Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a almost 4 yr old daughter, she is complaining that her throat hurts... i have checked her throat for redness and swollen tonsils... her throat appears slightly red, but her tonsils seem normal.... today while checking her throat i noticed a lump in the opening of her throat, behind her tounge.. i am wondering if this is normal or should i have her doctor check her throat out ### REPLY: Hi. Thanks for your query and elucidate history. This is not normal at all to have a lump behind the tongue. You have to get to see the child by an ENT surgeon, Has to undergo ultrasonography of the neck first to see whether the thyroid gland is in lower neck in its normal place or as at a place you described -- this is called lingual thyroid and is good that you noticed this at such an early stage. MRI of the whole area of neck and throat may be needed to confirm the 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: My 2 year old has a fever of about 102.7 with really swollen gums (she wont eat or let me brush her teeth) and bad breath even after we tried brushing. What could this be? Do I just let it run its course and keep trying to brush/floss? Which should I go to...pediatrician or dentist? ### REPLY: Thanks for your query, I have gone through your query. The swollen gums could be because of the deposits or herpetic gingival dermatitis(since you are giving history of fever) consult an oral physician and get her teeth cleaned, and you can use mouth wash or saline gargling. If the pain is more in the gums you can apply topical anesthetic and analgesics like Anabel gel. Consult an oral physician or a dentist. 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: Hi, I had swine flu after christmas and it took quite a while to recover, since then I have been extremely I met someone else today who also had swine flu after christmas and is also suffering from extreme anxiety. What does flu do to the brain and will it just get back to normal after a while? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Anxiety symptoms after swine flu has been found incidentally, but medical fraternity is yet to confirm this. But, for sure, such anxiety symptoms after swine flu tend to disappear after some months or so. But you need to adjust yourself. Go to work, engage yourself in physical activities and ignore the anxiety. That is the easy cure. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr, I have a question about little pin pricks in the shaft of the penis right before the head when i urinate. This doesn t happen all the time and when it does happen it may happen 2 times a day and then goes away. Recently I also noticed one day my urine was cloudy and not clear. The urine was still yellow but with a cloudy look rather then be able to see through it perfectly. This hasn t happened again in at least a couple of months now. Pretty much everyday it doesn t hurt to urinate which puzzles me about what it could be. Also it hasn t happened in at least a year but sometimes a drop of blood mixed with urine would leak out of my penis normally while taking a poop. I don t know if this helps or is enough information but any feedback would be greatly appreciated. Thank you ### REPLY: HelloThanks for query. You have not mentioned following facts in your query.1)Your age 2)Any history of unprotected sex with unknown woman 3) Did you have history of passing pus per urethra. The symptoms that you have are suggestive of inflammation of urethra (Urethritis) . Take antibiotics like Definite along with urinary antiseptic like Nitrofurantoin twice daily for 2 weeks. If symptoms persists consult qualified Urologist for clinical assessment and get endoscopic examination of urethral passage and bladder done (Cystourethroscopy) to confirm the diagnosis. Further treatment will depend upon result of these tests and final 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: Hi Doctor I have taken 10 tablets of Oleanz 5 mg last night. Later i tried to vomit with salt and water but tablets did not come out. Today I am feeling really dizzy, lack of concentration, no focus and hands and legs are numb. Please tell me how can i reverse the side effects. Thanks and regards, Mariam ### REPLY: Hi, You need immediate hospitalization. Based on the history you seem to have taken larger doses of antipsychotic medication Clean and started to have its toxic effects. Since you have already consumed 10 tablets of Clean last night, it may not be possible to revers its side effects by yourself. I advise you to go the emergency room of your nearby hospital for immediate supportive measures like maintenance of airway, stomach lavage, intravenous fluids and continuous monitoring. 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 mom came down with a bad chest cold and cough today, she is on hydrocodon-acetaminophen 5- 325mg. takes half a pill at night. I was going to give her nyquil severe cold and flu but it says nyquil contains acetaminiphen as well.Just worried about drug interactions if she was to take it or whether it would be better to take robitussen cough and congestion DM Thanks ### REPLY: Hello, As you have not mentioned your mothers age in this post I'm considering her to be somewhere around late 40s. As an adult, she can tolerate up to 500 to 600 mg of acetaminophen given no history of liver disorders. So you need not necessarily worry about the interaction. Moving on, if she is just having a day of cold symptoms without fever you can of course try NyQuil along with Robitussin for the cough only at night. Additionally, she can also try steam inhalation and humidifiers for symptomatic relief. Ask her to remain well HY .  If there is nasal congestion she might try nasal saline sprays as well. These are all supportive measures and have no adverse effects. If she develops fever, abdominal symptoms or respiratory difficulty then it is advisable for you to visit you PCP, just to rule out flu or strep. At this point of time assuming it to be just a day of symptoms I would say this is likely viral and a post viral cough syn ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 this is my second pregnancy, I feel like I am showing already but I am only 5 weeks along on paper. My last period was Jan 16th and was incredibly light. I have pretty normal pregnancy symptoms but I have noticed in addition that my stomach feels full and tight and I am very gassy. I have had constipation and some very light occasional cramps. Every now and then I will get a more noticable pain that is short lived in my lower abdomen. Passing gas and changing positions usually helps. My question is should I be concerned about the cramping or is it just gas. Also, is it safe to have intercourse at this time. My first OBGYN appointment is not until a month away. I am 5 2 and 33 as of right now (BD in a month). My first pregnancy was normal aside from a cesarean section. ### REPLY: Hello there, thanks for writing in. 1.  Feeling gassy with tight abdomen and constipation are quite common in pregnancy and can be attributed to loads of progesterone being produced in your body. It is not a concern as long as you can relate your cramps to bloated abdomen and if you feel relieved with passing gas. Do consume a lot of fiber and fruits to help you feel better. Warm water helps in intestinal movements and helps constipation. I recommend you to pay close attention if its cramps or if it feels like twisting menstrual like pain in the lower abdomen. If its menstrual like and if you see any spotting or bleeding, then you need to see your doctor early, which I don't think is a likely scenario.2. As your pain cant be reasoned out yet, I suggest you to refrain from intercourse till you see your doctor. There is no harm in indulging in intercourse after first trimester unless It's nor vigorous. Few physicians recommend abstaining in the last few weeks of pregnancy out of sheer caution that it may lead to preterm delivery as semen is known to contain prostaglandins which can set off labor.3. As you had very light bleeding (can happen when pregnant) and you are already showing, there is a slight possibility that your pregnancy may be a bit advanced which you will be able to know for sure by early trimester dating scan. It will be useful if you can reschedule your appointment a bit earlier. Hope