Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there, I have been given Rigevidon by my family plan centre recently. She suggested to start on the first day of my period however i dont want to mess my cycle( i have 28 days cycle ) and want to start last day of my period. would that be ok? I havent been on pills for a long time, but used to use femoden years ago. Also, wanted to know if that will have side effects as putting on weight and mood swings?? I had terrible mood swings and emotionally down when i was on femodon and alos put on weight :( that was the reason i stop using pills for a long time. I wonder if there is another birth control without hormones giving to the body. Many thnaks, Oz ### REPLY: Hi, Welcome to . It is advised to take Evidon within the first five days of your cycle. Birth control pills do have side effects, but they vary from individual to individual, it actually depends on the body system and the duration of the intake. Some take it quite comfortably while others suffer from side effects.  The side effects are symptoms like depression, weight gain, loss of libido, breakthrough bleeding, plasma, menstrual changes, skin reactions, etc. Keep yourself well HY .  You can limit the use of birth control pills and use barrier methods for contraception if you feel you are getting affected with the side effects or weight gain. You can consult your gynecologist before switching on to other pill or contraceptive device. 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, after falling down from stairs I have got an internal abscess in my right hip. It is around 15 cms in length and approximately 10-12 cms wide. My doctor has suggested few tablets for it and a cream called Su-gam. Is it the right treatment or it needs to be drained out immediately? Please suggest.... ### REPLY: Hello, As with the abscess, the first line of action is to try with conservative management. Usually, in most cases, it resolves with medication, in case if it's not resolved than surgical route might be looked for. Till then have patience at there might be an infection and I think you should be fine with the conservative management. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Since last night I have a dull ache on the middle of my stomach I dont feel sick Im going toilet normally but this gas been constant it cant be period as I have the implant in but every month gets worse and this is worse than its been help no painkillers help at all havent eaten Im hungry but cant eat cause of my stomach ### REPLY: Hi ! Good evening. I am  answering your query. If I were your doctor, I would advise you for a routine complete blood count, urine routine and culture sensitivity test, an ultrasound abdomen, followed by a clinical examination by a surgeon/gynecologist to rule out any intro abdominal pathology or a pelvic inflammatory disease. I would also give you a dose of deforming .  I would suggest you not to eat from outside your home if you do to prevent some intestinal infections from unhygienically cooked food. My further management would depend on the reports of investigation and clinical examination. 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. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 1 yr and 7 month old and his doctor said that he has child hood Asthma and prescribed Montair Lc Kid for 6 months. After taking that medicine there is no change in his health and every month he is compelling to take antibiotic due to cough . I have showed Laziness for giving that maontair LC kid, due to my phobia towards continues in taking of medicine and he is showing aggressive behaviour after taking that.Is it good for health, Please give me answer ### REPLY: Hi Sharia, Thanks for writing your query. Metier LC contains montelukast and levocetrizine. These medicines help in control of symptoms of bronchitis. The montelukast have to be taken for long duration. Almost every medicine has some or the other side effects. Your doctor who have examined the child is the best judge and must have prescribed the medicine if the benefit is more than the side effects. You should take care that the child is properly covered during the climate change. You should give him fresh fruits and vegetables to increase his immunity. His hands should be kept clean to prevent entry of infection causing organisms through dirty hands. I hope this is helpful to 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: hello sir...i am 23year male..before one week i suffered from chicken pox.During that  night time,i found sperm coming along with urine..this is not my usual case of sperm coming with urine.i want your answer sir.but still after 1week its continuing.i need your help..advance thanks sir.. ### REPLY: Dear serve understand your concerns went through your details. Please do not panic. This is quite natural because the oozing sperm was already inside you. The stored sperm is always a waste product for your body. So the body is removing the waste product. Please do not worry about it. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, recently my lips have been extremely dry, so i have been using medicated lip glosses that have helped in the past with only slightly chapped lips. I have had problems with severely dry lips in the past, but i cannot remember how i dealt with the problem. This time i believe the problem is worse, because my lips have become dark in color, almost a black, and they have been throbbing slightly. What can i do to restore them to their natural/ healthy state? Could the cause of this be an allergic reaction or severely sensitive skin? p.s. I have had problems with sensitive skin; I got eczema last summer. ### REPLY: Hi, You seem to have chronic charities. There may be erythema, .  You might have mild pain, burning and itching. There may be some cause. Lip licking might exacerbate the disease. Sundays exposure, cosmetics, lipstiks toothpaste, dusts...etc. might be responsible. Vitamin B complex deficiencies, anaemia or nutritional inadequacy might cause the disease... You consult dermatologist for firm diagnosis and treatment of its cause. Have blood tests to rule out any internal disease or vitamin deficiencies. You may take folic acid 5 mg thrice a day with iron tab. Antibiotics may be needed if there is secondary bacterial infection. Apply antibiotic cream with mild steroid like mometasone. You avoid soap, cosmetics and lipstick for good and fast result. Avoid bad habit of lip licking, if it is there. Do not injure the lip skin with your nails. You might get good result after few weeks. I hope this would help you in your 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: i have been having a sever pain on the upper right side,it came back after i ate 1/2 of a hamburger , i was able to drink a bottle of water and lay down with pressure on pain, in about 1/2 hour it went away but i could literally feel food traveling through my system. i have history of gallstones by ultra sound but no pain . i wonder if it is necessary to go to hospital(which I hate- Doctors do what they want don t listen to you) or if there is a home remedy to get rid of this problem. ### REPLY: Hello, Since you have gall stones confirmed by ultrasound and the pain occurred after a fatty meal, it is very likely to be a colic arising from the biliary system. You can try an antispasmodic like Tuscan and the pain may go off. If it persists or returns, I think you should go to the hospital because a gall stone may have entered and is causing a block in the biliary tree or there may be an infection. I hope you will find a compassionate doctor this time. Remember to ask them one question at a time and most doctors are willing to help you. Hope you get well soon. If you have any further query, you can contact me and I shall be happy to give my opinion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Height: 55 Weight: 121Medical History: AsthmaI accidently mistook my friends Symbicort inhaler for my own albuterol inhaler. That was last Thursday and since then I have had a slight fever,  aches and pains (predominantly back and legs), and a throat pain. This Thursday I am going to see my doctor, but I want to know what I can do to reduce the throat pain because it hurts to swallow. ### REPLY: Hi welcome to ... You are having acute pharyngitis infection... Mostly it is viral in general . For which symptomatic management done.... You can take antihistamines . ... Salt water gargles done three times a day... Steam inhalation useful... Avoid excess spicy foods .... If post wall pharynx congestion more diluted Betadine gargles useful.... More water.... Avoid smoking..... If symptoms increasing then antibiotic prescribed...like definite.... Hope your concern solved. 