Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 using Minerva 35 and Ive being having sex every day for the past 5 days, but on the 3rd day I forgot to take my Minerva pill. I took it the following day at the same time as I took the pill for that day....is there any chance I could be pregnant ### REPLY: Hello misunderstand your concernMinvera 35 is contraceptive pill, and it is very effective in preventing the pregnancy (failure rate 0. 5-1 %). As you missed one tablet and took it no next day along with next day pill, the is no chance of pregnancy as it does not decrease the efficacy of contraceptive pill. So there is no chance of pregnancy. Take the remaining tablet on same time every day.(make habit to take on SME time by putting reminder in mobile)Hope this may help you Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: SIR, MY CHILD AGED 6 IS A HEALTHY BOY WEIGHING 25 KGS HE IS DOWN WITH FEVER WHICChatDoctorES BACK SIX HOURLY SINCE LAST 4 DAYS. HE IS EATING WHEN THE FEVER IS DOWN I HAVE NOT GIVEN HIM ANYTHING EXCEPT PARACETAMOL. HIS BLOOD TEST DONE ON THIS THURSDAY SHOWS A NEUTROPHILS COUNT OF 64 BUT IS OTHERWISE NORMAL. NO MALARIA ### REPLY: Brief answer :It indicates infection. Detailed answer :Hi, welcome to . Your child has fever for 4 days and neutrophil count is 64, this indicates infection in child. Since, malaria is negative, you need to do some more investigations like NS1 Antigen test for dengue, typhoon IGM for typhoid. In my opinion, your child will probably need antibiotics based on above reports. I hope this will help you. Take care. Regards - .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, On January 15, 2014 I had spinal stenosis surgery to open up space in the L3, L4 and L5 vertebrae. The surgeon found torn tissue wrapped around my spine and it was leaking fluid. I had been having headaches. I have been having muscle spasms in both legs and pain. There has been numbness in my feet and burning sensation. This has been going on for three months. The surgeon had a Nerve Conduction Study done and the results are Peripheral Neuropathy and Sural Nerve damage. He told me no physical therapy which I don t understand why not. I m going to ask him. What do you recommend? Thank you! I m hoping to make an appointment with a neurosurgeon or Neurologist. ### REPLY: Hello. I have been through your question and understand your concern. It is a bit unusual to report these problems after a spinal stenosis surgery. Anyway, at this point you have peripheral neuropathy which is mainly seen in diabetes, and probably you had it before surgery. Another cause is intoxication generally by .  In this case Gabapentin and amitriptyline would help a lot on nerve repair and relief from numbness. While rural nerve damage can cause burning sensation but other than that it is not very concerning because it is a sensory nerve and does not cause weakness or major problems. As for the burning sensation gabapentin and amitriptyline are recommended. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI. I AM 42. HAD AN CERVICAL DISCECTOMY AND FUSION ON C4 C5 ABOUT 2 YEARS AGO. 6 MONTHS AGO MY SISTER HUGGED ME AND SQUEEZED MY NECK WHICH HURT. SINCE THEN I HAVE A NERVE TWITCHING IN MY ARM AND PAIN IN MY THUMB JOINT PLUS PAIN IN MY KNEE. I HAVENT BEEN TO THE DOCTOR YET. I M NOT TAKING ANYTHING BUT HAND PAIN IS GETTING WORSE EVERY DAY AND STARTING TO RESTRICT ME AT WORK. ### REPLY: Dear Sir/Madam have gone through your query and read your symptoms. In my opinion, you specifically describe your symptoms and your thumb pain means your sixth cervical nerve root is getting compressed, please get a MRI done and confirm, if the compression is more you may need a repeat surgery, but that can be judged by a clinical examination. I hope that answers your query. If you 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: dear sir, I have taken antibiotics during first 3 months of pregnancy due to severe lungs problem...will it affect baby complexion? ### REPLY: Hi;welcome to  Modern day antibiotics are designed in a way that they have minimal side effects unlike previously used antibiotics like Tetracycline which used to cause yellowness of teeth. The recent antibiotics will just help treat infection and do not affect the complexion of baby. Secondly the most important point is complexion is governed by genes that run with in a family, so he will have complexion like his father or mother so don't worry. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My left hand is getting numb only during night time and few months back my wrist was hurting.I am lefty. Also little overweight.But do regular exercise pretty much 5 days a week.Also, sometimes I feel my heart palpatation is high. Please let me know what can I do. ### REPLY: Good day! The most common answer to the symptoms you are experiencing is Carpal Tunnel. It is compression of a main nerve in your hand that comes from repeated movement and compression of the wrist. The symptoms can often occur at night due to accumulated tension throughout the day. As for the palpation, how high is your heart-rate? Common causes can be coffee, deny .  If you experience any other symptoms certainly see a physician for a Cardiac Check-up. As for the wrist, try taking breaks from repetitive tasks involving your hands. There are wrist splints that can be bought over the counter, they are very useful. Stretching exercises may also help: make a fist and then spread your fingers out. I hope this advice can be helpful, and leads you in the correct direction. You have my 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 i had a  kidney stone 2 years ago ... i feel like its coming again soon it hurts me by the lower right side of my back kind of the meddle of my right side it also hurts every time i take a deep breath and i keep burping.note: i drink hard alcohol 2 to 3 days a week!any idea of what i might have? ### REPLY: Hello, I had gone through the case and found that if you have history of stone then you must go for ultrasound of whole abdomen. Renal stone pain never aggravate with breathing and burping never occur due to stone. It might be due to week digestion causes burping. So After the ultrasound take proper treatment. Avoid alcohol because it creates stone and liver cirrhosis. Take antacid for burp. Hope my answer will be effective for you. 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 m a 27 female I ve smoke ice method 3 days ago I don t smoke often and I was having trouble taking deep breaths and then today I started getting chest pain in the middle of my chest like a real bad heart burn that goes and comes bck should I go see a dr ### REPLY: Thanks for your question on . Smoking ice can cause HERD (Castro Esophageal Reflux Disease). It is due to laxity of gastroesophageal sphincter because of smoking. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Try to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and anxiety. 4. Start proton pump inhibitor. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in the bed. 7. Avoid such habit of smoking ice. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 fell and hit my arm between elbow and shoulder. It now is hard to lift my arm. My hands and mobility below elbow is fine. Is it possible that I bruised a muscle. I have no black and blue and no cut. Does not look swollen but difficult to raise arm. ### REPLY: Hi, This treatment is being suggested on bases of the information provided. However, I would like to examine & investigate the patient in detail. Control hypertension, diabetes or any other metabolic disorder, if there is any.  Any way it may be tried:- Looking Plus (Mankind) [Diclofenac + Paracetamol] 1 tablet OD & SOS for 5 days.- Calcified plus (Mankind) 1 tablet OD for 10 days. (You may need help of your local doctor to get these medicines.)- Fomentation with warm water. Let the part not be exposed to cold air.- Sleep on a hard bed with soft bedding.- Use no pillow under the head.- Avoid painful acts & activities.- Do mild exercises for neck and shoulders and hips and knees and ankles. (Take help of a physiotherapist.)- Do not ignore, let it not become beginning of a major problem.- Do ask for a detailed treatment plan.- Make sure, there is no allergy to any of these medicines.- For emergency treatment visit the nearest hospital. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi for months I have had pain on both butt cheeks/ bones and right in the middle of lower back. Times I cant even get out of bed. Plus I do not sleep well. I always have to flip from side to side. I feel nauseous in morning and throughout day. Im also tired. I also get tingling in my legs and feet. The back of my calves get heat in them. My hips and butt cheeks ache daily. ### REPLY: Hi, Thanks for posting your query. The description suggests that you have lumbar disc disease with radiculopathy. The initial management for this problem is conservative by following means : - Bed rest - analgesics and occasional muscle relaxants - Methylcobalamine preparations which helps to alleviate your "pins & needles" sensations - lumbar back support while sitting for longer periods - intermittent pelvic traction If you don't get any relief within 3 weeks, you need an orthosurgeons consultation to decide upon the need for surgical intervention. Hope this will help you. Let me know if you have any more concern. 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: I have been taking Fexofenadine , 60mil, for my multiple allergies since 1998, and have had asthma since the age of 3. I am a VA patient since the first of this year and the pharmacist took me off of the above medicine because they don t have it here in Tucson, AZ. Instead, she sent me a prescription for citrizene, 10mil. I have been a pro truck driver for 43 years and I don t need something that will put me to sleep behind the wheel. I still take two Fexofenadine per day and that not only has practically eliminated my allergies but I very, very rarely get colds or flu . This Citrozene, from what I have read (because I haven t taken any), will do absolutly NOTHING for me. Please tell me the difference so I can confront this so-called Pharmacist. I am an Army Veteran and we have enough problems without someone mis-diagnosing us. Thank You; Bill ### REPLY: These type of symptoms are only seen in food substance allergies like milking my 32 years experience if on my experience you stop all milk and diary products completely you will be out of allergies and won't need any medicine get blood serum test for milk wheat rice egg nuts rice potato to find out additional interference from other food stuff go for elimination diet and slit therapy for cure of allergies ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 doc.. my health problem is i have a vaginal infection my doctor give me  albothyl suppository  and she said not to have sexual intercourse in two weeks but suddenly  i have sex and after my menstruation , the infection of my vagina come back...  my question is what should i do with this situation? ### REPLY: Hello dearWelcome to  family. I have gone through your concern in depth.@ Flaring up of vaginal infection is highly common after intercourse.@ Recommendations for better recovery $ Sit in a tub filled with lukewarm water and added10 ml of antiseptic liquids 3 times a day.  $ Continue suppositories use as directed by your doctor.  $ Strictly no vaginal sex till further 3 weeks.  $ Wear loose, clean, cotton undergarments.  $ Systemic molecules in form of antibiotics, antifungals require in person check up. Hope this will help you for sure. Always feel free to ask further questions. Thanks for evaluation of my answer. Regards dear. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have been having a uncontrollable cough now for 2-3 weeks and nothing has helped me only cough drops temporarily and my parents will not take me to a docter cause they said I will be fine they always say that but im scared and I was wondering what it is and is there anything you can recommend me for this ? ### REPLY: Welcome to ChatDoctorI have read and understand your query hope this will be useful you having any associated flu or heart burn? Do you smoke ? A runny or stuffy nose, A feeling of liquid running down the back of your throatFrequent throat clearing and sore throat, sour taste in your mouth or any coughing up blood? Prolonged cough can be managed with few home remedies and an ivy leaf extract cough syrup. Take a lot of fluids, particularly warm. A teaspoon (5 grams) of honey in warm water is a good home remedy. Take an anti allergic along with a cough syrup. Quit smoking if you are a smoker. A cough caused by acid reflux can often be treated with lifestyle changes alone. This includes eating smaller, more frequent meals; waiting three to four hours after a meal before lying down; and elevating the head of the bed at night. I hope this would help you. You can reach me anytime with any other queryRegards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 take lostartan/hydroclorazide 100/12.5, but the pharmacy gave me 100/25. I wasn t feeling well and realized they gave me the wrong prescription strength. I have a stent in my renal artery. I have been having back pain (kidney since I took the wrong meds. Could this have caused a problem with my kidney ### REPLY: Hi, Thanks for writing in. Losartan is a AT1 receptor blocker in the kidneys. In pathologic states, AT1 blockade improves the impaired autoregulation induced by chronic abnormal activation of Renal Artery Stenosis. AT1 receptor blockade has experimentally been shown to decrease renal fibrosis. Losartan may also be able to decrease inflammation by decreasing leukocyte proliferation and blocking up regulation of adhesion molecules. Overall benefits are more when taking losartan. It has not caused any problem to 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 have had a sinus infection since last Saturday. I am on septra d  I also used after for 6 days but my docs nurse told  me to stop due to a rebound effect. Right now I am totally congested in both nostril. Am I having rebound effect and if so what should I do? ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to acute exacerbation of Sinusitis. Investigations like complete blood count & X-ray of paranasal sinus will be helpful in clinching the diagnosis. Management includes:1. Steam inhalation.2. Analgesics like paracetamol3. Nasal decongestant . 3. Antibiotics depending upon culture & sensitivity reports to remove the causative organism.4. Antihistamine preparations can also be used to provide symptomatic relief. Your symptoms will be relieved with this. Wish you good health & a speedy recovery. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor, mom aged 54 had high esr of 99 and uti . she had low grade fever for almost 3-4 months. now her esr has reduced to 62. wat can b treatments ? ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion treatment of the UTI is the treatment of the high ESR. As you started taking the treatment improvement in the ESR is noted. ESR is non-specific marker of inflammation. It raises in any inflammation in your case it is UTI. If your ESR won't fell down again. I advise you to so culture and sensitivity of your urine. Once sensitive antibiotic is in hand you can take the cheapest and best .  I will be happy to answer your further concern, you can ask me on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a very healthy, athletic 26 year old female. I had a fever starting 2 days ago that has gone down after taking aspirin over the last 24 hours, but instead of feeling better, I feel worse. Shortly after I woke up today I started feeling pressure in my stomach, as if I was hungry, but eating didnt help. The pressure has gotten worse and risen up to my chest. I feel as though I have to belch, but forcing myself to makes me feel better for about 1 second, and then the pressure comes back even stronger. Additionally, I am salivating so much that I need to keep a pail next to my bed to let the drool fall into. Swallowing also makes the pressure in my chest feel worse. Laying down aggravates it too. Any ideas what is going on? I vaguely remember having similar experiences a couple times as a teenager, but dont think they were this uncomfortable. ### REPLY: Hi. Thanks for your query and an elucidated history. Read the history carefully. IT looks the aspirin has caused all this problem added on by the fever you had. This may be severe gastritis, causing all the symptoms you have. Excessive salivation is present as a reflex mechanism, body trying to dilute the effect of gastritis. I would advise you the following: (You need a prescription)Antacid gel with