Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 died last week of a haemopericardium, he was sixty two years old. Cycled and swam daily, fittest nut. He had been suffering heart burn, chewing too many Tums. If he had seen the doctor would they know what tests to run, could they have saved his life? ### REPLY: Hello, before I start I would wish to tell you this that thinking in this direction will never bring closure, and so you must consider it ad gods will. Hemopericardium means blood around the heart. It's not it which would have caused demise of your husband, rather the cause of it. As you said he has heart burn s, it probably would be because of a heart attack like generic, which weakest the heart muscle who h may give way and cause spillage of blood outside the heart I the covering causing death.  Alone hemopericardium can prevent any effective circulation of blood causing an event. If clinically suspected the doctor can do an echocardiography which helps to confirm such a problem. May his soul rest in peace. Again it's very common to MIS interpret heart events as heart burn related to stomach and no where he or you were at any fault Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my wife aged 42 has been suffering acute dry cough since last two months.  FRCS drs. prescribed anti allergy medicine but no result has been found.  Recently a chest specialist given the following medicine for treatment stating minor bronchities:a) Tab Gembax - 320 for 1 tab for 5 daysb) Wysolone (10 mg) 1 tab thrice daily for 3 days, 1 tab twice daily for 3 days and 1 tab one daily for 4 days. please suggest your opinion whether the above medicine would give good result or not? ### REPLY: Thanks for your question on . I can understand your concern. Bronchitis is inflammation of airways. So anti-inflammatory .  Since you already consulted chest specialist and her bronchitis is mild, she will definitely improve with cyclone (prednisone - oral corticosteroid). If she is not improving then she will need inhaled bronchodilators and inhaled corticosteroid. So continue with cyclone and wait for improvement. Hope I have solved your query. I will be happy to help you further. Wishing good health to your wife. 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: well im having lower abdomen pain from last two weeks and from this sunday its my third week.. at first i thought its coz of menstrual cycle date coming near... but it persisted and so i consulted for a gynaec thinking its something related to periods... but on scanning its says "bladder distension with post residue" i.e. urine infection... the gynaec gave ciplox-tz for 5 days two times a day... even after taking the tablets the pain is still there... ### REPLY: Hi. The post -residue is uncommon in female patient. This is suggestive either some obstruction to the urine out-flow or bladder problem itself. Get the urine tested even for the culture and sensitivity. I would advise you to consult a Urologist who on careful medical history, clinical examination, tests and cysto-urethroscopy can tell what is the problem. Infection::: UTI needs weeks course of an antibiotic. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 niece 13 be 14 in may always sick they never help her has constant UTI hurts all over had staff before swine flu before lime disease before feels bad all the time she is on anti depressants she stays constipated. Over weight irritable lashes out. She take probiotic, omeprazole 20mg,fluxetine hcl 20,desmopressin acetate 0.2 mg, guanfacine hcl 1 mg, these 2 only as needed sudgest 60 mg, and certizine hci 10 mg. stays depressed and is suicidal a lot right now hateful and suicidal thoughts ### REPLY: Welcome to Ask a doctor service. I have read your query and here is my answer. Suicidal thoughts in depression is a bad sign. It means that the treatment is not adequate. As a rule, electroconvulsive therapy is treatment of choice for depression with suicide thoughts. You should better consult your psychiatrist for reevaluation of your child. I hope I have solved your query. Let me know if I can assist you further in this query .WITH REGARDS, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, I am 31 years old & I am in my 33rd week pregnancy with my first child. My fasting blood sugar was done & it is at 111 & the PPBS with 75 gms of glucose ( 2 hrs) was 166. Is this really bad & what do i do to reduce my sugar level Regards, Anusha ### REPLY: Hi dear, I have gone through your question and understand your concerns.You're fasting and post glucose blood sugar levels are high, and you have thus got gestational diabetes mellitus. You should follow diabetic diet for one week followed by repeat blood sugar levels. If controlled, then you should continue taking diabetic diet. However, if not controlled, then you have to start insulin to control your blood sugar levels. Hope you found the answer helpful. Wishing you good health. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 27 and been having re-occurring bouts of severe abdominal pain, nausea and vomiting to the point of dehydration.  He has been to the er repeatedly, receiving fluids and having tests periodically. He has no insurance so he has been unable to follow up. And all they do at the er is re-hydrate him and send him home basically. The last ct said that his liver was notable for the presence of periportal lymphedema. Which stated that it could be indicitative of infectious or inflammatory process in the liver. They didnt mention anything about this to us, nor did they say anything about the labs, which several things are flagged as HIGH or LOW. That was 2 days ago, he is back at the er again today. I am extremely concerned. I guess my question is could there be something really wrong here, this has been going on for about 2 years ### REPLY: Hi, Welcome to  forum.  So far it is clear that the liver is effected, with peripheral lymphedema.  Now liver function tests are to be done, to know what is the wrong. S.G.O.T, S.G.P.T, Bag, SERUM BILIRUBIN, etc. are to be done.  I advise you to consult a gastroenterologist for diagnosis and treatment.  His habits are also to be taken into account, like alcohol, smoking, marijuana, etc. and should be avoided.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: mammogram, ultrasound and punch biopsies of breast all came back inconclusive. but still experiencing symptoms of redness, areola different from other breast, puckering, thickening. family history of inflammatory breast cancer. dk what to do next. please advise. ### REPLY: Thanks for your question on .You're all symptoms like puckering, thickening, reddened areola are suggestive of malignancy mostly. And you are also having positive family history. Which makes you suspect for breast cancer. I advise you to get done1. PET SCAN 2. Biopsy from PET positive lesion.3. Get done ER (Estrogen Receptor) and PR (Progesterone Receptor) study from biopsy material. This will give you exact idea about you are having malignancy or not. If PET SCAN is negative than no need to worry much. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has Stage 5. He also has a poor heart, with less than 20% EF. He is on BP meds to lower his BP. However, with his low BP (average 83/54) his dialysis center is afraid to remove the fluid that is necessary. So he is gaining weight. We went to his PCP who has ordered a paracentesis for him for this week. He is very swollen and having uremic spots on his body, along with severe nausea. He has both Zofran and Reglan. We are new to dialysis. Started on June 13, so I don t know how much to advocate for him or just trust the dialysis center. I will be calling the M.D. tomorrow. He also is having a hoarse voice now, which I am reading can be due to the ESRD. ### REPLY: Hello and welcome to . As a Urologist, I can fully understand your concern.It's very essential to know the age of your husband, and present He, urea, creatinine, GFR,Na, K,uric acid, sugar/ HbA1C, urine protein, and ultrasound scan of abdomen.  