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, first symptom I had was a very sensitive and slightly swollen tongue, no discolouration. I bought some corsodyl mouthwash because it felt like it would help. Tongue is now fine, but now the gum right at the back has swollen and become quite painful, especially when I bite as it seems to get caught. Im at work for the next 8 days and have no time to see dentist, is there anything more I can do to help the inflammation and pain? Currently using salt water, corsodyl, brushing my teeth twice a day and being very careful on the gums. Thank you, mark ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have mentioned that you have swollen gums in right back tooth region, don't worry go it can be due to Periodontal problem, it can be Periodontal Pocket, or Periodontal Access, You do Chlorhexidine mouthwash 2 - 3 times a day, Do warm saline gargle 3 - 4 times in day, take Analgesic tablet Paracetamol 500 mg twice daily, for 5 days, then Go to dentist and get ORAL PROPHYLAXIS done Hope this will help you.  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: I have numbness in my left foot (ball of my foot). I also have lower back pain and pain in my left hip. I have a slightly herniated L4L5. I ve done physical therapy and a lumbar and Si injection. Nothing has worked. The doctors seem to think my SI joint is the main problem. Could it cause the foot numbness? Or am I dealing with 2 problems now. ### REPLY: His read your query and understand your concerns am sorry for the symptoms you are suffering It seems your symptoms are provoked by the herniation, so I don't think you are facing two different problems In my opinion you should schedule a lumbar MR which will confirm the gravity of herniation Then you may discuss other treatment possibilities You can forward examinations to me and I will be glad to advice you Please feel free to ask further questions or discuss doubtsMeantime you should wear a lumbar fortress and continue pain killers Hope I have been of heptane you for trusting ChatDoctorBest 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 fell last week whilst snowboarding and landed on my front, smacking my pelvis hard onto the ground. The impact reverberated through to my back and I developed a swelling/bump to the left of or actually on my spine - one of my upper lumbar vertebrae. It hurt when I arched my back and I carried on snowboarding for a few more days but then have been off for the last 4 days but very slow improvement. Please can you advise? ### REPLY: Hi, Thank you for posting your query. Based on the description of your symptoms, you seemed to have had a severe impact to the ground, however, it is fortunate that your injuries do not seem to be serious. As of now, you can continue to take analgesics such as ibuprofen or diclofenac tablets for pain relief and for the reduction of swellings. If the swelling does not go down or if the pain persists, it may be better to get an MRI of spine done to exclude any injuries to spine or the nerves. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . 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: My fiance gets extremely scared if someone touches, talks to him, or even gets to near him while sleeping. Is there some type of therapy or treatment we can do so he stops getting so startled? It takes him a few minutes to calm down if he wakes up scared. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The reaction from your friend could be due to anxiety disorder and apprehension. In that case, the anxiety should have some reason, and you should be able to see this anxiety in so many other circumstances in his daily life. Find out and let me know. Such a disorder can be treated with the help of desensitization therapy. Relaxation methods are to be worked out and his fear desensitized. Step 1 - Practice Deep and full breathing whenever possibles 2 - .  Step 3 - A Tomato a day keeps anxiety at basted 4 - Exercise regularlyStart these and follow strictly. After 7 days Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Can you tell me what patients should definitely avoid taking or doing,  while taking an anti-seizure medication?If a person gets seizures during the night while they are sleeping can this be more dangerous?As a person gets older, do they end up having more seizures?Are seizures in adult patients (40+) common? What could have caused the seizures to suddenly come out?  What can be done to reduce or stop the number of seizures. ### REPLY: HI, Thank for choosing ChatDoctorSeizures is symptom and not the disease itself, and this could happen due to the abnormal electrical activity of neurons inside the brain, often called convulsion in medical terms, It can be Epileptic convulsion, convulsion due to potassium, sodium disturbances (either Grandma or petite MAL) Febrile Convulsion (Pediatric Age group) Brain infection (Meningitis) also induces convulsion, the most common type of convulsion is generalized tonic-clonic one (epilepsy), this can be occurred at any age groups more common in male patients, newer .  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: went to dentist and they used anisthesia and im guessing hit a nerve because Ive had pain for 2 weeks since then from where they gave injection to top of my head.   i went back today and she wasnt concerned at all, more concerned with finishing my crown (which i didnt do not).   should i be concerned ### REPLY: Hi... Welcome to . As you mentioned after dental treatment at anesthetic site still pain is present that may be because of nerve injury or muscle injury or other reasons. Consult a dentist for oral examination and treatment. Mention any swelling present or not. Also mention which nerve block given to you. Detail history and clinical examination of oral cavity give exact idea about problems. Start a treatment as per reason behind it. I hope this will help you. Get well soon. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I caught a cold or allergy the other day now it is in my chest. I cannot cough anything very well. I have COPD and asthma. I have taken a breathing treatment three times today, as well my regular 2 times per day inhaler. I am still having a hard time breathing . My pulse is 122. Should I give it a couple of days to see if it passes, or go ahead and go in now? ### REPLY: Thanks for your question on . By your history and description, I think you are having COPD overlap syn . I advise you to consult pulmonologist and get done1. Chest x ray2. PUT (pulmonary function test). Uncontrolled disease can be due to untreated or recurrent infection. So chest x-ray is needed to rule out infection.PFT is needed to know the severity of the disease. And treatment is based on severity only. Along with inhalers I think you should follow these things too for better symptomatic relief.1. Enroll in pulmonary rehabilitation center where chest physiotherapy and deep breathing exercise are done.2. Get done adult pulmonary vaccination with pneumococcal and influenza to prevent future infection. So consult pulmonologist and discuss all these ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 implanon birth control for a year now but the cramping pain is so bad lately an I usually get my period even after having the implanon for a while like normal until this month I only spotted for half a day now all I do is sit in pain and nausea and vomiting how likely can it be pregnancy ### REPLY: Hello misunderstand your concernImplanon is 99 percent effective, so chance of pregnancy is one percent. You should go for pregnancy test if period is missed by 10 days that confirm the pregnancy. Spotting and abdominal cramp may be side effects of implant. Following are the side effects of it: spotting, irregular periods, amenorrhea pain and cramps in abdomen and breast tenderness. If period will not come, consult the gynecologist and go for ultrasound and hormone testing that rule out cause like pelvic inflammatory disease and uterine pathology. 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: hi my last period was on November 5th and i just found out that i was pregnant and me and my boyfriend have been together for 2 1/2 yrs and havent gotten pregnant and i cheated on him on November 15th(only this day), so is it possible to tell by ultrasound if i conceived on that day or after that. so will i be able to tell whos the father of my baby by how far along i am? ### REPLY: HI I understand your concern.  