anesthetic 5 SF every three hours. PPI and / or RanitidineDomperidonecold milk / water orally only if tolerated. Consult a Doctor /Gastroenterologist- you may need to undergo upper GI Endoscopy, and to have investigations and treatment for fever too. Do not self treat. Consult a Doctor for proper diagnosis of fever, present problem and proper treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am facing from quite wierd problems, i am blank all the time , i tend to forget things just like 30 - 40- secs after it , while studying , i just keep copying thin gs from blackboard , and camnt even ermeber what was the nlast line i wrote , even if i study constantly for 6 hrs or do a heavy workout , i neither feelk fresh or tired , its the same black and dizzy mind , i have lost my identity , i dont know how to respond to phone calls, i mean what to speak , when i go to shops , i am always confused what to buy , i am feeling sleepy whole day and cant think of anything , this has effected my personal as well as social life very negitively , is this fatique or nanxiety disorder or what ? ### REPLY: Hi dear, what ever you described is suggestive of depression or negative schizophrenia, but actual diagnosis is not possible without detail history and mental status examination. Hows your mood and your interest regarding your work?sleep and appetite habit?is there any fear or auspiciousness in your behavior ? Consult psychiatrist for detail history and treatment. There are many medications which is helpful and so not to worry about it. 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: Sir, I am feeling insane type, unconscientious mentaly for 1 year. can t memorize things for long time. my hairs are getting white in the age of 24. my mental power is loosing, mentally getting weaker and weaker day by day. I am not going to see doctor just because i am frightened that my be i have some mejor disease. can you explain me some why this could be? ### REPLY: Hi, Thanks for writing in to us. There are many conditions which can make you feel mentally weak and have symptoms like inability to memorize. It is suggested that you get investigated for any medical condition which might be causing your problems. You can get thyroid function test done to know if your thyroid functions are normal. If your thyroid function is abnormal then it can cause these symptoms and treatment is usually with medicine to control the thyroid hormone level. Please get a blood count done to know if you are having anemia and also get your iron and vitamin B12 levels. Anemia can cause weakness and tiredness and this is the case with many people. Correction of hemoglobin level and iron supplement helps. Vitamin B12 supplements might be required. Hair whitening is in the genes and sometimes it can happen due to malnutrition and vitamin E deficiency. Please have a balanced diet and make your lifestyle healthy. Anxiety and stress can cause the symptoms like difficulty in memory and weakness. Please control your stress level and do physical exercises to keep your mind free from anxiety. Please do not worry ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 4 year old daughter developed red spots on her knee, chest & underarm 2 weeks ago, gp advised Fucidin Cream, over a week later it was not working and started to spread, now I am using Daktacourt but it is still spreading to the other side of her body and small spots are starting to appear around her eyes, what could this be, should I be concerned? ### REPLY: Hi, new line welcome to this forum. Can understand your concerns. Rush Hour body for about 2 weeks could be due to bacterial infection, fungal infection, Eczema, Rash due to low platelet count. Since you have already given juridic acid cream, if it's a bacterial infection it should have corrected. The chances of fungal infection and Eczema cannot be ruled out without examining the patient. The Rash due to low platelet count can occur in some devices like idiopathic thrombocytopenic purpura, so it is very necessary to do platelet count in child and look for any low platelets. In my opinion, you should immediately do a platelet count and an examination by Dermatologist is a must. I hope this will help you. Take care. Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Dr I am 26 yrs old.married in june 2009. I was having irregular periods before marriage. After marriage it remains continue. In Nov2010 I went to gyn dr & she told me that my left ovary is fully covered by dermoid cyst and right ovary has PCOD. So I went for surgery of dermoid cyst & removed my left ovary also in DEC2010. At the same time she drilled my right ovary also. I didnt get my periods till JAn & she gave me some injection to start my periods, Then feb2011 she gave me Diane 35 for 3 months to regulate my periods. I got period 11mar, 11apr 14may and went to dr on same day14may 2011 noe. I want to conceive so she has given me OVIGYN-D for a month 3 times a day & ovofar 5 tab i started from 15may11. She told me to come on 23maywith husband for ultrasound which will continue be done for 4-5 days to check ovulation of egg. & To make contact on ovulation with husband. Kindly tell me can I concieve with this ???? What other precautions should i take in my diet?? Kindly help me from ur side pls ### REPLY: Hi... looking at the case history ... origin d contains DHEA . It increases quality and quantity of eggs and beneficial in women with less ovarian reserve(as you he history of Desmond in one ovary and PCs as well)ovular would also be helpful in the egg formation.it would improve your conception chances and avoid stress by all means. Regarding diet you avoid rice, potatoes, cakes muffins, white bread etc you can take unprocessed food, fiber rich, whole grain, sprouts, grapes, apples, brown rice, beans, broccoli etc ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im having alot of symptoms all over the place. not sure if all have anything to do with one another but here it is.. I get CRONIC headaches at least every other day. I have a sharp pain in my lower abdomin, back pain, nausea, bloating and it almost feels like a baby is moving in my belly but I took a home pregnancy test and it came back negative. I also have the Mirena IUD ### REPLY: Hi! Good evening. I am  answering your query. All the precautions including birth control pills and IUD are not 100% foolproof in protection against a pregnancy. If I were your doctor, I would go for a serum  determination to rule this out and ultrasound of abdomen if need be. At the same time I would also go for a urine routine/microscopic test along with a culture sensitivity test to rule out an unsuspected asymptomatic UTI and treat it if positive. The headache might not be related to the IUD, and could be a separate entity. I would do all the routine investigations including a blood pressure measurement and serum lipid profile and treat if any abnormality detected. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 4 year history of L4-L5 & L5-S1 nerve compression, bulging disc & herniation. Has Steroid inections 2 years ago with moderate relief. Pain now bearable, pain/numbness is right leg & foot. For past 6 months have been experiencing constipation, tight anal sphincter. Could this be associated with spinal problems ? ### REPLY: Dairy would advise you to be regular with your diet and have more roughage so that there is no constipation. To get rid of constipation you can have Isabel husk, Hagar or trifle, If acutely constipated then have tab. Herbolax 2 at bedtime with hot water. As far as herniation is concerned in Ayurveda we offer Kate vast which has got very good results. Along with this some GGUL combinations are given internally. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi..good evening...Just got out from hospital last week...and my doctor said I have pneumonia??? just got also my sputum culture today and it states there I have moderate growth of enterobacter species...do I have to worry about this sickness??? are there no complictions for this??? ### REPLY: Pneumonia is treated by antibiotics. It is chest infection caused by bacteria. If pneumonia does not respond to antibiotics then u need to do culture sensitivity test. This test identifies which antibiotic is sensitive to work for this infection. In most cases pneumonia is a short-term, treatable illness. But frequent bouts of pneumonia can be a serious complication of a long-term (chronic) illness, such as chronic obstructive pulmonary disease (COPD). 