Report the intake / output of urine in 24 hours. Mention the present medication given and send them here, in my name, for an expert opinion, regarding further management. Generally, in this stage, most people need thrice weekly dialysis. Wishing him well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Moved an office last Wednesday. Lifted multiple heavy objects. I usually sit behind a desk and do very little heavy labor. Woke up Thursday morning with an excruciating pain in my back behind my left shoulder blade. Pain has continued to worsen and now has moved around my rib cage and to my left breast/chest. Feels like I am being pierced thru the chest. ### REPLY: Hello, It is due to minor contusions after heavy physical exertion. Its quite common after strenuous activities and will settle with conservative measures. You can apply warm compresses and take analgesics like Ibuprofen or Diclofenac for symptomatic relief. If symptoms persist, you have to consult a physician and get evaluated. 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 sister had a cardiac cath last week.  On the third day, she got excruciating pain in her lower leg along with some numbness. Since then, the pain has continued to get worse. She went to an ER and all tests came back normal.  She is in agony and nobody has any answers. Can you help? ### REPLY: Hi, Thanks for writing to , I am . Catherization is invasive procedure it can have complication like nephropathy, enolization, bleeding etc.as the numbness n pain which is after cauterization is high likely due enolization . If u were my patient I would like to run some test to make sure is it embolism causing pain or DVT (disease causing pain redness n swelling) I would like to have atrial n venous Doppler USG of leg n some blood test, so I can r/u what it is n will treat it accordingly hope this answered your question, if you have more feel free to ask. 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 health concern about my mother. She had a kidney stone removed on Friday, and since then has had numerous fevers, generally in the 102-103 range. They go away when she takes tylenol but then come back shortly after. With that being said, I searched online and I see that a fever can come after removal, but I am wondering how alarmed I should be. Her history is she is 57 years hold, diabetic (prior to surgery her bs had been dropping as low as 50) and has high blood pressure . I have told her to go to the emergency room, but she would rather hold off to see her doctor. I really want a professional opinion to see if I need to intervene and force her to go to the emergency room. ### REPLY: Hi Welcome to , and thanks for your query. Fever after stone removal may be common if there was associated infection/ if the stone was completely blocking the urine tube or if it is percutaneous stone removal. If the doc had placed a double J stent or PIGTAIL CATHETER in the kidney, you need not rush. Otherwise, it is wise to take medical advice. Diabetes, fever and urologic intervention is like a time bomb. Kindly act asap. 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 suffered from nuero problem on january month ,doctor says u will suffered problem such as stroke due blood clot in vane and epilepsy . doctor treat me with certain medicines & he will suggest me to take a tablets like orafore XT ,acitrom,levigress 500&1000mg,lobacheck etc eventhogh iam taking a tablets still suggested by doctor iam not satisfied with these medicines because still I suffered the head cache and muscles pain please give me a valuable solutions for these problem ### REPLY: Hello! Welcome on  ! I am glad to attend you! I reviewed the therapy prescribed by your doctor and would agree with some of these .  You should know that the pain in your limbs and headaches are common symptoms after a stroke. Your current therapy is focused in the prevention of future strokes or seizures. The headache, could be tension type, related to your current situation and the psychological stress. The pain in the limbs is common, and it is related to the damage in the central nervous system. Physiotherapy is the main  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, 56 had two stents put in last Tuesday, he was told he should be on the mend after 24/48 hours but 5 days later he feels as weak as a kitten, no appetite and keeps having really bad sweats where you could actually wring his top out then he is freezing cold - is this normal ? thank you ### REPLY: Hello! Thank you for asking on ! I understand your concern, and would like to explain that stents do not exert such a symptomatic scenario, when everything is performed without complications. Your husband complains are more probable to be related to the primary disease he has experienced, which leaded to stent implantation. He needs to be under medical supervision, until the acute phase of your his illness is over. Hope to have been helpful to you. Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For the last two months i have been feeling like something is constricting my lungs and making it very difficult to breathe. It sounds like i am clearing my throat all day. I have went to the doctors office and the ER, they have told me it was my asthma, allergies and a mix. When I went to the ER it was just said that I have allergies with a nasal drip. I was prescribed a new inhaler and some nasal spray. What else can I do to help get over this! I feel like it is driving me insane! Thank you. ### REPLY: Hi, Thanks for using . Asthma is a part of allergic disorders. Post nasal .  Get done complete hologram, AEC level and spirometry once to diagnose. Your symptoms do not point towards asthma. So tell us if any breathless less, night awakening, difficulty in laughing or playing, what time of the day you suffer from symptoms. For allergic rhinitis you can take nasal steroid spray and antihistamine  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 went to the emergency room last night for severe pain in my left side .They did a urine test and said there was a little blood in my urine and gave me pain killers and muscle relaxes saying I pulled a muscle . Should I be worried about the blood in my urine? The last three times I had a urine test there was traces of blood. Is this normal? ### REPLY: Hi, welcome to our site. I am . Read your query. That is a very significant question and I appreciate your problem. I will try my best to answer your query get yourself an ultrasound/MRI of the abdomen. With pain in the abdomen, especially on the sides (flanks) and with hematuria, there is a string possibility of recurrent kidney stones if that does turn out o be the case you will need to meet a urologist to decide the kind of therapy required depending on the size of the stones meanwhile . painkillers will give you temporary and possibly incomplete relief hope this helps you. Inform the reports mentioned above so I can be of help further. Best of luck. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Looking forward to your return query with the details asked so that I can help you further.(If the answer has helped you, please indicate this) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Could I possibly get pregnant? My boyfriend and I had sex and I think he may have came a little in me. I was on the last day of my period, or I had just stopped cause my tampon had very little blood on it. I immediately went to the bathroom and used water to try to wash myself off. There was a lot on my leg and on the bed but if any got in it must have been a very small amount. What is the likelyhood that I could possibly get pregnant? ### REPLY: Hello dairy understand your concerned not worthier is no chance of the pregnancy as you did sex on the last day of period. It is very safe period of the cycle. During this day there is no ovulation, so fertilization will not occur. But if some sperm concentration enter in to the vagina during the fertile phase/ovulatory phase of cycle then chance of pregnancy is high. But you are safe. Avoid stress, take healthy diet, maintain proper pelvic hygiene, do regular exercise. Use safe sex practice like condom in future to prevent the unwanted pregnancy. Hope this may help you Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My child is extremely tired all the time was going to buy her a tonic minadex but unable to find it can you suggest something else, she is 10 years old growing all the time and started her periods in may still irregular but know thats normal. Was at doc today but he suggested waiting a bit see how she goes but this been going on since may. ### REPLY: Hi....by what you quote I feel that the irregular periods she's having might have resulted in some anemia. Anemia can cause such easy navigability and lethargy. Rather than multivitamin I suggest giving her iron and vitamin D supplements as she's a growing adolescent. If I were your pediatrician I would suggest using 100 mg of elemental iron and 1000 IU of vitamin D supplements for a period of 3 months and then review her progress a month after starting the above medications. 