Conception is around ovulation which is 14 days prior to expected day of menses. So ovulation can be calculated. Now if November 15th happened to be your ovulation time (or a couple of days before or after that). You have possibility of conception with sex on 15th Nov. Sonography can not calculate date of conception. It reports in terms of weeks of pregnancy.  Confirmed Paternity can be tested by chromosomal analysis only.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir my name is omar. As per the local doctor m suffering from chronic allergy rhinitis . I have a lots of post nasl drip, specially when I wake up in the morning I cough like anything as if therr is somethingstuck in my throat . One of my nostrils is always block. I have tried all kinds of anti allergies n antihistamines n all kind of available nasal sprays but obviously they seem to have a very temporary effect. I ahve been doing gargles of salt n luke warm water but I am not fine n m getting sick of it. My quality of life has gone down to drain. Worst thing is that I am a smoker Plz plz plz help ### REPLY: Hi Omar, Thanks for writing your query. Allergy can be prevented by knowing the allergens which are triggering your problem and avoiding them. I hope that you have been already investigated previously by your doctor. It will be helpful if you mention the reports of the tests done. If not already investigated, you should get the following investigations done :-1. Complete Blood Count(CBC).2. X-Ray PNS3. Culture/Sensitivity of the nasal discharge. I would suggest that you should take Fenofexadine 120 mg once a day along with phenylephrine, if already not taken. Rest treatment depends upon the reports of the investigations. You should also get yourself examined by an ENT specialist to rule out Deviated Nasal Septum(DNS). I hope this is helpful to 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: i have been diagnosed with hepatomegaly with fatty liver grade 3. Liver size is 16.9 cm and shows diffuse increase in parenchymal echotexture. No focal lesion is seen. IHBR are not dilated. Portal vein radicles are normal. CBD and MPV are normal. I am scare please suggest ### REPLY: Hi thanks for asking question... Here before answering I need to know about whether you taking alcohol??? Overweight ??? Serum cholesterol value??? History of jaundice etc.....Anyhow, here strict dietary control needed. Avoid fatty food. Fried food taken less. Only good oil in little amount used like sunflower oil. Fruits more. Green leafy veg ... Do one hour exercise regularly.... Papaiya good fruit to be taken. Licorice with honey one tsp good herbal remedy ... Avoid trans fat food like cheese, meat, baked pastry, chips etc..... Avoid alcohol . Take care. If jaundice occur consult 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: i have developed some skin allergy from last 3 months and today there is a red inflammation on my hand and its itching.my doctor today prescribed wysolone 10mg for 10 days(3/day for first 5 days and then 2/day).i just read about the drug thats its a steroid and has several side effects...now should i take the drug or not. Also ever since this allergy developed i m takin levocet 5mg every night... ### REPLY: Hello, Welcome to  forum. Yes cyclone(prednisolone) is an oral steroid and has many systemic side effects.However, a short course (5 days) is not very harmful and prescribed in many allergic conditions if other anti allergy medications especially local steroids' antihistamine (levocetrizine etc.) have failed to provide relief. So please discuss your fears with your doctor and if that is the last alternative treatment for your condition then do go ahead with it. Hope I have answered your query. Wishing you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, My mother s age is 46 years old and she is suffering with minimum level of himoglobin. Now she has 31 himoglobin countability and taking medicine. So I need help for her diet chart to increase himoglobin countability. kindly help me and send perfect diet chart as per food available in India. Thank you Doctor Ranjan ### REPLY: Hi, Welcome to , I am .  You told that your mother is taking medicine. I don't know any medicine which can increase the He level from 31. Your mother needs to be admitted immediately in hospital, get blood transfusion which will improve the condition. And after reaching a steady level of hemoglobin, medication can be started. And after 14 days of blood transfusion or before starting transfusion, Bone marrow study is essential to categorize this anemia. So, don't waste time. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: have been getting a bump on jaw line same color as my skin.it contains a dry substance bump will go flat if  substance is removed only to fill up again in a short time.i can put something on it to dry it up and heal it over time but soon as I do it pops out again next to where it was and keeps doing that over and over and keeps following my jaw line it has been going on for over a year.would you have any idea what let could be? ### REPLY: Hello, It looks like a sebaceous cyst and as the internal content is removed. It becomes smaller and then fills up again. So my suggestion is to consult a physician and get evaluated. It can completely remove so that the bump does not appear again. The gland along with the cyst is completely removed so that it heals completely. Do not try to treat it at home only as it can get infected and become painful. So better get it treated professionally. 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 gave my 4 years old son (40 lb) an Ultrafen (iBuprofen) 200mg suppository (to treat 38.8C fever). After one hour he got a rash all over his body and I discovered than the medicine was expired (12/2010). His temperature is down now and the rash is gone.Is there anything I should do now? I gave him one (from the expired suppository) yesterday too. ### REPLY: Hello, Precaution is better than cure. Always read Exp date before giving medication. Now that its already administered, kindly keep watch for any new symptoms. If there is visit your doctor. Disclaimer"This provisional advice provided by me stands subject to the patient undergoing a physical examination and is based entirely on inputs provided by patient/attendants. The patient is advised for physical examination at earliest" ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 in the hospital for 11 days now on TPN and have alot of stomach pain and they cant do a catscan because there is barium stuck in my stomach from last week and wont come out. Tried laxatives and enemas and still nothing. in so much pain and just want to know whats wrong??? ### REPLY: Hi. Thanks for your query. Read the history and understood your problem. You are in the hospital for 11 days now and that the barium is stuck in the intestines from the last week and hence the CT scan can not be done. Tried laxatives, enemas, there is so much of the pain too. I would advise in such a situation the following:-Continue the treatment for pain in abdomen as before. -You have not mentioned the report of the Barium studies as this might have shown something positive. -If there is no suspicion about diverticulitis or appendicitis or Enteric fever-typhoid or any intestinal severe inflammatory process the following thing is to be done:For cleaning the barium from the intestines, one need to give the patient a cathartic which . This will surely help to clear the bowel off the barium. Nothing to worry. Once a Ct scan has been done get treated as per the reports. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently discovered a lump on the inner part of my left breast. its pretty big for a lump and the first time I squeezed it, a considerable amount of pimple-like pus came out. Now the lump is still there, no more pus coming out, and its tender to the touch. It doesnt feel the same as breast tissue and im nervous about it. ### REPLY: Welcome to  .1. Your history suggest that you are having an infective breast abscess.(painful lump with discharge) 2. Please do not squeeze / compress the lesion / lump.3. In this case visit your GP let it get examined - request for an ultrasound breast.4. That will give exact nature of the lesion / lump (solid, cystic, mass), its source (muscle, dust, gland) and its extensions. 