerys and turbinates (i guess ) so we made a ct scan please see below the pictures and tell me if it requires a surgery. http://nextechno.com/Sinus/UpView.JPG http://nextechno.com/Sinus/f1.JPG http://nextechno.com/Sinus/f2.JPG http://nextechno.com/Sinus/f3.JPG ### REPLY: Hello, Welcome to  ! Your wife is probably suffering from chronic sinusitis with DNS. Well there can be hyperplastic mucosa in sinuses due to sinusitis also. Contrary to views expressed, an allergy can only be avoided, not cured. Modern sinus surgeries like FESS are safe & effective in expert hands. Please take second ENT opinion but go for surgery. Donor fear of a repeat surgery because any disease can occur again. So will you not treat due to this reason (i.e. recurrence). 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. Three months ago, I began having pains in my back that feel like twisting stabs to my left shldr blade, sometimes throbby pain, accompanied by anxiety . Sometimes it s accompanied by dull pain in the upper abdomen in the center just below where my ribs meet. My GI doctor ordered a HIDA scan to investigate the gallbladder function. I m scared because a friend said a man she knew died recently from pancreatic cancer , and the first symptom he had was stabbing back pain . I would like to know if you have any suggestions other issues this pain may be related to, or other tests I should discuss with my doctor. Thank you ### REPLY: Hi there, Thanks for writing in. Please follow your GI doctors advise and get the HIDE scan done. And please be optimistic. Just because somebody has pancreatic cancer does not mean you have it too. Gall stones or Gall bladder inflammation (cholecystitis) might be the cause of your stabbing back pains with radiation to the shoulder blade. Other possibilities are acidity/ pancreatitis/gastritis/ peptic ulcer/Anxiety etc. Has an ultrasound abdomen (USG) or GI endoscopy been done? I would like you to follow the following general measures.1. Avoid oily, spicy, deep-fried/fatty foods.2.  . 3. Sign up for yoga classes. Deep breathing exercises will help you to relax and be calm. Yoga will take care of the anxiety issues.4. Have frequent small meals rather than 3 large meals a day. I hope I have answered your question. Please do get back to me if you have further queries. Get well soon :)  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have developed a fear of pretty much everything. I am afraid to be alone, I am afraid of every stranger I see. I cant sleep at night because I am worried someone is going to break in, or is watching me through the window. I cant walk alone outside because Im afraid Ill get attacked. This is affecting my everyday life. Please help. ### REPLY: Hi. I understand your concern. It is anxiety of being fearful. Phobia is one of the type, and it can be social phobia or specific phobia. Fear of being attacked can be categorized in psychotic anxiety. So fear and anxiety of everything require further evaluation to categorized in types or form confirm diagnosis. So consult psychiatrist and get help. It can be treated with psychotherapy. CBT means cognitive behavior therapy is the choice.  Exposure and response prevention/flooding etc. can be useful. Medicines like combination of SSRI and benzodiazepine will be useful. Treatment can be possible after proper consultation with psychiatrist. Get well soon. Happy to help you further. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I have little red bumps on my hands and feet that look like little blisters and itch and hurt at the same time. My 7 month old son had them and had an infection and is on ammoxycilin. I think I got what he had and now am on augmenton. He had the same bumps. Could it just be from the virus or do you think it s an allergic reaction to the meds? My son had the bumps before he was on the antibiotic. ### REPLY: From your description, it seems you are suffering from urticaria which is an allergic condition. Allergy may be to intestinal worms, .  If there is no super added infection like pus discharge, antibiotics may not be of much use and in fact may be a cause for it. Take an antiallergic like Allegra or cetirizine and apply calamine lotion for soothing effect. Also, deform yourself with albendazole. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 38 year old man married to a 27 year old lady last year....we have been diagnosed of PCOs (my wife) and myself having asthenoteratozoospermia with a sperm count of 30million/ml, 57% motility , 10% normal sperm and 46% slow progressive....56% have head defect, 68% neck defect and 80% tail defect.... fructose test positive and pH=8.....my wife has already been in treatment with progesterone and clofert 50.....kindly advice as to how can we have a child.... ### REPLY: Hello, Welcome to , I am  Look, your semen analysis report indicates normal sperm count (normal is > 15 ml as per WHO 2010).  The motility is within normal limit (as per WHO 2010, grade a should be >25% or all total >50%).  The Normal sperm count is also within normal limit (as per WHO 2010, normal sperm should be > 04%).  So, overall, your report indicates no abnormality. You do not need anything to do. You are absolutely normal. Furthermore, you can take a vitamin E that is enough Previously you were diagnosed wrongly. Furthermore, you should consult with your treating doctor about it.  Furthermore, you should concentrate on treatment of your wife. That is very important.  Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 28 yrs old girl and liver cirrhosis and ulcerative colitis was detected and treated by the doctors in year 2000. i am under medication and the medicines prescribed to me are mesacol od  1 in mrng udiliv 300mg 2 per day aldactone 100mg 1 in mrng. how long should i take these medicines and im thinking of changing the dr due to few reasons. i need ur suggession sir ### REPLY: Hello, I hope you are very well. It is very important to know your antecedent that you have ulcerative colitis because for that reason the cause of your cirrhosis can be a Primary sclerosis cholangitis that is related in approximately 5-10% of the patients with colitis, whose main importance of the early diagnosis of the Hepatic disease is the risk of developing a cholangiocarcinoma. In your case, if you already have irreversible liver damage, it is very important to determine the etiology, and if it is the case of Sclerosis cholangitis as pharmacological measures should be considered the administration of ursodeoxycholic acid. In addition, it is necessary to perform an ERCP in view of the possibility of finding stenosis in the biliary tract and to perform a palpation of the biliary tract to improve obstructive symptoms. This besides the basic management of your ulcerative colitis and the measures for the attention of your cirrhosis, an adequate nutritional management, diuretic treatment with its renal and electrolytic follow up as well as surveillance endoscopies, so I suggest you go with your Gastroenterologist or hepatologist, and you can continue your integral management. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi sir, i am shankar, age 28, i am suffering from dust allery. From last 3days, i have breathing trouble  at night time only. my doctor prescribed dexa injection, pantoprazole 40mg, deriphyllin 150mg, gemifloxacin mesylate IP 320mg for 5 days... how will i get permanent solution for dust allergy? ### REPLY: HI, thanks for using  The only way to completely eliminate an allergic response would be to avoid or eliminate the source, in your case dust. In terms of your home, you may need to eliminate carpets and rugs or clean them daily. Special pillow and mattress covers would help to reduce dust exposure as well. Since it is difficult to eliminate exposure to dust completely then you may need to continue on at least some of your medications. 