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: Okay, so I had the depo injection 2 weeks ago today and was advised to use condoms because I wasn t on my period but the Wednesday after, the condom split . So about 13 hours after I took the morning after pill (the doctor said it would be 95% effective because it was within the first twenty four hours) and since the Friday after the unprotected sex, I ve had this weird pain when urinating, like a UTI. It s now nearly 2 weeks after the unprotected sex and I m worried that I Could be pregnant or have an STI. A friend says it could be due to the mass of hormones I took in such a short period of time but I don t want to be 17 & pregnant. ### REPLY: Hello, and I hope I can help you today.First, the Depo-Provera injection becomes immediately effective against pregnancy the day you get the shot. The reason why it is recommended for you to start taking Demo while you have your period is to make sure that you have not already become pregnant and get the injection while pregnant. So if you had a shot two weeks ago, even if you had a condom accident, and especially since you took morning-after pill, there is no reason to suspect that you are risk for pregnancy. However, a urinary tract infection, which is inflammation of the bladder, can occur after sex if chafing during sex especially externally rubs bacteria into the urethra (the urinary opening).  This is common in women who use condoms as the ring on the condom can irritate this area during penetration. So I think you can be reassured that your symptoms are not due to pregnancy. However, I think you most likely do have a UTI and should visit your local physician or clinic for evaluation, so you can get a prescription for antibiotics to treat it.  If you are now going to be having unprotected sex with your current partner, you both should be tested for STDs to make sure that you are not at risk of giving anything to one another.  However, this point there is no evidence that your symptoms could be caused by an STD. I hope that I was able to adequately answer your question today, and that my advice was helpful. 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: Dear Hematolog DR,my girlfriend said me that she made a blood test and she found that she have a high PLT count! In August 2009 she got  a test result 520,000, (The range is 150,000 - 450,000 platelets in one microliter of blood) ,  and in April 2010 she got 800,000!  on the 13th of May she got a check up in the hospital the physician think of iron deficiency as the reason behind high platelets in the blood, furthermore the DR she gave her a receipt of iron tablets + B12 and vitamin C for a duration of 1 months till the next check-up in the hospital on 17 June, till that date she has to make some additional blood tests necessary to identify the reason of iron deficiency , the Dr she thinks that the problem is with iron deficiency but to make sure she asked my girlfriend to do some blood tests, before she made ultra sound it was ok, Jak 2 it was ok,  my questions is that what is the reasons for iron deficiency? is iron deficiency might be Transient issue due to bad Nutrition? in case we got married are we going to have healthy and normal kids? what is the risks of getting married? Kind Regards Tim buckle ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She may have reactive thrombocytes.  It is common in anemia. Her iron deficiency may be due to nutrition deficiency or may be due to some chronic blood loss. She should go for ultrasound abdomen to search for the cause of blood loss.  Iron deficiency anemia is very common problem.  No need to worry about that.  You can marry without any problems.  No need to worry.  Consult your doctor and take treatment accordingly. 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: Hello about 8 months ago my fingertips were exposed to battery acid. I washed them thoroughly but since then my fingers peel when they come in contact with anything acidic. It concerns me because this includes when I am intimate with my wife, and now she is starting to itch down there as well. What should I do? ### REPLY: Hello, I can understand your concern for the problem of peeling of skin after exposure to the acidic material. It is quite common to find such kind of thing after exposure to battery acids. I suggest you to meet an expert for the same to get the earliest relief. It could be possible that you might have touched the genital area of your wife with the same hands which touched the battery acid. In your kind of cases I generally prefer to give a mild steroid cream along with a cream containing moisturizing factors. It is quite important to see the peeling of skin to be vanished after the use of this combination. In case if the peeling is still present, then a course of oral steroid might be required. You can consult a dermatologist for the same. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had joint pain in my hands,knees,wrists, ankles. my fingers do swell and get a purplish color on the knuckles at times I have had blood work and my ra test came back on the positive side but the other test they did for inflamation was normal... I am 42 years old and am so sick of doctors is this all in my head??? ### REPLY: Hi, No, these are signs and symptoms of arthritis as your RA factor is positive and indicates towards arthritis but to elucidate the type of arthritis. You need to get some other tests done which in most hospitals are grouped under arthritis panel and encompasses anti CCP, HLA B-27, serum uric acid and like though pattern of your joint involvement clearly indicates towards rheumatoid arthritis but still confirmation is necessary before starting treatment. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: good morning .my son of 22 yrs is having abdominal pain in his left side.it is painful when he cough . he has no fever nor vomitting nor dhiarrea.he says it get better after he has eaten. just last week he said he lifted a heavy pale of paint.. what should i do..is it hernia or appendix or just a muscle spain. thank you ### REPLY: Hellos is simply a muscle spasm in the abdominal and has been caused by lifting the heavy weight. There is nothing o worry and do the followings him not to lift any weight local hot fomentation twice a damask him to refrain from doing any exerciseGive him an anti-inflammatory medicine like ibuprofen in combination with a muscle relaxant, like FLEXION MR, three times a day for 5 days. If he has some cough, give some anti-tussive syrup. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I need to speak with a psychiatrist . I am looking for a new medication. I have been on 37.5 mg of Risperdal consta. It caused terrible problems with anxiety and depression and insonmia. I was then prescibed 100mg of seroquel xr . It caused my face to swell and eye lids. I was diagnosed and bipolar affective disorder (manic depressive). what can I take that does not cause so many side effects. Thank you for your time and consideration. ### REPLY: Hello........... I am able to understand your apprehensions regarding psychotropic medication considering significant side effects in your cases. Medication you are on Risperdal cons ta (Risperidone) and Seroquel (T. Quetiapine) are standard medication prescribed for psychotic disorders. Kindly report your side effects with medication to your psychiatrist so that your treatment plan can be re-evaluated and a suitable . 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: mi freind is haveing bad dizzy spells and she dnt rember anything and she went in the kitchen to make her daugther a bottle and she fell out she said that she dont remmber anything and she starts haveing these really bad headachs after the dizzy speels this started happening at 9 00 pm n she normally remmbers everthingg and she said that she seen lighting and there was no lighting so what shall we do ### REPLY: Hi, First, she should measure her blood pressure, and it was high, she should receive medical treatment, decrease salt and fat intake and do an ECG and an ECHO on her heart. Second, the hormonal therapy for contraception or replacement therapy can cause similar symptoms, so she should ask a gynecologist for help. Moreover, the hormonal therapy can lead to decrease vitamin B complex in her body, so she should take vitamin B complex once per day after meals. 