5. Treatment in this case would be a small incision and .  Good luck. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, So I got my wisdom teeth out almost 4 months ago. About a week ago I noticed puss from one extraction site so went to my oral surgeon to have him drain it. The next day I had an appointment to have it curretted but that dentist (a different one) said that was not necessary and that I should just continue to rinse with warm salt water. It is now 1 week after that appointment and I am still having puss ooze through the hole if i put pressure on my gums. I am not in pain and there is very minimal swelling . I also have not had a fever nor any swollen lymph nodes. I have a follow up appointment in 1 week to make sure the hole is healing nicely. However because I am concerned about this puss I called the dentist to see about an earlier appointment, they said that the puss is fine it just means the hole is draining. Should I continue to rinse with salt water religiously or insist on an earlier appoinment? I am afraid the hole will close with puss still inside and cause an infection. ll ### REPLY: Hi, THX for your query, extraction of any teeth must be done very carefully this depends on doctor and later maintain of proper oral hygiene and correct usage of tablets this depends on patient. Go to your oral surgeon and get an x-ray for that region so that we can come to know whether the tooth was completely extracted or not. Later he will prescribe you antibiotics, and please do use the complete course along with this maintain good oral hygiene. Hope this helps out. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 full blood work up and everything came back okay. They performed an ultrasound and found gallstones in which I will be meeting with the surgeon to discuss options Stress test performed and all looks good. I m a 49-year-old female and I m finding myself extremely tired, achy and some shortness of breath. I have begun taking vitamin D. First question would be can gallstones cause the symptoms ? Is there any other ideas as to what could cause the symptoms ? Thank you ### REPLY: Hi.noted history of gallstones, fatigue, and shortness of breath. Your presenting symptoms are constitutional and may not be related to your gallstone pathology. It is possible that your doctor is investigating further to rule out any cardiac pathology, hence, the stress testing. Usual symptoms presented in conditions related to gallstone disease are abdominal pain, fever, nausea, vomiting, jaundice. It is best if you do a follow-up consult with your doctor, for physical examination and clinical evaluation. Your stress test result is also important. Other diagnostics and management 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: Hi.. My daughter is 11 months old and is suffering from fever for the last 2 days. We are giving her 1.25 ml Calpol drops. Fever drops and after taking the medicine and again gets increased after 4-5 hours. Shall we continue Calpol drops? She is having 100.9 now. ### REPLY: Welcome to the ChatDoctorI understand your concerns but don't worry. The most likely reason for fever in this age group is self limiting viral infections. It improves within a few days with symptomatic management. Do, continue cal pol for fever spikes. If the fever persists for more than three days or there is any worsening than do visit a pediatrician for proper clinical examination and definitive treatment. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor... I am 31 and facing a problem of erectile disfunction for last one year. My testosterone level 2.99 ng/ml which is marginally low as per my doctor. My doctor has advised me to take Duzela 30 initially for 3 months and after that he advised to take Duzela 40 for 2months more and report after that.. But it s not showing any remarkable results, moreover I m feeling dizziness.I have read in some medical sites that duzela 40 causes erectile disfunction as its side effect. So my question is whether I m under right treatment? Should I continue to take this drug? I have never faced any condition of depression, my BP and blood sugar level is normal and one more thing to mention I take Thyrox 125 daily. Please help n suggest another suitable drug for me. ### REPLY: HelloThanks for query. You are facing problem of Erectile Dysfunction since one yer and your family physician has prescribed Duel. Duzela is generally prescribed for depression and has side effect of ED. You need to consult qualified Urologist to evaluate to find out cause for your Ed. You need to do following base tests to rule out any organic cause for your Ed 1) Mammogram 2) Thyroid Hormone assessment 3) Color Doppler ultrasound Scan of penis to rule out any vascular insufficiency as a cause of your Ed. Marginally low level of Testosterone can not be a cause for your ED. If any organic cause for your Ed is ruled out it can be considered to be Psychogenic in origin. 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 Zinc3)Take anti oxidants like Almonds 5-6 every day.4) Avoid alcohol and smokingTaking Sildenafil as on demand will help you to resolve issue of Erectile Dysfunction. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 cirrhosis of liver - I don t drink anymore and have not for 6 years - my doctor s office called at closing time and asked me to come in and redo blood tests because Bilrubin level is at 3.0 - it has only ever been up to 2.4 4-years ago / 2.2 9-months ago and I had an ultrasound done then - it showed gall stones - could the gall stones be blocking a duct ??? I just started taking phentermine 37.5 per day Monday to lose some weight - I have taken them before - have not had much sleep - body is stressed from 1500 calorie a day diet Current weight 182 - goal - 175 age: 49 ### REPLY: Hello dear.I understand your problem. Being a patient of cirrhosis along with gall stone you will have raised bilirubin.to differentiate between these two look at report of liver function test. Stone in Common bile duct causes raised direct component of bilirubin along with raised alkaline phosphatase enzyme. Another mean is ultrasound study, which shows stone in bile duct or dilated bile duct and intrahepatic biliary reticles. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 16 year old daughter has been having random gasp of air, that at times are quite violent and almost seem like hyperventilating, and just recently it symptoms are including blackouts. These gasps of air occur typically when she is not stressed. We have had several blood tests, xrays, and the doctors have no ideas what is causing the problem. ### REPLY: Thanks for your question on . I can understand your daughters situation and problem. Since her routine investigations are normal, no need to worry about major heart and lung related diseases. This kind of symptoms are commonly seen in psychotic diseases like panic attacks, attention deficit syn .  So better to consult psychiatrist and get done counseling sessions. Try to identify stressor in her life and start working on its solution. She may need psychotic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I was diagnosed with mono about 6 weeks ago....I am still very fatigued and out of it but my main concern has been the progressive but gradual swelling of the right side of my face and both of my eyes. My forehead has also now started swelling and it is very concerning. I had an MRI done of both my brain and sinuses and it was all good with no signs of tumor or swelling of the brain. Is this normal with mono? And how long until these symptoms will start to fade? thanks ### REPLY: Hello, I understand your concern. I am , Infectious diseases specialists, responding to you. No, such symptoms are not common with mono. You should be thoroughly examined by for such a swelling. Continue the medication prescribed to you till that time. I think it will be a week or that to complete the diagnosis. I will be glad to answer your further query. Thank you for your contact to . Wish you the best health. Thank you, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife has an infection under her thumb nail. She has stripes under 2 or 3 finger nails. Has had this off and on for 5-6 years. But The thumb infection is the worst yet. We went to the local doc. and she said fungus and proscriped smz/tmp ds. With a follow up with clobetasol Propionate ointment. Can t find online any reference to fungus with these meds. Jim Wheeler ### REPLY: Hello, doc scratch is minor injury unless there was bleeding. If it's only oozing of blood it is a minor injury. You just have to undergo minor category vaccination schedule. Apart from that you have to have an antibiotic and tetanus toxic.  