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: i have what i believe is a nodule / small hard swelling at the lower end of my anterior tibialis tendon - on the top of my foot. It is exacerbated by my running shoes - initially cause mild pain. Am i ok to continue to train (6-15 miles, 3 times per week)? ### REPLY: Answer: Hello, Thank you for using . I read your question and understood your concern. I think It's a benign lesion so get done x-ray and will be able to see if its bony mass but keep a watch over it if it grows rapidly in size over few days bring to a doctors notice it may require biopsy and excision by meanwhile have tabbed.aerosol p mg twice daily for 5 days you may continue training and try to change shoes which does not cause too much irritation  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mothere has a kidney problem doctor said that there is a blockage in a tube which passes the urine Comes out of kidney and also said that there is also a stone at the end of that tube which do not allow urine to pass through. What should i do know please tell me...??? ### REPLY: Good Day, and thank you for being with  ! It will all depend on the size and location of the kidney stones. If it is smaller than 4 mm then your mother can pass out the stone spontaneously with intake of 2 liters of fluid every day and alpha-blockers (e.g. tamsulosin alfusozin). Stones less than 4 mm in size has an 80-90% chance of spontaneous passage. If the stones are bigger than options would include ESL (shockwave therapy) to fragment kidney stones and Ureteroscopy (inserting a small scope in the opening of the urine to remove the stone). A CT SONOGRAM would be needed to see the stone sizes and location to determine the next course of action. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.ChatDoctor .com/doctors/ .  Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having a old problem of chronic cold...and cough. now i am even getting throat infections frequently.also pain in my eyebrows. cold has been a problem with me since childhood now i am 28. I have visited many ENT specialists and they just gave medications without diagnosing the root cause. I work in A.C, is that the reason for this? ### REPLY: I am having an old problem of chronic cold...and cough. Now I am even getting throat infections frequently. Also pain in my eyebrows. Cold has been a problem with me since childhood now I am 28. I have visited many ENT specialists, and they just gave medications without diagnosing the root cause. I work in A. C, is that the reason for this?you have allergy from cold when you are going out to outside there is no A C if you want to go outside you should off at least A C for 3 to 4 minutes then you can go out. You diagnosis is recurrent tonsillitis you need tonsillectomy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 football and got hit. I flew in the air and landed straight on my hip, I felt pain immediately. It hurt tho rest of the day I coul hardly sit down, get up, walk, or lay on the left side of my hip. I thought maybe it was just bruised and I iced it. It felt better for a couple of days. But yesterday I twisted my hips while running and it popped and now it feels as bad or worse than before. Can you help please? ### REPLY: HI, Thanks for posting on . After reading your symptoms, I would like to suggest you a certain investigation:MRI of the right Hip to diagnose any ligamenta injury/ fracture. Meanwhile, you can take any good analgesic and anti inflammatory .  You must also use cold compress and rest your hip by avoiding vigorous physical activities such as running, jumping etc. I would strongly recommend you to visit an orthopedic doctor to diagnose and treat the problem effectively. 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: The area inside my navel appears to be slightly swollen. No larger than a pea. It is not painful on its own, but is tender and slightly uncomfortable (2/10 on pain scale) when you press on it. It also feels as though I am pushing something small back into abdomen when I press on it.Do you have any ideas?Additional info: yesterday I was helping someone attach a rope to a hook in the pool. it was difficult and I had to strain to connect it. I was on my knees pulling rope towrd my body. Abdomen did nothurt yesterday, and still only hurts if I press on it. ### REPLY: Hi. Thanks for your query and an elucidated history. The condition of a pea-sized swelling in the umbilicus which is tender, and you get a feeling of pushing something in on pressure is called an umbilical hernia. This is a small gap in the wall of the umbilicus. You can consult a Surgeon to get an examination done and to decide whether you need a corrective surgery or not. In small sized umbilical hernia, where the content is always a fat-pad, surgery may not be needed until the opening is big enough to cause entrapment of the intestine to cause pillion sort of hernial obstruction or causes any other complication. You can keep this under observation and get operated only if causes pain. No pain at straining at the pool is a good sign. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I went to a gp sunday with thobbing bottom teeth and very saw chin and jaws. It is so painful. He gave me amoxyciilan 1000mg and metronide 400mg it is still so painful pain killers every 3 hrs, I carnt remember what he said it is but concerned as it is no better today driving me crazy. What do u think it is and am I on the right meds? ### REPLY: Hello, Welcome Thanks for consulting  I have gone through your query, don't worry you have pain in your lower teeth, it can be due to caries, or due to periodontal problem, if it is due to caries may be Access formation is there I.e. Periapical access, or due to periodontal problem it can be due to Periodontal Access that why you are feeling throbbing pain, You should consult dentist and go for proper investigations done (IOWA) X-ray done and go for Root canal treatment or Scaling and root planning properly, Do warm saline gargle two - three times a day you will get relief and medications you are taking will give you temporary relief go to dentist and proper treatment done.  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: I had a carotid body tumor removed in 2007. It was cancer. Currently have lession on gum (comes and goes), dentist can not determine if this is from tooth problem or sinsus. Is this possibly a spreadof orginal cancer.  Also had breast cancer L 1997and R 2003. ### REPLY: Thanks for your query, I have gone through your query. The lesion on gums can be a Paris or a myogenic granuloma or peripheral ossifying fibrous. Consult an oral physician and get it examined completely and get a radiograph done to rule out any tooth infection. If it is a tooth infection, it can be treated with RCT or extraction. If it is a myogenic granuloma or peripheral ossifying fibrous, then it can be surgically removed. The chances of spread of cancer to this region is less, but it can occur. Based on your description of the lesion, it is difficult to give a diagnosis and treatment plan, if you can upload the images of the lesion, we can give an exact diagnosis and treatment plan. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor,I need some clarification regarding my wife pergency tablets which my doctor have given. They have given the below tablets name to have until delivery. My wife delivery due date 20th December 2017. Now my wife is 12 weeks 5 days as per UGS report.1. Folomega - morning after breakfast 2. Tab Livogen -Z  : After Lunch 3. Shelcal 500 - Morning after breakfast and Night after dinner.Also, we have informed that we need to travel somewhere for two days in train after that my doctor gave Naturogest SR 400 Tablet to have two before travel and two days after travel.Here is my question.These all tablets are good to take?Naturogest is for what?Also Howz my wifes health now based on the tablets given.Please advise and suggest doctor. ### REPLY: The above 3 mentioned tablets have folic acid, multivitamins and calcium which are essential during pregnancy. The 4th tablet naturalist is progestin which helps in preventing uterine contraction which can occur un case of some undue work or movement. Its supportive medicine and will not cause any harm to pregnancy.It's safe to travel by train during pregnancy. Progesterone is a hormone which keeps uterus in relaxed state and prevents preterm labor that means labor pains before due date. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i want to know exactly what it is wrong with my 2 and half year old son has he has been occasionally having cough and cold and is unable to sleep at night. my doc presribed ventolin syrup sugar free for him and it relieved himwe had an xray done and his chest was clear.doe it means my son has asthma or we are preventing it.Doc also said we should have the drug handy at home. when he cant  sleep his breathing is fast and you could see his chest /stomach really rasing up and down very fast. ### REPLY: Hello, Thank you for asking at . I went through your sons history and would like to make suggestions for him as follows:1. I would like to know his symptoms in great details before considering whether he has asthma. Furthermore, I would like to know more about him like - a. frequency of his respiratory symptoms b. since what age c. requirement of nebulization d. any gastric symptoms e. any other allergies f. family history of allergies/asthma etc. etc2. At present, I would suggest you to give him combination of montelukast and levocetirizine for 1 months. 3. It is true that for fast breathing and wheezing (whistling sound from chest), some .  Were I treating you, I would suggest you to have albuterol in inhaler form with spacer and mask device or nebulizer at home, as it becomes effective earlier than an oral  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im phil from the philippines. i am starting to undergo infertility work up. i had my semen analysis done and it shows the ff. can u pls interpret it? is there a big chance can i be a father? color: pearly white volume approx:2ml viscosity:viscous liquefaction time: failed to liquify after 1 hr motility motile non motile upon receipt 60% 40% 1st hour 50% 50% 2nd 30% 70% 3rd 20% 80% morphology: normal 92% abnormal: 8% giant head:3% double head:3% pin head:2% sperm count: 4,950,000/mL ### REPLY: Hi Phil, I have read your semen analysis report with diligence. Your sperm count is very less at 4 million and nine Hun .  The normal sperm count is a minimum of 20 million per ml. However, the morphology is good at 60%. Also, the semen failed to liquefy even after an hour. This is not normal. Normally, semen should liquefy in 40 minutes.  You should get back to your infertility specialist and discuss further options available for you. Hope this helps.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have sore places in my mouth,and my jaws & teeth are hurting,also my throat is so sore that I can t hardly swallow . I feel like I may have a bactorial infection, my husband has had MERSA and has a fistula which I dress twice a day, I don t think it is active @ this time, but my mouth is hurting so very bad. What do u think i should do, besides going to the ER? Patricia Brown. ### REPLY: Hi. Thanks for the query. As per your complaint sore places in mouth along with pain in teeth and gums can be due to inflammation inside mouth leading to inflammation of gums causing GINGIVOSTOMATITIS... It can also be secondary to wisdom tooth related problems like inflammation of gum flap over the wisdom tooth leading to Peritonitis. You should consult an Oral Physician and get evaluated and a thorough clinical evaluation and a Panoramic x-ray can help in diagnosis and treatment can be done accordingly. As of now you can take anti-inflammatory painkillers like Ibuprofen or Naproxen. You can gargle with numbing mouthwash containing Lidocaine to relieve soreness in mouth and throat. You should avoid spicy foods and . . Hope this information helps. 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: Greetings to Dr. Rohit. I am Elizabeth Lee, from Malaysia.I have been suffering from psoriasis since I was 23 years old.Now, I am 34 years old.My psoriasis have been ups and down. But then its still manageable.But things turn differently, after my delivery of my baby since January 2010.My psoriasis have flared up so much that it covers 85% of my body, especially both my legs.I have seen many doctors, and even skins specialists.But then my psoriasis has not settled or remained the same severe.I had used 707 Oil, from India, by an Aryuvedic practitioner.And taken some oral Aryuvedic pills , Dermaflex, from India.But then my psoriasis has not improved.Now, after 4 months after my delivery, my skin has noit gotten any better, even though I have applied medication given by skin specialist.Any alternative medication??Please help. ### REPLY: Thank you for writing to . Psoriasis is really kashtsadhya to Ayodhya classification disease. You are advised to undergo Panchkarma at some good Ayurveda hospital near you. Till that time please take following for some relief. Karachi - The juice of the leaves of the Karachi can be applied locally on the affected regions.Garlic-Take 2-3 cloves every day with Khadirarishta10 ml+ Manjishthadi kvath10 ml+ 20 ml water.Jasmine-The flowers of the jasmine have good effects in the treatment of psoriasis. The flowers are crushed, made into a paste and are mixed with with need oil and applied on affected part. Kaishore GGUL- 2 pills thrice a day with lukewarm water water(1 glass at least)Need- Need cap 1, Hard . Taruni kusumakar powder 1 tsp at nightnightNote: Karachi and jasmine may be used separately for sustained effect. However, it can be used simultaneously too, but I would prefer separate though its time-consuming.It's a vat key disease hence treatment is along those lines involving charm and rat. Food: Simple and light. If you feel satisfied may ask any query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had sex with my girlfriend 10 days ago and I started to put the condom on backwards by mistake, but then I flipped the correct way. I only rolled it down a little before I realized my mistake and then I put it on correctly. I have seen various answers for this question online. Can you tell me what the chances of pregnancy would be in this case? ### REPLY: Hello dairy understand your concerns do not think there is chance of the pregnancy. You put the condom backward and rolled just little. So there is chance that pre-cum was contacted with the condom. But this pre-cum is very less, and it does not cause pregnancy. Precum can cause pregnancy when it was entered into the vagina before ejaculation in full penetrative unprotected sex. So I don't think there is chance of the pregnancy. Avoid stress, take healthy diet, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 32 yr. old daughter was found setting on a ledge above a highway nothing there but a strate drop down on the road. she has been threw alot in her life, she lost her brother when she was 15, he was only 16 . a 4wheeler and car accident. she has never delt with anything shes been doing drugs probley about anything right now. I called 911 and 2 police came to take her to the hosital but didnt want to fight with her, didnt even get out of there car. they told me to put her to bed and deal with this tommrow. she says if she would of fallen and died that it would of only been an accident. what do I do now ### REPLY: Hi dear, She is going through many stresses and due to all that she might have depression, and so she is suicidal. So best to consult her at psychiatrist and start medication. If she is tried many times or sever suicide also start ECT (electroconvulsive therapy) which helps her very fast. What are other features associated like sleep and appetite disturbance, crying spells, easy irritability etc... Consult psychiatrist. Awaiting your response. 