Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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. Good day. Im trying to find some information. On my top gum, by my teeth (between my two front teeth), it seems to be swollen. Also on the roof of my mouth there are some swellings and two white dots. I used a treatment called Bonjela. i have noticed this for two days now and Im really trying to find out about this before anything serious happens. Thank you in advance. ### REPLY: Thanks for your query, I have gone through your query. The lump swollen gums can be because of the gum infection. The swelling and white spot on the roof the mouth can be secondary to tooth or gum infection forming an abscess. Consult an oral physician and get a radiograph done to rule out tooth infer ton. If there is tooth infection, then it has to be treated with RCT. If there is a gum infection then the teeth has to be cleaned. Msanwhile you can take a course of antibiotics like penicillin and metronidazole combination(if you are not allergic) after consulting the physician.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: I not sure if I am pregant or not the following is what I am feelingHeadachsHad stomack cramping but not anymoreI am always sleepyI dont really have appetiteconstipationnausea just started today but its been off and onmy period was late but only by a couple of daysbefore my period was late I had hives ### REPLY: HI, I understand your question. Pregnancy signs are due to raised pregnancy hormone in blood. some of the signs you have narrated can be seen in some patients as sign of early pregnancy .  But earliest sign is delayed period, nausea, vomiting, giddiness, lack of appetite, psychological stress/ breast signs and more. . And confirmation of pregnancy is either pregnancy test / USG at 5 weeks of pregnancy.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir, I have a baby 11 months old. When he was of 3 months, a convulsion occur in his left hand and inside last 4 months 13/14 times the convulsion problems occered. The intensity of the convulsion was sometime mild and sometime very intense. Though, he is of 11 months but he cannot eract his neck till now and he cannot sit yet. His heeath and weight is like other normal baby of his age. He also had congenital cataract in both of his eyes. He has got operation in his two eyes and uses spactacles. I would like to take him to india for better treatment. Please suggest me how I can get my baby well and fit like ohter normal baby. ### REPLY: Hello, I am sorry for your kids symptoms By what you say I feel the kid is having cerebral palsy with seizure disorder which may be a dynamic for progressive disease. Unfortunately there is no permanent cure for this and the only treatment options are available for good seizure control physiotherapy occupational therapy and early stimulation therapy. You can approach AIMS New Delhi for Free Chiara tribunal institute in Driven .  Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am male, 54 years of age. I am 1.73M, 75kg. With a BMI of 25, I am a bit overweight as an Asian.My blood test results in early March is AST 40, ALT 77 which was 24 and 40 in the last test of 2013. My Cholesterol is 6.54 and Triglycerides is 3.0. I seldom do any serious exercise in recent years. I don t have hepatisis. I am afraid I might have fatty liver. What should I do? ### REPLY: Hi thanks for contacting ... Noted you have elevated liver enzymes and over weight..... So here two differential diagnosis can be there......-gall stone or -fatty Livermore its detection ultrasonography useful... Here you have to lose your weight. For that calories must be burned.... Regular one hour exercise is the best one. Try to avoid sedentary lifestyle... Use very much less oil in diet.... Use sunflower like good oil only.... Avoid alcohol.... Trans fat food like pizza, burger, cheese, butter, meat avoided.... Take care... Hope your concern solved.... .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Husband was diagnosed with pneumonia with a temp over 103. Doctor prescribed Zpack and ibuprofen for fever. It s been 7 days and he is sleeping a lot and complains of weakness if he moves around. Coughing a lot with a rattle sound in his chest but no fever. Can the pneumonia still be in his lungs? He is a 60 year old male with sinus and allergy problems; otherwise in good health. He did take the flu shot ### REPLY: Thanks for your question on . I can understand your husbands situation and problem. In my opinion you should consult pulmonologist and get done 1. Repeat chest x-ray 2.  Sputum culture and sensitivity report. Since he is not improving and still having cough and congestion with fever, even after antibiotics, we need to rule out worsening of underlying pneumonia. So chest x-ray is needed for this. Sputum culture will isolate the causative organism and sensitivity report will guide you about effective antibiotic therapy. By this, we can achieve faster recovery. So consult pulmonologist and discuss all these. Appropriate antibiotic treatment is the main thing in pneumonia treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am concerned about my mother.She is 48, epileptic,no recent change in medication, no recent seizures or injuries,allergic to codeine and acidic fruits. She started having a burning sensation in her thigh, which then progressed to the skin feeling like she is being electrically shocked,now she feels it in her arms and says it is unbearable if anything touches her..i dont know what to tell her,besides go to the doctor....because she has no insurance right now and my dad wont pay for her to get checked out..please,any information would be appreciated. ### REPLY: Hello dear, The of symptoms as mentioned in your post can be due to:1. Peripheral neuropathy2. Any abnormality in blood pressure & blood sugar levels3. Anemia (either Iron deficiency or It B12 deficiency anemia)4. Deficiency of certain nutrients like Iron, vitamin B 12, Calcium, etc. which also interferes with blood formation & nerve conduction. Symptomatic relief can be obtained with intake of cervicogenic agents like It B12, It B6 & Folic acid. If symptoms still persist, then kindly consult her treating Doctor for proper clinical examination including nerve conduction studies. 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: HiMy husband had penile cancer and had to have his hip lymph nodes removed in 2011. He has been suffering with a balance problem 0 vistibula neuronitis ? i think its called. Today he has developed a rash over his hip are - from one side of his torso to the other. His temperature is lower than normal too and he is suffering with feeling extremely cold - although he is well covered. He ia also a type 2 diabetic ### REPLY: Hi and welcome to . It sounds like infectious disease, so I don't think it is related to his previous medical history. It can also be allergy reaction. Whatever it is, he should go to a doctor and do basic blood and urine tests. Usually this is respiratory or urinary infection, but some insect bites may be considered as well. Till you visit doctor, keep him HY .  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: Hello, I m a 16 year old male and I ve got a severe case of acne vulgaris . It s all over my chest, back, and the nape of my neck, and it hurts! It s super itchy and I can t help but scratch them, tearing the scabs off in the process. They re probably really infected because the pus is a little orangish in color. So I d just like to know the easiest ways of curing this problem. ### REPLY: Hi Fairbanks for your query Don't worry too much .... Do not squeeze or scratch the pimples. Keep your skin clean, Have healthy diet & lots of fluids. Avoid too many oily foods. Apply topical Clindamycin gel over the pimples for a month. You can use topical retinoid over the comedones [but be careful as sensitive persons develop burning sensation and redness after application].and use oral Isotretinoin for 4-6 months [but always under supervision of your dermatologist] Hope this helps you. Stay in touch with your dermatologist.  