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: im 25 and trying to get pregnant. my husband has just started taking all kinds of medicine to increase his penis size and help build muscle mass and powder to gain. weight and more but I don t want to put it on here.my cycle is has been regular every since we had our first baby. just this month my cycle has been doing really really crazy stuff. so can all of his medication plus unprotected sex 3-4 times a week b messing with my body? ### REPLY: Hi, Thanks for the query. Usually the size of genital organs won't influence the fertility. The count and quality of the spermatozoa is more important. Stress and strain and medicines can affect the hormonal levels and can alter the menstrual cycle. So you once consult gynecologist and get examined to find out the cause for irregular periods. After regularization of your periods you can track ovulation and plan intercourse around that time that will increase the possibility of pregnancy. For more details you can ask me through: http://www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a 28 year old male. I have discovered a round lump one of my ribs on the right hand side. it feels roughly 2cm wide. I am unable to move it around if I push it, etc. It is quite tender to touch but not particularly painful when I am not touching it. Im pretty sure it just happened overnight. Any idea what this might be? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have lump on rib.  It can be bone tumor, soft tissue tumor or cyst.  You should go for x-ray first.  If it shows any bony lesion then you should go for biopsy.  If x-ray is normal then it may be soft tissue tumor like lipoma or neurofibroma or some cyst.  Then you should take treatment accordingly. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im 18 year old female, Ive been having abdominal pain for a little over a week & now showing some small blood clots in my stool. What do you think it may be. I do need to say I eat everyday where I work. Its cheeseburgers & fries, do you think that may have something to do with my problem ### REPLY: Hello, welcome to  forum, It looks like you have infection in stomach, we call it colitis due to any cause either bacteria, protozoa,fungus, helmets.etc., most commonly observed in people eating outside stuff like you eat where you work, so in this situation I usually prescribe my patients with Tab-Oflox-OZ, and advice them not to eat outside food, prepare food at home and eat, or eat food which is cooked and served hot, and water as well .  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 woke up 2 weeks ago and my back was hurting so bad I had a hard time standing walking or sitting couldn t bend or twist. It s been 2 weeks now and my back still hurts but it has been feeling a little better as to walking and some what bending and twisting. Now I noticed my lower back is splotchy and in center looks yellowish brown and 1 spot that looks like could be a bite. What is the issue and what do I do ### REPLY: Howell come to ChatDoctorBackache could be due to spinal condition and this could be spondylitis, disc degenerative disease, muscular spasm, but yellow brown area could be different one and this may not be related with backache and if this need to be ruled out then clinical examination is the only option you have, for the pain you can try "Tab Diclofenac 50 mg sustain release once in day" hope this information helps, 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 48 years male and suffering from low platelet count i am also a known case of bicuspid aortic valve server stenosis with aortic regurgitation on 25 mg metaprolol my physician advised me to take wysolone 20 mg morning 20 mg after lunch and 10 mg at night with half tablet of ditide 10 mg in morning at present my platelet count is 90,000 please advise me ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Platelet count of 90000 is not be worried about. It is a bit below the normal limit.2. Due to aortic regurgitation and stenosis, increased risk of thrombus formation and hence low platelet count is possible. Also, ITP and It B12 deficiency needs evaluation.3. Get a bleeding time, and bone marrow study for evaluation of low platelet count for evaluation of immune thrombocytopenic purpura.4. Platelet count below 20000 is serious, otherwise, nothing to worry. Cause needs to evaluate. If severely low, platelet transfusion can be given. Continue all other medications including steroids, ITP could be a major cause. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 notice a slight pressure in my sternum area, especially after a night of drinking. I do have acid reflux, but I worried as to what this could be. It feels right on the bone area when i move or laugh a certian way, not pain but slight pressure... ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you are having HERD (gastroesophageal reflux disease) mostly. Because this is worsened by alcohol intake. And your symptoms are worse after .  But better to rule out cardiac cause first. So get done ECG. If ECG is normal then no need to worry about cardiac cause. You are having HERD mostly. 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. This is further worsened by alcohol. So better to follow these steps for symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Start Proton pump inhibitors. 5. Avoid alcohol  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I need to know if I am pregnant. I have been on birth control for a couple months now, however I took the pill late one day by about 8 hours. On this day my Husband and I had sex. He never came in me, and we used a condom about halfway through. I stopped taking my birth control and though it has been two days I still have not had my period. Please help me. ### REPLY: Hi, If you have taken just 1 pill 8 hours later, and all your other pills have been regular then it is very unlikely that you are pregnant. Oral contraceptive pills are very effective method of contraception if taken regularly and 8 hours late would not be accountable in case of combined estrogen with progesterone pill. So do not worry you should be getting your period in a weeks time. If not do a pregnancy test after a week and see a gynecologist. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi...1--i m 26 year married female  n have pcos prblm2--TRYING FOR A chid but conceiving prblm3--my gync suggest me some drug (duphaston 10mg,lupi fsh 75 iu,ovurtrig10000)4--n also doing Follicular study result is -   12th day tvs rt.ov.-f1-1.9*1.2 f2-1.6*1.1cm lft.ov.-1.5*1.2 type    3rd thickness 7mm.i cant undarstand plz describe me . ### REPLY: Hollowed under following carefully, and you will receive your answer :The size of follicle should be around 19-20 mm (1.9-2.0 cm) on day 14-15 at least to rupture and liberate ovum. The endometrium thickness must be around 11 mm to conceive. Now about the size of follicle in your case. On day 12th right follicle 1 1.9x1.2 (over ripen) follicle 2 1.6x1.1 cm (may dominant and burst to liberate ovum on day 14-15). Left side 1.5 x1.2 cm (may mature and can burst to liberate ovum). Endometrium thickness is not fit for fertilized ovum (ova). Since you are taking phaeton, FSH hurting, so there is variation in the size of follicles and also premature follicle. So sexual relation is important on day 14 -15 for successful conception. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear sir, Good Evening. Iam 26 years old, suffering from cold for last few years. Presently iam consuming Frisium 10Mg and Eption tablets to avoid nervous disorder. From Childhood I had a problem of Fitz if i intake some cold food items. Now iam alright, but still i feel i have nervous disorder problem. so can you please advise me what kind of treatment i have to take now. ### REPLY: His understand your concern.I do not understand about nervous disorder will you elaborate properly. Eptoin and Frisian are the remedy for convulsion or fits. You mean to sat you have fit in spite of taking this medicines then need to consult your treating doctor. There are many other anti convulsion medication which will help you. If you have nervous disorder like nervousness and anxiety then medicines like anxiolytic and benzodiazepine will help. Require proper evaluation. Still have question then feel free to ask. 