Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, I ve had this pain in my vagina for a long time, on and off. my symptoms include; itching, burning, sometimes slimy discharge, yellow discharge and yeast like discharge. I m not sexually active, in fact it I ve never had sex. I m not sure but I think it started when i washed my vagina with soap. could you please give me some advise on what it might be and what to do. thankyou ### REPLY: Dear lady, What you describe is a common yeast infection of the vagina. The skin inside your vagina is usually covered by a layer of healthy bacteria, which produce an acidic mucus that protects from yeasts and other sort of infections like bad bacteria. This is why you shouldn't use soap to wash your vagina, because soap can kill the healthy bacteria, and help the yeast infection to stabilize and produce the aforementioned symptoms. If you were my patient, I would recommend using Fluconazole 1200 mg suppository inserted in your vagina. It is used only once, and it will get rid of the yeast infection. But if you want someone close to follow you, please visit a local doctor. I would also recommend you to now use soap again to wash your vagina, running water is more than enough. I hope I have helped you understand your condition better. Do not worry, as I said in the beginning this is a common infection totally treatable. Wish you health, Manoku ENI, M.D. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries.I have been in contact with a sick patient for the past few days. He is nowing having a bad sore throat n fever. Hence, i am afraid his illness is contagious during the incubation period. How may i prevent or minimize possibility of contracting the vius from him? Does it help if i take regular dosage of vitamin c? Thank you ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have viral fever along with bad sore throat which could be contagious, so you have to booster your immunity to avoid catch of infection. Need not worry as most of the viral infection will subside by itself without any treatment as most of the viral infections are self limiting and most of the viral infections are highly communicable. You should take antiviral .   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 this relatively soft lump located on my inner butt cheek. It is slightly red and had a consistent round shape.I thought it was a normal pimple but it never went away, I just didn t think it was a big deal but now I am worries about it.. A bit of Information about what it could be would be greatly appreciated. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have soft lump on inner butt cheek. Well there can be many reasons for symptoms you mention in query like colonial cyst, external hemorrhoid, boil, perianal abscess or ischio-rectal abscess. I would suggest you to consult dermatologist for proper examination. Doctor may prescribe antibiotics along with anti-inflammatory. Doctor may also remove it surgically in case of severe infection. For now apply warm compresses on it, keep the area clean and .  Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr. Goyal, thank you very much for offering your service.  I was born with asthma, it would be mostly seasonal when I was younger.  I didnt have to treat it all the time, but when I had the occasional asthma attack it would be pretty serious, almost to the point of hospitalization.  As I grew older, the asthma became less and less apparent.  Up until about 2 months ago, I had not had any asthma symptoms for several years. Then, I did.  It went away for a week, so I thought it was ok.  Then, it came back, and it was very scary trying to breathe at night. I went to a doctor and they said I had pneumonia.  The antibiotics they gave me didnt seem very effective, and a few days later they also started me on a regiment of steroids.  The steroids helped, as did a nebulizer.  I was resting and feeling very ill for about a week and a half of that period, then I started to feel better.  Well, that only lasted a few days, and now for the past few days it has been getting worse again, necessitating several nebulizer treatments yesterday, and (after much effort and wheezing) coughing up mucus with a strange bittersweet taste (perhaps the albuterol from the inhaler and nebulizer?)I am concerned because the illness has already been exposed to a full cycle of both steroids and antibiotics, and yet it persists.  What might a doctor be able to do for me?  Does this require immediate medical attention, or might it subside?  Whooping cough is going around my area, and I do have a persistent cough.  Thank you. ### REPLY: Hi, This could be acute bronchitis with your asthma as you are having persistent cough with expectoration. It can be diagnosed clinically, but you must undergo routine blood investigation with septum R/ M and C/S, chest x-ray to rule out any other pathology of lungs. You might require long course of antibiotics (amaryllis with chavulanic acid or cephalosporins) with other supportive treatment like bronchodilators (steroids, beta agonists, anticholinergics) inhalers or nebulizers with steam inhalation frequently. Consult pulmonologist immediately and take advise. 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 there, i was born with a clubbed foot on my right leg and after 10+ ops to correct this but have now found out that the cartilage has all but gone and im now in constant pain. and because of my job i am unable to take anything stronger than paracetamol is there anything i can do to help reduce the pain? ### REPLY: Welcome to  I have gone through your query and understand your concern. Your cartilage has been damaged. So it causes pain. Diapering and glucosamine are the best medicine to help you. You can take analgesic such as ibuprofen for pain relief. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is Candice. I got a bite on my neck last Saturday/Sunday. I went to the doctor and I have an infection. She gave me a prescription for doxycycline. When I had the prescription filled the pharmacist informed me I shouldn t take it cause I had Botox for my migraines. She said to talk to my doctor but I can t find him!! I had my last injection on May 6th. I ve been reading on the Internet lots of people who have had nasty reactions from taking the antibiotic. Any thoughts? ### REPLY: Hello, thank you for your contact to . If I am your doctor I suggest you not to take antibiotics with Botox. There are chances of getting worse reaction. Though there is no study till date to show reaction with .  It is advisable not to take if antibiotic taking is not essential. If you have to ask me anything you can contact me. . Infectious disease specialist. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I had the coil fitted in on Monday 16th of December 2013 and I have to continue using my pill for ten days , but I am still passing brownish blood clots and have abdominal cramping as well as a sore lower back, the sore back is constant and the cramping is more at night , is this normal to be happening even when im still in the pill.Stephanie ### REPLY: NamastheWelcome to ChatDoctorGreetings of the davits quite common to experience symptoms of lower backache, It is due to uterine spasm as a reaction to any foreign matter present in it. It will subside in a couple of week. In case the symptoms persists, there is fever, foul smelling discharge then one should consider removal of coil. These symptoms are unlikely to be due to pills In case you need any further assistance, will be glad to assist you. Wishing you happy and healthy lifetime Care 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: Sometimes after I get up from bed or couch , my vision goes black and i cant control my muscles and it feels like my body would shake :/ Most of the times I fall on the ground and I have hit my head many times because of these . I have had these many times for 2-3 years . Im 16 years old male . And i cant hear anything when i blackout and it feels like my mind is somewhere else and i get flashback memories when im having these seizures but afterwards i cant remember what i saw :/ i weight 65kg and i am 180cm tall ### REPLY: Dear User, Thanks for posting a query at . From your description it appears hat you are suffering from syncope. The other possibility is dissociative disorder and epilepsy. You need to contact a physician with full details to ascertain cause of your syncope. If you never injured yourself while falling and every episode occurred in presence of others and never in alone, Then you can meet a psychiatrist as soon as possible. 