Take care :) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am an 18 year old female. I have excessively sweaty armits and both my lymph nodes sell and get sore for several days at a time. My joints ache badly. My knees, my elbows, my hips. All of my joints crack and pop constantly. My back cracks and constantly hurts as does my neck. My feet are almost always purple and cold. I often get the sensation in my feet like they have been asleep and the circulation is just returning. Sometimes they burn. When I throw or do certain things I get a terrible shocking pain in my elbows. I have chest pain often and shortness of breath. I feel my heart beat sometimes and it will skip a beat and it just isnt rythmatic. I am concerned for I am so young and I am afraid I will end up in a wheelchair before I am forty. I do not have medical insurance but I plan to consult with the dhhr for something so that I wont be charged to get help. My first cousin was recently diagnosed with lupus. I know that this is genetic. Couldvthis be whats wrong with me? ### REPLY: Thanks for your question on . I can understand your concern.You're all symptoms are more suggestive of stress and anxiety because of the fear of lupus. But better to first rule out heart diseases and lupus. So get done ECG, 2d echo and Holder monitoring (24 hours continuous recording of ECG). If all these are normal then no need to worry about heart diseases. Also get done ANA (anti-nuclear antibodies) profile to rule out lupus and other connective tissue diseases (CTD). If ANA is also normal then no need to worry about lupus. Consult psychiatrist for counseling sessions. You can, may need anxiolytic . Don't worry, you will be alright. Avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my friend consumed half a cup of harpic (toliet cleaner ) it contains hydrochloric acid . he did not vomit after consuming . it s been almost a year and now he has pain in his chest and has the problem of asthma . he consulted a doctor and the doctor said that the infection can t be cured. but there many cases that are worse than this but they have been cured . so please suggest me somthing ### REPLY: Your friend is lucky that he didn`t have much damage after consuming Harris which contains acid though mild and many other chemicals. He could have developed hyper reactive airways after inhaling the fumes or some of it may have gone down his airways. He may go in for chest CT to assess the damage to the lung parenchymal and a PFT. The risk is if he has any damage to lungs he may develop bronchiectasis, and he may get repeated chest infections. He may develop hyper reactive airways and have asthma may develop OLD.  If he has no symptoms at present. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, my son 6yrs having fever from 27th and we started paracetemol p 250 and Taxim O from 29th, now my son fever is 98-99 sometimes. He is now having vomiting tendency and gone to toilet 6 times today. His urine and previous stool was quiet Ok. Sir please advice what to do, will I stop giving Taxim-O and wait for the best. Plz advice ### REPLY: Hi... Thank you for consulting in .UNNECESSARY USAGE OF ANTIBIOTICS LIKE MAXIMO MAY CAUSE ANTIBIOTIC ASSOCIATED Diarrhea. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. 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 has a cyst on his neck got it lance 3rd june, went back into hospital got it drain on 3rd july and he is for surgery today as it has got very big, the opening is still there but there is a lump fill up again below where it was lance.he has a cough with this i just notice the last 5 weeks, they are going to do a biospy today on ### REPLY: Hello, Thank you for your contact to . I understand your health concern, if I am your doctor I suggest you that definitive treatment can only be possible after the biopsy. But after at all surgical therapy is the definitive treatment for all the lump. So you should be prepared for it. I will be happy to answer all your future concern. Thank you, ChatDoctorInfectious disease specialist. Wish you the best health at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 woke up yesterday with a swollen lip, ( bottom lip left side) with what seem to be hives, as far as i know i have no allergies, my lip itches and burns and after 36 hours is still swollen, what could be the cause and how do you think i could fix it? ### REPLY: Hello and welcome to  I would keep a possibility of Angioedema. Angioedema or Quinces edema is the rapid swelling of the dermis, subcutaneous tissue, mucosa and submucosal tissues. It can be either Acquired OR Hereditary Angioedema. I would have liked to gather some more information from you regarding your concern in order to be able to help you better.-Since how long do you have this problem? -Are you on some oral medications? Painkillers? Antihypertensives? -Do you also suffer from Hives/Urticaria? -Does anybody else in your family has the same problem? Apart from being hereditary, Angioedema can occur due to various other causes like(similar to urticaria):--Infections(bacterial, viral, fungal) -- .  I would advise you to get few basic lab tests like Hologram, stool for ova/cyst, Urine routine, Chest X-Ray. An oral antihistamine like Fexofenadine (Allegra 180 mg tab) OR Loratadine (Alaskan 10 mg tablet) once or twice daily for a week would be suitable. They are non-sedating and won't affect your alertness level. If I was your treating doctor I would have also given you a shot of injectable antihistamines like Evil(pheniramine) and Injectable effcorlin(HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a callus like spot on ball of my foot in middle for years, have done the trimming of it tried pads to keep pressure off it while walking ....basically ive tried it all, not it is really big and thick and it causes me some really bad pain. what should I do? could it be a bone spur in that area of my foot? ### REPLY: Hello and thanks for consulting . It could be a callus, but it sounds like you may have a plantar wart. Warts are different from calluses in that they often have a small dot in the middle of them and calluses do not. They are common on the bottom of the foot and can get very thick and painful. If you think it may be a wart, there are two types of over the counter medications you can try. One is a salicylic acid preparation that you apply twice a day (it can take months) and the other is a small instrument that freezes the wart. If you are not sure, see your doctor for a diagnosis. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi... i am 25 year unmarried male and facing of fluid leakage (same as urine but with very different smell) each time when i go for toilet .This phenomenon makes me vry tired and tiredness can be fell on my face by any body.my penis is also getting weak and small. I am not habitual of masturbation ,use to do it thrice a month but each time i do this its makes me very tired and eyes goes down regularly .Even after that i feel some at lower part which is making my body lower part wider and bad looking. why my eyes going deep inside even i do hv good diet is it curable my face can same as previously and with good looking eyes ### REPLY: Degree understand your concerns went through your description. I suggest you not to worry much. The fluid you are talking about is actually the semen itself. Body produces semen whenever it is sexually aroused. Such semen should be ejected out of the body, and it is the need of the body. If you do not masturbate or indulge in sex regularly, body finds its own way to eject produced semen. It could be through night fall or urine. Your case is normal and stop worrying. As such leakage is normal, all your tiredness feelings are just in your thoughts. Divert your attention from sex related matters and prioritize. Channel the thoughts towards education and career. You might need psychotherapy and other cognitive behavioral therapies. I can help you through telephone. Please do contact me through customer care of www.ChatDoctor .com for a telephonic consultation session. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i ve acne and spider veins on my cheeks . There are also scars left by acne. I m a 21 year old woman. Plz help ### REPLY: Hi! Welcome to  forum, Treatment for acne and acne scars are two different treatment. First get your acne treated. Once you are through then go for scars. Treatment for acne depends upon the stage of acne. Selection of right soap or face wash is most important. You should not use oily soaps. Use decade acne soap once daily. Apply mandolin cream topically over the lesions once a day. Take tab Literal(500 mg) once daily for 5 days(1hr before food). . Take good 7hr sleep. For scars, you can go for lasers like fractional laser which is the latest of the lot. If its mild then even dermatome is ok. For spider veins you have to go for lasers again and it's a different laser than that for acne scars. You can go for 532 nm q-switched laser or long pulsed Nd:YAG laser or a PDL(pulse dye laser) laser which is the specific laser. Some doctors even do electron cautery for the same. If you can tell me where you belong to, then I can guide where to consult for all the three treatment. Take care, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...my-8-year-old-son-has-a lump in his lymph node, in his armpit.  His doctor saw him today and said it was in an odd place and could find no reason for it.  He is going to childrens hospital on Tuesday, 5 days from now.  I am sick about it and can barely function, what could it be?  It is the size of about a quarter. ### REPLY: Hi.it is best if you consult with a doctor, preferably a general or a pediatric surgeon, for medical and physical examination. Based from your description, it could be hi .  These lesions usually occur on the underarm, especially after shaving or plucking and/or usage of deodorants with strong chemical contents. Hair follicles get infected. Inflammation and subsequent abscess formation occur. Medical (proper antibiotic regimen) and surgical (excision or incision and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 24 years old male, I am having problems in my sleep and i cant have food as i regulary used to i feel like vomiting after having some, i cant concentrate on anything, i recently had a break up in relationship, everytime random thoughts hunts my mind please suggest a solution ### REPLY: Hi. I understand your concern. Relationship problem can lead to stress. Secondary to stress there are problems like sleep disturbances, fatigue, unable to concentrate etc. Need to divert your thoughts and environment. Relaxations method like deep breathing can help. Exercise and meditation can be useful. Change in lifestyle and always keep yourself busy will helpful to divert your thought. Psychological evaluation help to identify stress triggers factors and psychotherapy will help to modify it. Medicines like anxiolytic will help. Benzodiazapine and Mizoram will be useful. Consult psychiatrist for further assistance and take advise before taking this medicine. Still if you have a query then feel free to ask. 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: I am 60 years of age and am in great health..exercise regularly, great shape weighing 130 pounds throughout the life cycle. However when I was 30 years of age I had a complete work up on my heart because of excessive tiredness. A team of doctors, full exrays, EKG test etc revealed that I may have a slight heart murmur or caused by pigeon chest. People still comment about my outstanding posture, not stooped nor do I have a pot belly. I have had a few doctors say also that I have an athletes heart. Am rarely sick and havent been to doctor in years. Dont drink or smoke and eat well.  I have a great cardio fitness and it takes a lot to get me out of breath. Need I be concerned about the pigeon chest or slight heart murmur in my senior years? Do I need to have it checked for the future?. Doctors reported thirty years ago that I would die with it and not of it. Thankyou. ### REPLY: Hello, No you need not worry at all about the region chest or murmur and as your doctor said it will go with you to your grave, but will never be the reason for it. Region chest is a deformity of rib cage where its maligned, but there is no problem with the heart. The murmur is because of physical change in orientation of heart valves, that's it ! . Here its physiological and no problem whatsoever in the structure or function of the heart . As you have described that you live a healthy lifestyle, do continue the same and your risk for heart event is similar to any person of your age and way of life. Hoping I could reassure you. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife (41 yrs) used to get sudden chills and recently had a few incidents of spinning head for a couple of seconds. We got her tests done and had couple of factors out of range. Her ATG levels are 934 and AMA is 314. T3 and T4 are normal, however, TSH is 7.5. Lipids are normal. She has been prescribed Thyronorm 25mcg for 3 months. Is hypothyroidism curable? Also, she has a family history of heart problems. Does this add to her risk of developing heart problems even though presently her tests results are normal? ### REPLY: Hello. I am . There are three parts to your query which you seem to want to know about-heart problems, thyroid and vertigo. I will try to answer them one by one.1. Ideally you need to be more specific about the exact heart problems that are present. If there is a family history of heart problems, where you are considering heart attacks, yes she may be at risk. However, if she takes good care of herself, she need not necessarily have an attack herself.2. Hypothyroidism- well the blood levels certainly suggest mild hypothyroidism. It is not curable. But it is well controlled if she takes her medicines properly and regularly. The thyroid medicines are best taken on empty stomach in the morning. 3. Spinning of the head may be a positional vertigo. That is why she gets it temporarily, probably when she looks in one direction or bends her head in one direction. You will need to visit a neurologist to perform a Dix Hall pike maneuver. If the condition is confirmed, medicines can be initiated like betahistidine. I have tried to make it as simple as possible. Let us know with the results of the tests for further suggestions. Best of luck,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor,Im a burn victim..I was burning waste paper in my lawn on jan24 th and there happened to be a commpressed can which exploded..I had superficial burns on my face and second degree burns on my right upper limb..now my burns on my face and limbs have healed but it has left behind areas of hypopigmentation and hypopigmentation..Pls advise me for my further treatments..also I would like to get rid of pigmentation...pls help... ### REPLY: For hyperpigmentation, you can use a skin lightening ointment like Delaware for a couple of days. Hypopigmentation resolves in many cases, so it is best to watch for the initial period to check if any change in pigmentation is appearing. If the hypopigmented area persists then there are treatment modalities like micros kin grafting and epidermal grafting. Talk to a plastic surgeon regarding this. Also, do not forget to apply sunscreens over the burnt area before sun exposure. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 7 year old female with abdominal pain mainly in belly button area but does move to sides . has interupted her normal activities dance, basketball, recess,etc. constant pain and in tears and kepps her out of school . she has been on rx hyoscyamine 4times a day didnt help, went to dr again now on dicyclomine10mg 4 times a day still not better. nothing i give her will help the pain or improve her pain. ### REPLY: Hi welcome to  forum.  Thanks for asking a question to . Forum.  The pain at the belly button signifies the worms in the intestine. Getting to the sides may be due to urine infection, or abnormality in the ureter, or stone in the ureter.  Only anti spasmodic will help only to relieve pain for a limited time only. You need to give her antibiotics or antelmenthics for cure of the causative factor.  I advise you to consult a pediatrician for diagnosis and treatment.  Wishing for a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my baby is 10 weeks,she s suffering from stomachache,she s feeding well(breastmilk) but when I rub her to burp she cries and doesn t want to lean with her stomach and after that her stomach get hard now her stools r stringy and it hard for her to pass stools ### REPLY: Hi... This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to .  