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: Ive been having heart palpitations for a few years now. They seem to come in streaks. But last night while lifting weights, my heart was jumping from about 150 bpm to about 280 bpm for 15-30 seconds and then immediately dropping back down. It felt like a lot of blood was being pulled from my face and head. ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you something and give you some advises. As you describe my opinion is that we are dealing with a rhythm issue. Someone might feel heart palpitations for different reasons. It may be a simple sinus tachycardia that means that the heart is beating regularly over 100 beats for minute. Its normal resting rate is between 60-100 beat for minute. You may experience palpitations because of extra-sistolyc beats. These is electrical impulses generating from parts of the heart different from normal sinus rhythm. This gives the sensation of an escaped, skipping beat. But there are all sow different rhythm problems like atrial fibrillation ore supra ventricular tachycardia where the heart doesn't beat normal, it suddenly beats fast or in a chaotic way with very high frequencies and this might be what we call atrial fibrillation. My opinion is that lifting weight is not the reason of your palpitations. It's quite known in cardiology that during physical exertion the heart rate raises. Its maximal frequency should go 220 minus your age, and it should slowly go down. But you describe a long history of palpitations and a sudden heart jumping just for some seconds, immediately .  So, I think that we should see what are these rhythm fluctuations. Does this happen even in a resting situation or only when you exercise? If I was your treating doctor I will recommend a blood analyze, your thyroid hormones, an electrocardiography, echocardiogram and of course a holder monitoring to see your rhythm tendency. Ones we have all these we can say what are these palpitations and how to treat them.These is all for a simple check-up to reduce these episodes in the future. Whish I was helpful. Take good 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: Hello, I am a female, age 53. I am feeling pain in my left arm and same side in the back ( whole back up to half)! The pain is more severe in the night and some time during the day! It comes for few days and goes away. This time it is continues from last week! I am under lots of stress. Is it spasm? ### REPLY: Slight tearing or spasm of connective tissue around upper back region can cause pain in upper back pain and may radiate to surrounding areas typically as a result of bending, lifting, twisting or shoulders forwards activities or trivial movements, such as picking up a pencil or sneezing. May cause upper back pain with or without symptoms radiating along shoulder, arm, forearm, hand or fingers. Pain may increase on firmly touching the affected level of the spine and spinal movement is often stiff or restricted. Pins and needles or numbness are occasionally present in affected arm or hand. Symptoms may increase with repetitive or prolonged sitting (especially slouched sitting or during computer use), bending, lifting, shoulders forwards activities, coughing or sneezing and are often worse first thing in the morning. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my father has an enlarged prostate and is affecting his health. His urologist suggested that he should undergo an operation, but first, they must check if his heart is capable of such. So his cardio would like him to undergo angiogram. Is it advisable for him to undergo such process knowing that he is already 76 years old and is diabetic? and What is the difference between 2-D Echo and Angiogram? please enlighten me. thank you. ### REPLY: HelloThanks for query. Enlarged Prostate is a disease that affects man after the age of 60 years when most of the men have cardiac problems and diabetes.However, there is no risk in operating after proper evaluation as far as cardiac status and diabetes is controlled. It is not mandatory to do angiogram to assess the cardiac status. The 2D Echo Cardiogram is an ultrasound study of heart and is an invasive procedure and routinely carried out before any surgery in elderly patients to assess the cardiac function and ejection factor whereas angiogram is invasive procedure where radio opaque dye is injected in to femoral vein and mainly done to study the status of coronary arteries (blood vessels supplying blood to heart itself). It is not done if one has to undergo endoscopic surgery for Prostate removal(TURN). .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have been on Noriday. Missed one pill on day 8 and haven t stopped bleeding for 30 days straight now. It s not agreeing with me and I m OVER IT!!! Doc said to carry on taking it, but I don t need this and my body doesn t either, clearly its not right for me Vanessa ### REPLY: Hello, I have gone through your query and understood the concern. During the initial months of hormone contraception, menstrual irregularities are observed and these include persistent bleeding/spotting, mid-cycle bleeding/spotting, irregular cycles and heavy bleeding etc. These usually settle down after a few months as the body adjusts itself to the new hormone level. If you do not find any respite after managing your diet, weight and styptics, you need to get a complete physical evaluation, hepatic/renal profile, blood counts and coagulation profile, stop the medication and go for a suitable alternative. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a series of lymphnode  swelling all over my bodyI had a stroke a year and a half  and the doctors keep changing my medsknow I have swelling all over my body..... in different spots.... I can push them inand leave hand prints... I had a blood test done but when I call I get an answer machine.they say the will have the results after taking them nearly a month ago.....  any insight ### REPLY: Hello, Lymph nodes all over the body have many vivid reasons as tuberculosis, lymphoma, HIV and others. But according to your narration, it seems like multiple neurofibromatosis most likely; without any reasons, no treatments still I would recommend uploading at least 2 to 3 photos of the said lumps so that I can focus more over the issue. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have just spent 6 days in hospital with what they diagniosed as sereve gastroenteritis- requiring 3 days of fluids and potassium . I had a number of invetsigations due to right sided lower abdo pain - no appendix, results also showed the following, unremarkable cyst in the liver , 2.7cm right adenxal cyst- 2 small further cysts in the uterine fundus. I am going to be having a referral to Gygn locally. I feel very weak, shaky and bit lightheaded, and it feels like my heart is beating heaver than usual as I am more aware of it- all my obs in the hospital once I had had fluids were withing normal limits, CRP less than 1, bloods unremarkable.] How long will I feel like this?? ### REPLY: Hello! Thank you for the query. As you have mentioned, right sided abdominal pain should be always checked with appendicitis. And the appendicitis diagnostic is as hard as hell. Nowadays in the edge of CT scans and MRIs we still can not find a way of ruling our appendicitis other than surgery. So if your abdomen ultrasound tells that no appendix was found, it does not mean that you do not suffer from appendicitis. It just means that the doctor couldn't find it at all. If you were treated with antibiotics during the hospitalization, there is a chance that this antibiotic treated your appendicitis for a while. In 50% of appendicitis antibiotics therapy will give positive response. But it does not treat the appendicitis permanently. So the conclusion is, if all others possible reasons of your pain were ruled out, and the pain is not gone, or the pain is recurring, there is a time for surgery to remove your appendix. And by all others diseases I understand: pregnancy, urinary tract infection, urinary tract stones, ovarian infection, ovarian cyst. And if it's about your blood work results, if an antibiotic is given, CRP and WBC will be low. So it does not rule appendicitis out either. 