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, im michelle and im 20, ive had a stroke 3 years ago and now im wearing a walk aid on my right leg. however, the right side is affected and i cant feel anything. although, recently, my right heel hurts. i did some research and the two that popped out the most is the heel busitis and heel spur. usually its fine in the morning but then it right leg and heel hurts like crazy. should isee a doctor or possibly take some treatments. what do you think? ### REPLY: Hi, as mentioned by you the brief history of you I will recommend to first take an x-ray and confirm that it's a spur. Also, post that your physician may help with treatment which will help ease the symptoms. Next to understand is that this spur once confirmed needs an attention by doing some exercises for feet and also getting a shoe insole. Which will help further to avoid the pain and reduce the inflammation.regards. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ITP (Idiopathic Thrombocyetic Purpura) is the case.......the patient is 14years old child...having weight 42kgs and height 5feets....she is having this problem from last 3 months....the case is having a problem that "the platelet count increase is not in an order(means not in an order like ascending or descending).......she was treated with steroids after platelets have decreased...she has given IVIG(84mg) treatment...after IVIG treatment there is no improvement ............but at present the treatment is going as by giving WYSOLONE-40mg(daily 1 tablet),AZATHIOPRINE-50mg(daily 1 tablet).....still the count is less than 30000......soo sir u please suggest for the best treatment......i shall be very happy if u kindly send the suggestions to my gmail:  YYYY@YYYY ### REPLY: Hello and welcome to , Idiopathic thrombocytopenic purpura (ITP) is an autoimmune condition characterized by low platelets. The common cause for ITP is viral infection.ITP has a natural course for few months. However, some cases can become chronic and can last for more than 6 months. Treatment of the condition consists of corticosteroids for suppressing the immune response. Continue the treatment till the platelet count recovers. Thanks 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: namastey . my name is Jayant Sharma . my age is 18 years.  I m from n.e.b. alwar . i am persuing my b.tech from poornima college jaipur . i m in first year . Sir plz help me i m in deep depression . i have very negative thinking about everything and everyperson, i start thinking a lot about small small things.  I crack unwanted and foolish jokes . i make fun of myself in front of others .Since last 2 weeks i wished thrice to commit suicide but i just thought of my sister who is going to  get married I m not addicted to alcoholic and smoking . ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I can understand your feelings. First let me assure you that you are not at all depressed, but you are just disappointed. You are an engineering student and doing your first year. You are adolescent. So many negative things happen in our life, and it is natural for a person of adolescent age period to get disappointed. Don't worry. You need to find solutions. If you think you are talking unwanted things, then you should curb yourself, who else can help you except you yourself? I can advise but you have to do it. Your negative thoughts are because you think too much and you think too much because you are not interested / dedicated in your studies. Change yourself. You need counseling and psychotherapy. I shall provide you with the required counseling and psychotherapy techniques online, to overcome these problems. Please describe the whole problem in detail and post a direct question to me. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is Brittany. I had my appendix removed 3 years ago but for the last 2 - 3 days i have had really bad abdominal pain . I have had a miscarriage 2 years ago and had some complications with it.. I ended up having an emergency D&C as i was passing clots the size of tennis balls. My lower belly area and back are sore my lower belly is very tender to touch. I know that without actually feeling and seeing me in person its hard to diagnose but i was just wondering whether i should be worried. I also have a Mirena and i can feel the strings. ### REPLY: Hi Brittany welcome to  forum.  Thanks for writing to . F.  As you describe you have got lower abdominal pain and tenderness and back pain since 3 days, Your appendix removed 3 years back, and an abortion 2 years ago. You have arena still in position.  It appears to be the pelvic inflammatory disease, urinary tract infection, or stones in the urinary tract. If arena is there more than 3 years you may get infection due to it.  I advise you to consult a gynecologist for diagnosis and treatment. You may need to have U.S.scaling besides other routine tests for confirmation.  Wishing for a quick recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 52yr old husband, an alcoholic with alcoholic hepatitis, gross ascites, jaundiced. clotting screening normal, hyponatraemia and raised total bilirubin (was 300 on admission, now under 100). recent 11week hospital admission following collapse and confusion, weight loss and poor balance. He had an Abdominal CT scan which revealed a shadow on an adrenal gland. what would this indicate? would it be related t his alcoholism? I remain uncertain re his prognosis and extent of liver damage. ### REPLY: Hello,1) He might be suffering from acute hepatitis on background of end-stage liver disease due to alcoholism2) Prognosis is depended upon liver functionality to produce proteins and clotting factors; level of bilirubin, ascites3) According to his laboratory data as written here roughly, he might have moderate-to-severe type of liver damage which has 2-year life survival 40-60%.4) Shadow on a .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been cracking my toe (third) lately and it seems to be getting darker than the rest of my toes, like I ve a habit of trying to pop the same toe until I feel like it s better, and everytime I try to pop my toe and strain it, it gets darker. Is it bruising? I ve a weird habit. And I need to know what is causing me to get the darkness or the bruising on my (third) toe. ### REPLY: Hello, Welcome, and thanks for sharing your concern I went through your query, and I feel, darkness and bruising are signs of vascular problem with your limb, do not try to strain the legs, and see if it improves, if it doesn't than you will need some investigations, but I would like to know if you are a smoker and if yes since how long, and what is your frequency of smoking. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I HAVE A NEICE JUST DIAGNOSED WITH FOURTH STAGE ORAL CANCER. 