this was helpful to 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 d like to know what effects would I have after surgery. How long the recovery - would it change speech - pain involvement - how soon can I recover - and eat! ### REPLY: From your question I take note that your surgery for leukoplakia is done with a laser probably a CO2 laser as it is quite hard for a diode laser to perform. The quality of tissue healing following a laser excision is far superior to conventional type and the healing shows no scarring due to the laser limitation of the cells called fibroblast that is responsible for scarring, so you don't have to worry about speech, however lasers are to be used only by adequately trained doctors ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 am i having blood pressure spikes? I can be feeling fine one second and then start feeling funny. When i take my pressure i get numbers like 175/100, then it may start going down when iToday when i took it take it a second time. I am on Losartan. This is the third medication we have tried. Today when i took it , it sent my BP to 200/101. The only thing that brought it down was the garlic soft gell and a sip of apple cider vinegar. What causes the blood spikes? i have been getting them at least once or twice a month, some ending in the ER. ### REPLY: Hi, If the single molecule for hypertension is not working then the second molecule can be added along with a cut down of salt in the diet and a change in lifestyle. If you go on reading the blood pressure on your own, it will show a great deal of fluctuation. It is most advisable to get the reading done by a physician and let the physician decide about the medicine. The blood pressure you are reading on your own is nothing to worry. Hope I have answered your query. Let me know for further assistance. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 takes prodep 10mg and he not finding it useful at all...he increased to 20 mg but is keeping him awake the whole nite..this is for general anxiety and negative thoughts...is there any other mediaction...pls dont rite anything negative cos it gives me more negative tohughts ### REPLY: Hi, thank you for using . I can understand your concern. Prodep 20 not helping in general anxiety is not an end. There are lots of other medicines like sertraline, Escitalopram, clomipramine, buspirone, benzodiazepines which can helpful in your husbands condition. Take consultation of psychiatrist who will be able to assess your husbands condition more accurately and able to guide you people out of this. I hope this will help you. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I was diagnosed with Acute Lympho Leukemia in May 2010 and was asked to take Predinsone for 29 days. In Feb 2011 I was diagnosed with bilateral Avascular necrosis and i uderwent bone grafting Surgery. After 9 months of surgery I am still feeling that pain and havin limited flexibility in the hip, (cannot fold my legs nor can take the knees towards my chest). What should I do now? ### REPLY: Here I would like to know first about leukemia, are you still suffering with it? Or its over and now you are fine. Since there is no clarity on this I am giving general guideline. You can visit your doctor and take suggestion on physiotherapy. It can help for mobility and strengthening your muscles. Also use hot and cold pack frequently at your painful area to have some more relief and relaxing your soft tissues. You should also take good amount of needed vitamin D and calcium supplement. And with your doctor consultation also start with ipriflovan supplement too. It helps for calcium absorption from digestive system, deposition on bone, reduce demineralization, as well helps for generating osteocytes which are also called as bone cells. I am sure this was useful for 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 need help.. I m tiered of feeling fobbed off. I have so many problems at 22 it can t be nothing.. So I will try and make this as short as possible.. I m 22 5ft2 and 9.1/2 stone and have 2 children under 3 years old.. For a few months now I have been experiencing a lot of pain in my knee and hip joints. Mainly on the right side. Its effecting sleep and my mobility. I did go to the accident and emergency and without taking any tests (bloods x-rays etc) the doctor (who was also a student) told me it was sciatica and has me on zapain/codine/paracetamol. The pain hasn t got any better. Whilst the doctor was tending to me she asked to see my knee but couldn t because of. The fact I had skinny jeans on.. She asked if there was any lumps or swelling.. As for the swelling that s not an issue but 2 days ago I noticed a little red spot. Well it was a spot to start with. Its red, sore when I kneel down and tender to touch and is now around about the size of a 5p coin. That s only the start of it for the past say 7-9 weeks I have been experiencing extremely bad stomach pains and follows through to my lower back. I have been going to the toilet more frequent than normal (no pain when I wee or poo) but my number 2 are loose and pale there is blood a majority of the time but I had a termination last january and had the contraceptive implant placed and have been bleeding since with the odd breaks, the blood in the toliet isn t consistent with the amount that s on my pad. For example my pad would have a few spots and when I go to the toilet for a number 2 (which has increased to around 3 times a day, but blood isn t in the toilet after every time I go) the water will be scarlet red, fresh blood and when I wipe there is hardly blood from my period but when I press the paper on my anus the fresh red blood is there. (This does not happen all the time but frequent enough for me to take notice that it isn t coming from my period) I don t strain when I m on the toilet, it just literally falls out. Its gotten to a point now where I m losing sleep. My appetite is fine.. I m still eating the same but probably smaller amounts as I m getting fuller quicker than I used to the pain is more situated around the left lower side of the abdomine but sometimes goes to the right. I know my body and I know something isn t right.. I just can t go to my docs because every time I do I never get any real tests. I also suffer with chest pains I have had ECG, echo scans, blood tests and all have come back fine. I suffer with a low blood pressure and anemia too. I am registered with a walk in centre and when I do eventaully get an appointment I m in and out in 5 mins and feel they never pay attention.. I have beens asking for months for them to sort out physiotherapy for the sciatia I have been diagnosed with and I m still waiting, if that s even what it is. I know something isn t right.. Can you help me? Is it something I need to get checked? Is there any specific tests I can ask to be done to put my mind at rest about the larger medical problems? My family history isn t great, 2 passers with pancreatic cancer, 2 triple heart bypasses on nana and grandad, COPD in nana and mother aand great aunt who sadly passed with it. Sudden heart attack leading to death in great uncle and aorta valve replacement in brother when he was 22-23 years old.. And that s just my mothers side. ### REPLY: Your symptoms appear to be very troublesome and confusing. They appear genuine hence I request you to get investigated. To summarize, you are having anemia, low blood pressure, stomach fullness, abdominal pain, bleeding from rectum, knee and hip joint pain with a strong family history of cancer. I want you to undergo a CT scan of the abdomen with contrast, a chest x-ray, a complete blood count, CEA and CA19-9, ESR, CRP, rheumatoid factor, ANA, ANNA And Clotting profile. Meanwhile you can take pantoprazole tablets 40 mg twice daily before food, and pain medications for your knee problems. To explain if you have anemia you are either deficient in iron or loosing blood from somewhere in the stomach or intestines . that's why the pain and bloody stools. This may also be due to abnormal clotting factors which lead to bleeding in the gastrointestinal system and also maybe in your knees. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My daughter (age 20)  was hospitalised 6 weeks ago with an acute kidney infection. She was given an IV with antiobiotics and fluids for three days. Her right kidney was swollen as well as her right ureter. She was sent home with trimethroprim which she finished but developed rashes etc. Within a few days she started getting pains again even though her tests came back negative. She was put on Alprim for two weeks, followed by cilex. She is feeling better now at week 6, but is still having twinges when she moves about more, or lies the wrong way. Her last ultrasound a week ago showed there was still some swelling in the right ureter.  I feel she is doing better, she is taking D Mannose, garlic and colloidal silver, but the twinges still worry me. She cant get in to see a urologist for another two weeks. What I want to know is it normal to still have twinges. Other than that, no burning etc. Thanking in advance ### REPLY: Hi there, It sounds like your daughter had a moderate case of pyelonephritis, or kidney infection.  These infections often take a while to clear and even after some swelling can still cause pain and perhaps the twinges that she is still having.  I would say as long as she is not having any blood in the urine, pain with urination, any fevers above 100.3 F or vomiting or back pain at rest this could all be part of the healing process.  I hope this is helpful to you and let us know if you have followed up questions, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 boy child of 3+ years had 3 times fever within 40 days duration ,1st for a period of 3days 2nd time fever for 1day and 3rd time fever yesterday night, and he is having sometime extream / mild caugh & nose block throught these period ,he used to get fits if the temp goes beyond 100 degree earlier and now also we fear so, please suggest what is the indication - 0000 ### REPLY: Hi...by what you quote I feel that your son might be having a recurrent viral illness. To relieve your distress I will suggest you how a viral illness behaves. 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: sir i am having dark spot on my face ,it is because of burning ,and it is not going can you suggest me any cream to remove that spot, burning was due to garnier fairness facial , i have kapt it for long time & due to that whole part burn and turn red . please help me for this doctor? ### REPLY: Hi sim, Thanks for writing in.  You seem to have postinflammatory hyperpigmentation. For pigmentation as a general rule-Avoid sun exposure Use a good sunscreen of SPF 30 and repeat application every 3 to 4 hours Take antioxidant and vitamin C supplements. You can apply Costco cream at nighttime over the affected area. You need to consult a dermatologist as dermatology being a visual field, the cause for your pigmentation and the treatment required can only be suggested after proper skin examination.  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 have this horrible feeling of gas.. everywhere..lower abdomen and lower back. on the sided of my lower body as well.. it feel better when i release air, but my back hurts like crazy! what do i have? any other helpful infor is that i currently have a UTI and my period is coming in abut 4-6 days. i am also sexually active ### REPLY: Hi, Thanks for posting on . After reading your symptoms I feel your pain is due to 3 reasons:- Amoebas : It causes pain in lower abdomen and back along with gas which eases off after the gas is released.- Pre menstrual back pain : Before Menstruation certain patients get cramps leading to back pain- UTI : As you know that you have UTI, It also causes pain in lower abdomen and back. I would strongly recommend you to visit your physician as he will confirm the diagnosis after clinically examining you and getting your stool test for the presence of amoeba. He may also give you muscle relaxants for pre menstrual pain and antibiotics for UTI. Meanwhile, you must avoid eating junk food and oily as well as spicy food. Your doctor will prescribe medicines accordingly. Wish you a speedy recovery. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I hv an appt with a psych as I believe after 30 yrs my issue is I am an adult (50) mother, professional with ADD. My appt is 3mths away. My girlfriend adult ADD gv me a Ritalin 10 dosage. Within 30mi a I experienced such peace in my mind, slept thru the night and finished my work. I am worried 3mths is a long time to wait. Any further strategies to help now? Thank you Michelle ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. You should not take self medicines for any health problems. Consult a psychiatrist for diagnosis and treatment. I sincerely opine that ADD is universal problem and worrying about can be trouble. Learn to live with it. Do not try to oppose or overcome or defeat your ADD. If you try these, obsession may result. Researches prove that medicines alone cannot cure AD disorder. Along with medicine you should practice psychotherapy techniques to streamline your lifestyle and meditation and yoga techniques to calm your mind, body, streamline your metabolism and thinking style. Please consult a psychologist. If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to overcome your problems. Hope this answers your query. Available for further clarifications. Good luck. We understand your concerns went through your details. I suggest you not to worry much. I sincerely opine that anxiety is universal problem and worrying about can be trouble. Learn to live with it. If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to overcome your problems. 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: Had catscan showed severe scar tissue and 5 nodules in my lungs.Dr. ordered another scan waiting on results.meanwhile he has been testing my WBC monthly.It keeps rising.I have no fever.He put me on 2 weeks of Biaxin.when done i wait a week and go for blood work again.what could be wrong with me? ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You may have some infection in your lung. It may be the cause of your rising WBC. You don't have fever, so it may be other cause. You should wait for your report. Till that continue with your treatment. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband s lymph node on the underside of his jaw has been bothering him lately. Today he noticed a lump about the same size of the node on his neck tendon above is collarbone... Does this sound at all familiar for something? Its extremely sore and bothersome and both lymph node and lump are on the same side of his neck. ### REPLY: Welcome to  .1. The history provided by you suggest me - the lump / lesion at the underside of the jaw - could be sailoadenitis (salivary gland pathology - dilatation of the duct due to infection and inflammation).2. The one below it could be the lymph nodal enlargement (lymph nodal enlargement is seen in infection or inflammation localized / systemic, here it looks like localized.3. An ultrasound examination will help to assess the nature of the lumps its source and their extension.4. After that if required an FNAC - fine needle aspiration cytology would help to know the type of cells.5. Depending on the findings the treatment will be given. As a home remedy do not scratch, press the lesion - it will day healing process, maintain local hygiene. Good luck. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, I am 24 now , and I have the pcod...actually the problem started after my dad died.. .I became too stressful and didnt get my periods in the next few months. ..then found that I have thyroid..nd now I got married after marriage I was recognised with pcod & am taking metformin along with dronis 30 for the past 3 months. .but in the last 2 cycles my periods was less ..and it was a brown discharge....now all my dosages are over .. will I normally ovulate in the 14th or still will it be irregular ...am confused ....or shall I take some ovulation tablet....am badly in need of a child ..please help me ### REPLY: Hour anxiety for a child is good. But Don't be tense.your saying u have POD.u have taken medical treatment for regular periods. Go for USG.ask for ovarian / follicular reserve stromal volume. If these r normal go for follicular study to assess follicular maturity & to know time of ovulation. If stromal volume is high go for laparoscopy . Consult gynecologist & discuss regarding it. So many treatment plans are available. Thank u ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am a 48 year old active male, normal build. For the last year I have been experiencing back twinges upper left side and also a tight chest. The tight chest comes on normally at rest and not when I am active. Am on medication for reflux and GP thinks this is the cause.Any ideas? ### REPLY: Thanks for your question on . I can understand your concern. Yes, HERD (gastroesophageal reflux disease) can cause similar symptoms. Only .  