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 baby is 21 days old and is having loose motions.He is on top feed.My doctor has asked me to give him enterogermina oral suspension (1/2 bottle twice for 3 days) and Taxim 0 (5ml for 3 days).Are these medicenes/antibiotics fine for such a small baby. ### REPLY: I understand your concerns. Are you also breastfeeding him? Usually it is normal for breastfed babies to have some loose stools. If you are breastfeeding him, there is no need to give probiotics like Enterogermina. Also, Taxi O is usually started only if they have blood in stools or high fever. These medicines are safe for small babies but if there is no blood in stools, my recommendation is that you can stop the medicines If top feeds are being given by bottle, I would suggest you change to a cup and spoon or palatal (or garage feeds) as bottles, even if sterilized well have more chance of harboring germs. Also check that you are giving the correct dilution of 1 scoop formula in 30 ml water, as over dilution can cause loose stools. Make sure you wash your hands well after cleaning the baby, and before giving feeds. My last recommendation is that you give him rotavirus vaccination from the age of two months, to protect him from rotavirus diarrhea. Warning signs which should make you take him for a review to the pediatrician:1. Blood in stools2. Persistent vomiting3. Poor feeding4. Decreased urination (less than once per 6 hours)5. High fever Temperature >102 Hope this helps. If you have further doubts, please do not hesitate to ask. Wish him a speedy recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: NASH w/ T2 hyperintense, T1 hypointense nonenhancing lesion in the right lobe. A thin internal enhancing septation is seen at the periphery of the cyst. It has a slightly lobulated contour. I hold fluid in my abdomen and am short of breath after eating & drinking anything as well as constant nausea.Have a history of breast cancer in 2010-Triple Negative...I am deeply concerned that with my enlarged liver & my history that I should be allowed a biopsy or a closer look at the liver. My liver enzymes have been elevated since 2006. Cyst on liver appeared in  2010.I would be grateful for any insight on my situation.Thank you. ### REPLY: Hi and welcome to . Thank you for the query. These are significant liver symptoms, but if there is no focal lesion seen on MRI then biopsy cant be helpful. There can be certain degree of fatty liver or liver damage due to other factors such as viral hepatitis, autoimmune or alcoholic hepatitis etc. Most commonly the cause is only fatty liver, but you should rule out malignancies since you had cancer in medical history. So just check your tumor markers and LFT frequently. I am sure there is no serious disease. 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: Hi, my son is 10 years old and is generally healthy, he has an Asthma cough occasionally. I am worried and made an appointment to see a doctor as he has been vomiting. It has become a bit of a habit as it happens every 4-5 days and tends to be an hour after he has eaten! He is also quite sensitive to smells and that can make him vomit. There is no blood in his vomit and he doesn t have diarrhoea. What do you think it might be? ### REPLY: Hello. Thank you for asking at . I went through your sons history and would like to make following suggestions for him:1. From your history, I would first think of gastroesophageal reflux disease (HERD) and food allergy.2. Were I treating him, I would prescribe him antacid like sanitizing or omeprazole before each meal for at least 2 weeks. If his symptoms are improved, I would continue the same for at least 6-8 weeks.3. I would also suggest him to avoid hot, spicy foods, teas & coffees and chocolates. 4. if he does not improve, I would suggest testing him for food allergies. Hope above suggestions will be helpful to him. Should you have any further query, please feel free to ask at . Wish your son the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 36 years old female, 55 kg and 163 cm. I seem to have neurological problems on both side of face after wisdom teeth removal . My right lower lip and chin are numb, but I have strange feelings all over the face. In forehed, around eyes, nose, in nostrils, right lip. Now I m starting to hear my own ecco in my left ear. In feb 2011 my right wisdom tooth was removed without any problems. But few month s after I started to find strange feelings where it was, pressure and throbbing feeling. In December 2011 I got the right one removed.. He was troblematic, lying very close to the the nerve. But when I got rid of him, the feeling on the other side changed. Before the procedure I had been sick, with sinus infection and had been given zitromax. The numbness on the rigt side and the overall problems on the same side are due to Ian damage but I m wondering about the left side. - My surgeon thought I was only under stress when I told him about strange feelings on the left side. I AAAAAAA t been overall well but for 13 years ago I developed Herpes Zoster and for about 3 years ago I developed Herpes infection in my ears. That caused a loss of balance and tinnitus for about 6 weeks. Should I do something more about this og just write this all on IAN damage because of surgical removal of wisdom teeth ? Another problem has to do with my shoulder . I fell while skiing for about 20 years ago and I dislocated my sholder. I have never checked this out. I don t think it gets compleatly out because I can relocate it myself. I know this hurt s when this happens and it can happen in bad circumstances. This happens few times per year and yesterday it was enought to open a door to dislocate it. Is thera a possibilty to fix such a problem ? ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern what ever history you gave here are nothing to take anything with your tooth extraction and these symptoms are non-specific and highly related with the functional elements only you have to control your thoughts and keep your stress level low if I would look such case then I would treat this case with the, "Tab Amitriptyline twice in day" just no need to worry about this, hope this information helps you have good day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I sort of regularly forget my birth control, like a lot. Im not sexually active, so that isnt a concern, but today Im having stomach pains and my head hurts a bit, and I just feel nauseous. Could this be the missed birth control? Is that a serious problem, or will I be okay if I just start making sure that I always take it on time? ### REPLY: Hi. Thanks for asking in . The main problem of failure in taking the OCS is unwanted pregnancy and this does not normally cause the symptoms you mention unless you have taken more than two pills the previous day to compensate for the missed pills as your symptoms are suggestive of progesterone excess. Since the OCP are hormonal pills, they need to be taken properly otherwise they may result in unnecessary hormonal imbalance. You should take the pills regularly and that too on the dot in the same time. If you miss the pill one day, you can compensate by taking two pills on the next day. But if you miss more than 2 pills, you should discontinue that pack and opt for some other contraceptive method till you get your next menstrual cycle. Although your symptoms are not a serious, if it continues you should visit your treating  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 chlamydia once last august and got tested positive the first time. Took medication and tested again but results came back positive. So took medication again and tested myself. Results came back negative. But after about 2 months got a pain in my left testicle and went into the clinic. They tested me again for sti/std s and said results came back negative . They said it could have been a bacterial infection that caused the pain in my testes. Now its been almost a year since all this happened but I am just worried if I should test myself again and not able to get peace of my kind. Any suggestion? Do you think I might have contracted other sti or std? ### REPLY: Hi, Thanks for writing in. Chlamydia causes inflammation of the epididymis, a structure inside the scrotum (sack that holds the testicles) attached to the backside of the testis (testicles). Signs and symptoms include red, swollen and warm scrotum, testicle pain and tenderness which is usually on one side, painful urination, frequent urination, painful ejaculation, painful intercourse before ejaculation, lump in testicle, swollen inguinal nodes (lymph nodes in the groin), discharge from penis, and blood in the semen. If you have taken treatment and do not have any of the symptoms then there is no need to worry or get checked further. However, if you have any of the symptoms then additional check and treatments might be required. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear sir, I am Bangladeshi , i am patient lung problem/ Age 50 / Man ,Bangladesh doctor pr, Ali of ( medicine specialist and pulmonogost )found my lung text/ BRONCHOPROVOCATION report report of lung BRONCHOPROVOCATION IS POSITIVE, pls adv urgently for my best treatment . i am ex smooker, pls advice me which doctor will be best for me, if you cnfm me i will come to india and see your doctor , AWaiting for your reply, best/ redgs Enamul / Dhaka / Bangladesh ### REPLY: Thanks for your question on . Bronchi provocation test is done to rule out allergy to inhaled substance like dust, pollens, chemicals,animal fur etc. So if person is susceptible to allergy with any of these, then on inhalation of these substances, his FEV1 starts decreasing, which in turn suggest bronchospasm and asthma. So positive test means, you are having allergy to that substance and your bronchi are constricting on its exposure. So treatment of this is1. Avoidance of provocative substance.2. Inhaled bronchodilator.3. Oral antihistamines etc. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hey this roy  doctor my sperm comes out daily i was mestrubating since 10 year so plz tell me wat i do after 2 year i am getting marry my age is 23 i am getting shame wen girl kiss me my sperm comes out or wen i watch porn movie my sperm comes out  plz help me out doctor ### REPLY: HelloThanks for query. What you get is not a premature ejaculation but early ejaculation that happens due to excessive secretions of mucus by Bulb Urethral Glands located in urethra and contraction of Bulb Sponginess muscle in penis triggered by audio, visual and tactile sexual stimulation resulting into ejaculation of a pre-cum. This is normal at the age of adolescence and does not require any treatment. It will get resolved spontaneously once you get engaged in sexual activities with your wife . .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 nilima as my husband was having piles and his heamoglobin was 5 he was admitted 4 bottels of blood was given to him and piles operation was done his heamoglobin reach till 10 how 2 increase his   heamoglobin after taking medicine his heamoglobin has not increase he is taking beetcarrot juice also but no use pls give me some suggestion so his heamoglobin should reach till15 in 5 days ### REPLY: Hello and welcome to , Blood loss from the piles is responsible for low hemoglobin levels. After treatment of piles, the chronic blood loss has got relived. I would suggest you to get a complete hologram and peripheral blood examination to assess the status of red blood cells and /or type of anemia. After characterizing the type of anemia, appropriate treatment will be started. In case there is iron deficiency anemia, iron supplements will help. In case there is megaloblastic anemia, vitamin B 12 and folic acid will help. Iron deficiency is expected since there was loss of iron during blood loss from piles. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: three days ago I fall and hit my back where the kidney is.. the next day I had a doctors app. I told him what happen and the bruise on by back. he had me test my urine and it came back full of blood. he sent me for a CT scan Friday morning. so I won t have to go through the weekend they sent my results of my test back and the doctor call and told there was nothing urgent and told me he would see me Monday. I am having a lot of pain in by whole back. It even hurts to talk. what do you think is happening? ### REPLY: HelloThanks for query.severe pain in flank with hematuria following trauma strongly suggest injury to kidney. Though your C. T Scan has not revealed any gross injury (Report yet to be confirmed officially), In view of persistent pain and hematuria even after three days, possibility of internal injury to the kidney or rupture of small blood vessel can not be rule out. Please consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis3) Intro Venous Paleography.(I.V.P.) You need to get admitted in hospital and has to be under observation .with me. V fluids, antibiotics . .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, For the past week I ve been feeling unwell. It began with a sore throat, fatigue and clogged ears. Whilst my throat has cleared, my ears are still clogged and I m still feeling tired. This morning I coughed up a solid piece of orange phlegm. I m now worried i have a viral infection. Are you able to determine the extent of my illness and most effective ways to treat my case? Many thanks, Daniel ### REPLY: HI, thanks for using  Viral infections of the upper respiratory tract can result in different symptoms such as those you are experiencing. The symptoms can last 1 week to 10 days. There are medications available that may help. These are available over the counter. Treatment involves rest and fluids. In addition to this you may need a bucolic to help break up any mucus in the chest. Examples of Multics are bipolar, ambrosial, Mucomyst, guaifenesinI 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: Hello.  Im 22 years old and have recently been dealing with chest pain and discomfort.  Ive picked up on my exercise running about 6 miles a week.  Last night was the first night to experiance chest pain while sitting.  Moving made it worse and it was tender to the touch.  Its only on my left side.  Last night it lasted for about 3 1/2 hours.  It just started again about 30 minutes ago.  What does this sound like? ### REPLY: Thanks for your question on . I can understand your concern. Possibility of musculoskeletal pain is more likely because your pain is associated with specific body position and movements. So follow these steps for better symptomatic relief in musculoskeletal pain. 1. Avoid movements causing pain. Avoid sudden jerky movements of chest.2. Apply warm water pad on affected areas of chest.3. Take painkiller and muscle relaxant . 4. Avoid heavyweight lifting and strenuous exercise for few days.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: Hi, my 6 year old son hard fever off and on for last couple of weeks and day before yesterday he complained about his left leg hurting. That went away this morning. Now he is coughing real bad and he threw up twice and had nose bleed soon after that. I am really concerned ..not sure what is going on with him.. ### REPLY: Hi... Thank you for consulting in . 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. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. 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. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am 35 years old my weight is 65.5 kgs and height is 53.We Got married in October 2009. we are planningFor family now but we want to know if we really need to see the Gynacologist before we plan.is there any medicine required to Ready for pregnancy? My periods are perfect. ### REPLY: Hi, Were you using contraception all these years to avoid pregnancy? Since your periods are perfect, in all probability you are ovulating regularly. You are slightly overweight. A normal BMI increases the chances of conception.  It will be excellent if you can reduce around 5 Kg weight. IF you and your husband smoke, you must quit smoking. It is important to have intercourse at least three times in a week to improve your chances of conception. Have one tablet of folic acid daily. If you don't conceive within 6 months of trying for pregnancy, you must consult Gynecologist for baseline subfertility tests (hormone assay and fallopian tube patency test for you and semen analysis for your husband). Based on the results of investigations treatment can be planned. I hope I have answered to your satisfaction. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mother in law is a cardiac patient she dont have any bypass nor any of her valves are block but her heart is weak she feel breathless,but 3 days before she was breathless we took her to hospital they treated her but she was on ventilators but now she is no more on ventilators but the doctor said that her heart is working only 10% i m really worried about her plz help me out....plus she is diabetic olso! thank u ### REPLY: Hello and welcome to . I have read your query. I hope this will helpful mother is having HEART FAILURE. Diabetes Is a very important risk factor for developing heart failure. Your doctor would certainly have had her ECHOCARDIOGRAPHY to say that her heart is working only 10% and when it is working less than 30% HEART TRANSPLANT is the definite treatment. But . . I will advise you to take her to a CARDIOLOGIST, have all of her necessary investigations done in time, and she should be started on HEART FAILURE MEDICATIONS...Meanwhile good diabetic control is necessary along with salt restriction. I hope this was beneficial for regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My daughter has very small red bumps on her legs, arms and neck that itch a lot.  She has been taking prednasol and it helps with the itching.  However, if she stops using it, the bumps appear again with the itch.  What do you think is going on?  Id really appreciate your opinion. ### REPLY: Hello, I think your daughter is suffering from urticaria which appear as red, raised, itchy lesions and disappear in another 24 hours. If this is the case, prednisone will not do much good for a long time, but it will cause a lot of harm due to steroid use. I would suggest her to stop steroids immediately if she has been taking it for less than 3-4 weeks. And if she has been on steroids for a very long time, then she should taper it slowly to avoid symptoms of with . For disease, an antihistamine like fexofenadine/ levocetrizine will provide relief in her symptoms. Also, try to rule out for the cause for urticaria like worm infestation, urine or any other infection in body, thyroid problem, any intake of new medicines or food itemsThanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is a average resting heart rate of 100-114ish bad. I m a 17yr old male. I ve been a pretty lazy and not eating healthy recently since school let out. But I ve been getting back into being active and eating better over the last few days. This is when I realized an estimate of my resting heart rate. Thanks ### REPLY: It's better that your heart rate be less than 100, as along term increased heart rate is not good for heart.  But however as you say you had a lazy life and so now when you start getting active the heart who is not used to work much will have higher rates to compensate which should settle in a month a or two, don't worry about the same and continue with a good and healthy life.  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: Since Thursday night I ve been waking up while I am sleeping due to stomach pains and constant sweating throughout my body. It s weird because my room is at room temperature and it s typically very cold outside. I also just got my monthly visit yesterday, and I ve been having diarrhea for the past two weeks. I ve been getting alot of goosebumps and chest pain, I ve been feeling very weak, and my head hurts. Do you have an idea of what these symptoms mean? ### REPLY: Hi, Welcome to the .First I would like to ask that if you're taking any medicines? Since some medicines can cause these symptoms as side effects. Else you may need to rule out thyroid problem, for that get a thyroid profile done first and discuss further. These symptoms can happen because of changes in body metabolism, which can be effected by thyroid hormones deranged level. For chest pain get an ECG done first and if it is normal, you may try antacids medicine, as some time acidity can cause epigastric pain, which feels like chest pain. Hopefully, my answer will be helpful. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good Day..My son 15 yrs old had a molar removed yesterday, but the bleeding is continous..we went back to his dentist and some reasons why its still bleeding because it might be the platelet..and the dentist had a suture just a 2 stiches to his gum..but still bleeding, inshort iv noticed that shes not skilled in suturing because while she was suturing my son gums i heard that how she will lock the thread( i dnt how what the thread using) ..and she said she still needs another suture to be stich the gum because i heard she called her friend what to do and she just only relying because seems like she just new in the suturing.and she said need to inject to stop bleeding..which is she dont have need to buy (inshort the dentist not ready for all the emergency)..My son feel nervous of what the dentist said to suture again and he was had dizziness...I told to the dentist better to bring him to the emergency room hospital...So in ER they gave my son an injection to stop bleeding and some medicines to take like hemostan and anti biotic..as of now my son not bleeding at this moment but the er doctor said to bring again to the dentist to check ..Is it ok not bring to the dentist if its totally not bleeding anymore?.. but if ever to the other dentist not the first one who made me so scared and stress..Thank You..( sorry im not good in english)...GODBLESS us always!!! ### REPLY: Thanks for Using . Read your query. Its good the bleeding has stopped, though it has cost your son a lot of stress. I would advise you to get a checkup done by a dentist (If you are apprehensive of the previous one, you can go for the one you are ok with but have to give the new doctor the detailed correct history of the procedure done, so that he know what exactly is being done).*Continue with medicines as prescribed.*Do warm saline gargling and avoid more vigorous gargling. Hope this was useful. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 8 year old daughter has a gastric bug and has been vomiting since 1:00am on sunday. She vomited dark green bile on tuesday. this is day 6 and she had dark brown clots in her vomit today. Showed this to the gp. She had a very small nose bleed this morning which resolved very quickly and only left 3 spots of blood on the tissue. the gp states that this is the cause of the blood in her 2 episodes of vomiting 4 hours later. How does he know this is the case an it is not a gi bleed? thanks ### REPLY: Generally in GI bleed the feces would have come black which you have not reported. However, there must be some lesion causing bleed shown in vomiting. If it persists, you need to get further investigation of the source of bleeding. Sometimes green vomiting is associated with Kafka humor vitiation also. To stop the bleeding from nose and vomiting give her maximum coconut water. If you can get Naagkeshar (Mesa ferret) powder, any .  This is the best hemostatic combo. Even if anyone of the three is available, pl start with that. Its absolutely safe n harmless. It can be found from where to get on the net. As an alternative, Himalaya herbal co.s Stepson tab may also be used, but it may not be as quick. Cynodon dactyl on or Bermuda grass or Survey grass extract may be instilled in nostrils to stop nose bleed immediately without side effects. You may not find extract in market but have to extract at home. If qty is more, it can be  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 36 years old. This will be my 3rd day with zero voice. Dry cough, tight achy chest. Almost feels like its hard to breath. I have a 5 month old baby....that I am breast feeding. Very worried about her getting whatever I have. At what point should I take myself to docter? Or ER? I read up on laryangitus and its seems like most people said to wait...awhile before seeing docter.Thank you....Leia Barrientos ### REPLY: Hello dear Leia Barriers, warm welcome to .come have evaluated your query in details .* This is due to lower respiratory tract infection.* As there is difficulty in breathing, I strongly recommend to immediately consult your doctor before the infection flares up. Hope this will help to clear your doubt . Wishing you fine recovery. Always welcome for any further assistance anytime. 