39 YEARS OLD HAS FAMILY HISTORY OF ORAL CANCER. SHE LOST HER FATHER TWO YEARS AGO. SHE IS A DRINKER AND A SMOKER. OBVIOUSLY THAT HAS STOPPED. WHAT ARE HER CHANCES OF SURVIVAL? WHAT CAN WE EXPECT FOR TREATMENT ANDHOW DO WE TELL HER 7 YEAR OLD SON ### REPLY: Thanks for your question on . I can understand your situation and problem. Stage 4 oral cancer has not very good prognosis. Life expectancy is less than 2 years. Because of decreased or absent oral intake, Malnutrition is the biggest problem in these patients. Feeding jejunostomy is the option for feeding in such cases. Treatment in such cases is palliative only. Palliative treatment is consists of1. Palliative chemotherapy2. Palliative radiotherapy3. Multivitamin, proteins supplements4. Painkillers. Better to consult psychiatrist for end of life issues and counselling of her son. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son is a 9 mnths old now, he had been confined to a hospital for two days on a diarhea last two weeks, he take a lactosefree milk and his poop is ok, now i go back to his old usual milk not lactosefree and he didnt want to take it nicely, now he didnt take a good sleep and had a lowgradefever andhas a husky voice, hope somebody can have an answer for us, thanks ### REPLY: Hi.... I understand your concern. By what you say I feel that your kid might be having a viral diarrhea. This sort of feeding pattern is very common till it gets adjusted. I will tell you how a viral diarrhea behaves, so that you will feel more confident. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am breastfeeding, and my baby gets bottles during the day because I work. My 3 1/2 month old, who was sleeping 7-8 hours straight at night, has been waking up 2-3 times during the night to eat. Is it possible she isn t getting enough to eat during the day? ### REPLY: Hello, It is very common for babies who used to sleep through the night to change their sleeping habits. This is not necessarily a sign of hunger. But just to be sure confirm from your babies caretaker the amount of formula she is receiving during the day. If she is receiving adequate amount of formula then you need not worry. She may take some time to get back to sleeping through the night. Just stick to a sleep routine.  Hope that helps. Preeti ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What can cause an inclusion cyst in a 5 yr olds scrotum?  How likely is it that sexual abuse or assault was involved to cause this?  To explain a little this child had an inclusion cyst removed and has made accusations of other things happening (sexual in nature) ### REPLY: Hi! Epidermal inclusion cysts or commonly known as sebaceous cysts are caused due to minor or major trauma to the skin epidermis, shaving, cuts, bites, nibbling any kind of injury! In the events involved, portion of skin epidermis get deep into the dermis or suburbs along with its mother cells/stem cells in the basal layer where it proliferates like a normal skin tissue but no way out for the keratin which therefore is collected within a cavity / cyst! Hope you could understand that kind of sexual abuse too can lead to the cysts!regards, Therefore ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: have copd .. d/g was air sacks getting hard......do I use spiriva or combivent........i got TB 42 years ago in USMC and was treat for that ......VA say may have caused copd   scarred right lung....got pneumonia 3 times while in the jungle....also ischemic heart disease (3 stents)       abdominal aneurysm of the aorta ( 1 big stent) and bladder cancer removed 4 tumors and had full bcg treatment twice    VA says some from agent orange.... but they are not very helpful, I use my personal doctors and not VA. Many of my brother Marines have died of these same problems lately.     Question is about spiriva and combivent   and any thoughts about agent orange and my medical problems....promise I will not use any your info..only for my personal knowlege ### REPLY: Thanks for your question on . I can understand your situation and problem. Treatment of COPD needs following treatment simultaneously for better symptomatic control.1. Stop smoking. This should be the first step in the management of COPD.2. Start inhaled bronchodilators and inhaled corticosteroid. They are the .  Spirit and Combined are good in this aspect. So you should start Spinoza or combined.3. Enroll yourself in pulmonary rehabilitation center where chest physiotherapy and deep breathing exercises are done. These will improve your lung functions.4. Take adult respiratory vaccine like pneumococcal and influenza vaccines to prevent recurrent lung infections (pneumonia). You need to follow all these steps simultaneously for better control in COPD. So consult pulmonologist and discuss all these. You should definitely start Spinoza or combined. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 12 year old brother is having middle stomach pain. This has been going on for about 7 months now. My mom has taken him to the doctor and the have done tests that haven t shown anything out of the ordinary. He has asperger s syndrome and that comes with hypersensitivity issues so this might be hurting him worse then it would someone without these issues. He likes to sleep on the couch at night. He says his stomach hurts more when he sleeps in his own bed. He takes prozac for the asperger s and clonidine to help him sleep. They also put him on Lorazepam because they thought that the stomach pain might be from anxiety.He weighs about 140 and is about 4 9 . We just don t k-now if it s anxiety or something actually physical. Can you help? ### REPLY: Hello, As you already consulted with doctor, still has abdominal pain. Do ultrasound abdomen and endoscopy. You can give tablet Norfolk TZ, tablet Cyclops, and tablet Albendazole as per his weight. Did he have history of vomiting and diarrhea? Give him boiled or RO water. Maintain proper hygiene. I will suggest you to follow up with detailed history or consult with pediatrician for detailed examination. 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: Hello. My partner is 65 male(office work) 30lbs overweight and went to the doctor today witha 230 heart rate.  Tomorrow he is going to a cardiologist.  He also has 3 stents.  The doctor also had said that all other tests were fine.  What would cause a 230 heart rate and should we be concerned?...Thank you ### REPLY: DEAR USER, THANKS FOR CONSULTING WITH ChatDoctorYES YOU SHOULD BE CONCERNED AS AN HEART RATE OF 230 IS ABNORMAL REQUIRES REGENT MEDICAL ATTENTION AND AS HE HAD HEART DISEASE IN PAST YOU SHOULD BE CONCERNED AND TAKE HIM URGENTLY TO THE CARDIOLOGIST AN ECG AND ECHOCARDIOGRAPHY IS REQUIRE TO TELL YOU ABOUT THE CAUSE OF SUCH HIGH TACHYCARDIA PROBABLY ITS ARRYTHMIAHOPE I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 burning in my left testicle for over a month now, have had a Doppler test, been checked for a hernia and still no relief. The Doppler showed left sided varicocele and also a small epiididyman cyst there also. Is there anything else I can do, Thank You. ### REPLY: Hi, what is your age? Your burning could be due to the Varicocele. We usually operate on Varicocele if the patient comes to us for Infertility or inability to bear child .  Varicocele has been blamed for decreasing sperm count in healthy males. If you are very symptomatic with the problem then you can undergo a small surgery to remove the dilated veins. And Epididymis cyst is a common finding and needs no treatment unless you have pain in it. Do not worry. 