You need to follow certain lifestyle modifications for better symptomatic relief. 1. Avoid hot and spicy food. Avoid junk food. 2. Avoid large meals, instead take frequent small meals.3. Avoid stress and tension, be relaxed and calm.4. Go for walking after meals.5. Quit smoking and alcohol if you have these habits.6. Keep 2-3 pillows under head in bed to prevent reflux.Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, My son started about a year ago getting this redness on the backs of his hands and the tops of his feet with some welts. I have sone all the questions like what he touched ate drank if it was after a shower etc. Nothing It just appears and spreads and will be there for about a hour or so and will go away He is 15 and has autism. this has been going on for a couple of years One time it was all over his back and stomach I took pictures It seems kind of pointless to take him to the doctor when I walk in with a kid with no rash can you advise ### REPLY: Hi... By what you quote it should be an urticaria or a simple skin allergy.  Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine, but I suggest you get the kid evaluated with your pediatrician. A simple suggestion is to carry an image of the welts in your cell phone when you go to your doctor next time. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband broke his neck over 20 years ago, lately he has been sneezing which is followed by intense pain to the point that his veins protrude in his face and arms. He has sliva coming from his mouth and the pain is so intense it causes him to vomit. ### REPLY: Hi, Presumably, the pain is in the neck. Cannot say in your particular case, but generally, nerves which are hyperirritable respond quite well to nerve dampers. These include anti-epileptics such as gabapentin and pregabalin, spinal inhibitors such as carisoprodol, local anesthetics such as lidocaine and heart pills with lidocaine-like effects and antidepressants that have a variety of these effects like amitriptyline. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 29 years old man , married since two and a half years. My semen analysis shows a sperm count of 30 million and motility score of 130. How can i increase my sperm count and motility score to increase chances of fertility? ### REPLY: Hello. Thanks for writing to us.  To enhance your sperm count and its motility, some simple lifestyle changes that can help you are:1) Have a healthy nutritious diet comprising fruits, veggies, salads etc. Include bananas, avocados, nuts, tomatoes, oysters as they help in increasing sperm count.2) Take a Zinc, selenium, l-carnitine, vitamins C and E supplementation once daily for few months.3) Abstain from smoking and alcohol.4) Do some form of exercise daily.5) Avoid stress and practice meditation. Consider visiting an Infertility Specialist for thorough evaluation. I hope this information has been both informative and helpful for you.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi..i got hurt in my mouth and had a tear on the gum of the lower lip....at times my tooth aches....but when i brush my teeth i get relief but...from yesterday....its paining much....even i went to the dentist he said i got hurt on the bone of the teeth and he suggested for root canal...please advice what to do ### REPLY: Hello:)Welcome to . A x-ray is necessary to assess the bone and tooth. I do not know if your dentist took an x-ray. A fracture in the tooth or trauma to the blood vessels supplying the tooth can lead to pain you are experiencing now. A root canal will include removal of the pupal tissue. This will eliminate the pain. I advise you to go for the root canal, but after an x-ray.Don't worry about the lip, cut or bruises in the mouth will heal very fast. Apply a soothing gel like Qua . Ask your dentist if you will need a suture if it's a deep cut. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had root canal done yesterday. the dentist prescribed oflin 200 mg twice a day for 5 days. I took one tablet yesterday and have been experiencing great discomfort with pain and lot of gas that I am unable to expel. should the antibiotic be continued? ### REPLY: Hi, I had gone through your problem. Basically Olin is an antibiotic which may also act upon the beneficial intestinal flora leading to some gas formation, diarrhea or abdominal discomfort. To get relief from this you can use Lactobacillus spores sachets like similar or Darla etc. along with the Olin. Otherwise, you can consult your dentist if the symptoms persists. KINDLY NEVER DISCONTINUE ANY ANTIBIOTIC COURSE Without DOCTORS ADVICE. Hope this explanation would satisfy 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: hii am 26 yrs old.. my husband was diagnosed with a low sperm count 5.8 m/ml, 11m/ml and 7 m/ml. in the last report it was said that.. after post wash the count remained 0.5m/ml healthy sperm only and our option would be to go for IVF. is there a chance of increasing his sperm count by having1.paterina tablets, 2. co q, and 3. evion... my in-laws suggest that a homeopathy treatment will be an effective one.. but doctors say if this is not treated immmediately then the sperm count may reduce completely. what can b done? ### REPLY: HelloThanks for query. Based on what you have described your husband has low sperm count (Oligospermia). Truly speaking there are no medicines that can increase sperm count however Following general measure will help you to increase sperm count. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc 3)Take anti oxidants like Almonds 5-6 every day 4) Avoid alcohol and smoking. If it does not increase even after 6 months of following this regime you have to consult qualified Infertility Specialist for help and guidance as regards assisted reproductive techniques like IVF or CSI. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 missed about a week of bc pills and had unprotected sex. I stopped taking my bc 2 weeks ago and took a pregnancy test to be on the safe side and it was neg. For the past few days now I have been having an odorless yellow mucus like discharge, back pain, and what feels like period cramps that come and go. Could I be pregnant? Or would this just be due to my discontinuation of bc pills. ### REPLY: Hi, As you did not use your pills properly in your previous cycle, your cycle was no longer protected and if you had unprotected intercourse during your fertile days, there is every chance that you could have conceived. To know for sure, you should test for pregnancy 3-7 days later if you miss a period with a fresh early morning sample of urine; for better confirmation you may get a blood test along with a trans-vaginal sonogram. The discharge you are experiencing may not be due to pregnancy; yellowish color suggests some infection which needs to be ruled out by a local exam; please see a specialist for further advice. 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: IM A 37 YEAR OLD MAN AND I DONT HAVE INSURANCE OR A DOCTOR..RECENTLY I WENT TO a e.r. for tooth pain and my blood pressure was191 over 121...and i have noticed severe ankle swelling around my socks at end of the day...and i just went to the bathroom and it looked like i was shot in the but...blood ..lots of bright red blood...im scared im dying? ### REPLY: Hello, After going through your medical query I understand your concern and would like to tell you that high blood pressure with ankle swelling is most likely due to cardiac disease which requires proper evaluation. It's recommended for you to get basic cardiac evaluation done which includes ECG and Echocardiography and consult a Cardiologist with reports. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my grandmother is 84 years old and a diabetic. recently we found out that 3 of her arteries are blocked. shes not had a heart attack yet, but were very worried..... is there any way we can clear the artieries? Doctors suggest since she may need upto 3 stents to be put, her kidneys may get damaged as a side effect of the dye and hence need dialysis afterwards. Shes too old for a bypass... what other alternatives do we have? how effective are medicines at this stage? ### REPLY: Hi, The treatment of choice for 3 blocked arteries is a bypass surgery. Alternatives are multi-vessel stenting (angioplasty) or keep her on medical therapy. Now as she is very elderly, bypass will definitely be more risky than a younger patient. Other option angioplasty is a good alternative and can be done safely if the kidneys are fine. Risk of damage to kidney post angioplasty can be prevented by proper HY .  3rd option, medical management is a good option for her if she does not have very frequent chest pains. Medicines these days are very effective for chronic stable angina. Hope I have answered your query. Let me know if I can assist you further. 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 wife took the birth contole tri-spentec for almost a year and stoped taking it nearly 3 months ago and we have been trying to concieve for 2 months now our first child concieved on the first try is this a sign of infertility or is it normal after coming off berth controle ### REPLY: Hi, Thanks for writing to . After stopping of birth control pills it takes average 6 months for body to adjust and become normal. Some may take more and some less. Because whole one year body is getting signal not to become pregnant.It's not a sign of infertility. I suggest you to try for 6 months if didn't conceive then consult sync. If your wife cycles are not regular then you may consult doctor now itself. But even cycles take time to become regular. Hope I have been helpful. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had to put a few things up in the attic today. When I went to close the overhead door the string on it snapped and I fell backward hard. My boyfriend aid I flew in the air before I landed on the floor. It happened about 10:30 /11 this afternoon but my back still hurts really bad and its hard catching my breath. I have a bad headache too. Should I take something or go to the doctor? ### REPLY: Hi, Welcome to . After going through your query I think You are suffering from acute backache after injury. Treatment of it is rest and analgesics. Diclofenac three times a day after meals is effective. Sometimes strong analgesic(such as attract three times a day after meals) is required. OMEPRAZOLE before meals prevent acidity caused by analgesics. You can discuss with your treating Doctor. There are three possibility, one is simple muscle injury, second is disc prolapse and third is compression fracture of vertebra. To further investigate MRI of the region is advised. You are advised to see orthopedic. I think your query answered. Welcome to any follow-up 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: I am otherways healthy with fair clinical reports age 40, 75 kGand 5 ft 9 inchave alow back pain due to L4 l5 ISSUEStried Dyclofenac dosent work its acute last 2 days, pls suggest which is better, Acy+paracetamol orAcy+tramodolits for immediete use, pain is troubling me ### REPLY: Hello, Thanks for your query. The description suggests that you have lumbar disc disease. The initial management for this problem is conservative by following means : - Bed rest - analgesics and occasional muscle relaxants - Methylcobalamine preparations which helps to alleviate your "pins & needles" sensations - lumbar back support while sitting for longer periods - intermittent pelvic traction If you don't get any relief within 3 weeks, you need an orthosurgeons consultation to decide upon the need for surgical intervention. Hope this helps do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor Recently I have been diagnosed with an enlarged fatty liver .echogenisity is also high.Size of my liver is 15.5 cm.all other ultrasound test for abdomen were normal.my shot and sggt levels are high by 30 to 40 % of normal range. Hb is 10.9 ESR 18 KFT normal Bi lure Ben .567 Please advise how to treat this? To add it further I was detected with positive helicopter bacteria for my superficial ulcer in my stomach through endoscopy . I am not having major physical symptoms other than constipation even after taking lubowel 8 ( twice a day) and laxopeg sachets twice a day.I am taking iron supplement .can this leads to constipation? Day before yesterday I have finished my ltc kit course for ulcers.my triglycerides are marginally high , 196 Total chl 162 Hdl 29 Vldl 39 LDL/HDL 5.6 Direct LDL 103 creatinine 9 Potassium 4.9 Sodium 141 Chloride106 Uric acid 7 ESR 18 RDW 18.5 platelet count 355 Rbi 4.99 MCV 74.9 MCHC 31.2 MPV 9.2 vitamin D 24.3 Vitamin B 12 197 Folate8.1 Human tissue transglutamine 6.06 I am stressed and panic disorder patient but I have not taken any anti depressant and trying to beat with yoga. Please advise and also suggest me about my diet plan.Can I take boiled eggs? ### REPLY: Hello, Thanks for approaching! You have to follow these guidelines in your diet for your "fatty liver".1)No junk, processed food and food with preservatives.2)Avoid white rice, white breads, corn flour. Have multigrain breads and flour, brown rice.3)Avoid potatoes, water chestnut, sweet potatoes, lotus stem, jackfruit., bananas.4)Use olive oil/canola oil for cooking.5)Avoid butter/ghee/excess oil/cheese./spicy food.6)Avoid red meat. Remove the skins from poultry after you cook it7)Avoid full cream milk. Have skimmed or single toned milk.8)No soda. Have herbal teas/fresh lime.9)can have egg white in any form(no yolk)10)No alcohol.11)Try to bake, broil, steam, grill,roast, boil foods instead of frying them.12)Regular walk/exercise/yoga/physical activity. Pls take care of your constipation, Can have any mild Laxative Isabel husk/Trial/Avipattikar churn. Hope this information will help you in regulating your diet.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 28yrs female.few months back i met with an accident and lost toe nail....nw whn m toe nail had starting growing again i hv started experincing ankle pain...its severe whn i rest and jst start walking...m worried abt this and wanted to knw the cause and remedy for this... ### REPLY: Hello, As the toe is growing again there will be a muscle strain and leading to abnormal biomechanics of the joint and muscles.  Using hot water fermentation and doing ankle stability and strengthening exercises should help. If the pain is not coming down in the long run than removal is always advised. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi My name is Soraya, I`m a 27 years old, health woman. This week my heart start to act strange and sometimes beat very fast. It`s hurt very much in 2 places on my chest. I also feel weak and almost fell into the floor twice. My vision this time was confused. My mother died from a very rare kind of heart attach but I think I`m too young and health to have one. What is your suggestion? ### REPLY: Hi, As you have a strong family history of heart disease, it is very important for you to get evaluated thoroughly by a cardiologist.  Palpitations occurring in you especially when you are having episodes of syncope (fall) is very important, and you need to see a cardiologist urgently. ECG, 2D echo and Holder monitoring (24hr continuous ECG monitoring) should be done, and further management will be decided after that. 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 have being diagnosed typhoid. widal results are sal.typhi O 1:160,sal typhi H 1:80,AH 1:20,BH 1:20.my doctor provided me cefixime tablets.the important question is i have pre employment medical examination for gulf country,will this blood result fail me.if so when shall i take the medical examination.course started yesterday 16.12.13 ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern looking to the history given here I could say that the given report of blood is suggestive of typhoid fever now the norms of all developing countries are different from each other, so you have to confirm this with the concern department, once the positive titration detected in the blood for the typhoid then this could remain in the blood for quit long time, take care and have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About 3 months ago I had a bad toothache (my left side back tooth) I went to the dentist because I.wanted them to pull it but they wanted to do a root canal and then cap it. I did not have the money for all of that so they gave me antibiotics and pain medicine. I finished the antibiotics and my tooth quit hurting so I never went back to the dentist. About 3 weeks later I got a knot right below my jaw line its about the size of a quarter and is very sensitive to touch. Is this an infection or something else? ### REPLY: Thanks for your query, I have gone through your query. The knot you are describing can be because of the tooth infection resulting in the formation of a cyst or osteomyelitis. So consult an oral physician and get a radiograph done to confirm the diagnosis. But get the tooth treated as early as possible. Once the infection is treated the lump or knot will automatically reduce. 