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: I am 76, ht 5ft 5 in, weight 150 lbs.  I take Diovan 80 once a day.  Lately I feel very tired in the PM and started monitoring my BP.  Today i took one-half of my pill and now, at 1:30 my BP is 108/83 , pulse 59.  Should I be worried?  Should I contact my Dr.? ### REPLY: Hiyou were on a dose of 80 mg Alsatian and you were feeling week even on halving the tablet your blood pressure is still on the lower side while taking any hypertensive medication you should keep a record of your blood pressure every week and should visit your doctor every two months, because on the basis of the blood pressure records doctor is going to taper the dose of the blood pressure medicine you are ones of now your weakness is most likely because of the overdose of divans make the doses half and check your BP twice a day and try to taper it to a dose where your BP is 120/80 .yes you can plan a visit to doctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My name is Rahul, am from Hyderabad, INDIA. My sister (29 years) is suffering from kidney problem. Her serem creatinine level is 9.9mg/dl for now and doctors here say that kidney transplant operation has to be done as soon as possible. But getting the source for kidney is never easy. My entire family is worried about this. I request you to suggest some thing that can help us to save her. I hope you will definitely come up with some positive way to get out of this problem. Please Help! Regards, Rahul ### REPLY: Hi, as i don't know what kidney problem is your sister suffering from it is difficult to say whether a kidney transplant is going to solve her problem. Kidney or renal transplant has its own problems and it's not easy to say that is the best of solutions as it itself involves a large amount of expense plus its own known side effects which are very common like a person has to stay on immunosuppressive .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 64 resting heart rate of 75-80 with good health, only medical problem is hypothyroidism well controlled. Is a heart rate of 125-135 on elliptical with moderate resistance too much? Rate returns to normal after about 2-3 min post. If range is ok, how long is too long at that rate or should I keep it lower? ### REPLY: Hai, As your resting heart rate is normal. And hypothyroidism will lead you to slow heart rate. As you're on medication no need to worry about it. As your post session heart rate 125 to 135 seems to be perfectly okay. If you didn't feel any discomfort after that then it is normal.however he elliptical will automatically change the resistance levels to keep your heart rate at a specific number or range, based on your age. Regards . Senthilnathan ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 experience neuropathic symptoms that are like electric jolts traveling along a pathway in my hands and feet. Leavesmy hand and feet aching. I am an ICU RN on my feet many hours but now even on my days off I am having these symptoms. I am healthy. No chronic diseases, no meds but daily vitamins and calcium ### REPLY: Hello !  Thank you for the question on ! I understand your concern. In my opinion the troubles you have may be related to a peripheral neuropathy. It usually starts only in the feet but pain and paresthesia occur during rest and movement. I would recommend you to consult a neurologist, have a good neurological examination and a full blood work. An electroneurography would be very helpful for the examination or peripheral nerves. Hope to have been helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 57 year old female who lives in central Texas (all of my life).    I had a surgical procedure 1 year ago that removed my gallbladder and corrected a bad para esophageal hernia.   Much relief was given to my digestive system for a couple of months but my stomach remains boated, feeling of quick fill after eating is back with some mild indigestion and sense of tiredness again.    I was sent to an allergist for food allergy testing and the results is very surprising to me.   It shows that I have a strong level allergy to: pork, beef, rice, wheat, corn, melons, pinto beans, pineapple, pears and sweet potatoes; very strong allergy to oranges; and moderate allergy to:peaches, string beans, carrots, fish, egg, cows milk, brazil nut, and coconuts.    My question is: what do I do to cope with this wide range of allergies?    I know to avoid the strong and strongest ones altogether - but how?   How did I end up with so many allergies now ? ### REPLY: Hi, Welcome to  forum.  You had surgeries, for gall bladder, and the hiatal hernia. Usually these conditions are associated with the gastric erosion. Which is to be treated completely, after surgery.  I advise you to consult a gastroenterologist for diagnosis and treatment.  You may need to have a gastrostomy, for diagnosis, and treatment.  I usually prescribe to my patient with such symptoms' omeprazole, risperidone, and and antacid gel.  Now you start, avoiding the strongest, and stronger allergic substances, after observing the effect of the .  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 28 54 235 I am on Clindamycin hcl and Tramadol for abscessed tooth. My lower left jaw is swollen. I need to chat with a dentist. I started the Clindamycin on 5/30. The swelling has went down a bit, but not much. Will it ever go down?> or will I need to be drained? ### REPLY: Hello, Thanks for consulting , Read your query, as you have swelling in lower jaw this abscess formation may be due to caries tooth or due to periodontal problem may be Periapical abscess or Periodontal abscess. As you are taking medication this medicine will give you temporary relief go for it treatment either Root canal treatment or Extraction of tooth so that Pus can be . Hope this will help you. Wishing you good health.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 30yr old and married for 1 yr 8 months we trying to conceive but i am unable , my gynic told me that i am having infection on cervix opening she did some treatment for that. i want to know that because of infection is it possible i am not able to conceive. i also have white discharge problem from childhood.what i should do so that i can conceive ### REPLY: Hello, thanks for using . There are several causes of infertility other than just infection and appropriate diagnosis is key in instituting a treatment plan. Infections are a common cause of infertility but with effective antibiotherapy, the infertility should resolve except in chronic infections witChatDoctorplications such as pus or fluid in the fallopian tubes. Poor sexual exposure is a common cause of difficulty in conceiving. Effective exposure requires at least 4 sexual exposures per week spread out throughout the week.  I will advise you and your husband get complete panel of tests for infertility including hysterosalpingography, pelvic ultrasound, chlamydia serology, urea plasma and cytoplasm sexologies and program and a temperature chart. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 61, very active, a little overweight. I had an xray done last week and it showed that I have bone on bone in my hip joint. I have had a severe pain in my groin area for sometime. Is that pain coming from the bone on bone in my hip? Should I consider hip replacement right now? ### REPLY: Dear patient bone on bone in right hip means there is severe arthritis of right hip. Your age (61) is appropriate for total hip replacement, and it is the best treatment for hip arthritis.  Hip joint pain can be seen in groin area, buttock area and even referred to same side knee joint. There will be limping while walking with antalgic gait. You need to consult arthroplasty surgeon nearby you for THR. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir ihad severe pain in low back 10 yrs backI was diagnosed for HLA B 27 test whicChatDoctore positive.Then onwards i have been taking Nucoxia on SOS but from last3 years i am having UVities in peak summer does it mean i am suffering from Anklosying spondiliyiswhen  i take nocoxia i get temporary relief and i do not have that much severity shd i take saaz and what are its side effects ### REPLY: Thanks for writing to us. Ankylosing spondylitis is an inflammatory disorder affecting various ligaments and causing ossification of the same. It leads to progressive stiffness with restriction of the body movements. In acute attacks we always prescribe the anti-inflammatory medicine. However, in long run you need to keep yourself quite flexible and regular back muscle stretching and exercise if possible swimming will definitely delay the body stiffness. I would suggest consulting a rheumatologist for medicinal treatment. 