Unless the air comes out like burping or flatus this discomfort will be there and next time check if she is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief. The constipation you complain of is quite common in this age group...do not be concerned about it unless she is passing 10 days once. 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 keeps having fever for 2 weeks now., It will usually be fine with in 24 hours then come back after 2-5 days accompanied with colds and cough. his temp will be anywhere from 38-39.1. He was hospitalized last week but was just diagnosed with bronchitis. what to do? ### REPLY: Hello, Welcome to , Bronchitis is a condition in which the bronchial tubes connecting airway to the lungs become inflamed. Various agents like viral infection and bacterial infections may lead to mild inflammation of the bronchial tubes. The patients will have symptoms like edema of the airway, productive cough and breathing difficulty. For patients with bronchitis following measures are advised.1. Bronchodilators -i n the form of inhalers or pills.2. Corticosteroids- Steroids should be given in the form of aerosol sprays. They reduce inflammation and swelling of the lung tissue.3. Antibiotics like Tab Augmenting, 625 mg, in case of bronchitis due to a respiratory infection.4. Oxygen therapy is advised where breathing is very difficult. The aforementioned measures will help to improve your husbands condition. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have been feeling sick for about 3 days now. I don t have any energy, feel constantly tired (I am not having trouble sleeping) The top of my stomach feels really tender and a bit of a butterfly like feeling in my stomach. I feel really fed up and a little down. I have googled my symptoms and am not sure if these are stress related. I am getting married in 8 weeks time and I should be really happy but I just can t seem to put on a smile. I have no reason to feel fed up but I just can t find the effort to motivate myself. The feeling of feeling sick is not very nice and it comes and goes. I have spent the past 2 days in bed trying to relax and have not been thinking about anything but this sick feeling is still there. Any ideas of what my symptoms may be? Thanks for your time. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  Tiredness, feeling sick, lack of energy etc. are indeed related to stress and disappointment. You cannot term your current state of mind as clinical depression. Rather, this is just disappointment. Disappointment which arises out of unforeseen life events do bring such symptoms like sadness, irritation, anger, lethargy, lack of interest, lack of appetite etc. Please understand this fact and make sure to introspect. Talking to your friends, outdoor activities and being creative should give you relief. Find the reason for your disappointment and consult a psychologist if need be. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. 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: Hello doctor, I got my semen analysis report couple of days ago and i am worried when i saw that report... Sperm volume - 1.8 visibility normal concentration - 0.0 I dont understand why my report is like this. Please help me whether I can become father or not. ### REPLY: Hi welcome to . I have gone through your question. Your report to described here is incomplete. Motility should be at least 50%. Morphology at least 70%. Liquefaction time less than 20 mins. If your reports don't have normal parameters or have low count or motility then ultrasound color Doppler of scrotum should be done. Hope I answered your question. Would be happy to help you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im 37weeks tomorrow ... very excited but feeling very unwell. for the last 5days ive had lower back pain and started to lose what i believe is my plug. Only little amounts of clear jelly when i go to the toilet. Also im losing alot of creamy discharge that i feel trickle out. since yesterday i feel very sick and cant stop sleeping. Also my throat is very sore to swallow and i barley have an appitite for food. Is labour close? and should i see my doctor about feeling unwell... Laura x ### REPLY: Welcome to  .1. You are having general symptoms as seen normally in the late pregnancy period.2. Now concern is what discharges you are experiencing, for which you have to get an ultrasound scan done, and find out the conniption of the AFI (water level) and the fetal wellbeing.3. At this time nothing much one can do for back pain, only painkillers which are allowed in pregnancy.4. You need to visit your treating doctor and get some antibiotics for the throat infection which you are experiencing (as a remedy salt water gargling would help to some extent)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: Hi, My father travelled  to USA and got unexplained rash on his earlobes - redness and mild swelling or itchy bumps. Now he is back and still getting those rashes but worse on lot of areas of body esp. exposed to sun. He has developed extreme fatigue and bone/muscle tiredness. He checked his vitamin D which was low. Then took Vitamin d and now he seems to have normal levels of those.  He still  has extreme fatigue and bone/muscle tiredness. He also developed diarrea /stomach ache recently. Conditions do not seem to improve. Doctors in india have not been able to diagnose the issue. Please help. ### REPLY: Hi, It seems that your father is having actinic purity. There are itchy papulonoduar lesions on sun exposed area. The disease may be due to over exposure to sun. He must avoid sun exposure. He should cover the affected area. Give him anti histamines like levocetirizine till itch subsides. If there is infection, give him antibiotics. If the condition is embarrassing, give him steroids in tampering dose. Apply steroid cream on the lesions. Fatigue may be due to senile age, vitamin deficiency or some internal disease. Complete blood check up may be done to rule out DM, thyroid,liver diseases, renal diseases, blood diseases or other. Antioxidants, calcium and vitamins may be given to improve general health. Keep him reassured to improve psychologic status. I hope you got my answer. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor, My father is 62. he is having liver problem and is taking medicines. He is non- alcoholic. we got his hepatitis C test done and it was negative. We recently had his LFT done. His report was Bilurbin1.20, Conjugated Bilurbin - 0.70, Unconjugated Bilurbin - 0.50, Total Protien - 6.70, Alumbin - 3.60, Globolin - 3.10, A/g ratio - 1.16, SGOT -67, SGPT - 81 Alkaline Phosphate -134. From last few months his SGOT and SGPt has increased earlier it was normat SGOT 58 and SGPT 63. No one in our family had this genentic disease. doctor has further advice to go for ANA and ASMA and Coesophonal level test. is it really require. kindly suggest and is there any risk facto if SGOT and SGPT level goes higher ### REPLY: Dear FriendWelcome to . I am . I advise you to get also Hepatitis B testing. If it comes negative, you should get ANA, ASIA, to rule out Auto immune hepatitis. However, in autoimmune hepatitis, Serum Globulin levels are raised. Also, get an ultrasound of liver to see for size and echo texture of liver. Based on the available details, this is my best advice for you. You should discuss with your doctor and share my opinion, I am sure he/she will agree to my opinion. Good Luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my brother in law have a low level pphn problem which is bron form six days ago and it is well in all activity...but it have only one problem of pphn, in this problem the are  taken breathing plus 6o which should be 90.....so plz send to me whats the solution of this problem....? and how to improve breathing plus...? ### REPLY: Hi dear, I understand your concern, it seems she has fever with unknown cause. With such presentation in my clinic, we try to differentiate next statements:- intestinal infection, parasites (stool culture, stool for cyst, ova);-respiratory infections(thyroiditis, sinusitis-consulting of ENT doctor+nose, throat culture);-thyroid function (exclude hyperthyroidism-TTH,T3,T4);-autoimmune diseases (circulating antibodies, immunogramm);-UTI(urinalysis). Treatment depends on from cause, then we can receive results. Hope it helps to confirm diagnosis and prescribe correct treatment. You can discuss it with your treating doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A week ago, it started with a slight discomfort in my left knee. Two days later, I could walk without much pain, but stairs had to be done one at a time. Pain helped by taking Aleve. Icing the knee did not appear to help. Feeling around the kneecap, the painful area is above the kneecap. Occasionally, the knee feels unstable. ### REPLY: Hi, I understand your concern. From what you are describing, I think there is a problem with your knee ligaments as you feel your knee unstable. Apply analgesic cream locally. Take glucosamine supplement orally, apply glucosamine gel locally. Try to limit knee movements. If still no improvement, should consult further with orthopedic specialist and run further diagnostic tests. Wish fast recovery.