Ideally by washing thoroughly under running water for 20 minutes removes 80% of virus. But don't worry your self of it since you have already taken the vaccination. Hope this helps. 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: CAN A MOTHERS POOR EATING HABIT DURING PREGNANCY RESULT IN A BABY WITH MACGRONATHIA? I HAD MY DAUGHTER AT THE AGE OF 24. AT BIRTH HER UPPER GUM WAS NOT DEVELOPED PROPERLY. IT TOOK HER A YEAR BEFORE HER FIRST TOOTChatDoctorE IN, MY DAUGHTER IS NOW 13 AND IS EXHIBITING SIGNS OF MACGRONATHIA. HER LOWER JAW IS SIGNIFICANTLY LARGER THAN HER UPPER. I AM WONDERING IF THE FACT THAT I WAS EXTREMELY STRESSED OUT DURING PREGNANCY AND ATE POORLY IS THE CAUSEE OF MY DAUGHTERS PRESENT AILMENTS? ### REPLY: Hellooo....read through your query....based on your symptoms I must say that growth of the jaw depends on many factors. It may or may not be influenced by Food habits but more importantly is the hormones of the child.so don't worry.what has happened.she 13yrs now if her 2nd molar is not erupted I can say that u hurry her to a periodontist and get correction of the growth of her jaws(using orthopedic and dysfunctional appliance).if her 2nd molars are erupted take her to orthodontist he will see the situation of her growth based on cephalogram X-ray and do treatment accordingly...so don't think about what u did in past and do correction of the child for her future.!!!it's the right time.!!hope u r benefitted by my reply.have a healthy 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 just found a stalk like growth on the back left side of my tongue.  I had a sensation that I had something in my mouth (like a piece of food or something) but i couldnt dislodge it.  Looked in the mirror and was shocked to see this 1/4 inch long stalk like growtChatDoctoring out of my tongue ### REPLY: Hi, As you saw in the mirror and found out the growth, it suggests that you do not have pain in the area. Any unusual growth on the tongue or any other area in the mouth should be physically examined by the dentist promptly. There are many reasons that can cause growth on the tongue. I can explain you some of them here:- our tongue normally has many papillae on tongue that give us the sensation of taste and temperature. If these papillae get irritated due to some foods, hormones or stress, they might get enlarged and show the growth. It usually requires no treatment and disappears on its own.- A viral infection can also cause such growth, mostly Human Papilloma Virus (HPV). It usually has a stalk like structure as you described. Furthermore, it can be removed with surgery or laser. - If there is continuous irritation in the area, it can give rise to traumatic fibrous. It is pink and painless. For the treatment, the irritating factor has to be removed along with fibrous.- There are lymphatic glands present in the area that may get enlarged due to bacterial infection. The growth resolves when the infection is treated with antibiotics.- Last but not the least, it could be cancerous though most growths on the tongue are not. In that case, it may need to be biopsied, and according to the stage of the cancer, surgery, chemotherapy and/or radiotherapy are given. However, a growth on the tongue should not be ignored and should be diagnosed and treated as soon as possible. I hope this information helps. Thank you for choosing . I wish you get cured of the swelling soon. 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: Dear Doctor,i have pblm like anxiety on my future due to iam not professional & no permanent job. becz of this my fingers are shaking while writing, after consulting doctor iam using rexipra 5(not continuosly), even though i have same problem still on (hand & finger shaking while writing in front of others tooo much). pls. advice me what to do?thanks.mohammed ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  This is panic attack. Panic attacks always happen due to underlying anxiety. Therefore, you must add .  Please understand anxiety and related problems. Once you understand your anxiety, you will be able to keep yourself away from panic creating situations. Therapy always starts with avoiding such situations along with coping techniques when forced to be in such situations. Start slowly, progress gradually, attain neatly. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Lifestyle changes, change in thinking pattern, relaxation etc. are as essential as medicines. Psychotherapy can help you to change your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Already taking medication for depression ... continuing to have crying spells over ailing husband that is verbally abusive about life . Can t think just want to sleep and get away in my mind. Need suggestions or more medication so I can not have panic attacks. my life consists of going to work and taking care of a house and everything going with it. Husband talks about death and unloading remarks that are offensive to me. Help help help ### REPLY: Hello Welcome to  First I would like to advise you that please be strong and be positive towards life. You have a lot of problems but only your determination will help in fast recovery. You are taking medicines for depression, and you have not mentioned them but on medicines you are having crying spells, poor sleep etc. So I would like to advise you to visit your psychiatrist again regarding dose adjustments. Depression is a recurring episodic illness and long term treatment is advised in cases of depression. Medicines like Benzodiazepines as Clonazepam will help to relieve anxiety and stress. Short term use of medicines like Collided will help to induce sleep for some time. You have continuous stress from your husband, I will advise you to talk with him regarding your problem. Or at least make him agree to go to Psychiatrist along with you. A proper counseling will help both of 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 doctor, Please help me - This night I ate before I slept and then Ive notice that blood coming out from my mouth while Im sleeping just like saliva coming out from my mouth. What seems to be the problem? Is it my over fatigue or the fact that I immediately slept after I ate. please help me. This happen twice while I am sleeping, and lots of blood coming out. ### REPLY: Hello, Thank you for your contact to . I understand your health concern, if I am your doctor I suggest you that bleeding has nothing to do with eating. But it can be because of over fatigue or some systematic disease. It is necessary to do completed physical examination and history to come to diagnosis. I will be happy to answer all your future concern. Thank you, ChatDoctorInfectious disease specialist. Wish you the best health at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has severe knee,foot, and muscle pains. His doctor recommended for blood test to find the vitamin D3 levels. The reports showed levels as 5.5. His doctor suggested to take SHELCAL 500 -1 Tab / day. Now he started taking this SHELCAL 500 from last 2 weeks. But the muscle pain has not yet gone.Can you please kindly suggest how many days after taking this tablet, we can expect the pain relief. ### REPLY: Hello, In my opinion you are doing a good job by following the doctors instructions, however there is no specific number of days that he can feel better as it depends on many factors, but you can do things better by giving him more vitamin D from sun exposure for 20 to 30 minutes daily. Also increase food intake of vitamin D, . Walking also can help within tolerance of pain. Hope I have answered your query. Let me know if I can assist you further. Take care Amman Darragh ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 just started my period today. It hasn t been that heavy as a flow as usual. I also have delveloped constant chills for the past 2 and a half hours. I am only nervous because I feel faint and have a head and neck ache. I am known to often have low iron because I am a vegetarian. Would my being low on iron cause these things? Or could it be something else like mono, or a pregnancy? ### REPLY: Hello, THX to contact us. I understand your concern. If I am your doctor I advise you that having low iron level cause you all such symptoms this thing is increased by pregnancy. Pregnancy is anemic condition, so it is advised for every pregnant women to take