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 had a baby in march, used the mini pill until beginning of may and then had a mirena coil fitted, i carried on taking the mini pill for a further 7 days after the coil was fitted as doctor suggested i do. 2 days after i had coil in i had a little spotting which was fine and then 2 weeks after i had some bleeding but not alot. i havnt had any bleeding at all since that so a good 9/10 weeks ago. i was supposed to return 6 weeks after the coil fitting to check it was still in place, but with a new born baby that was poorly i didnt go for the check unfortunately. for the last couple of weeks i have had a very strong sense of smell, very overpowering at times and its making me feel very sick and i have also tody been sick, i have had no bleeding as i explained for about 9 weeks now, also tired and gaining weight. is this normal for the mirena coil or could it be something else? thanks ### REPLY: Hello, and I hope I can answer your question. The IRENA coil normally produces irregular bleeding in the first few months of use, so those symptoms are completely normal.  However, your fatigue, weight gain and feeling sick make me concerned that your IUD may not be working properly (you never went back for the re-examination) and that you may have gotten pregnant.  The device can fall out occasionally, especially in women who have given birth recently. I suggest you do a pregnancy test right away. If the test is positive, you should see a doctor immediately, as there is a risk of a tubal or ectopic pregnancy if you get pregnant with an IUD. An ectopic pregnancy is an emergency and can even result in death without proper treatment. If you are not pregnant, I would still advise you to see a health care provider to check that the IRENA is working properly and evaluate your other symptoms. I hope this advice was helpful, and that you feel better. Sincerely,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,My daughter is 8 yrs old and her teeth have not yet fallen, there is no sign of the same as well. She is otherwise normal but her growth to me is seemingly slow.I have been told that it may be genetic, but she has reached all her other milestones in time. I am suspected to have MEN 1 disorder and investigating the same, worried about her growth and teeth milestone! Abha ( Mother ) ### REPLY: Thanks for using . Read your query. Eruption of teeth gets delayed in some child .  Relax as you are aware that all other milestone is good in her case. I would suggest you to visit your local periodontist and get her checked. Have radiograph done to evaluate her milk tooth and developing teeth status. If required any treatment such as removal of the milk teeth, go according to it. Hope this was useful. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i have been getting sick spells for months now a nausea felling lightheaded some dizziness almost have blacked out i have been doctoring for 6-7 weeks and they have ran test bloodwork heart monitor ekgs my bloodpressure was up and my vitamin d was low i am now on pills but all the test came back fine and i am still getting this spells could you suggest anything that it might be ### REPLY: Hi. I did review your concern. Since your heart and blood work are fine, the next logical step would be to rule out cerebellar, inner ear and peripheral problems. I would advise you to consult a neurologist and get tested for any inner ear and cerebellar problems. Also, orthostatic hypotension may be a cause. For that I would advise you to wear compression stockings that increase blood flow up towards your brain when you suddenly get up from bed or stand UPI hope this yellowish you all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a terrible coughing attack due to allergies - one week ago. Two days later it felt like someone hit me with a baseball bat along the curved portion of my ribs. And it hurts worse now, 5 days later. Sneezing almost brought me to my knees. Any suggestions? ### REPLY: HelloSevere cough, pain in the ribs and uninterrupted sneezing may be due to these reasons, these include:1 Allergic rhinitis, sneezing, cough, animation tears and nasal itching are the symptoms present in this disease and cause is allergy. 2 Asthmatic allergic bronchitis is another most common cause of such symptoms. Usually this is due to bronchoconstriction caused by some allergen associated with infection.3 Flu or common cold is another such reason. When such patient visit my clinic I prescribe them to take montelukast+fexofenadine once in day with dextromethophan + chlorpheniramine male at+menthol syrup. Also take levofloxacin 750 mg once in day. Since all these . But if cough is very severe then take codeine + chlorampheniramine syrup (but this causes addiction, so you can't take this without prescription of a qualified doctor). Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got bronchitis a week before Christmas and took 10 days of doxycycline and was better for about 5 days and relapsedand I am now on a second course of doxycycline for 5 days. I am still coughing and have congestion and fatigue. I am taking benzonate for cough. I think this should be over by now. Shouldn t it? I am getting depressed over this. I am 67 years old. I had pneumonia last Christmas ### REPLY: Cellophane you for trusting ChatDoctorDear possible causes for recurrent bronchitis is 1. Smoking2. Irritants:pollution, dust or other air irritants.3.HERD (gastroesophageal reflux disease)4. Low immunity status5. Eosinophilia6. Cystic fibrosis patients avoid allergen, Avoid cool . Avoid smoking and alcoholism. Use tab. Deriphylline twice a day for five days, tab.azithromycin once a day for five days. If symptoms not improved please consult your doctor he will examine and treat you accordingly. 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: Iam a 37 year old male planning to get married. I feel i have a low lipido and erectile strength is moderate. I hit gym every day and workout for an hour, both weigth training and cardio for 5 days a week, I have no diabetes or BP. Can you please advice some general medicines that can improve lipido and erectile strength and also sperm motility? ### REPLY: helloThanks for query. Based on the facts that you have posted you seem to have facing problem of Erectile Dysfunction. In absence of any major health issue the cause of Ed at young age is mostly Psychogenic in nature and is due to what is called as performance anxiety. Following measure will help you to boost up your confidence and getting good erection and delay ejaculation. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc 3)Take anti oxidants like Almonds 5-6 everyday4) Avoid alcohol and smoking. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 experiencing fever since for 12 days and the fever is coming right at 1845 hrs to 1945 hrs. It touches 100.2 approx and again automatically coming down. During fever I am experiencing back pain as I am suffering from L4-L5,S1 since for 12 yrs. I had also under gone epidermal injection in L4-L5 2 times but the problem remains the same. All necessaey blood test have been done but nothing has been detected so far except TB test. Pl advise. Sujoy Kumar Das ### REPLY: Hello Enjoy, as mentioned in your history that you have not done the test for TB so first I will advise you to go for it because evening rise of fever is typical symptom of tuberculosis as you had. As far as medicines are concerned you have to take some antibiotics as suggested by your doctor with some antipyretic like tab solo or tab kilos 8-12 hourly for fever and pain. Take care of your self. 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: What is Biliary Colic I have had pain in my right side for about two weeks and it has not left and I am nausea all day hurt worst when I eat been on light diet still the samewhat shall I do I have dr. apt 3more weeks away don t no if I can take the pain have pain meds but still the same. please please help. thanks ### REPLY: Hi.biliary colic is the symptom you experience when you have a concern in any part of your hepatopancreatico-biliary tree. When you experience a colicky pain, it is intermittent, waxing and waning in character, epigastric to right upper qua .  