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 doc,i had an abortion 4 months ago,there was very little bleeding and i got medication to prevent infections....4 months later,i have under gone treatment for an infection because of the chronic mild abdominal pains and my urine tests had protein and pus in it ...the abdominal pain persists..wat could be causing this and can i continue with that treatment! ### REPLY: Hi ! Good evening. I am  answering your query. If I were your doctor, I would advise you for a urine culture and sensitivity test to know the exact antibiotic to be used for a cure of the infection. The complete course should be taken. At the same time I would examine your abdomen clinically and with an ultrasound if need be to rule out any other intra-abdominal pathology. Till then, you could continue the treatment advised for you. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my 3yr old has had stomach cramps everynow and then for nearly two months , last week had vomiting after pain with temp had urine checked had ultrasound all clear doc said irregular constipation gave her fructose stool softener to take it s been four days since still having temps on and off again tonight stomach cramps what could this be ? ### REPLY: Hello, If she is having vomiting, abdominal pain, and temperature on and off then probably she has some infection. Ask your doctor for some blood investigations, and he may prescribe some antibiotics depending upon the reports. Ask your doctor to prescribe antispasmodic medicine like Dicyclomine for abdominal pain, antiemetic like Ondansetron for nausea and vomiting. 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 son was in an automobile accident 6 days ago he has a broken shoulder blade and informed me that he started passing black stools yesterday is this something I should be concerned about, he has no pain and is not nauseous, and the black stools come and go ### REPLY: Black stools ate generally due to bleeding inside abdomen. There may be some injury in abdominal cavity which might have bled. This bleeding may not be acute but may small leakage and blood into the intestine lead to formation of black stools. Check your sons hemoglobin and note the frequency of stools.  If possible get a sample so that it can be tested. And my advice would be to so your son to specialist as soon as possible No harm in taking extra precautions. Wish you luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is seeing a Doctor tomorrow as a follow up for dealing with low blood pressure. She is 13, a competitive gymnast and has been experiencing light headed, dizziness periodically for almost a year. She had a blood pressure monitor take readings for 24 hours and it showed it was low at different times including when she was sleeping. Her ECG and bloodwork results are normal, I want to be sure that we rule out anything that could be serious ~ especially heart conditions. Any suggestions of things I need to ask? ### REPLY: Hello, I have gone through history of your daughter. Overall it seems that she has constitutional blood pressure on lower side. Not serious at all. As you mentioned that ambulatory pressure monitoring reveal low reading .but let me tell you it is natural and necessary that pressure should . If it does not dip it is bad sign. And I presume that she had no symptoms of low pressure during low reading of ambulatory monitoring. So just don't worry. Encourage her plenty if fluids. My best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am feeling down and low without understanding why I get angry quickly and can be very violent my family are worried and say I need help I cry sometimes for no reason and am very loud and excited the next can you help me please  I have tried anti depressants called citalopram but to no avail my mum is worried about me what is wrong with me please help me please ### REPLY: Hi, Thanks for using . I have gone through your available history. It seems that you are suffering from Depression with impulse control disorder but bipolar mood disorder and personality disorder may need to be ruled out. The reason of non-improvement with citalopram is - Less duration of treatment. Anti depressants take time to start action and one should allow 12 weeks before diagnosing it as non-working.- Inadequate dose of .  Usual dose range is 20-80 mg per day.- Presence of other diagnosis like use of substance, bipolar disorder-Physical causes like thyroid dysfunction should consult your psychiatrist for detailed evaluation and treatment as per cause. Meanwhile, you may do stress management and relaxation exercise to control stress. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 26 year old and 18 weeks pregnant, I had glucose tolerance test recently. Fasting blood sugar is 90 mg and blood sugar after 2hours of taking glucose is 145. My weight is 70 kg and height is 165 cm. Did I get Diabetes? is there any risk to fetus? ### REPLY: Hi there,Please do not worry it does not seem like you have diabetes with the values that you are showing. . Your Body mass index based on the values you have given is in the normal range putting you at a lower risk for diabetes. Diabetes is more common in pregnancy in women who have had a family history of diabetes, diabetes in a previous pregnancy, history of polycystic ovaries, or if overweight, if you do not have any of the above factors you are at a lower risk for it. Diabetes can affect both the mother and the baby in pregnancy. It can cause excess weight gain of the baby making delivery difficult to achieve and more likely of a Cesarean.Also, certain complications such as bleeding after delivery and chances of Admission to NICU of the baby increases. The baby needs to be monitored in the first few hours after birth for sugar levels and other complications, some may have breathing difficulties. But all these complications can be minimized by checking sugar levels regularly in the mother who is diagnosed to be diabetic in pregnancy, she may also be given insulin to control the sugars. So just repeat the glucose tolerance test at 26 weeks and if its normal do not worry. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there, I have been unwell, for over two yrs now on n off. With one 5 day hospital stay, with zero answered outcome.My symptoms since April of this yr and pretty much throughout are deep seeded upper epigastic pain, contanst nausea, constipation/ diarrhea , diagnosed severe fatty liver , inflamed gallbladder , have not eaten a proper meal since July , am obese I weigh 216lbs. have lost 12 hard fought and lost lbs as I simply cannot lose weight therefore I am not taken seriously as a pt malnourished . I have no energy suffer from chronic depression and fibromyalgia and chronic migraines . Thank you ### REPLY: Hi. Your history of unwell goes back to 2 years, and severity increased for the last 9 Months. With the similar symptoms of any other patient, I would like to go for your upper GI Endoscopy, Ultrasonography and preferably Contrast enhanced CT scan of whole abdomen after preparation with laxatives and antiflatulent tablets. Obesity itself is a disorder, a root cause of many of your problems you are suffering. Wight reduction and a diet as per Dietitian is recommended. Inflamed gall bladder may need a removal. I am sure you would be benefited with treatment of obesity. I hope my answer has helped 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 ve been going to my doctor for back pain since I was 16 after I had a ATV crash and got hit buy a truck on my left side they did ex rays and could not see nothing wrong my pain when away for a few years I was 18 and got a Job iron scraping I fell while carrying heavy weight on loose footing and hurt my back the same part I didn t go to see the doc that time I had 2 other injeries since all to my left side.for the past 4 years I ve been in bad pain I ve try therapy and injection s and it has done nothing for me but east my money and time. I got a MRI and they said I got birth defects putricals and dehydrated disck es but my pain should be mild. Now I m 26 I ve ate so much ib profin it fucked up my stomick no help for so long I turn to the street doctor stared buying pain killer s I got my life back for a while as fare as working and walking but my tolerens got to high so I was working to be pain free .now I m not taking pain killers I had to take methadone to get off the now I m not working I m losing every thing in cluding my wife and kid. I m not on drugs 4 the past 4 month I m still in pain in my back and mently and my left ball has Ben swelt up but anyway I feel like just being done with life now that all is lost and was wondering if it is common for people in cripiling pain to shoot them selves ### REPLY: Painkiller will provide only a symptomatic relief, it will not treat the condition. I have seen a lot of patients with low backache of long duration. You may be having a disc prolapse or something like that. I would advise you to do back stretching exercises and physiotherapy. I have seen a lot of patients who are benefited by physiotherapy. Sometimes when pain is very high, you can take analgesic like Tab Victorian but never forget to take Tab Rant ac or tab Pan 40 with it, as all the painkillers causes gastritis. I hope physiotherapy and stretching exercises will help 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: im 7 month pregnant.i had a scan before 2 week.in that result it is said that the left kidney appears to be hydronephrotic with residual parenchymal thickness.the left renal pelvis measure 16.9mm in transverse calibre.left ureter normal in calibre.will this is curable.and what is the exact size of renal pelvis.? ### REPLY: HelloThanks for query Your prenatal ultrasound scanning of abdomen done at 7 months pregnancy has revealed left kidney of the fetus to be HY . 