iron supplements. But you should check your hemoglobin and take treatment accordingly like if you have severe anemia think for injectable iron preparation or blood transfusion in advanced pregnancy, and for low anemia oral iron preparation can be taken under your doctors' guidance. I will be happy to answer more of your concerns, kindly know me, Wish you a very good health at . . Infectious Disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My 3 yr old son suffering from seizure fro last 2 yrs his active seizure after 1 yr of age with fever 2 to3 episodes come seizure with fever after then sezure come without fever after 12 to 20 day repeated more than 1 mints before attach he is crying and jerking hole body & eye & lip blinking. Diagonist: His MRI CT Scan & EEG are normal 30mint EEG 4 time repeated but normal. Treatment: Last 1.5 yrs given - Valparin 200 - 5ml x 2 time, Clobazam 5mg - 5mg x 2time, Last 5 month given : Valparin 200 - 5ml x 2 time, Clobazam 7.5mg per day in night, Levera Syrup: 3ml x 2 time. Last 5 month given : Valparin 200 - 5ml x 2 time, Clobazam 7.5mg per day in night, Zanoxa 150mg (Oxcarbazepine) 1 tab mornig & 1.5 tab in night and Levera Stop. But still no any improvement last year 4-5 month control but stil is not improvement. Please help any one hi is treated in delhi Proff Dr Veena Kalra, Appolo Hospital, Retired proff from AIIMS (Ped. Neurology) Thanks Shashi - 0000 ### REPLY: His have gone through the detail, and it is a CSE of refractory seizure. EEG test can show false positive or false negative result. I would like to know was the MRI done with epilepsy protocol as standard MRI brain may also show no abnormality. There is one modality called MRI with epilepsy protocol in which emphasis is given to find out the cause of epilepsy like medial temporal epilepsy or conical dysplasia. These condition needs to be treated surgically if not controlled by medication. I would like to add topiramate which is a very good medication particularly for refractory seizures. 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 , why dose scortum becomes lose after masturbation . It dose and remains like that if masturbation is resumed in consecutive days.  i have abstained since 3 months and i feel better, tighter scortum and better libido when its erect . i rather go to my peak excitement and do not ejaculate. why is it uncomfortable to have a lose scortum ?? ### REPLY: Hi. I have understood your query. The scrotum and smooth muscles which are controlled by the autonomic nervous system. When you masturbate the sympathetic system activates and causes contraction of the muscles of the scrotum and therefore the scrotum becomes tense. When you ejaculate the parasympathetic system activates and causes loosening of the muscles of the scrotum and your scrotum sags down.  It is perfectly normal to have this. This variation in the tone of the muscles happens with every male and hence you have nothing wrong ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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! Ive got a bump in my left inguinal area which is oval in shape and about 2cm x 1 cm. The skin over the bump is very smooth and a bluish-grey hue with a black circular lesion in the middle which is only about 1mm in diameter. The skin over this black spot seems to be slightly rougher, but it is not ulcerating and I cant tell if its umbilicated.The bump first appeared over a year ago, maybe even two years, and I want to say that it began as an ulcerating erythematous pustular lesion (like a pimple, perhaps infected with staph) although its been awhile so I cant say for certain. Regardless, it has not been swollen or pruitic since the initial erythema resolved over a year ago. It really hasnt changed much during that time either. Its possible its gotten ever, ever so slightly larger, but I really cant say. It also seems as if that black spot at one time used to be deeper under the skin (but faintly visible) and is now at the surface as I mentioned earlier.I have no sexual history and my PMH is not significant for anything other than a benign parotid tumor about 7 years ago. Im a medical student spending my third year in a small community away from home and there arent really any physicians out here that Id feel comfortable showing/asking about it (since Im rotating with most of them). My biggest concern is that it could be a lymphoma or some other sort of cancer, but Im not certain about this presentation (namely the coloring).Thank you so much, I really appreciate it. Its something thats been concerning me for a while now. ### REPLY: Hello and welcome to , An inguinal swelling occurs most commonly due to lymph node enlargement. The blue-black discoloration of the overlying skin with a black circular lesion can be due to infection or some kind of skin lesion. An aspiration cytology of the lesion is required. This investigation will sample the cells of the lesion. The cells are stained and examined microscopically. The origin and character of the lesion can be determined by examining the cells of the lesion. Lymph node enlargement can occur due to inflammation, lymphoma or a melanoma as suggested by black discoloration of the skin. Malignancy is accompanied by weakness, loss of appetite, and weight loss. A preceding history of infection of the urinary tract, lower limb can cause inflammatory enlargement of the inguinal lymph nodes. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 18 month old son have problem of cough regularly and for that we visits several times to doctors. First time in the month of March only one day in night he finds difficulty in breathing , he crying & irritable that time, after visit to the doctor & giving nebulizer (Steam) for two times in a day he feels ok and play & eat well. After one month, around 15 days before he feels likes same problem and that time the treatment is same. Next time he hospitalize for 4 days for the same problem. After checking the entire test report Dr. said that he having the problem of asthmatic bronchitis . After hospitalization and continue with medicine he feels good for next 4-5 days but again in one night he feels the same problem. Please help & guide me. is it really an asthma problem ? I attach the medical reports that taken before hospitalization and the treatment details. Treatment during hospitalization: inj. monobact 375mg -- twice a day inj. augpen 300mg ---- twice a day Kindly give your valuable suggestion. ### REPLY: From your description, it seems your son is having asthma problem. He should be nebulized with leveling and decor 2 to 3 times a day. He can also be given a short course of oral steroids like omnacortil 2.5 to-5ml once a day for 3 to 5 days. Give him some antiallergic in the form of cough syrup like cockpit pediatric or Petersen. You have already given him adequate antibiotics and no need for further antibiotics. If symptoms still persist, get a X-ray chest and routine blood tests done and consult your pediatrician to rule out any other disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 crashed a UTV hunting and it scraped my left shin to the bone. it did not bleed so i did not go to dr. Later it got infected and i went to my doctor who put me on antibiotics. It cleared it up and the cut is healing. it scabbed over several times. looks like i may have one more scab over before it heals. This happened in January of 2014 so it has been a while. My ankle is still swelling up and is larger than my right ankle. sugessitions? ### REPLY: HiT hank you for asking . I have gone through your query. Muscle and ligament injury (strain and sprain) cause long term swelling and pain on ankle. X-ray of ankle followed by MRI will be helpful to find the exact status. Wearing compression bandage, elevation of affected leg while sleeping and sitting will be helpful. If there is any major injury visible in MRI then it can be corrected by surgery.  A consultation with an orthopedic is well appreciated. Hope this may help you. Let me know if anything is not clear. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I hit my leg on the side of the tub when I was in mexico in January, it is still discolored and very painful. I saw my dr and he said to come back in 6 months if it still hurts. I think it is more serious because it is hurting more now. even when I take a deep breath in I get a stabbing pain. ### REPLY: Thanks for your question on . In my opinion you should get done chest x-ray first to rule out below-mentioned things. 