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 33 year old female with lower back problems sciatica caused by herniated discs. I have had a numb right calf and foot since my last serious attack in December. It seems to be improving slowly but it cramps up multiple times a day. Im not sure if this is related but my left arm has been numb and tingling for about a week now and I have experienced a flutter in my chest which causes me to cough. Im starting to worry a bit as Im on Diane 35 and Im not sure if these symptoms are due to a possible blood clot or to the nerve damage caused by my back issues. Any input is much appreciated. ### REPLY: Hi, Based on details you have sciatica caused by herniated disc. This can produce right calf and foot symptoms which you have mentioned. You need to have neuralgic . Numbness and tingling in left arm is also sensory symptoms related to impinged nerve.Hence, you require detail examination for same. Most probable cause would be cervical disc. Consult neurologist/Neurosurgeon Diane contains two  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 brother has some problem, he is 30 years old ,married ,previously he doubted his sister in law that she told some thing about him ,then doubted another man he trying to spoil his marriage life, after that he doubted  another person,and finaly now his doubt with  his wife that she has many illicit relationship with  others,we know there is no reality likewise he is guessing many things like this, physically also he is obsessed , (talking are constant no anger voice)also his father had some this type of problem ### REPLY: His understand your concern. This type of auspiciousness and belief suggest delusion. Delusion is fixed firm belief which are not fact, but patient is not able to accept it and not sharable by any mean. Delusion has many types and to reach how it forms and how much it affects personas thought need to evaluate it properly. Delusion is prime symptoms of psychotic illness and if it is associate with other features like hallucinations and disorganized behavior then it suggests diagnosis like schizophrenia. So please do consult psychiatrist and get evaluate his mental status properly. After proper diagnosis and evaluation it will be possible to treat him. Early treatment will bring better recovery. So consult and get well soon. If still have a query then feel free to ask. Happy to help you. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I woke up this morning in immense abdominal pain. This can be normal to me due to the fact that I have IBS but it doesnt usually occur when I first wake up. I have had frequent urinization for the past two weeks and have been tested for a bladder infection and UTI botChatDoctore up negative. Today, I found myself in a great deal of pain when I got into the bathtub and my clitoris started burning. After examining, it is very swollen below the hole and there is lump where the swelling occurs and puss in the hole. For records sake I am a stone-maker and have had. Y gallbladder removed because of it. What does this sound like? Could I be possibly passing a kidney stone? ### REPLY: Hi. This passing the urinary stone is not likely because this could have caused tremendous pain. The pus, swelling and burning clitoris looks to be a local problem, may be with vulvo-vaginitis and needs active treatment with local application of provide iodine and oral antibiotics. The severe pain in abdomen in the morning can be due to IBS only. Frequency of micturition can also occur in medical problems like diabetes and so get all the blood, urine and stool tests done. Once in a while a CT scan of the abdomen with proper preparation can help to get a differential diagnosis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes i am a 30 year old male who was diganosied with a ventral hernia i have noticed that the hernia is getting larger and my abdomen is getting more painful pleas inform to what i can do that might help take away some of the pain in my abdomen it is almost to the point of being unbarable ### REPLY: Hi ! Good afternoon. I am  answering your query. With the history of your hernia getting bigger and the pain becoming unbearable, I would advise you to report at an ER of the nearest hospital instead of trying any medications to rule out chances of obstruction/strangulation of the hernia which might prove to be quite detrimental for your health. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My brother had a laparoscopic appendicitis mild surgery on 14th april 2013.after 3 days of surgery a sudden attack started creating numbness in whole body, tongue has gone out of his control which lead to tongue bite, persistant drooling and motion stopped for a week accompanied by stomach swelling ### REPLY: Hello! Thank you for the query. Such symptoms are most likely a complication of anesthesia. Especially if he has had subarachnoid anesthesia (if there was any injection to his spine). If so, he may have meningitis. Abdominal issues may be also caused by an abscess in the surgery area. I suggest your brother to visit his surgeon and consult neurologist. Abdominal ultrasound and spine function should be done. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. My friend may have ovarian cancer. Her parents had kicked her out and she can barely afford an apartment and food from her job. Not only that, but its a seasonal job and she may barely have enough in winter. She cant pay for treatment and refuses to go in unless there was a way to either postpone payment or even lower the payments. She has no where to go and is in pain constantly. Is there somewhere where she can go to get proper treatment and pay less. ### REPLY: Hi, Thanks for writing in. Cancer is a challenging disease and early detection and treatment is best to control and cure the patient. You have not mentioned which place and area you are from and without knowing it is not possible for us to suggest any local health treatment center or cancer support group where your friend can get treated at low cost and probably without much of difficulty. There are much cancer support groups all over the world, and they sponsor treatment for cancer patients of all ages and regions. Do not delay the confirmation of diagnosis and starting treatment for your friend. You can also form a group on social networking sites and collect money to be given to her for her cancer treatment and healthcare need. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Liver; The hepatic parenchyma shows minimal coarse.Texture with increase in its echogenicity.There are peripheral attenuation of the hepatic venous radicals.Normal appearance of protal veins.MPV =11 mm.  