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, I am 15 years old. I am a female, and I am ppretty healthy. I m really never sick. About a couple months ago, maybe, my chest just started to hurt badly. The pain is in the center of my chest, right between my breasts. The pain radiates to my back, and it kind of numbs my shoulders. It s kind of hard to explain. The pain feels like someone is sitting on top of my chest. It s like I m being squeezed really hard, and it hurts really badly. I have to move around to relieve it, but it only lasts a couple seconds then it s back. It comes and go s at random times, and lasts about 20 minutes. I can breathe, but there s a lot of pressure. Should I see a doctor, or is it normal? Thanks for the help, I appreciate it a lot. ### REPLY: Thanks for your question on . I can understand your concern. Yes, you should definitely consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). Central chest pain, chest pressure on Breathing etc. are seen in bronchitis. So PFT is must for the diagnosis. If PFT is normal than HERD (gastroesophageal reflux disease) is another possibility. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of Central chest pain, pressure in chest etc. So avoid stress and tension. Start proton pump inhibitors. Don't worry, you will be alright. But first rule out bronchitis. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Heart beatMy heart beats go from very slow to fast and pounding. I have many dx pvcs & pacs daily. Heart structure is normal. My heart pounds so hard it vibrates throughout my whole body...leaves me feeling exhausted. I used to run 2~3 miles a day.... What could this be? ### REPLY: Hello! Welcome and thank you for asking on ! I understand you concern, and would explain that your symptoms may be related to a cardiac arrhythmia. Anxiety and some metabolic disorders (like thyroid dysfunction, a . ) could also mimic this clinical scenario. It is normal to have some PACs and PVC's during the day. But what is their frequency in your case? I would like to know more about your past medical history. Do you suffer from high blood pressure or diabetes? What tests have you performed to examine your cardiac function? As far as I understand a resting ECG and a cardiac ultrasound have been performed (you mention PVC's, PACs and a structurally normal heart)You should consult with your GP for a careful physical exam, a chest x-ray and some blood tests (besides resting ECG and cardiac ultrasound) :- complete blood count (for chronic anemia)- PCR, sedimentation rate (for chronic inflammation)- fasting glucose-thyroid hormone levels-cortisol plasma levels (a ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: had strange sensations in left upper side of head, doc ran a blood test and called today saying something was elevated and had temple vein and wants me to get a bioposy of the temple vein? I do not know what they are talking about or what they are looking for? any information before I allow this done? ### REPLY: Hello, You might have a temporal arthritis (also called giant cell arthritis). It is an inflammation of the artery which supplies blood to the head and brain. The disease presents mostly with tenderness in the upper ear zone (temporal zone) and headaches. Also, it might cause fever, muscle pain, joint pain, and jaw pain after chewing. The condition is diagnosed by blood test initially (measuring erythrocyte sedimentation rate) and confirmed by biopsy. Treatment should not be delayed.  Initially your doctor prescribes high dose steroids to prevent eye complication. The dose will be subsequently decreased. You might also prescribe aspirin or other non-steroidal anti-inflammatory .  During the treatment you should have follow-up eye exam. Best regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i am 50yrs old male. in 2009, my right kidney has been amputed due to formation of malignant tumor over it. last year when i undergone my routine checkup in chennai apollo where i got my operation done, formation of multiple calculi of size 4mm in gall bladder was seen in USG report. since last few days i am having pain near my shoulder blade. now when i went through ultrasonography i found my gall bladder wall is swollen and the size of stone is 8mm. my local doctor has given me antibiotics to cure the swollen.next month i will be going for my scheduled checkup to chennai .what should i do now. should i immediately move to my doctor or having the antibiotics i can go after a month? ### REPLY: Hello Your findings suggests acute calculus cholecystitis. Acute infection is indicated by swollen wall of gall bladder. You need definitive treatment of gall bladder calculus i, e surgical removal of gall bladder(cholecystectomy). Gall bladder calculus is prone to infection and obstruction, so it is advised to get rid of calculus early. Operation can be done after stabilizing conditions like alleviation of pain, infection. Surgery can be done even in acute condition after evaluation. Right shoulder blade pain may be related to gall bladder calculus. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MY 4 YEAR LD SON CONTINUES TO GET ABCESSES IN HIS MOUTH HE ALREADY HAD A SURGERY RESTORATION OF TEETH BECAUSE HE HAD HIS TEETH ROOTING AWAY BUT HE IS CONSTANTLY SPITTING UP WHAT CAN THAT BE? HE ALWAYS RUNNING TO BATHROOM TO SPIT UP AND SAYS HE HAS TO MANY BUBBLES IN HIS MOUTH? ### REPLY: Hi. Welcome to . As per your complaint it seems that your son has a dental abscess due to a deeply decayed tooth and as it is appearing that it has started . . Due to rotting or decaying of teeth, when the decay progresses below the root tips of the teeth there is pus formation and at times the pus perforates the bone and accumulates below the gums and at times there is an opening formed on the surface leading to pus discharge. I would suggest you to consult an Oral Physician or a Pediatric Dentist and get evaluated and a thorough clinical evaluation and x-ray can help in diagnosis. In case if there is a deeply decayed tooth then Root Canal Treatment or Lumpectomy can be done followed by a course of antibiotics and painkillers. At times Incision and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i a 43 year old woman, slim and active, I dont smoke, i avoid salt and i exercies at the gym 3 times a week plus i exercise daily walking my dog. I am currently taking 5mg Ramipril however on monitoring my blood pressure at home it is still high at 149/78. What could possibly be causing this and what else can I do to bring it down? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should first rule out diabetes and dyslipidemia because both these can cause poor control of blood pressure. So get done sugar level and lipid profile. If both are normal then you should consult your doctor to increase the dose of April. You are taking minimal dose of April. You can increase the dose to 5 mg twice daily. Ideal dose of April is twice daily only. So consult your doctor, get tested for diabetes and dyslipidemia and discuss increasing April to control your blood pressure. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. A horsefly bit me in the hand. It swelled up quite nicely, but over last nights dinner, it faded away. This morning, I woke up feeling slightly nauseated, and had a stiff arm. The swelling was back, and much redder than before, and I have a serious sensitivity to touch under my armpit. It seems to help if I hold my arm up. How urgently would I need to see a physician in your opinion? I dont have temperature, and took 1 antihistamine that I have for my hayfever. Thanks a lot! ### REPLY: Hello, Welcome to . I understand your concern. You have lymph node enlargement in your armpit due to horsefly bite on your hand. It might have been infected a bit. It's good that you took antihistamine which will help relieve the allergy. Continue the same till swelling subsides. You need to take care of wound by topical antibiotic cream like Betadine along with topical steroid cream like dexamethasone. You should also take oral Ibuprofen to relive pain in armpit and inflammation. Wash the area with mild soap and water and apply these cream 3 times a day. You need to visit local GP to get these medicines. The pain and swelling should go away in a 2-3 days if properly treated and not infected further. Hope this will be helpful. Do ask if any further question is there. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i recived the depo shot 3 days ago this is my second shot the nurse that did it this time told me this was her first time giving this shot when she gave it to me it hurt more then the last one she said not to rub it or itd bruise and i did not rub it and i now have a large bruise, pain and and when you touch around where the bruise is it feels like theres a large hard bump in there and this did not happen the first time should i be worried ### REPLY: Hi, Welcome to the forum There is nothing to worry, it will get fine in 1-2 days. You can apply a thin film of Aureomycin ointment on the bruise. If it is painful you can take an analgesic.  Do not scratch or rub. To reduce the inflammation and hardness you can apply thrombophob ointment, it will aid easy blood circulation and reduce the swelling. Do not let the bruise get infected. However, if you see any pus forming, you should take antibiotics to help wound .  If wound remains the same get clinically assessed and treated. When you take the next shot, do not take it in the same spot, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in one of my tooth only when I drink water or after eating my meals, yesterday I went to my dentist and he told me that my new teeth was a little high but the pain will go away soon. But did not give me anything for the pain I am suffering, what can I take for the pain. Thanks a lot for your answer! ### REPLY: Hello, Dental pain can be treated with anti-inflammatory medication such as Tylenol and Advil. Try to take two Tylenol and two Advil at regular intervals if your pain is severe. If you have had recent dental treatment, you may need your bite adjusted. You refer to a new tooth as being high, so I am concerned that the pain is related to your bite and the high spot should be reduced to relieve your pain. I suggest contacting your dentist to ask this question. What is your age and do you having teeth that are erupting in your mouth? Your bite may be affected as to continue to erupt. I would still recommend that you take anti-inflammatory medication while this occurs. Rinse your mouth with warm salt water and maintain good daily dental care. I am glad to help you further if you provide me more details about your teeth. Please try my suggestions and I hope you will feel better soon. Thank you for your inquiry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive had a lower back strain/pain/injury dec. 2014 .  I was off of wrk for 4 months.  Jan. 2016 I got 4 spinal taps in emerge which caused lower back pain again and bad headaches which eventually subsided but I still get on occasion with certain positions of my body.  What are the long term effects of the spinal taps.  This pain refuses to go away.. Its been well over a year ### REPLY: Hi I am . .  In my opinion I think you may need some physical activities to prevent pressure on your spine and your back muscles. Physiotherapy sessions with a good chiropractor, hot massages, spinal straightening exercises and even yoga is very helpful in most of the cases.  Try to avoid heavy lifting, obesity, over weighing, vigorous movements, bad sleeping or sitting postures, and you will be fine.  Long term effects may include headaches (post lumbar picture)it may stay for 2 to 3 weeks, back pain or discomfort, bleeding or brain stem herniation are the most common effects.  Try to follow previous instructions and if pain persist I recommend MRI on spine to rule out any kind of spinal injuries like discs or herniation and follow them up with your neurologist for proper evaluation and management. Please click and consider a 5-star rating with some positive feedback if the information was helpful. Wish you good health, Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my wife suffering low ferritin level and she has micro anemia,,,last 8 months she lost her libido and total not interested in intimation,then i consult with a doctor did blood test and last one months she is taking medicine but her libido level is not improving...how much time need to improve libido level ### REPLY: Hello and welcome to , Iron deficiency can lead to tiredness, lack of concentration, irritability etc. Decrease in libido can also occur. Iron deficiency anemia is treated with iron supplements and is monitored by routine blood examination. It takes 3 months for the iron levels and iron stores to completely replenish. However, iron deficiency is not the only cause for loss of libido. Thus, if the symptoms are too prolonged you can consult a sexologist for clinical assessment and counselling if required. 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: Hi there! 27 years old. I am trying to conceive. I stopped my contraceptive pills in February 2011, but the only problem is that I used to take Jasmine so that I could get my period and now that I have stopped it, my period just never returned. I dont think I am ovulating aswell. Is there any medication that I can use or anything that I can do to get pregnant fast. Regards Louise ### REPLY: Hi dear, I have gone through your question and understand your concerns. Delayed or no periods at all is indicative of an ovulation and decreased ovarian activity. Conception is very difficult if there is no ovulation and the ovarian activity is decreased. I will suggest you to consult an infertility specialist to get properly examined, investigated including ultrasound and hormonal profile and get treated accordingly. 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: Ive been having undiagnosed back problems with severe pain for a while now, and nothing has been able to get rid of it. My doctor gave me a med called Keflex (cephalexin) for a skin infection, and it somehow causes the pain in my back to temporarily stop...could that mean anything at all? ### REPLY: Hi, As you got relief from back pain with cephalexin indicates that there might be having some infection in your urinary tract. Due to infection in urinary tract you get this problem of having low back pain and with antibiotic medicine infection controls, and you get relief from pain. Go for routine urine check up for pus cells and WBC. Take plenty of water. Consult your doctor and get examined. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 20 years and 6 weeks pregnant with my second baby i had a operation when i was 14 for PUJ on the left kidney it was 2 blood vessels crossed over after i had key hole surgery i was fine for about a year then the pain slowley came back and when i fell pregnant with my first baby i had pain the whole way through pregnancy then when i had him the pain eased of but i would get the pain once a month i seen the specialist at the hospital and they said they wasnt worrid about it because the pain wasnt as reacuring as befor so it couldnt be bad i was due to see my doctor about 2 months from now but now i have fell pregnant again im about 6 weeks and i am having the pain every day again do you think i could have ther same thing again (PUJ) and if i have will i have to put up withe the paion the whole way through pregnancy and if so will they opperait again after ? ### REPLY: Hi, Vessels crossing the junction is one of the frequent causes of POJO. If treated properly, is unlikely to recur. Pregnancy itself is a strain condition to the ureters. The gravid uterus compresses the pelvic inlet and the ureters. This can lead to urinary retention. This requires no active treatment except changing the position sometimes. Try lying in left lateral decubitus position. If you are very afraid, you can get a USG of the kidneys. But don't be afraid if there is HY .  (Because the size of kidneys will not become completely normal even after surgery). After your delivery, you can get a DTPA genogram to confirm unobstructed  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, im a 38 year old female with no health issues apart from a small lump in the groin area as a result of falling off the saddle of my bike and hitting the bar three months ago, i have only just noticed this lump today so i thought id look on line first before going to hassle a doctor at the surgery. Im not overweight so i cant see as though this is fat however it feels hard. ### REPLY: HI, Welcome with your query to . Cause of the lump in the groin after fall from bike 3 myths ago-Based on the facts of your query, you seem to suffer from-resolving fibrous from hematoma(hence a hard feel of that lump) after the fall from the saddle of your bike.USG would confirm the nature of this lump. Second opinion from Surgeon would resolve this issue. Hope this reply would help you. Welcome for any further query in this regard Will appreciate writing your feedback review comments, to help the needy patients like you at . 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: my husband has atleast stage 3 possibly stage 4a pancreatic cancer ( I say it that way because I do not fully understand the staging and no one will tell us what stage he is) his tumor is located at the head of his pancreas with venous involvement of both the SMV and the portal vein. He has had his gall bladder and appendix taken out as well as having a bowel blockage bypassed and a j tube inserted. He is now experiencing pain every time he eats as well as more frequent bouts of constipation again accompanied by a lot of nausea after eating. I have him on resource 2.0 270 ML at 60ML/hr as well as a low fat, low fiber, low salt diet as tolerated by mouth. He takes Reglan to aid in digestion, as well as Nexium for Barrett s Esophagus and this is supplemented with Zantac once a day (nexium at night, zantac in the morning). He also takes Tramadol for pain, but if the pain gets to be too much he will exchange a dose or two for a dose or two of Oxycodone. What else can we do to ease his pain and constipation? Oh, I forgot... to help aid in the fluid absorbtion in his bowels we use 60 ML 3x a day of water to flush his j tube. ### REPLY: Hi, Welcome to  forum.  I am sorry to know his health history. Every step of the treatment is going on good according to the situation.  I may suggest some . So I advise you to stop the intact, and if necessary you can give him the medium for the second time.  You can give him raglan for 2 or 3 times a day to prevent, the constipation, and for sleep. If there is frequency of stools, you can give it twice, or once only.  Wishing him a pain less, recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had injury while training karate; I kicked with my right leg and when I landed, something happend. I don t know what exactly, but slowly (in about month or two), everything was getting better, but not 100%, so I went to doctor. They said that there might be collateral ligament damaged, but they just said I should work out for my thigh muscles....But then once again (first time was december 2010, and then second time march 2011) the same thing happend (as if my knee went out of it s position and jupmed back). I went to doctor immediatley and I got crutch for one week and once again they said that cruciate ligaments look fine and that there might be latteral ligament streteched and that my kneepan moved too much -left and right; but there shouldn t be a problem if I strengthened my thigh muscle. But now after a half jear I want back to get note for MR (to be sure everything is OK), and the same doctor said I had crushed cruciate ligament (one of them, don t know which exactly), and that my kneepan really moves too much (the first time he said Arothmetere on left was -3+13 and on right -3+12) but now it was the same on left, and -3+18 on right (the injured one). He mentioned operation, but first of all I have to go to MR and then I ll see. Now my question is, can I got to fitness and work out for my thigh muscles or should I rather not? Because I didn t went to MR the first time, I don t know for sure if there was something wrong with crucial ligaments the first time, and now is-so did doctor not notice that the first time, or did that happen while training again after injury (nothing similar happend after the second injury). I probably shouldn t train now until I get MR results, but can I got to fitness and train my muscles so at least something will be done? I don t have any pain, but I can t contract my leg fully (if I can contract my left leg 100%, I can do with right 90%), and it s a bit strange when I try to contract it fully, as if something jumped left and right(or in and out)...And I can feel some bone on the upper right side of the knee that jumpes a bit when I extend or contract my leg (it s the same on the left, but if I want to notice that on the left I have to press my finger on it...on the right it s more obvious). And the second, should I visit some other doctor to see different opinion? Thanks for your ancer in advance! ### REPLY: Hello, It looks from your details that you may have injured your cruciate ligament, most probably anterior cruciate ligament. In your age for proper functioning of your knee and to prevent damage to your knee, it is advisable that you should have surgery. Please do not do heavy strength work till you get a complete 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: Hello doctor, Thanks in advance for your advice. Doctor, I do have swelling(which is very mild) and pulling sensation of my left face for the past 2 months, and my doctor had tested me and said I had parotitis, and he said it will be cleared by itself, but till date, it hasn t get cleared; and he sent me to a dentist; he took an OPG test and said i had infection in my third molar teeth and asked me for excision of this tooth. My complaint now is severe chills and slight pain and slight swelling in my left jaw as well as my right jaw... Can you please suggest me what to do.. I am scared to remove my third molar because of the fear of getting ill again, since i have been ill for the past 2 months.. I have attached my OPG image here.. Please do spent some time and help me.. thank you.. ### REPLY: Third molar infections are quite chronic in nature. Please get the 3rd molar removed as the source of infection will be gone. There is no problem with the 3rd molar removal it is regular procedure where in it is done under local anesthesia. Please do not have a myth that 3rd molar extraction results in complications. The swelling can be controlled by cold pack, avoid hot food and start antibiotic coverage. Get the tooth removed during the antibiotic cover to avoid retrograde infection. Use Betadine gargles to keep mouth free of infection ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi sir,I have got infected with chronic haepititis B in year 2011 aprrox. mate 3 yrs ago.I was with a SGPT value of 900 and and bilubrin was up to a level of 4.5..later on within 6 months I got well physically but I am not sure that I have taken a lab test of HSBe and sure of whwter the antibody is forming is not so that I may sure that liver cirossis will not occur in future also now after 3 yrs more I am again feeling suffering from jaundice due to eating of some contaminated stuff and due to not having proper life style due to my job...what so I do? and what are the test and medicine I need to take? and how can I be sure that in future I will not develop liver cirosis? ### REPLY: Welcome at  I have gone through your query and being your doctor I completely understand your health concerns.... What is your age? Have you completed the treatment for hepatitis b ? When did u get your last PCR and HE e antigen and antibody testing done?? These all question needs to be answered in proceeding your case... Hepatitis B if not treated will lead to cirrhosis eventually... So a stitch in time saves nine... If you already got treatment you need to check. HE e Antibody And HBV DNA by PCR ...to look for recurrence... Meanwhile continue with your routine chores and do regularly check your liver function tests along with liver ultrasound at least once a year. If you find any abnormally immediately consult your hepatologist... Hope your query is adequately answered.  