1. Pneumothorax2. Rib fracture3. Pulmonary contusion. Also get done x-ray of affected part of leg. You may have million or some soft tissue injury. So better to consult doctor and get done chest x-ray and x-ray of local part. Start painkillers with anti-inflammatory .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have bad allergies and asthma, i sneeze alot and cough from asthma. The past few days days i have been getting pain on the left side of my upper back area and i have been having pain in my chest area and i am very shaky and it  hurts when i breathe. What could be causing this? ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to Acute exacerbation of asthma, secondary to respiratory tract infection. The pain in chest & upper back is due to fatigue/ exertion following attacks of asthma. Management consists of:1. A course of antibiotics based on culture & sensitivity reports.2. Stalin+ Aeroflot inhaler-provide symptomatic relief by causing bronchodilator (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs). So, it can be used during an acute attack.3. Montelukast preparations- used as a maintenance therapy to relieve symptoms of asthma & allergy.4. Antihistamines like Cetirizine can also be used to provide symptomatic relief.5. Also make sure that you are well protected from exposure to cold, dust or other allergens. If symptoms still persist, kindly consult a Pulmonologist for proper clinical evaluation. Wishing a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a CT scan a few months ago because of lots of pain and bloating in my upper right side, it showed a moderately enlarged diffusely infiltrated fatty liver . My liver tests are still normal however the pain is worse clear through to my back and I feel like my side is so full that it will bust open soon. My Doctor says there isn t much I can do and will probably end up on a transplant list in a year. Any suggestions? ### REPLY: Hi and welcome to . Thanks for the query. This is absurd to say that fatty liver should be treated with transplantation. Only cirrhosis and terminal liver disease require transplantation and fatty liver is the most benign liver condition which is primarily treated by dietary and lifestyle habits, so you need to follow hepatic diet, avoid alcohol, regulate sugar and lipids in blood and lose weight. If there is no improvement you need some medicines. If there is sign of cirrhosis you need liver biopsy to find the exact cause. 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: I am 26, 210 lbs and have history of anxiety.  I have taken anxiety medicine but I am experiencing more frequent chest pain. It is as if there is a cloud around my heart.  When I take a deep breath I feel like the air isnt getting into the left side of my chest.  It give me a tight feeling in my chest.  This has been going on for around 2 months now. ### REPLY: Hi I can understand your concern... Noted you have chest pain.... You have history of anxiety. Let me know you excess stress can lead to panic attack and such symptoms can occur like chest pain and dyspnea by panic attack... So here try to avoid stress. Daily yoga and exercise is good remedy for it...... Try to avoid situation that lead you in stress. Daily meet with friends and relatives to relieve stress. Behavioural therapy also useful in relieving anxiety.... Get enough sleep.... Take care.... If still after relieving stress, pain present then your physical examination done to investigate further.... Take care.... .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, A few months ago, I keep smelling a moldy smell in the air (in my room) and its really bothering me, Ive began to sneeze a lot, my nose is always runny in one and stuffy in the other. After some time, Ive finally located on the back of a piece of furniture, there were tiny, hairy black spots growing all over the surface area. Ive cleaned everything with bleach and sanitize everything and I stopped smelling the moldy smell. However, for past two-weeks, I keep smelling a strong pungent urine smell everywhere, especially at night as I lay in bed before falling asleep. During the day the smell is more faint and doesnt last as long. But at night it seems like my bed was once soaked in a pool of urine but is now dry; when I smell every surface area of the bed, it smells like clean linen but the urine smell just floats in the air. Dreadful as it sounds, I actually get down on the carpet and sniff for the smell and I find nothing. I own a small dog for almost three years now, he is house-trained and only goes outside or in a designated area in the house (we trained him to use a litter box.) I checked the carpet area around his litter box and there are no urine smell either. When it smells so bad and someone is home with me, I ask if they smell it too but no one never smell anything. I have had migraine headaches for years and when the pungent smell lingers for too long it triggers my migraine. Every day for two-weeks now, I would wake up with a runny nose and sneezing for the first 30-45 mins. When I get out to go to school or at work, I sometime smell a faint urine smell as well, it reoccurs outside of home. This have led me to searching online: some people smell cat urine during their pregnancy or it is a bodily smell. I am not pregnant and I do not have any vaginal disorder or bodily smell, so could it be that I am just imagining it?I did not hit my head or am suffering from any concussion. The smell is too strong to disregard. Is this a psychological disorder? Is there a way to treat this problem? Could it be an allergy? I apologize for such a long post and thank you for your valuable time. ### REPLY: Hello, You need to consult a Neurologist to ensure that the migraine attacks are not as frequent as you think. There are several types of migraine, or worse case scenario he would ask you to get a sleep-deprived EEG done to ensure there are no abnormalities with an MRI backup. Allergy tests are certainly required, specific IGE blood test against aeroallergens including molds to ensure that the rhinitis bit is figured out. Long acting antihistamines with nasal sprays will help. Cinnarizine is an antihistamine that combined with paracetamol and risperidone has anti-migraine effects, so may be worth trying. 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: Light periods lasting 2 days, bloated stomach. Feverish occasionally and dark urine sometimes. Middle back ache and had pain on right side kidney area that went away after taking antibiotics for water infection eve though no pain on urinating and no frequent urinating. Kidney pain seems to be returning and feaverish again ### REPLY: Hello, I got your history and it is due to persistent urinary tract infection. Though you have taken medications, but infection has not cleared. You require urine culture and after that proper and selective antibiotic can be tried. There is nothing to worry, report to emergency room for examination and tests so that .  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: Ok so I did an artificial insemenation on april 26th my last period was april 8th and my cycles are 33 days like clockwork. On the 9th I went to hospital for back pain n got treat for uti while I was there they gave me a pregnancy test which was positive and told my levels where 129. My period was due on may 11th. On may 13th I went to the doctors and he tested my levels again and they were 849 the very next day on the 14th I had some spotting around 6pm and went to the ER where they tested my levels and they were 1560 and they did a pelvic ultrasound and said they saw the sac n everything looked ok. They also treated me for a bactrial infection. I never had any cramps or pain whats so ever. I am no longer spotting. Yesterday I went bcak to doctor which would be may 20th and they did a pelvic ultrasound and said they saw the sac and nothing else which he said he wasnt worried aboit but he said next Friday may 27th we should see something and know if the baby is ok or not. He calculated me at 6wks yesterday but thats based of a 28 day cycle I think Im only 5wks 4 days. Is what I seen on my ultrasound yesterday ok? And how far along am I based off my cycle n the only day I was insmenated? And what should I see on my ultrasound next week? The doctor I been seeing is new to me n doesnt take time to listen to me ### REPLY: Hi, thanks for using . I understand your concern. There is something called implantation bleed which occurs around the next expected periods. This occurs when the