No evidence of dilated radicals.Picture of mild diffuse fatty liver For further laboratory working up.Thank You. ### REPLY: Hello! Thanks for putting your query in . I am a Gastroenterologist (DM). It suggests that you have fatty liver, which has many causes like alcohol intake, metabolic disorder, hepatitis B/C, and autoimmune disease etc. So I will suggest you to visit a Gastroenterologist or Hepatologist for evaluation and management. I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and 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: My 13 yo son has CF. He has been having problems with pancreatitis. He had an ERCP in October, which seemed to help for awhile. He began having pancreatitis again. Another ERCP was performed with sphincterotomy and stent placement. That was almost 2 weeks ago and he continues to have a 4-5 pain level. His enzymes are normal. He is being treated with oxycontin and oxycodone. What could possibly be the reason for his ongoing pain? ### REPLY: Hi, Welcome to  forum, Its a real sad thing to hear what your son had to go through in this young age. However, I would like to assure you that he is getting the appropriate treatment for his condition. Usually such surgical procedures take a long time about 2-4 weeks depending on the children immunity. As he had it for the second time, so healing can be a bit slower. I would advise you to continue with the pain medications your doctor prescribed. However, if the pain is very severer than before, then it's better to consult you doctor for an evaluation to make sure everything is fine. Hope he gets 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 Doctor , It has been diagnosed as Molluscum Contagisium. I have a dozen bumps localized on my neck, some big enough to be a little visible, the rest very small. The doctor I visited states that Curettage is the only way. My own research shows that Pulse laser is the safest ( safe w.r.t. risk of scarring) when compared to curettage and cryotherapy. What do you suggest? Thank You. ### REPLY: Hello, Welcome to , Molliscum contagious is a viral skin disease which is contagious and can spread to other areas. Isolated lesions can be expressed or removed by minor procedure. Topical treatment includes imiquimod cream or retinoid cream application on those lesions will cure the problem. Proper evaluation of the lesions and appropriate treatment modality should be suggested considering also the age of the patient. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor,im 27 yrs female not married yet.im having hypothyroid and taking tablets for past 1year.Thyroid level is normal now.Marriage proposals are going.I have read that thyroid patients will have problems in getting pregnant.Can i get pregnant.Im very confused and get angry very often.will it affect my family life in any ways?Please help me doctor. ### REPLY: Hi, Thanks for the query. I understand your concern . It seems you are under medication your thyroid levels are normal now. Please always consult the treating endocrinologist routinely. Get thyroid function tests repeated ... as per his advice.and continue the thyroid supplements without any break... Though low thyroid affects pregnancy child (irregular periods causing difficult in conceptional intellectual development of the fetus) * but with thyroid level maintained normal there is no such risk. Be cool.  *The irritation you have does not seem to be due to thyroid....it's the tension you have about the possible problems in your family due to thyroid... now as it is settled, you would be tension free&pleasant personality again.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my right side of my mouth(tooth),inside my ear and left side of my neck are hurting.what is happening? i was told i have an infection on my rightside tooth.Never had that problem before.what toothpaste and what else do you recommend that i should take so the pain stops? ### REPLY: Hello, Thanks for consulting , Read your query, as you have pain in right side of mouth this pain can be due to some factor it can be due carious tooth, decayed tooth, periodontal problem can be due to periodontitis, gingival problem may be due to gingival inflammation or enlarged. I will suggest you to consult dentist and go for IOWA X-ray of right tooth region if it is due to periodontal problem or gingival problem then go for oral prophylaxis, if pain is due to caries or decayed tooth then go for its treatment, restoration or root canal treatment. Hope it will help you. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having weird symptoms for over 2 years now. I have been experiencing dull head pressure 24/7 jittery feeling, like being anxious. Right arm and leg gets weak off and on, and clicking noise when I turn my head from side side. My right eye has pressure a lot, because I did get hit with a softball my freshman year of high school but that was years ago. I had a cat scan two years ago, and it came back normal. I am worried about possible brain tumors or something. Roshaunda Hayes ### REPLY: Hello 1 I understand your concern. In my opinion a brain tumor is the less probable diagnosis in your situation. It may be just migraine. Your head CT scan has resulted normal, so this is a high probable diagnosis. I would like to know more of the duration of the headache, is it preceded by the weakness in the right arm and leg? Do you have members of the family suffering from Migraine ? How long do weakness in right limbs last? Another probable diagnosis would be partial epilepsy, but the headache is not typical. I would recommend an EEG to rule out epilepsy. Hope to have been helpful! Thank you for using .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I just had a check-up, and the only thing is not in normal range is ALT level, it is 122, the normal range is 0-50. Prior to my check-up, about 8-9 months, I had been taking some over the counter Chinese herbal medications for digestive disorder and supplements for strengthening liver and kidney functions. Besides, I also included ginger root into my diet quite excessively. I wonder if my ALT level is raised by Chinese herbal medications or ginger? Thanks for your help! ### REPLY: Hello Chinese herbal medicines may increase ALT as its safety is not proved scientifically. High ALT may indicate liver injury. You may need clinical evaluation and investigations like routine hologram, viral markers, random blood sugar, lipid profile, ultrasound of abdomen. I suggest tablet ursodeoxycholic acid 300 mg tablet twice daily for three months. It helps in regeneration of liver cells. You should avoid herbal medicines and consult gastroenterologist for proper evaluation. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my son is 7 years old and he s still wetting himself only at night. I ve tried to minimize drinking water..etc 2 hours b4 he goes to sleep, we made some urine analysis and complete blood picture and seems everything fine, next step the doctor gave him MINIRIN 650 mcg he took it for one month but no use....what else can i do?? ### REPLY: Hi, I have few questions for you -1. Has your son stopped bed-wetting at a certain age and again started having it2. If so at what age he stopped and when did it start. If he had never stopped bed-wetting form birth...you can try some behavioral changes which I can elaborate after proper history and interaction with you, but the effect will not be immediate, but it will be permanent. If it's a recurrence after attaining nighttime control, I suggest you see your pediatrician to rule out pathological causes like urinary infections or Voiding dysfunction. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My urine microscopy result are, Epithelial ++, presence of pus cells, and the doctor spotted bacteria others: nil. culture yielded no growth after 48hrs of incubation at 37 degrees. The doctor went a head and tested syphilis and the results was negative. My penile itch and scrotum . Could this be UTI or Chlamydia? I don t discharge anything in my penile. Please explain this result to me ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have UTI due to Ecol infection. Please take broad spectrum antibiotics like Čeferin along with urinary antiseptic like Nitrofurantoin twice daily and urine alkalizer thrice daily. Ensure to . To keep your urine dilute This will help to control dysuria. As itching of the penis is presenting symptom in Diabetes get your blood sugar levels on fasting stomach and 2 hours after lunch done to rule out the same, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi.I was diagnosed with psoriasis this year in the summer and since august or so i have been taking 30mg of Neotigason a day during meels at the lunch. I have been sober for 4 months now but the New Year is coming and i would really like to particitae and obviously party little with my friend. Is it really bad ti drink that night? Just would like to do that on new year. What do think about it or maybe just quit taking them for a week and then continiue after? I dont know. ### REPLY: Hello, Welcome to , Alcohol worsens Psoriasis. Moreover, you are on Accretion which causes burden to your liver for excretion. That is why liver function tests are monitored when you are on Accretion. Alcohol will add the burden to liver. I would not recommend you to take alcohol. Why should you spoil the psoriasis control just or 1 day of .  