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: Hi there me and my husband had anal sex last night, after I went to the bathroom to clean my self up and had a speck of blood on the tissue paper. Ive recently opened my bowels and theres no blood but Ive got back ache and abdominal achy pain. I feel abit dizzy but I dont know its thats because Im worrying my self sick about it. Please help me ### REPLY: Hello There can be injury to rectal mucosa due to anal sex. As you may not be doing it routinely, so that lead to mucosa tear. You can use anesthetic Kelly for pain, and use laxative or stool softener. If bleed persist you may need to consult doctor. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A TV scrapped down my leg hitting the left side of my calf muscle. This left a big knot with bruising which is now draining. I put aan ace bandage at first which pushed the blood on down to my ankle and looks brusised. I ice it, soak in epson salt and elevate it. I can walk on my leg but the knot doesn t seem to be going down, Red spots are now popping up around the knot like it is draining more. Should I wear a support hose or is there any other suggestions. I have no money or insurance to get it checked out and would like to try to heal it at home. Thank you. ### REPLY: Hi, Good Evening. This is . -I studied your query in-depth and Understood your concerns.-You suffer from mostly-a severe abrasion of the left leg with hematoma with Contused leg tissue and muscle.-Treatment advised at home-a-Compression bandage to left calf.b-Ice Compresses to reduce the lump.c-Tb-NSAID-d-Turmeric powder locally or/ detail wash and detail- pads under the bandages.f-Antibiotics -to prevent any risk of infecting the hematoma with traumatic induration. Change the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am getting my wisdom teeth removed using IV sedation in a couple weeks. I am on birth control pills. I dont recall telling my dentist this - is this something I should notify them of beforehand? I have done some research to find that this can not only increase dry socket chances but also that they can be ineffective after.I normally take it in the morning and my wisdom teeth removal is in the morning - is it okay to take my pill the morning of with a small amount of water?Thanks a lot! ### REPLY: Thanks for your query, I have gone through your query. The wisdom tooth extraction requires prescription of antibiotics and analgesics. The antibiotics can interfere with the birth control pills, so you need to inform your dentist about your . The birth control pills will be ineffective when you take antibiotics. So that other preventive measures can be taken instead or use of birth control pills. 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: Sir, I am 46 years old, having Epilepsy since 2006. I am taking Enchorate Chrono 600 mg twice a day for 8 years. I also have Diabetes for 4 years and taking Melmet SR 500 mg + 1 mg Glimperide in the morning and Melmet SR in the evening and Astat 5 mg also in the evening. A few days ago, I consulted my doctor and he ### REPLY: Hello! Valerie acid (anchorage throne) is a well-known anticonvulsant. It is indicated for complex partial seizures. It is also used as a mood stabilizer in bipolar disorder and in preventive treatment of migraine. Valerie acid has many side effects like gastrointestinal discomfort and complaints (nausea more frequent, dyspepsia, diarrhea, abdominal pain), increased bleeding time, decrease in number of platelets, tremor, hair loss, weakness, infections, increased appetite, weight gain, hepatotoxicity, etc. The adverse effects may become frequent and severe if the doses are higher, but there isn't any connection between the severity of side effects with the duration of treatment. There isn't any interaction found between Valerie acid and the antibiotic agents you're taking. In my opinion you should continue to take your medication carelessly if no new symptom or sign appear. I hope I have been of help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently went to a doctor about a possible fatty tumor on my right side around where my liver is (right side)he confirmed it feels like a fatty tumor, non-cancerous. However he did not test it or anything just felt it. Now on the right side of my body around where my liver is, it feels harder than the left side. Its not like rock hard but it feels very firm. Also i have a really bad problem with my stomach growling and it does it all day everyday around that area of my body. Could this be related to the tumor? The stomach growling problems? Or is this just my liver and i might be over reacting. Keep in mind there is no pain in the tumor, and no pain in the side where its harder. ### REPLY: Welcome to  and thanks for the query. Well it is not easily to verify fatty liver without ultrasound and LFT findings, so you should do it and everything will be more clear. Cancer is the last thing to think of. It sounds to me like fatty liver too associated with gastritis or herd, so you need to do gastrostomy to rule this out. Growling is also not an usually sigh of tumor and if symptoms persist you need to do more detailed Gastroenterology work up. Wish you good health.  Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir I would like to keep some question for feet that I m suffering for past some times so please give me some solution for me. Sir I have liver problem that is liver cirosis I Jane lever stone and puss I m suffering from 18 yrs, now I m 37 yrs, and I have pre ejalculation during my sleep time I use to loose my sperm with out knowing now a days I found that my sperm is in dark colour that I m Merrown colour I think may be blood ice coming in the sperm, sir I beg you pls give me some solution for this problem. ### REPLY: Hi thanks for asking question. First your seen has altered color like blood. So for that do your semen examination. If it shows pus cells then acute infection could be the cause. Like prostates or seminal vesicle infection can lead it. You can have acute urethritis that can lead bleed during semen ejaculation. For above condition antibiotic need to be taken.USG abdomen will be useful. So it is to be done along with semen examination in your case. As far as liver problem is concerned....- . -avoid refined food. Do regular exercise. Avoid stress and smoking.avoid alcohol. I hope I have solved your query. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a ball that formed mid day today that is tender to the touch about two inches from the elbow on the inside of my arm in between the bicep and tricep. I am concerned because i recently suffered a puncture wound on the forearm on the same arm. I m hoping it is not a blood clot ### REPLY: Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and I feel, since it is of recent onset, it could not be a tumor growth, with history of injury, this could well be either blood, or it could be pus following the infection in collected blood, note if you have fever or there is raised temperature at the swelling, if so than the chances of its being infective will be more, also see your doctor and ask him to aspirate it and see the content, weather it is blood or pus. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, my sisters widal test shows 1/160 (positive).  She is taking anti-biotics for 18 days. Initially she took medicines orally and for 8 days through drips.  Now, widal test shows negative.  But, she still has fever after 7-8 hours.  