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 had to do a DE six months ago because of my child loss . Then my doctor prescribed me MHR tablets when I would like to conceive . She prescribed one per day . Will you please tell me when should I start to take the tablets ? Is it when we start intercourse without precautions ? Please also tell me the advantages and disadvantages of the tablet .Thank you ,Payel ### REPLY: Dear Panel, MHR tablets are Folic acid supplementation tablets. You should start them immediately. You need not wait till you decide to conceive. These tablets will help healthy growth and healthy implantation of the products of conception. Since it is now more than six months of your miscarriage, you may attempt the pregnancy now. You can go ahead with the unprotected intercourses now with the aim of conceiving. I hope this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 6 year old daughter is hot to the touch but has no fever.  Her body is achy and she is very sleepy.  I detect a swollen lymph nod on her left neck but she says it doesnt hurt to swallow.  There is strep throat going around and Im wondering if I should take her to get tested. ### REPLY: Hello and welcome to ask a doctor service. I reviewed your query and here is my answer. You said she is hot to touch but no temperature, which means she is not febrile, hence this rules out infection as a cause of enlarged lymph nodes. Besides this, you said she is sleepy which means she is tired and weak as well. Since when she is like this and her lymph nodes are enlarged? If it is from a long time, then it could be chronic disorder for which she definitely needs to see a doctor and have some tests. But if it is acute then it might be due to sore throat. Hope I answered your question.  Feel free to ask if you need further assistance.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had 2 babies in the last 4 years. In the last year I ve lost around 10 pounds and have been exercising Much more regularly than in the past. In the last month I ve noticed a bone near my sternum sticking out. I ve also had discomfort in the area (what feels like could be heart burn). Should I be concerned? ### REPLY: Hello, What I feel is since you are exercising too much there might be losing of the fat tissue from the area. Also, having it checked is no harm but a sensible decision. The bony appearance should be just the Costco .  If you have any kind of breathless and chest pain in combination then better to get it checked once. Hope I have answered your query. Let me know if I can assist you further.  Jay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, I am Sridhar Mani from Qatar.. My age is 34, sex ; M .. Last one week i have been facing a nausea/hunger most of the time with slight giddiness most of the time in a day. Do not see any disturbance or vision effect during day/night during sleep. Last 10 days back had done the ECG/Blood/uric/Sugar test where everything was normal except very miniumul increase in cholestrol level. Just due to this i am unable to concentrate on my work and panic.. I did also taken some paracetamol (panadaol) for two times during a week and stopped taking it further.. Whom should i consult to get this cured and what is the reason for this dizziness and nausea.  Please also give your suggestions on the food to be taken during this time to get it cured. Thanks, best regards,Sridhar ### REPLY: Hello Sridhar! Welcome and thank you for asking on ! I passed carefully through your question and would explain that your symptoms could be related to gastritis or gastroesophageal reflux. A metabolic disorder can not be excluded either. Coming to this point, I would recommend consulting with your attending physician for a careful physical exam and some further tests: -a fibrogastroscopy to investigate for reflux or gastritis- PCR, ESR for inflammation- thyroid hormone levels for possible thyroid gland dysfunction. Hope you will find this answer helpful! 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: Dear dr. I m having lumps in both of my breasts.. the fnac test conducted n detected them as fibroids.. dr suggested macgla capsules for them.. since almost an year.. the breasts r paining...n the size is increasing... there is no leakage from nipples... kindly suggest me ### REPLY: Thanks for your query... It seems that you are suffering from Bilateral Fibroadenomas which are benign, discrete mobile lumps...and u were given Manila which contains gamma linoleic acid and mecobalamine that are proved to be of ineffective. ...as per the latest studies in both fibroadenomas and fibroadenomas....... U need to be reexamined by a surgeon and if they are fibroadenomas....get them removed (Excision biopsy) and tested definitely...... if it is only fibroadenomas causing pain....u shut start wearing tight-fitting dinnerware brassiere regularly and can use medications like simple analgesics, diclofenac local ointment, tamoxifen tablets prescribed by a doctor only 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 got bit by a dog that according to the owners has all its shots, on my pinky just two days ago. now my whole pinky is numb and swollen. starting like two hours ago my ring finger and side of my hand is randomly getting numb. the numbness comes and goes? should I go get it looked at ? ### REPLY: Hello, Welcome to , As you were bitten by vaccinated dog following which you are having numbness in the bite site. Rabies is a disease transmitted by dog which is 100% fatal, but it is 100% preventable with proper and adequate treatment. You need to take vaccine on days 0, 3,7,14 and 28, if the dog is available for observation and not having any symptoms of rabies for 10 days you can discontinue the antirabies vaccine. The numbness is may be due to the pain caused by the bite and not because of the disease rabies. I would suggest you to consult your doctor for the shots of antirabies vaccine. 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: GOOD EVENING, I NEED A PULMONOLOGIST I WILL BE STARTING ON A DAILY DOST OF BREO ELLIPTA IN ADDITION TO MY DAILY DOSE (1X DAILY) OF SPIREVA. I AM SOMEWHAT AFRAID OF THE BREO - BECAUSE IT IS NEW, AND I KNOW NOTHING ABOUT THE CLINICAL TRIALS. BUT, I AM LESS COMFORTABLE WITH MY MILD COPD THAN I HAVE BEEN FOR A LONG TIME AND MY BREATHING RESULTS HAVE NOT BEEN AS GOOD AS THEY WERE FOR THE PAST SEVERAL YEARS. THA NK YOU JUDY BELFOR ### REPLY: Thanks for your question on . Breo Elliott is having bilateral and fluticasone curate. Bilateral is newer long acting beta 2 agonists. And fluticasone is long acting inhaled corticosteroid. And it is very well studied .  It is long acting so given twice daily. And you can definitely take this with spirea. Also enroll yourself in pulmonary rehabilitation center where chest physiotherapy is available. Besides vaccinate yourself with pneumococcal and h.influenza to prevent future infection. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 just had gallbladder surgery earlier today. I have mild pain in the incision sites, still slightly drowsy from pain meds & slight sore throat from intubation. Taking Norco every 6 hours for pain. Within the last hour, both of my hands up to my elbows have become numb. Should I be concerned. ### REPLY: Hi.noted history of gallbladder surgery associated with postoperative pain and numbness on upper extremities. Post-operative pain is expected at this early phase of your recovery. The important thing is it could be controlled and decreasing as you go through your recovery period. Even some of those who have been operated on years ago still experiences discomfort or mild pain from their operative sites, which doesn't necessarily mean that there is something wrong. Re the numbness in your upper extremities, it may be positional. You could start to move around as tolerated and not just lie in bed for faster recovery. It is also best for you to do a follow-up consult with your surgeon and let him/her know about these concerns. Diagnostics and management will be advised accordingly. Low fat diet is also recommended. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. Over the past few months I ve been starving myself because of weight issues. I realised I had to stop because I had developed a surge of red/pink spots on my chest, neck & nape area. I hadn t realised they were that bad because it was itchy & provoked me to keep scratching until I stopped when I saw the spots forming. I also had a lump on the side of my neck.. Thinking it was a swollen gland.. Then fearing the worst that it could be an abscess etc. My Doctor said it was actually a viral infection & prescribed me some allergy tablets to treat it. I have managed to lose some weight.. Yet have also gone back to very bad habits; like purging everything I eat.. Bulimia is something I ve been going through since 2009. I just feel the need to puke all the time. I understand that my periods have been somewhat irregular which is down to not eating healthily or on time. I skip breakfast & eat in the evening which leads to more purging. I drink plenty of water to compensate fir the effects. I ve also noticed tiny lumps in my breasts. Sometimes my right.. Sometimes left.. Even feel very itchy.. Then tender. These patterns have been developing around the time of on it before my periods. I once felt a blunt pain in my lower abdomen.. Then a few sharp ones on the inside of my vagina; feels like the pain is coming from the left side of the ovaries. These sharp pains occur from time to time. Sometimes they go away.. Then come back again. ### REPLY: Welcome to ChatDoctorGreetings of the davits quite common for people resorting to crash dieting and bulimia to have Vitamin deficiency especially vitamin E and Vitamin B6. They present with skin lesion and itching. Taking vitamin supplements containing this vitamin will definitely help. I would also like to suggest getting a counseling done from your physician for the symptoms. Take disregards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son headbutted me in the mouth a couple years ago and cracked my 2 front teeth since then I ve had another baby and it took the calcium out of my teeth and my 2 front teeth are just half teeth however I really want tget my tongue pierced will it affect much more than is already done? ### REPLY: Hello. Thank you for your question at . No thinking about calcium loss piercing will not accentuate it. But piercing has other side effects like, it may cause infections, .  You can visit American dental association www.ada.org for further information on adverse effect of piercing. ADA strongly discourages piercing. So advice not to go for piercing from my side. On the other hand about cracked tooth I would say go for laminates on those teeth. You can go for zirconia or other porcelain veneer crowns.it will protect your teeth from further calcium loss as well as will give you good appearance. 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: Three weeks ago I had ingunal hernia surgery on my right side. After surgery by scrotum was brused and swollen, also where my penis comes out it was brused and sore. now when I have erections my penis is bent upwards and not as thick. there is also a thicker ridge (ring) around the base. Please help me, let me know what s happening.. ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have undergone surgery for Inguinal Hernia which was followed by swelling and bruising of the scrotum and base of the penis. This is common to have swelling and bruising of the scrotum and soft tissue around base of the penis after surgery of Inguinal hernia. Normally it gets resolved within 3-4 weeks. As regards bending of the penis it is most likely to be due to edema at the base of the penis with will also get cured within 3 -4 weeks. Please take broad spectrum antibiotic like Čeferin along with anti-inflammatory .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 31 year old female living in Pakistan. I have an oily acne prone skin for which I got treatment for an year. I dont have acne now though pimples pop up every now and then, like 1 pimple at a time. I have wheatisChatDoctorplexion. I want to improve my complexion with better and even skin tone. What cream (like that of Fair & lovely, though I know it does not address hyperpigmentation and does not last long) or medicines like (supplements) or both (cream and supplements) should I use? Cream should have permanent effect unlike Fair & Lovely. Thanks ### REPLY: Hello, Thank you for posting on . Complexion of any person is having two components; constitutive, one which is predetermined by genetics and racial factors and usually cannot be changed with any treatment. The other component is due to external agents like environmental exposure, sunlight, use of any cosmetics etc. and is amenable to treatment. You can get a series of chemical peels, which actually remove the upper dead layers of skin and stimulate regeneration of collagen and thus newer layers of skin. Many options are available in chemical peels depending on the requirement and skin type. (Glycol peel, retinol peel, cocktail peel etc.)Also, chemical peeling can be preceded by a simple procedure called microdermabrasion or commonly known as skin polishing to augment the results. Also, at home you can try using cream containing comic acid, betray . Always use broad spectrum sunscreen before going out in sun. Use a plain moisturizer like detail DAM on daily basis for healthy and HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Rught after hurting my lower back yesterday, both my legs became extremely weak and shakey feeling as though they couldn t support me anymore. My lower back feels very very weak now too. What s wrong with me? Do i have to pay to continue to consult I m sorry, i just read that I have to pay. I have no money at this time. Thank you anyway for taking the time to read my question. ### REPLY: Dear patient You have got para paresis due to back injury. This is serious issue, and you need to consult spine surgeon as soon as possible. Spinal cord and nerves travels through spinal canal and back trauma may lead to vertebral fracture or disc prolapse with spinal cord compression.  Spinal cord compression leads to weakness in both legs and loss of bowel and bladder control. This if not treated in time may not recover. So the need of urgent consultation. I would advise MRI of lumbosacral spine with screening of whole spine to confirm diagnosis.  Visit expert spine surgeon with report. 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: Hi, Three days ago my boyfriends penis started bleeding when he got an erection and we were about to have sex. It bled enough to soak through his shorts. He blamed it on getting his penis caught in his zipper earlier that day.  We didnt have sex because we were both freaked out by what happened, but now three days later his penis is still bleeding when he gets an erection. Should we be worried? What could be causing this? ### REPLY: Hello, Bleeding from the foreskin of penis is normal during initial days of having sex. As you have mentioned your boyfriend has injury by zipper. Whenever he will get erection he will have some pain and bleeding from damaged capillaries. Nothing to worry, it will resolve in few days. He can take painkillers like Ibuprofen for pain. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have two very sore ribs and one that goes under my breast gives me pain once on a while.  