Wish you good health 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: why every time i eat my first meal . i feel like i have to throw up after or my stomach gets in pain i am in perfect health i just feel i have pains and feel like throwing up after wach meal. ### REPLY: Hello;welcome to  During the first meal the stomach is empty and the symptom you are telling is due to acidity or even gastritis which may be causing you to throw up. Please take antacid like ranitidine-300 mg and if required for nausea you can take risperidone 10 mg. Both 1 tablets each before every meal three times a day for 1 week then you can reduce for 2 times a day and continue for 2 weeks and the problem will settle. 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: Can poor posture or pelvis tilt effect my erection and size of my penis? Im 30 years of age, and over the the last five years I have noticed it drop dramatically. Im fairly fit, played sports most of my life and now visit the gym regularly. Any advice would be appreciated. ### REPLY: Hi, Poor posture or pelvic tilt is not related to penis erection. There are 4 stages of penis arousal. Stage 1 excitementStage 2 plateauStage 3 orgasm and ejaculationStage 4 refractory periodic increasing age, the duration of excitement stage increases and that is the reason you take longer time to have orgasm when compared to earlier times. This can be seen as the longer time taken for full erection in your 30s as compared to your late adolescence and early 20s. This perfectly natural and with age the time taken for erection increases. It will help to reduce any stress related anxiety that you might be having. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mum has been complaining of abdominal pain for a few months now, however, recently it has become worse.  Today she was in utter agony, i asked her what it feels like and she said like bricks in her stomach area.  She indicated that today the pain originally started around her left hip but has extended beyond that, around her back and front as well as further up, as far as her ribs.  She is now refusing to go to hospital.  I dont know whether she needs to or not.  Please help, I am very concerned ### REPLY: Hi. This is a common sense that when mother is suffering from such an agony - pain in abdomen for the last few months and now has worsened, you have to take her to the hospital for a clinical examination, investigations of blood, urine and stool. CT scan of the abdomen and whatever will be advised on physical examination by a General Surgeon . Sh e needs to be admitted and investigated and surgery if required may be planned. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 full thyroidectomy 6 years ago (I am 54 years old now). The aftermath was nearly unbearable for the next 5 years. Only a few 20 minute naps each night in between terrible and very long hotflashes. No problem going to sleep, just awakened constantly by hotflashes. Also, 3-day migranes every 2-3 weeks. It was a living nightmare. Now I have been diagnosed with uterine cancer, and the plan is a full hysterectomy, and no more estrogen supplements (which could have caused this). My fear...there will be nothing left of me to keep me from just giving up on life. Can I actually survive this? The cancer was caught early. Isnt there any other options? I cant go through that nightmare again. ### REPLY: HI, thanks for using  It is very understandable to feel overwhelmed, but you mentioned that the cancer was caught at an early stage. This means that there is a greater chance of recovery and a better long term prognosis. The cancer would have to be treated surgically with removal of the uterus. The course of surgical and other treatment may be difficult at the time, but you would slowly start to feel better as the course of treatment is completed. It is important to surround yourself with family and friends that can support and encourage you. In addition, many medical institutions have support groups that would also help you to get through this time. 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 was bloated so I took a diuretic to help with access water weight. I have been drinking alot of water, but today for lunch I had a diet Dr Pepper with my meal. Just a few minutes later I am having sever pains in my lower abdomen. The pains are sharp and feel like maybe a urinary tract issue. When I try to pee, it hurts bad. Will drinking water help? ### REPLY: Hello dear, The symptoms mentioned by you such as pain in lower abdomen and burning sensation during urination suggest that you might be having Urinary tract infection. The treatment involves: 1.  .  Antibiotics such as Ciprofloxacin 500 mg twice in a day. To be taken only under the guidance of your Physician.3. If there is associated fever, then paracetamol 500 mg three times in a day can be added. One more thing, avoid acidic foods, carbonated  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I would like to enquire regarding babys milk. My son is now 15 months old. I have moved countries and my son refuses to take formula milk available here in India. I have tried three different formula cans. I finally had to give him Nestle tetra pack. Is that ok. He used to take 8 ounces of formula milk. How many ounces of nestle tetra pakc should i give him. ### REPLY: Yes, it is absolutely fine to continue with Nestle milk. No dilution is needed. Let the child decide the quantity. Feeding him with a feeder or a cup or glass is the right way, as it will give him the independence to decide how much he wants. Stop his bottle, as bottle-feeding is generally fraught with higher risk of infective diarrhea in India and other developing countries. Further, continuing with bottle feeds will discourage him from changing to a full family diet, which is where he should be from the age of one year. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 last 10 days I been fighting poison ivy. I took a shot 9 days ago and took the last of of predniSolone MedPak. I notice few welts 4-5 days ago but got worse 3 days ago. They go away slightly but comes back out and very itchy. They are o arms and thighs. I am still healing from the poison ivy. ### REPLY: Hi. Thanks for the query. As the diagnosis is clear that you have developed poison ivy rash along with hives ad welts... Redness, soreness and itching is an outcome of allergic reaction only.First start taking anti histamines like Ben . . Continue with another course of Prednisolone but only after consulting your Physician. Do cool compresses over the rashes. Apply a steroid ointment like Triamcinolone Acetone to reduce inflammation, swelling and redness. If there is pain anti-inflammatory painkillers like Ibuprofen can relieve. Avoid scratching it to avoid infection. If there is still no improvement consult an Emergency room and get evaluated. Hope this 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: Hi, am Anjan and am from Chennai. I am Allergic to smoke and dust because of that I start sneezing and get running nose. I always have cold and severe at times. Initially i consulted an ENT who prescribed me with duonase(nasal spray)and a  tablet by name allegra. Which gave me relief for few days but not a permanent one. Now i ve been taking Montek LC for about 8 months. I feel better when i take the tablet but when i miss a day or two i get severe cold again. Why is it so? ### REPLY: Dear anjanYou will have to increase the immunity of your body to the allergens that cause repeated attacks of rhynorrhoea. Herbal medicines are very good at it. I would suggest you to start with swamla [dhoopteshwar] 1tsf BD. mahalakshami villas RAS sworn yuk at one OD and hot milk with half teaspoon of hard .  