It usually occurs right after a fatty meal. I suggest that if your appointment is still in a few days time, diet modification would be best. Avoid high fat food as it might aggravate your condition, and the elective might be an emergency case instead. It is best if you consult with a doctor, preferably a gastroenterologist or a general surgeon, for physical examination and clinical evaluation. Diagnostics, such as ultrasound and liver function tests, 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: I have had asthma all my life and like a dummy I started smoking at the age of 19.  I am now 55.  It has been an on and off battle for many years.  5 years ago, I developed COPD.  Every year the flare ups have gotten worse.  This time around the antibiotics and prednisone seem to be making me worse.  Cramps, no energy, still coughing, and big time shortness of breath when I walk around. Should I go to the hospital? ### REPLY: Hello, Welcome and thanks for your query. You seem to be having COPD and this is the cause of your breathlessness. Unless you stop smoking it is going to get worse, and you will be required to be on home oxygen therapy and other treatments. For COPD, Geotropism bromide (Spirit) is better option than steroids and beta-agonist in my opinion. It may be better for you to go to the hospital now and get yourself stabilized, and then you can continue treatment with a healthy lifestyle and medicines advised. 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 having abdominal pains like when i gave birth to my son I am not pregnant the pain runs up to chest and gets worse then eases up and it hurts to pee like something is stopping up the hole where i pee. My guess is kidney stones cause runs in the family alot but i dont know i need to know what i can do to stop the pain it is like im giving birth all other again. can u help me please ### REPLY: Hi, From history it seems that you might be having renal colic giving this problem. There might be having urinary tract infection or kidney stones. Go for routine urine check up for infection and blood cells.If you require go for ultrasound of abdomen. After reports go for treatment accordingly.Meanwhile take antispasmodic medicine like Metal spas or Cyclops to get temporary relief from pain. Take plenty of water. 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 have been diagonised for arthritis...but in blood report everthing was negative ...oly CRP was lik6.34 something..and i hav been given steriods for a month dosage 10mg...but still i hav muscle pain in legs and also pain in feet in the morning wen i get up.pain eventulally goes off and the same pain occurs in the morning again...what should i do now..since all the test relating to arthirits nad rehumatic disease is been taken..no idea wat to do... ### REPLY: Hi, Arthritis means pain in joints and not the bones or muscles, so if you are having pain in your legs it means there is some other etiology for this pain apart from arthritis which is limited to joints, though referred pain can be felt in joints too. Secondly, medication for arthritis should be continued for at least 2 months before switching on to the second option, as your treatment had been started only a month back you need to remain calm and wait for improvements if there is going to be any. Arthritis medicines range from simple NSAIDs to biological Awards. Treatment strategy is to change from one to the other based on the effect harm ratio. In the meantime, get yourself tested for vitamin D and calcium as well. 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...m dr maira..i had 2 missed abortion this year..first in jan had blighted ovum and second last month due to baby stopped growing in 6-61/2 weeks..in ma second preg dr prescribed cyclogest and aspirin but again missed abortion..now dr is saying i should start ascard right now before concieving..i want to ask whether i should start ascard right now or i should wait when i concieve next time??and whether it has positive effect of taking Ascard before concieving??pls answer me drs!!thanx!! ### REPLY: Hi, There is no harm in taking aspirin before conceiving. But there is no proven benefit also. Starting aspirin may not solve your problem. You need some investigations to find out cause for repeated miscarriages. Though these investigations are costly, if abnormal some factors can be corrected to avoid miscarriage. You can ask your doctor about those investigations. Some basic cheap investigations are blood sugar level, V .  Costly investigations like karyotype can be done or deferred according to your doctors' advice. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My two yr old son was snapped at by a small dog. He did not get any bruise or even bled as he was wearing a thick t shirt. However, a small mark is there which has turned red. Can you guide if the child needs to undergo vaccinatiin for rabies. He was bitten yesterday at 6:40 pm. ### REPLY: Thanks for contacting ChatDoctorI am sorry to hear about your child being bite by a dog. The area that was bite does not sound like the skin was broken nor was there transmission of saliva into the wound. To transmit rabies the skin needs to be broken, and the saliva enter the wound. The red spot that you see is probably a small bruise just under the skin and should resolve on it own. Hope this answers your question. Please contact us again with your questions and concerns ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my mothers bp is 136(SYS) 90(DIA) 74(PUL) and whenever she lies down and changes her position in her sleep she gets dizzy, which is the right side. She has a habit of  freaking out, and she usually has high bp, but when eating her medicine its ok. Please Help. Lastly, she is 53 years oldThanks ### REPLY: HELLO, b.p of 136/90 in a 53-year-old after medication is considered to be normal. 140/90 can be taken as the cut off range. She is having a condition called benign paroxysmal positional vertigo. Please take tab vermin 16 mg twice daily for ten days. An ear, nose,throat specialist should be consulted to rule out any ear pathologies. The doctor might suggest you some exercises called repays maneuver for long term management. Continue using the medication for high blood pressure and get it monitored once a month. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Just got the craziest diagnosis.I am a 52 year old female. Supposely I have two leaky heart valves, (don t know which ones) and I m having mini strokes. Heart palpatations and heart flutters, feeling dizzy and like my heart skips a beat were the symptoms that would not stop are the symptoms that caused me to seek help. I also had sharp pains in my jaw, back and left arm one evening. I am a very physically active person, I mow my own grass and my job is outdoors not sitting at a desk. When this first happened I thought I just got over heated outside and thought I was going to pass out but it did not go away. I don t like to go to the hospital, I went to the clinic and they put me in an ambulance to the hospital! After stress test, echo cardio, cortery test and a lot more I don t know. The Dr has prescribed blood thinners and told me to go back to work at my regular job? So with this condition and mini strokes ok to shovel dirt and carry stones around? What will he look for in a month after blood thinners? ### REPLY: Hello Thanks for posting at . By your description seems like you have got atrial fibrillation which means irregular fast heart rate. This causes symptoms like palpitations, fluttering sensation in the chest, feeling dizzy etc. Due to irregular fast heart rate, clots tend to develop in the heart which then migrate to other organs including the brain. This is why you get ministrokes. Your doctor has put you on blood thinners so that the clots don't form. Please continue taking the thinners. You can go around doing your normal activities. But start gradually to see how the body responds. After a month your doctor has called you to see response to the treatment and an ECG and 2 d echo may be repeated if indicated. Wishing you good healthRegards. ### END