I was lifting very heavy boxes bending to the far left and lifting up and over.  Went to a chiropractor who gave me adjustments and said I was very inflamed.  Using ice and aleve.  Still hurts, not as much but constant.  Should I go for exrays? ### REPLY: Thanks for your question on . I can understand your situation and problem. By your history and description, you are mostly having musculoskeletal pain due to lifting of heavy box. Follow these steps for better symptomatic relief. 1. Avoid heavyweight lifting. 2. Avoid strenuous exercise. 3. Avoid bad postures in sleep. 4. Avoid painful movements. 5. Start painkiller and muscle relaxant. 6. Apply warm water pad on affected site. It gives more relief than ice. By doing all these for 1 week if you are still having pain then get done chest x-ray to rule out internal damage. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear sir i continuously masturbated from last 15 years, so my semen have thin and now when i masturbated i feel pain in my lest testis with pain feel on left side heap(thigh). kindly solve my problem. how i increased sperm, how i get rid from masturbation. thanking you ### REPLY: Hello,Masturbation is normal after puberty. It is one type of sexual function. But if person has to masturbate frequently and/or causing any troubles then it is a matter of concern. Frequent masturbation is reflection of deep-seated tension, stress, or high sexual desire. Homeopathy is very much helpful in this type of cases. Homeopathic treatment is based on total understanding of patient on physical and mental level. And that's why detail history of patient is needed for proper homeopathic treatment. Your problem can be cured permanently with homeopathy. So consult to good classical homeopath nearby you or contact us. Have a better 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 m an Asian Male, 33 years old married for 5 years. Since a year,as my wife & I were trying to conceive, I have had problems with my penis maintaining erection during intercourse.Also, there has hardly been any penetration. I had a visit to the doc,who ruled out any issues with my penis.He has recommended to use Duralast 30( Dapoxetine tablets) at least half an hour before sexual intercourse . Does this tablet act like a Viagr a? Are there any side effects from using this often ? ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you are facing problem of Erectile Dysfunction and have been advised to take Duloxetine, Dapoxetine is generally prescribed for premature Ejaculation. Please consult qualified Urologist for evaluation and tests to detect the cause for your erectile dysfunction. Following measure will help you to boost up your confidence and getting good erection. And delay ejaculation.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc3)Take anti oxidants like Almonds 5-6 every day.4) Avoid alcohol and smoking.In the meanwhile you can take Sildenafil (Viagra)as on demand. This will help to get good hard erection, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 31 year old female, I suffer from bad breath no matter how much I brush my teeth, tongue or use mouth wash. I go to the dentist every six months no visible problem other than a normal cavity treatment. no stomach problems what so ever or constipatation, I am even taking fibers to regulate. what could be the problem? ### REPLY: Hi ! Gone through your query. Diabetes is one among the medical conditions causing halitosis. You did not post blood sugar levels. Check HBA1C every 3 months. Make sure diabetes is under good control. Get professional scaling done every 4-6 months. Brush twice daily. Floss once a day. Mouth wash thrice a week(diluted in 1:1 ratio with water). Do not overuse mouth wash. Smoking, other tobacco habits, old unclean denture and gum infection can also cause this. Diabetics, liver and kidney disease, tonsillitis and other respiratory infections potentially cause halitosis. Check if you have a low salivary flow. If any of the above includes your general health, this has to be corrected immediately. Use saliva substitutes if you suffer low saliva flow. Keep away garlic, onion,tobacco products. Have plenty fluids., 3-3.5 liters per day. Keep HY . 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 husband 30 years old, height 5 8 & weight 68 kg. he suffering arthritis last 4 years. total heep replased. last 2 years have no pain but now he suffering pain his legs. legs are swelling and have a pain. so please suggest me best doctor in cmc vellore for treatment this problem ### REPLY: Hello, Thirty year age is very less for arthritis. If there is pain at knee then this does not look to be due to arthritis. There may be weak muscles or some cartilage issues. You may ask him to do some exercises which helps in strengthening his thigh muscles. There are also some medicines like glucosamine, Chen .  Take care. 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: Hello, I was scratched by a monkey s nail 3 days on my chest. There are 3 small wounds which are superficial and appear to be healing well. I am not experiencing any other symptoms. I am traveling abroad in Bali and just became aware of the rabies outbreak in 2010. Should I get the rabies vaccine or is it too late? Thank you. Any advise much appreciated. ### REPLY: Hello, Thank you for your contact to . I understand your concern. If I am your doctor I suggest you that there is nothing worry at this point of time to take the rabies injection. Secondly chances of rabies during this period is nil as there is no outbreak recently. But it is safe at this period to get vaccinated for you. I will be happy to answer your further concerned can contact me. . Infectious disease specialist. 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, may I answer your health queries right now ?  Please type your query here...There is an inch long lump on the left side of my pubis.  I doubt it is anything but I suspect a swollen gland.   Do I need to see a doctor or just wait.  It has been there about 2 days.  Showed up after a 10 mile bike ride - first bike ride in 9 years. ### REPLY: Welcome to  .1. The possible cause will be lymph nodal enlargement. Lymph nodal enlargement will be seen after any infection / inflammation.2. The excessive stress the thigh muscle have experienced after the bike ride after a long time - may give lymph nodal enlargement due to localized stress.3. If any other underlying medical condition you are experiencing - treat the cause first.4. If lumps persists without any pathology - an ultrasound examination of the lump - will help to analyze the nature of the lump, its source and extensions.5. Depending on findings a needle sample might be necessary. Ant treatment depending on findings. Good luck. 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: my husband is currently on a course of tetalysal for three months. can we try to conceive while he is on this medication or will there be adverse effects on the baby? Alternatively how long after he stops the course of antibiotics will it be safe to try and conceive? ### REPLY: Hi, Yes, as it can be taken safely by your husband. Betrayal (Lymecycline) is used for the treatment of infections caused by susceptible bacteria. If given to a pregnant mother it can cause harmful effects like bone and teeth abnormalities in the baby hence it is contraindicated during pregnancy. However, let your husband complete the course of betrayal as it is not going to affect your pregnancy and there will not be any adverse effects on the baby. Hope I have answered your query. Let me know if I can assist you further.  ### END