What should we do? ### REPLY: Hello there, I am . Is tidal test is done by tube test? Because slide tidal test is not confirmatory for typhoid. Is tidal test done after few days of first test?because rising(tier) result like 160 after few days 320 like. In this case according to your history it is mostly because of salmonella infection which is resistant to given antibiotics. So now you should go for culture examination of stool sample. Because from other sample salmonella mostly will not come. If culture comes salmonella positiver than you should go with  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 spouse and I are trying to get pregnant. She is an aircraft mechanic. SHe works around lots of different types of greases, fluids and paints. Should she be avoiding the use of those while we are trying to get pregnant? Once we get pregnant, should she avoid them? Thanks! ### REPLY: Hallow Dear, Yes, some chemicals do affect the baby while some affect even the fertility also. However, it all depends on which chemicals she is exposed to. In particular, she should avoid exposure to paints since the paints contain heavy metals and lead. This may affect the cognitive function of the baby. She should avoid volatile and/or irritant fluids as they will diminish the oxygen she is breathing and will lead to improper growth of the fetus. Amines are not good. Moreover, if the fumes are harmful to the baby, they should be totally avoided. It depends upon to which fluids she is exposed to. The best strategy is better to err on safer side. I hope this provides you some guidelines.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,2 years back in new year party i stomped my right foot very hard on floor 8-9 times, when i woke up in the morning i felt pain in my ankle, i thought it will go away in few days, later when i used to jog it slowly increased, i consulted almost 5 doctors they said i have heel spur. So i am doing some calf exercises they told me. I still used to run/jog for about a year, now after 2 years the pain has shifted to left side of the heel, and i cant even stand for 2 mins, cause all my sole is hurting allot. Please help me i cant even walk. Now a days from 4 days i am having pain in my foot ball bone, which is the second bone in right fool PS. I use silicon insoles still the pain is there. ### REPLY: I wish you contact me personally and give me the proper history of illness. As when you have mentioned do shifting the pain it is pure speculation that you applied a more pressure on the unaffected side when the other was injured. Only stretching is not the solution. You may need to go undergo a specialized training for the same as it is chronic issue now. Contact me directly if you feel so, where I can help you better. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It all started with a really bad gout flare up and now I have the worse swelling in my legs and ankles. Have been given series of medications such as high dose of prednisone with indomethicin and than given Cochin. They raised my lisinpril and changed my water pill to lasix. Nothing seems to be working for the swelling. Any suggestions? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have swollen and painful leg and ankle. Well there can be many reasons for symptoms you mention in query like taking estrogen or testosterone, taking certain antidepressants, blood pressure medications, blood clot of the leg, venous insufficiency, organ failure, particularly in the heart, liver, or kidney. I would suggest you to consult general practitioner for proper examination. Doctor will examine physically by pressing with thumb, order certain test like liver function test, kidney function test along with check vitals. Doctor may prescribe diuretics, beta blockers or refer you to gastroenterologist for liver problem or nephrologist for kidney problem. For now keep your leg elevated while lying down, lower salt consumption and eat healthy. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have liver cirrhosis from blood transfusions Inreceived in1977. I have already dealt with Class action over this I have never drank in my life-now ag 82. I have now been diagnosed with small varices and wonder how this will affect me--now I seem to hurt a little when I swallow and a pain goes through my shoulder bl.ade-- is this from the varices. I do see my specialist on Apr 4, but would like to know what is going on in the mean time ### REPLY: Hi and welcome to . It shouldn't affect you until it bleeds or cause stomach stenosis. Varices are usual consequence of liver damage and when it appears it usually goes through stages(grades). It is evaluated by gastrostomy where we can see how is it serious and is there any danger of bleeding.  So doctors need to see is there any progression in size of varices and does it need endoscopic treatment. It can cause symptoms you've mentioned unfortunately son consult your doctor about some method of varix removal. 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: yes, my son , who is severe to profound disabled and has an intractable seizure disorder has experienced a productive cough unlike what he has ever had. Considering everything he has always been very healthy. I May 2014 he had this cough and he went through bouts of being very active and then not-so-much. I took him to his doctor and was concerned about pneumonia, as he had that Dec 2nd 2012. The chest x-ray, an upright, was normal, but then June 7th 2014, he was very lethargic and it scared me and I took him to the ER and they did a semi upright chest x-ray and did blood work. I was basically left with the question, what do you want us to do, My response was, I wanted antibiotics, which they gave me. He took them for the 10 days and we went back to his doc and had another set of upright chest x-rays and confirmed a left upper lobe infiltrate and when compared to the one done in the ER and the previous one it confirmed that he had an infiltrate left upper lung. I saw it and being a retired ultrasound/x-ray tech I know how to read x-rays, etc. Another round of a more potent antibiotic and another set of x-rays 2 weeks later and still not cleared. Another 2 weeks without antibiotics and he is still not cleared. They are now looking at a pulmonologist for further study. My son also has a vagal nerve stimulator in his left upper section of his chest and it has been there since he was 8 or 9 and he is 21 1/2 years old. He is to have surgery to replace the battery and this can not be done until his lung is cleared. The device helps with his seizures. He is otherwise doing fine, healthy and active with no fever. He has has a lot of coughing in the beginning and now it is just slight and not every day. I do hear the sound of phlegm. He is disabled and can not talk. Thank-you for your advice This has been going on since May 2014 ### REPLY: Thanks for your question on . I can understand your situation and problem. Thanks for the detailed history. In my opinion you should consult pulmonologist and get done1. CT thorax2. Bronchoscopy and BAD (Bronchoalveolar lavage) analysis to rule out tuberculosis, fungal infection and other chronic infection. CT thorax is better than chest x-ray in diagnosis of pneumonia. BAL is superior to sputum report in isolating causative organism. And upper zone chronic infection is commonly seen in tuberculosis. So better to consult pulmonologist and discuss all these. First diagnose properly and then start treatment accordingly. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After 1 1/2 years of constant chronic back pain, sciatica etc. and trying any and all conservative treatments, my Dr has reccomended a lumbar spinal fusion of L-5 and S-1. I m 41 yrs old and work as a Cabinet maker.... Lots of heavy lifting, repetitive bending etc. I m wondering with a successful surgery will I ever be able to return back to that type of work again? Thanks Jon ### REPLY: Dear patient First we have to search for the cause of chronic back pain which might be 1. Mechanical instability 2. Disc prolapse.  Accurate diagnosis is must for proper treatment.  I would advise MRI of lumbosacral spine with screening of whole spine.  It shows discs, nerves and even bones. If MRI is showing disc prolapse with instability discectomy and fusion may be the treatment. After surgery there is loss of movements at fused levels. But there will be complete relief of symptoms and you we be able to do all your activities. Forward bending should be avoided. So if MRI is not done get it done and visit expert spine surgeon with report. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son has a temp of 37.5 (taken via ear) - is this considered a fever?  I gave him calpol at 4.30pm - as he is not himself at moment very wingy.  GP disgnosed gastritis on Tuesday and suggested no treatment - however he is still not eating properly (about half what he usually eats) and also will not take a bottle at all.  Drinking water via a beaker.  Any suggestions/advice or am I just being an over-anxious mother?  many thanks ### REPLY: HI, thanks for using  The normal aural (ear) temperature is 37.5 to 38, so this temperature is ok. It can take a few days for the activity and appetite to return to normal. The important aspect is fluid intake because though he can go a few days without eating as normal, he needs to take enough fluids daily. He may not want to use a lot at one time, but he can use small amount frequently. Monitor urine output to make sure it remains ok. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: .                                I have grade II fatty Liver, I have started exercise (1hr brisk walk) and diet control, Reduced weight by about 4Kgs(After GM diet) maintaining the same, still, I am obese required to reduce weight further by about 10Kgs. Please advise the additional precautions, I have to take to reduce/eliminate this problem completely ### REPLY: Hi, thanks for posting. Causes of fatty liver(FLD) are different. They are separated in two groups:1. Fatty liver(FLD) caused by alcohol.2. Fatty liver(NAFLD) caused by metabolic syn . I think that you suffer from the second group of the disease that is fatty liver (NAFLD). The treatment of this disease is complex.First you need to make the following tests:1. Glycemic test for diabetes mellitus.2. Lipid test for blood fat(cholesterol, Low density lipoprotein(LDL), High density lipoprotein(HDL), triglyceride)3. Check your blood pressure(BP).4. Function liver and transaminase level.5. Ultrasound of liver.6. Magnetic resonance images (MRIs). If the result of glycemic test is positive you need to be treated for diabetes mellitus. If the result of lipid test is positive you should be treated for High cholesterol. As for the diet you need to eliminate: carboy ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 tubiligation done 16 months ago.the dr.lost a gauze inside my stomach , as a result he had to do a mini laporotomy,i was in the operating room for 9 hours when i came out i had to be rushed to the ER because i was vomiting blood and i had lost almost half of my blood level .he forgot to suture one of the incission. i stayed at the Er for two days.at the Er the doctor informed me that my interstine that hold my bowel in my stomach was moved up and that i will need another surgery. since then i have been having so much pain in my abdomen , unable to have normal bowel movements i had to get a blood transfussion and i m anemic as a result. i have no medical insurance what should i do? what could be the cause of my pain? YYYY@YYYY ### REPLY: Hello! Thank you for the query. As you are after at least two abdominal surgeries, and there were some foreign body left in your abdomen, there is a 100% that you have a lot of adhesions in your abdomen. Gauze left inside abdominal cavity causes intra-abdominal inflammation and tissues irritation, what leads to many adhesions and intestines narrowness. So you probably are suffering from intestines obstruction as a result of these surgeries. There is no other way to get rid of it than surgery. You should have abdominal CT with contrast (so called enterocolitis) and probably you should have another surgery to get rid of these adhesions. 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: constant back pain for the past 5 years or so, now serious neck and shoulder pain for the past 6 months that lead to serve migraines. My doctor just keeps sending me for x-rays and MRI s and they are all clear. But I still have the pain. I have 3 kids and a manual labor job. It is starting to break me down and I feel like I am being a hypochondriac, but it hurts so bad that I have no idea what to do. ### REPLY: Hi, Welcome to  forum.  You are suffering with back pain for 5 years. Recently you had neck, shoulder, and headache for 6 months.  You are feeling that you are Hyperion .  Backache, and neck pain, shoulder pain, could be due to the spondylosis.  headache could be due to anxiety, other cause being hypertension.  I prescribe to my patients with such symptoms neurotrophic injections for 10 consecutive days, and the every week, fortnightly, and then monthly, alprazolam at night, along with the pain medication S.O.S. Wishing a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i feel a small lump with mild pain if itouch them on my right mid neck between right ear and right shoulder from last six months it is not incresing in size but when i consume cold things it increase and after leaving cold things it reduce some time i can feel the sound in both ear i feel that ear are closing and opeaning i have small buldge under my right armpit from last four years no pain and soft no lump it feel sponge type i got my blood test done in that my hemoglobin is 9.22 and my esr is 43 and thyroid and tb and sgpt test are normal i am worried doctor what it could be my age is 32 years i hav no fever my weight is 83kg and from last one month i am suffering from gas and acidity problem my all test regarding gastric is normal ### REPLY: HI. The first probable diagnosis I can think is you are under tremendous stress, anxiety. The lumps when present should be investigated by FNAC and ultrasonography. IF required or suspicious, they should be removed by operation and subjected to histopathology examination. Take a proper treatment for anxiety and your 50 % problems will be over. Rest of the treatment to be taken as per reports of FNAC ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 daughter of 3 yrs old is suffering from vomiting loose motion and not interested in taking any food from last 2 days. Doctor advised vibact syrup and oflomanc forte alongwith vomiof syrup. Still she is not ok. Any digestive syrup she needs.. ### REPLY: Hi, I had gone through your question and understand your concerns. Decreased appetite is common in gastroenteritis, which leads to decrease interest in taking food, give her oral rely . Is she passing urine 4-6 hourly, Is there pain abdomen, Is there blood in stool, is there high fever, does her eyes appear yellow, Is her tummy tight. If baby is well otherwise, active, accepting oral deny ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was operated for gall bladder stone which was not removed in 2002. Since last 2 months due to pain on the mid back particularly right side I went for ultrasound on 21/02/2013 which says: Calculous cholecystitis cortical cyst.- right kidney . But both kidneys are normal in size and position. GB:mildly contracted with mildly thickened walls and echogenic shadow in lumen (12.2 mm). All other features like sugar , BP,Chest are normal. Can it be done without surgery? My present age is 71. ### REPLY: Hello welcome to  Renal cysts is a fluid collection in the kidney. The Majority of renal cysts are benign and can be monitored without any treatment. However, some are malignant and have to be removed by surgery. Simple renal cysts are found frequently in the elderly. Regarding your Gall bladder stone I would like to know why was it not removed during surgery 10 years ago and were you asymptomatic since last 10 years. Because patients with symptomatic gall stone disease should undergo elective surgery for cholecystectomy to avoid complications of Gall stone disease. Adult patients with silent or incidental gallstones should be observed and managed expectantly, Oral bile acid dissolution: ursodeoxycholic acid.is given to patients who do not wish to undergo surgery. Stone clearance: 30 to 90 percent. Your Ultrasonography report suggests that you are having chronic cholecystitis and the treatment should be cholecystectomy., If surgery is to be avoided in patients unfit for surgery patient is advised to avoid dietary fats and large meals. Hope ii have answered all, l your queries. Wishing you Good Health ### END