This will increase your immunity for diseases related to URT. If there is acute attack of cold you can have one tablet of A flu CIL forte BD for five days with hot water. Avoid irritant fast food and cold things including curd. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had a high SED rate for about a year. This month is was 76. My doc thought it as PMR but has now ruled that out because the prednisone is not making me feel better and its not lowering the SED rate. I have her stumped but I need answers...what do you think? ### REPLY: High SED rate can be found in infections also. Like we need to rule out tuberculosis. Depends on what symptoms you have. Also autoimmune diseases like acidosis, SHE, Wegener granulomatosis etc. etc. can also have high used rate. But they all must improve with steroids except infective causes. Infection should be ruled out. Also I want u to undergo ANA, ANNA, RA FACTOR and serum ACE levels. Also used rate can increase with age. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 currently started taking cerazette for the past 8 day and now spotting I now that in can happen. But for how long as my boyfriend is only back for 3 weeks and really not good time. am thinking off coming of it as everything i have read sounds like it goes on for ever ### REPLY: Hi. Cerazette is a progestogen-only-pill or a mini-pill commonly used to prevent an unwanted pregnancy. If taken on the first day of your period you are protected straightway you do no require additional contraceptive. However, if you take your first pill on days 2-5 of your period use an additional contraceptive method such as condom or diaphragm for the first 7 days of pills taking. Vaginal bleeding may occur at irregular intervals while taking this pill, and it is not a sign that Cigarette is not working. In general, you need not take any action; just continue to take Cigarette. If bleeding is heavy or prolonged you should consult your doctor. Hope I have answered your 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: during a deep tissue massage yesterday, the therapist found two hard raised lumps on my back just below the bra line. they are on each side of the spine. symmetrical. no pain at all. i m heavy breasted so the back of my bra has dug in at that point for many many years. should i get it checked ### REPLY: Hi, Good Evening. This is . -I studied your query in depth and Understood your health concerns.-Accordingly on the facts given by you-Treatment I would suggest is as follows-a-I think you are a case of-? Sebaceous Cyst? Dermatofibroma? Keloids due to the friction ?b-I would advise Surgeons opinion for you. He would fix the cause and would treat it accordingly-if sebaceous cyst-Excision Biopsy /if -keloids-Inj steroids or by Excision pasty repair. Wishing you healthy living and early recovery of this query. Wellcome for more queries till you get the satisfied. Thanks for your query to  Clinic. Have a Good Day...!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Had shingles last Nov 7 this year..but now that d blisters are gone I have different kinds of pain in my left hand..painful to touch , sometimes it seems like there is electric shock, & sometimes..there is a shooting pain..I have tried various over the counter creams like capcaisin, lidocaine spray,terrain n m taking 300mg of gabapentin.but it seems does not work..I will feel relief for 1 to 2 hours only...this has affected the quality of my life and cannot work.. ### REPLY: Hi, Thanks for being on . Your pain apparently is post shingles neuropathic pain. The dose of gabapentin may be increased if it brings improvement. If increase in the dose doesn't bring improvement, alternative medicines like amitriptyline, duloxetine may be started. You may discuss these options with your treating physician. Hope that helps. If you have any further questions, I shall be glad to have you in follow-up. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 5 year old son is very bad. he was diagnosed with adhd, but i think its beyond that. he is very mean, hateful, throws toys and furniture. he swears, spits and likes to hit and call people names. he actually got kicked out of daycare for his behavior and not allowed back in. any other suggestions it could be? ### REPLY: DearWelcome to ChatDoctorWe understand your concerns went through your details. The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorized into two sets of behavioral problems. These categories are:inattentiveness hyperactivity and impulsiveness suggest you to read further about ADHD. The problem with ADHD child .  Whenever they want to behave normal, these mental problems never allow, and they get impulsive, frustrated, aggressive and show much abnormal behavior. They show this abnormal behavior because of their mental disorder with which they are unable to adjust. The present ADHD treatment should continue with psychotherapy treatment and calming meditations. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ive been diagnosed with acinetobactor lwoffii  ..... i am an avid surfer in San Diego and i had surfed is some dirty water after some big rains... Is it probable that i contracted this from the water? Perhaps the bacteria was washed into the ocean from some near by farm land? ### REPLY: Hi thanks for asking question. You have queried regarding mode of transmission of Acinetobacter. This organism is widely distributed in surrounding, and it can be present in fresh water and soil. Our normal bacterial flora of oropharynx and skin flora also containing it. As far as A. Coffin is concerned it is transmitted mainly through hospital acquired infection. It will lead to opportunistic infection. Mean when your immunity is low it can lead to serious infection. There is no clear-cut evidence regarding its spread through water. But according to few study Acinetobacter can spread through source outside the hospital. I hope this will solve your query. 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: A friend is going through diagnostic tests to determine what may be his problem -- he is extremely fatigued, is experiencing problems walking (tripping at times)  and his speech is continually getting slurred.   drs. have ruled out MS, Parkinsons, and strokes.  He had a sleep apnea test last night.   his MRI came back looking good.  What else could they be looking at? ### REPLY: Hi, Difficulty in walking with tripping episodes and slurred speech other possibility to be considered once MS, Parkinson disease and stroke are ruled out and MRI brain normal needs to rule out motor neuron disease (ALS) where both URN and LMN affected, and MRI brain can be normal You Need to consult neurologist for neurological examination and detailed history and evaluation is needed for further confirming the diseaseRegards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been allergic to fruits and nuts for over 20 years now. I am tired of not being able to eat them, with how beneficial they are and how yummy they are. I get what has been called herpes of the mouth and have gone into anifilactic shock after eating an entire bowl of strawberries. I get sores in my mouth that hurt and my throat closes up if I eat too much. What can I take so I CAN eat these things? ### REPLY: Hi, Food or Nuts allergy can be diagnosed only on the basis of detailed history taking and thoroughly clinical examination by an expert. Although there are laboratory allergic testing of food is being done nowadays but none of them is reliable clinically and also adds extra cost to the patient. The best way to cure allergy is to avoid contact of that particular allergen here in your case that particular fruit or Nut.However, there are very good medicines like epinephrine, steroids, antihistamines, mast cell stabilizers are available in market to combat allergic symptoms. Consult dermatologist or allergic specialist for further advise. Thanks. ### END