9 mm. Diameter of normal Renal Pelvis at 7 months pregnancy varies from 5-7 mm. Looking at the finding that left renal pelvis is 16.9 mm in diameter with normal ureter suggest that the fêtes has congenital Pelvic Ureteric Junction (PUB) Obstruction with considerable back pressure effect on left kidney (HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello!my query is regarding my 3yr old son... he recently suffered from lower respiratory tract infection due to which he had high grade fever and was hospitalized for 2 days. doctor says it was mainly due to dust allergy and is unavoidable since we reside in an area where lots of  construction work is going on (kharghar, navi mumbai) so what can i do to minimize this to reoccur ### REPLY: Hello, To prevent recurrent lung infections due to dust allergy, you may do the following things. 1. Use an air purifier in the home.2. Always give a mask to your son whenever he is outside home.3. Give him regular respiratory vaccines like influenza (yearly) and pneumococcal (5 yearly).4. Warm water gargles and steam inhalation 4-5 times a day. Don't worry with above practice his chances of recurrent lung infections reduce significantly. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI I AM ARUN I AM HIGHLY SUFFER IN THIES DAYS BECAUSE OF DUST ALERGY.I AM NOT HAVING A CONTINUESLY MEAN THAT FIX ASTHMA FEVER I AM JUST ATTACKED IN CORN CROP CUTTING SEASON I HAVE THIS INFECTION WHEN I AM ONLY 3 MONTHS OF AGE AND NOW I AM 20 YEARS OLD.PLEAS SUGEST A SOLOUTION FOR ME. ### REPLY: Hello Arun, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. I would suggest you regular montelukast & levocetirizine for at least 2-4 weeks. I would also suggest you to use inhaler like albuterol or levosalbutamol for asthma symptoms (wheezing or breathing difficulty) on as-and-when-needed basis.2. Furthermore, I would suggest you allergy testing which will help you identify the substances you may be allergic to and also to know the measures to avoid them. Based on allergy testing, an allergist-immunologist may prescribe you allergen specific immunotherapy which works on your immune system to gradually improve allergy symptoms.3. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution. Please cover your nose during crop cutting season. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you a very good health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I completed a root canal today and I m in pain. I was taking a capsule of ibuprofen 200mg paracetamol 325mg and caffeine 30mg for the pain (took 3 capsules today) along with amoxicillin 500mg and metronidazole 200mg. I wasn t feeling better so I took aceclofenac 100mg (took 2 tabs today at 6 hour intervals). The pain still hasn t reduced. Please help ### REPLY: Hello there... Pain after root canal treatment(RCT) is common...it usually lasts for 1-2 days following RCT.... If your age is above 14 years, metronidazole-200 mg insufficient...400 mg should be taken thrice daily....for a period of 5 days... If pain persists for more than 3 days of RCT get a X-ray done just to confirm the aptness of RCT.... It can be managed...Don't worry... Diclofenac should be taken only twice a day....100 mg with an interval of 12 hours will do....if pain persists consult your dental surgeon.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 under gone to widal test, and below are the test results: Salmonella typhi O: 1 in 40 dilution Salmonella typhi H: 1 in 80 dilution Salmonella para typhi AH: 1 in 40 dilution Salmonella para typhi BH: 1 in 20 dilution Is any one there to help on explaining me about the test results Balaji ### REPLY: Hello thank you for your contact to . If I am your treating doctor I would like to tell you that tidal title of 1:160 or above is considered positive. You have 1:80 title, which I consider it to be negative. But ideal procedure is that you have to count the community title and accordingly the cutoff is to be decided. If you have anything else to know kindly contact me.  .  Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have been taking Yaz however I have not changed to lavlin . Im not sure where to start my last Yaz pill was Friday and I would normally start again on Wednesday (4 day sugar pill). Should I be starting lavlin on Wednesday or take the sugar pills Wednesday Thurs and Friday as per there packet (7 day sugar pill) and start on Saturday ### REPLY: Hi. Thanks for asking in . Yaz contains 28 (24+4) pills with 24 active and 4 sugar pills and Devlin has 28 (21+7) 21 active and 7 non-hormonal pills. Since you are already on Yam and the sugar pills get over on Tuesday, you should start the active pills of Devlin from Wednesday. The small beige colored pills in Devlin pack are the hormonal pills and the large white colored pills are the non-hormonal pills. You should start with the small hormonal pill on Wednesday. Once the 21 hormonal pills get over, the non-hormonal white pills can be taken and during this time you will get your menstrual cycle. Devlin is a low dose hormonal pill. In case you have doubt about the identification of the hormonal pills in the pack, you should seek the help of your treating . I hope this is useful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good day. i just wanted to ask if what are the earliest and visible signs of rabies in humans? i was bitten by a dog 3 days ago and its not that deep bite. my skin was only peeled a little and theres no blood coming out after the bite. now, i am experiencing itch not on the site of bite but on any part of my body. im afraid if this is a sign of rabies or its only a skin problem. i have no fever nor signs of flu. only that itch. thank you! ### REPLY: Hello, Welcome to , The incubation period in case of rabies is variable ranging from 3 weeks to 3 years. If you are scratched by a stray dog 3 days and following which you have developed generalized hives all over the body. These symptoms are not the signs and symptoms of the disease rabies. I would suggest you to take active immunization with antirabies vaccine on days 0, 3, 7, 14 and 28. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi 6 months ago i fell off of my bike and had bad bruising on  my right upper thigh. Since then my bruising is gone away but now i have a lump that is starting to burn. I have applied cold and hott to it and still continues to burn and be sore. Should I see a doctor? ### REPLY: Welcome to . 1. History with symptoms suggest that the possible cause could be infective abscess / collection in the subcutaneous plane.2. The next possible cause could be hematoma formation after the trauma.3. In this case it needs to be examined, in case of infective collection in the subcutaneous plane - might need a small incision and .  4. In case of hematoma also needs removal followed by treatment.5. Small and not complicated cases a simple course of antibiotics with followup will be needed.6. Yes you need to see the doctor. As a remedy do not squeeze, press,scratch the area (as you will complicate in that way), maintain local hygiene and use soft clothing which touch to that location, clean the area with antiseptic liquid. Good luck. Hope I have answered your query,anything to ask do not hesitate to ask.http://doctor.ChatDoctor .com/doctors/ ### END