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 doctorI am suffering from jaundice. the day i was detected jaundice, my bilirubin and SGOT and SGPT level was higher than normal. Now after 10 days also the values are same. doctor says that earlier values were showing increasing trend of all the above three things and now it is showing decreasing trend. Is it true that in Jaundice trend reverses and is it possible that I might have got the blood test done at same levels of SGOT SGPT and Bilirubin but this time i might be improving... ### REPLY: Hi.noted history of jaundice. It is possible that you have an obstruction (maybe due to gallstones or tumor lesion) somewhere along your hepaticopancreaticobiliary tree causing your jaundice and elevated liver enzymes. It is best if you consult with a doctor, preferably a general surgeon or a gastroenterologist, for physical examination and clinical evaluation. Other diagnostics (such as ultrasound, ERCP, ct-scan, other blood exams, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, Im from South America. Im male, 23 years old. I was bitten by a bat while asleep today. So, I got the first rabies vaccine shot. The vaccine is called CRL or lactating mouse brain. The treatment is to get 7 shots in 7 straight days and one after 10, 20 and 60 days. I was wondering why is the reason they recommend to not exercise, drink alcohol and have sex? And does smoking affect the treatment? As I found in one source that smoking is contraindicative. Thanks in advance. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes, prescribed shots are appropriate and should be taken regularly. The act you asked is actually induced the injury and makes the rabies infection to spread more. Even smoking and alcohol may interfere in production of effective antibodies. This will create obstacle in the antibody formation. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently discovered a large, none painful lump in my lower back. It can not be seen just by looking at my back but if you put enough pressure, you can feel it. It is about an inch wide and is shaped slightly like an oval. It moves under my skin and i suspect it is a lipoma. I do, sometimes, feel like a nerve is being pinched and it feels like the pain spreads down to my lower thigh. The only think that is making me thing that it is not a lipoma is that is is hard all around. Can lipomas be hard or are they always soft? ### REPLY: Thanks for your question on . Lipomas are always soft as it contains fat tissue only. So if you are feeling hard sweller than lipoma is unlikely. The site you are describing is also unlikely for lipoma. Lipomas tend to occur more in flexor surface of forearm, upper back etc. In my opinion you are having benign tumor of nervous sheath (Neurofibroma). It is hard, mobile and benign tumor. And it is on the nerve so when you press it, you can feel pain on area supplied by the nerve, same in your case. So Neurofibroma is more likely. But clinical examination and ultrasound is needed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 34 years old woman. I am suffering from asthma and RA.I have been taking medicines for RA and inhaler for asthma. I am suffering cold from 2days. But now I am feeling chest pain in my left upper part. already 2 hours have passed. But I didnt get rid of it.Please tell me some home remedy. ### REPLY: **1. Since medicines for Asthma also increases the heart rate, and any provoking factor [cold in your case] will naturally increase the heart rate, resulting in chest pain, so whenever a patient complains of chest pain, first possibility whicChatDoctores in mind, is it related to heart, thus prior to taking any home remedy [since there is no relief from 2 hours], seek an opinion of cardiologist/physician who will go for necessary examination and baseline investigations.2. In the best Interest: avoid exertion, stop physical activity and start medical treatment immediately. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had unprotected sex at 2 am Friday and I then took the first morning after pill at 12 pm the same day. I was late on my second pill and ended up taking it at 11 am Saturday, so I was 23 hours late for the second pill from the first. Now should this be okay being this late for the second pill? Should I take a third pill? Or is the effectiveness of the pill still fine? ### REPLY: Hi, No this delay is not okay. The second tablet should have been taken 12 hours after the first dose. So its efficiency is no longer guaranteed.  Today is the sixth day from unprotected intercourse. So repeating the dose is not going to work. I would advise you to have pregnancy test if you miss your period. If it comes out as positive discuss with your doctor for abortion. 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: my dentist did a open my tooth up for a root canal while it was abcessed and did not give me any antibiofics for 2 weeks. then he gave me penicillin for a week. now he put some liquid medicine in the tooth and I go back to him in 3 weeks. this will make 2 months with this tooth and he did another root canal first and that is not filled in. someone please tell me how to handle this. im uncertain of how this could affect my body ### REPLY: Thanks for your query, I have gone through your query. The infected tooth can be treated with RCT once the infection subsides and when there is no pus discharge from the canals. You should take a proper course of antibiotics like amoxicillin 500 mg and metronidazole 400 mg TID for 5 days (if you are not allergic). Once the completion of antibiotics you can start the RCT. Consult one more endodontist and take one more opinion about RCT. It is not needed to postpone the treatment for such a long time unless there is severe infection. Even though there is such a severe infection, it should subside by taking antibiotics. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a pinching pain in my left chest area, which feels like is my heart. This has been happening for a while now and will come and go, but last for like 30 mins or so. I am in good shape 34 y/o female. Could this be caused by anxiety, or something else? ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you are having anxiety associated chest pain mostly. But as a rule in left sided chest pain, we need to rule out cardiac cause first. So get done ECG to rule out cardiac cause. If this is normal then no need to worry much for cardiac cause. You are mostly having anxiety associated symptoms. So avoid stress and anxiety. Be relax and calm. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 yawn a big one earlier and my chest started cramping to the point i had to breath and had to breath in little by little at the same time the back of my neck started to hurt. It probably happened to me atleast 5times since last year. It is pretty scary. ### REPLY: Hi Dear !! Thanks for your query to . Read and reviewed your query and health concerns. IN the given situation, You seem to suffer from-Hypokalemia with Muscle cramps of intercostal muscles. Scary feel is from low potassium levels. Neck hurting indicates low potassium causing cramps. Remedy-Would be to take- a glass of-Orange juice and banana shake-to supplement potassium and to raise accompanied glucose levels. Magnesium supplement-with nuts/lentils supplements. Be on high glucose diet, which would keep potassium to needful levels. Check out causes of low potassium in your case-like diuretics, diarrhea, magnesium laxatives, antibiotics etc. And reduces stresses from work. All this would reduce the yawning from weak muscles with low potassium levels. Check out blood sugar levels and potassium levels and consults with Physician would be needed to fix this issue immediately. Hope this would help you to plan further of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following  link-http://doctor. .com/Funnel?page=askDoctorDirectly&docId=70229Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at  services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 4 yr old has tummy aches,coughing frequently, i gav him asthma treatments.no fever.hes was active most of the day but always coughing.its been a week. No discoloration.ill give him liquid cough surpresssnt every 4 hrs.I want to avoid  the Hospital.Our last vizit i couldve treated at home. ### REPLY: Hi... Thank you for consulting in . Greetings from Chennai. By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever? If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing, and I suggest you meet a pediatric pulmonologist who is near your place. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir, i have dignosed with typhoid befor three month and i have taken medicines. my fever has gone but my intestine is still very sensitive and some time i feel itching after geting food and burning sensation in my body specially on my face. intestinal hardness and i feel very weak. is i have swallowed stomch prob or ulcer please help me ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion you should take small soft and frequent diet. Typhoid is notorious in causing intestinal ulcer. This ulcer may perforate if the proper care has not taken with. Perforation of intestine is very dangerous problem. Take above care if you feel some problem with perforation immediately contact nearby ER. I will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Mr bra, LKK(Handoko Nursalim)74, Chinese fr Indonesia, been consulting his Diabetic(typeII for ovr 10 yrs?)w Dr.GordonKu, Mt.E Hospital, Singapore.been dialysis for 6 mos?.Problem G6PD, red blood cell not stabil, over transfused, and Dr inject Aransep and Recommon 10000,still not normal up and dwn.Recently he got Amoeba after dialysis in Indonesia n rushed to SG for treatment n more or less cured, but now detected pulmonary n heart congestive symptom, Dr has to drain body water now he is oly 55kg-dry weight.Family are worried, how to improve his condition. His bone marrow test shown negative. medical report enclosed ### REPLY: Hi there, Please check his iron profile. He may need ferric carboy maltose infusion along with Erythropoietin to increase his hemoglobin level. Also give him folic acid tablets and vitamin B12 injections. Normal bone marrow test is a good news, as some serious problems are ruled out after doing that test. His anemia appears to be related to kidney failure, not due to G6PD deficiency. Hope I have answered your question. If you have any further questions I will be happy to help. 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: I was lifting something less than 10lbs, heard a pop in my elbow, dropped what I was holding bc I lost the ability to hold/lift it n the pain was so severe. From my elbow down to my hand. Still hurts super bad, can t straighten it, make a fist, carry ANYTHING. What happened? ### REPLY: Dear Sir/Madam have gone through your query and read your symptoms. In my opinion, you will need an X-ray of your elbow to see if you have done some damage to the joint, also in some cases if there is only ligament injury you may need an MRI to get it cleared. Meanwhile keep it elevated, and take tablet diclofenac 50 mg three times a day, and apply a crêpe bandage over it. I hope that answers your query. If your want any more clarification, contact me back. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It has been recently posited by my gynaecologist that I have suspected endometriosis. I have been reading a lot about this condition and I am panicking about the quality of life I will have to get used to due to the constant pain I am in. Sometimes I go through months where I am not in pain as much- which seems to correlate with not being as anxious. I find anxiety makes my pain worse. Is this possible that anxiety can make the pain worse? ### REPLY: Hi, The answer to your question is yes. Anxiety definitely increases pain symptoms. In fact, they could be the cause of pain symptoms. You could try lifestyle measures to help you to relax ;yoga or meditation for instance. If you are comfortable with medications antidepressants would help. Don't worry too much about your illness. Besides it is only suspected and not confirmed. Hope you get relief soon. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Can I know of the dental clinics in south Delhi which are under the CGHS. I want to get surgical extractions done for 2 wisdom teeth that have grown in a crooked way. Also can you tell me how long the procedure is to get the extraction done for both the teeth. ### REPLY: Thanks for using . Read your query. Removal of wisdom tooth (impact third molar) is usually based in the position of the tooth and by level of eruption which is evaluated by the oral and maxillofacial surgeon after a taking a radiograph. I would advise you to take an x-Ray, and then you can carry on the extraction procedure. The duration of the procedure varies for every doctor, so you cannot predict a time limit for it, unless it is done. I hope this was of use to you. Thanks and warm regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello ! My problem is that I have a cronic cough that wont stop until I throw up but this only happens when I get my allergies . I get itchy ears and its very hard to deal with it . I wanna know how to stop this . It is very tyring once I threw up this white flem . But it will continue the next night before I go to bed . HELLLLLLLP. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have symptoms of chronic cough which is due to upper respiratory track infection leading to bronchitis/ granular pharyngitis. Ear itchiness is due to left over upper respiratory tract infection which travels to ear by Eustachian tube. I would suggest you to do warm saline gargles and take steam twice a day. Avoid use of sharp and spicy food substances. Avoid cold carbonated beverages. Your symptoms will resolve in 1 week. If symptoms keeps on persisting you should consult ENT specialist and take proper treatment. You should get X-ray chest done along with pulmonary function tests. Doctor may prescribe antibiotics (amoxicillin or penicillin) at least for 5 days along with decongestant. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i started with a toothache after a filling. Now I have pain in my big toe and under my foot and instep. a few of my toes feel numb like I have been sitting on them too long. The is a swollen gland just under the tooth. This gets big or small at different times. This has happened for years. The pain is on the same side as the toothache. It is worse at night ### REPLY: Hello & welcomes you complain of pain after filling & some gland enlargement, then its quite obvious that there is some infection under tooth. Because if there is some pupal involvement & filling is done over it than this will aggravate the infection. So visit to your dentist for further clinical; & radio graphical examination, only after that further comments can be added. As far as problem of your toe is related, i don't think there is any relation, so visit to your physician too. Thanks & 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: Sure. In August, I was diagnosed with multiple small gallstones. today , my doctor told me my gallbladder is either partially collapsed or folded on itself. I have had loose stools for two weeks along with tenderness seemingly at the top of my rib cage (and not necessarily on the right side). Dr gave me a surgeons phone number. Is there treatment before surgery? ### REPLY: Hello! Thank you for the query. There is no other treatment than surgery. In most cases such gall bladder is removed with laparoscopy. Throughout 3-4 small holes the camera and tools are inserted into the abdominal cavity and the gall bladder is removed. This is quite safe and easy surgical procedure. Does not cause much pain after and gives fast recovery. You should not wait as small stones likes to migrate into bile ducts and can cause pancreatitis which is a very serious disease. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister has tried two cancer drugs for high grade papillary serious carcinoma after she had surgery. She will soon have a biopsy done on one breast to see if this is the cause for her CA125 to keep rising. Which Is now at 400. If they find no breast cancer then does this increase mean the cancer has spread some place else. If so, probably where to? Hers originated in the overies pathology says and OBGYN surgeon beloved the uterus-.... ### REPLY: HIT hank for asking to ChatDoctorIn the malignant lesion (Regardless of type and origin), the early detection and the stage is more important matter, otherwise the chances of metastasis is likely, if it is being detected lately, and have a stage that is responsible for spreading of disease, then spreading of lesion is more likely, but one thing is sure and that is natural remission it may some time happens, 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: My penis and scrotum has become sticky. All std test have come back negative and there is no smell it just feels very uncomfortable all the time. The doctor says everything is fine but I am worried something could have been overlooked.Any idea what could cause this. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  If your doctor says there is nothing to worry, then why are you worrying? If still in doubt, please consult another doctor whom you shall believe. Shooting questions here shall never help. You are seemed to obsessed with the sexual problems. That is why you are having such problems. Sticky problem could be just due to sweating. Just ignore it. Obsession may be treated if ignored in its early stages, or it may convert into Obsessive Compulsive Disorder. Please understand. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor! I m having very severe hair fall for the past six months! The hairfall is more especially when I m applying oil n after shampooing ma hair! And I had typhoid three months which made ma hairfall even worse:( can u suggest me a remedy for this? ### REPLY: Hello, Severe hair fall post typhoid is known as halogen effluvium wherein the hair gets transformed from growing phase (managed phase) to shedding phase (halogen phase).  This would recover gradually over 4- 6 months. I suggest you take an oral biotin supplement once a day for a few months.  Hope I have answered your query. Let me know if I can assist you further. Take care . , Dermatologist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Dr.  I have recently been diagnosed with cholecystitis  was prescribed ranitidine, ondansteron (to prevent vomiting), meclizine, tramadol and baclofen, then went back to Dr. who then said I have a kidney infection, prescribed me cephalexin, 500mg 2Xday for 7 days which I just finished this AM. Now, I have pain in my pelvic region, bladder hurts to urinate....Symptoms Ive been experiencing include tiredness, dizziness, nauseated and have vomited a few times,bloated feeling, swelling in facial area, right flank into back pain (intermittent, sometimes extremely painful, cant lay down on right side), lower back pain at times. IN a previous scan for a different health matter, It was revealed to me through my medical chart that I have a cyst on a kidney. Please give me your opinion on this dilemma. Thanks. ### REPLY: Hi ! The cyst in the kidney could just be a coincidental finding. However, seeing your present symptoms, you can go for a review ultrasound scan of your pelvis and abdomen. It seems that the urinary infection of yours is persisting even after taking a course of antibiotic which is an indication for going for a urine culture and sensitivity test. Cholecystitis is a different entity which needs evaluation and treatment separately, and this also could be a reason for your nausea, vomiting and bloated feeling. Please visit your family physician with your urine culture and sensitivity report for a review. Wishing 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: Ten years ago, I had surgery for removal of my gall bladder due to gall stones and pain associated.  Since then I occasionally have pain of the same nature prior to having my gall bladder removed. The onset of pain doesnt seem to be associated with anything in particular that I eat or drink, but mostly occurs in the morning after drinking coffee; or eating yogurt.  The pain lasts all day, into early evening.  Since I have no gall bladder, therefore it cant be a gall bladder attack, what is causing the pain?  What suggestions do you have for me so that I wont have this problem going forward? ### REPLY: I would suggest an H pylori test first. Since pain in that area may be due to gastric or duodenal ulcer. If positive I would suggest triple antibiotic plus proton pump inhibitors for H pylori eradication. If test is negative i would suggest ultrasound abdomen to look for large gall bladder stump left after surgery which sometimes gets inflamed and causes pain and look for stone in bile duct. On top of my list is gastric ulcer ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 3 yr old son has a white coating on his tongue with red blotches on, inside of his cheeks are also blotchy. he has already seen a dr on Monday because he had white painful spots on his tongue.. he is not in pain anymore but im concerned because of the change.  rgds, Tony. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand. As per your complaint the white coating over the tongue along with painful red spots seems to be due to yeast infection known as Oral Thrush and redness of tongue and enlarged papillae are due to both thrush a causing inflammation of papillae. As infants and toddlers have a less developed immune system therefore, they are more prone to get infected, especially by opportunist infections. You should consult an Oral Physician or a Periodontist and get him evaluated and in case if thrush is diagnosed you will be advised to take antifungal medications like Candid mouth paint and taking ample of probiotics like yogurt and garlic. For redness and soreness of tongue you can make him gargle with numbing mouthwash containing lidocaine, suck ice and take Ibuprofen. Avoid hot and spicy food. Hope this information helps. Thanks and regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have married sience seven days but I am unable to satisfy my wife in sexual intercourse . My penis is not able to cross the inside hole . Strongness is not 100 percent & penis length is 5inch . pl. give the solution.age-37,5feet3inch,lungs problem was before 1 yrs.i have done the treatment from DR. M.R.PATTNAIK. I am tension & pressure due to heavy workload.LEG PAIN  some time  & feeling weekness. ### REPLY: Hello, In initial few attempts of sexual intercourse, the erected penis can't make intercourse correctly. Gradually with few attempts, you will be able to do penetrative intercourse. If you are having a problem in getting form erect penis than you should consult a nearby doctor for checking blood pressure, lipid profile, prostate examination etc. The cardiac problem and spinal injury also can cause difficulty in an erect penis. You are having a history of blood pressure. So it should be controlled with medication. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mom is in her last stages of liver cancer. She hasnt eaten in 15 days and is on heavy duty medication. How long does my mom have and how long can your body last without eatingMy mom have a nurse coming in three times a week. Mom cant get dressed by herself or get to the bathroom. All she does is sleep. Please help ### REPLY: Hi and welcome to . Thanks for the query. Yes, these are signs of terminal malignant disease, and unfortunately you should not expect some miracle. Prognosis in such cases is very poor, from few weeks to month or 2. Without eating this is even worse. She may try with parenteral nutrition and rehi .  She needs all your support in these difficult days. 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: A couple days ago I noticed a pea-sized lump on the outside of my elbow, beneath the skin.. it is fairly hard to the touch and painful when my arm is resting on my desk or when it is gently pressed. When I extend or retract my elbow to its full range of motion there is some discomfort in the joint. When my elbow is bent all the way the lump is very hard to find, if at all. It sort of aches after it is touched. Any ideas? I cant seem to find anything about it online. ### REPLY: Hi, Dear,Good evening. Thanks for your query to . I studied your query in-depth. In my opinion the lump on the lateral side of your elbow-Could be -? A lump of the Tennis Elbow- ? Or it could be French cellulitis-as its hard and painful to touch. Bending vanishes the Lump -but aches on touch. Treatment-a-I would suggest consulting a Surgeon and Ortho-Surgeon both-who would differentiate the 2 possibilities.b-If its -Tennis Elbow-Tb NSAIDs, Rest, if recurs -In. Steroid local would relieve chronic Tennis Elbow-. But if its -Boil on outer elbow-then-Antibiotics, Tb NSAIDs, cold compresses would reduce the lump. If it doesn't, and increases, then Proper Surgical I & D-incision and . Hope this would clarify the worry you had. Would love to Welcome your queries to . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a terrible reaction to pine nuts - firstly a very metallic taste in mouth and everything tasting bad - soapy and metallic - this lasted about a week with v bad symptoms but Now - 3 weeks on I still have a metallic taste in mouth and feel very unwell - lethargic, tired - could this still be the pine nuts? ### REPLY: Hi, This is a not so common, yet one of the possible sequela of ingestion of pine nuts (spy a Chinese variety), that has surfaced nowadays known as pine mouth/ syn .  It causes this metallic aftertaste. But rest assured this is self limiting and would go away soon. Try taking a lot of juice/ fluids. If the symptom doesn't subside by 1 week, kindly get it re-evaluated by a physician. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello My name is Sheena Harris and I have been having chest pains for months now. My chest hurts when I bend down or stretch and it also hurts when I breathe. I have been to the er and they always tell me that  it is chest wall pain. what is going on? ### REPLY: Hello Sheena! Thank you for asking on ! Regarding your concern, I would agree with ER doctor for excluding a cardiac related option of your pain. Your pain doesn't look like being of cardiac origin (facing pain nature and characteristics of breath and position relations). But, it is necessary to exclude other possible causes, like pericarditis (a careful physical exam, cardiac ultrasound); backbone degenerative process (a careful physical exam, backbone X-ray study, CT or MRI); pleural inflammation (pulmonary auscultation, chest imagine studies), etc. I recommend you to consult with an internist for a comprehensive differential diagnosis work up, to identify the right source of your complaint. Hope to have been helpful! 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: Hello all. I am from Bangalore. Actually I got a wound(Red colour) in my pennies ball from 2 weeks back. I am really suffering because of this. I am not able to sleep , I am not able to walk properly. 3 weeks back I had sex with one of my friend. After 1 week it happened to me. I dont know what to do. Please suggest me about this. ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have a wound around glans penis after having sex with your girlfriend. This could be a wound due to . You need to get basic tests like screening test for STD and Swab test of fluid from the wound done to rule out STD. You need to take broad spectrum antibiotic like Čeferin along with anti-inflammatory  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was riding a bike and met with an accident, my left leg toes except the big toe got fractured and there is a swelling on my feet around this location. Initially i was bandaged with casting and later i was suggested with a aircast shoe. Iam wearing this shoe but over a period of time my swelling turns to black colour. what is the reason? ### REPLY: Rest assured your swelling turning to black color is just part of the entire inflammatory response to your injury. What you have my friend is ecchymosishere is how it happened to you :) for your question what is the reason:after you injured your left foot, structures underneath your skin gets damaged (bone ligament fat small blood vessels)they bleed temporarily, but since you don't have a break in your skin (external cuts, open wound) the blood is trapped underneath your skin. Even if you did not ask I would like to tell you this as well, because you probably would like to know this and save u some time of asking another question:overtime this blood would slowly be reabsorbed by your body but some of them will find their way to your skin hence giving the appearance of black or darkening of the injured body part. They temporarily "stain" your skin. But through time they will also get reabsorbed by your body.till go away on its own so relax. Merry Christmas in advance .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 repeated episodes of passing out & near passing out w/nausea/profuse sweating, cold clammy skin & confusion that can last for up to an hour. Sometimes I recover right away, & other times it takes quite a while. I have nausea almost daily along with getting light headed almost daily. This can happen while standing or sitting. I have it happen while driving. Luckily there was someone else with me. ### REPLY: HelloThanks for the query to . Forum. Nausea, passing out, light-headed, sweating, cold clammy skin may be due to .1 Hyper tension or hypotension. Diagnosis can be confirmed by physical examination at the time of these symptoms. Cold and clammy skin is due to sweating, while sweating may be due to dizziness and dizziness may be due to these both conditions. I mentioned in simple way, so that you can understand easily.2 Hypoglycemia or Hyperglycemia may be the another reason for such type of symptoms. Hba1 C and blood sugar level will find out the exact reason of such illness.3 Anemia and tension both causes such type of symptoms. In my opinion consult a physician and get his opinion. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir,I am 24 year old I have fatty liver last one and half year and my sgpt is now 55. Before one year it is 98 after taking medicine it become 32 in feb and I m not leaving to take medicine and food deit instead this in march I have sgpt is 68 I am very tense plz suggested me what to do ### REPLY: HelloSign SGPT may indicate liver injury. It may be due to many reasons like hepatitis, alcohol intake, altered lipid profile, medicines,autoimmune causes etc. High SGPT in your case may be due to fatty liver. You may need few investigations like routine hologram, random blood sugar, viral markers, lipid profile. Fatty liver is a reversible condition. You may need to change your diet and lifestyle. You should avoid fatty food and go for brisk walk. You may need to take few medicines after full investigations. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,  Two weeks back i was detected ITP and doctor started wylosone 45mg. My question is I feel always tired and fatigue since before starting medicine and still now. Why? I not able to walk more distance my breathing started fasting. I not feel still any better health after starting steroid. Why? Is tiredness is the part of ITP? ### REPLY: Hello dear thanks for your query at ChatDoctortiredness is not part of ITP. It could be due to steroids. Steroids can cause tiredness and restless less. But your saying tiredness is before starting steroid, other causes should be ruled out.important because I would consider here is anemia, it can cause fatigue, restlessness, and breathing problems. Get one complete blood picture to rule out any anemia. If symptoms are increasing, difficulty in breathing please consult doctor for further investigation and management. Do not stop steroid abruptly for any reason 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 NEED SERIOUS HELP. So to start off with I don t know where to start. hearing loss, vision blurred, balance off than normally, cloudy memory and thoughts. VERY ITCHY! scalp is pealing and sometimes I swear if I shake out my hair with my hand like a whiteish liquid hits the mirrow ect... also I feel sometimes like something damp hit me...weird right! I know this sounds SO CRAZY but I SWEAR TO YOU I m not lol...anyways theres more. I also have mucus in my stool sometimes constipated or diarreah. I m hoping I don t have any parasites. IDK what to do or where to start. My right leg also is kinda numb by my knee and my feet and hand are swollen a lot and burn. If I m not hot I feel clammy and oily. MY neck and glands often are in pain. PLEASE HELP ### REPLY: Hello! Welcome on  ! I read carefully your question and understand your concern. Your symptoms could be related to different possible causes: a chronic infection or inflammation, a vitamin deficiency, a hormonal dysfunction, etc. For this reason, I would recommend performing some tests to investigate for the possible causes: - a chest X-ray study-complete blood count, sedimentation rate, PCR for inflammation- vitamin D plasma levels - blood electrolytes- vitamin B 12 plasma levels- a stool analysis-kidney and liver function tests- a urinalysis. You should discuss with your doctor on the above tests. Kind regards,  ### END