fertilized egg gets implanted on to the endometrium. So nothing to worry about the bleeding. Your  title is increasing so it's a growing pregnancy. Your gestational age is calculated from the last period date irrespective of the length of the cycle. By 5-6 weeks a gestational sac appears. By 6-7 weeks fetal pole and cardiac activity should be seen. That's what your doc is expecting in the next scan. By next scan your exact period of gestation will be known. Don't worry. Everything will be fine. Hope I have answered your queries. Good day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother in law is in remission from limited stage small cell lung cancer and she wants a partial hip replacement. Her doctors gave her clearance for the surgery but I m afraid she won t heal well. will this surgery possibly cause her to relapse with cancer due to stress on her body? ### REPLY: Thanks for your question on . In my opinion you should not worry about relapse. Partial hip replacement is done under spinal anesthesia and stress level and risk both are less than general anesthesia. And doctors have declared her fit for surgery means she is able to cope up with the surgical stress. So no need to worry about relapse. Get done surgery. And continue her chemotherapy cycles as per schedule. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hep c and b I took the treatment interferon and ribovaron I was a success story back in 2001! Now I have cellulitis and found hep b active but not c, I have to c. Doctor next week! Could this be severe I was lead to believe I would not have future problems ### REPLY: Hi, Welcome to , I understand your anxiety regarding recurrence of Hepatitis B even after treatment. On an average, 90% cases recover completely, 5%-10% go for chronic carrier stage, of these chronic carriers few may progress as chronic aggressive hepatitis with repeated attacks of jaundice. I suggest you get in touch with your doctor and get investigations to rule out chronic stage of hepatitis B. You have to get tested for Head, Anti-bug. PCR also be done to detect the exact viral load. Wishing you all the best. 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: im 30 years old. Not sexually active.Been bleedng for two months, gynaecologist told me to get a sonography done and she gave me soe pills to regularize the period. I already have PCOS (polycystic ovaries) but no other hormonal imbalances plus she told me this was not from the PCOS. the sonographer told me that my endometrial lining is 13mm which is a little thick with 16mm cysys on the right ovary. she also said thata the liver is a little fatty and moderately enlarged and to get all these looked into. When i went to see her i had just stopped bleeding and i took the sonography 2 days later.Im bleeding again. but im not supposed to see my gynaecologist for 2 weeks yet to discuss the results.i know i dont really have much to worry about but id still like to know since im bleeding again and its a little daunting.history wise- ive been through bad phases of depression after my mother passed away suddenly and been on various kinds of medication. i used to be super active but thats been whittled down because of the depression. i was on medication and sleeping pills which contributed to weight gain. i didnt want to get hooked on those so ive also been doing my best tor regularize my life in terms of diet and exercise as ive been careful of that my whole life and led a very active sporty life. and while im not as active as i used to be, im finding it hard to do even the little things without getting tired. im frequently exhausted and frequently nauseous and constipated. i dont sleep well. i dont like going to doctors because i dont like worrying family or feeling like ive bothered people for no reason at all. so it took a lot for me to go to the gynaecologist at all. ### REPLY: Hi, Thanks for your query. I read your query and I understand your concerns. Following is my reply:1) Please see a gynecologist or an infertility specialist as worrying won't solve problem.2) Even if there is PRO, you can conceive.3) Get regular follicular monitoring done from your doctor who can tell you when is the best time to have intercourse and try for pregnancy.4) Meanwhile continue diet and exercise hope I answered your query. Let me know if you have any followup queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: when I tried two different birth controls separately, they gave me a year long non stop period both times. I don t want to try birth control again because of these problems. should I try another birth control or do you think it would be unhealthy because my body doesn t react well with it? ### REPLY: Hi How are you doing ? Birth control is used as a cafeteria method. Each method is good for some not for others. Without any personal / age/ medical history / pregnancy histories, it's not possible to decide. There are n number of methods. But let me put forwards a list of methods & the situations where they are suitable.1. Oral Contraceptive pills -- Has to be taken daily from Day 1 of periods for 21 days, give a gap of 7 days, then restart the next pack . This is ideal for those not yet delivered/ those can remember to take pills every day/ those with irregular periods/ those who are not breastfeeding/ those without any blood coagulation problems, DVT, heart problems etc2. Copper IUD - Can be inserted by gynecologist immediately after periods-Available for period of 3 yrs/ 5yrs/10yrs. Ideal for those who want one time method, with risk to forget pills daily/ not at risk of pelvic infections / HIV or any STDs.3. Norplant - Subcutaneous implants - can interfere with normal ovulation & periods may reduce or stop. Cheap & has protection based on which type you use Type 1 or 2. One time method for 5 yrs or lesser.4. Nuva ring-vaginal inserted ring of hormones-Which has to be removed every month end for periods to occur. Can give good cycle control. Not very costly. But needs removal & reinsertion of new ring every month yourself.5. Injectable hormones-Will act for 3 myths, not costly, No periods or minimal periods or only discharge. Good for breastfeeding mothers, those with irregular bleeding, endometriosis/ adenomyosis. Occasionally cause ovarian cyst but not significant. I have given list of common methods, the list is very long, but cam be used based on your profile Hope I have cleared your overall 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: My daughter (age 17) had severe abdominal pain for the second time in three weeks on Saturday. Each time the pain has only lasted around an hour or so. However, this time she fainted having been nauseous beforehand. We took her to A&E on the advice of the out of hours GP. They did bloods, ECG and liver tests and found nothing. Could this be a grumbling appendix and if so, what should we do next? ### REPLY: Hi ! It would have been helpful if you had mentioned the area of the abdomen where she gets pain. Anyway, pain must be of severe intensity to cause nausea and fainting. Usually colicky type of pain cause this and one of the common colicky pain which can be thought of is Ureteric colic. Appendix pain could also be bad sometimes, but it may not be that severe enough to cause fainting attack. The second common colicky pain of this severity could be a gall stone/CBD stone colic. The liver tests in this case may be normal in initial stages. As it is a recurring in nature, I would suggest you to consult your family physician who may advise your daughter for an abdominal ultrasound for more clarity of the intro abdominal pathology. Wishing your daughter an early recovery. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 9 years old. she is seeing a pediatric urologist for interstitial cystitis. we have been in and out of the ER and after hours clinic with an increase in her urinary symptoms. she has had dysuria, pelvic and low back pain. this past week her symptoms have worsened. she did not urinate for over 24 hours. i took her into the ER and she did eventually urinate but had to strain to urinate and has ever since then. this has been going on for 4 days now. her urine came back clear under urinalysis as it always does due to being on a daily antibiotic, macrodantin 50 mg. she is now having more severe back pain and i am unsure of what i should do. can you please help me. Casey- concerned mother ### REPLY: Greetings... Firstly recurrent UTI is concerning. Please look into the hygiene and into the habits of handling private parts.Also, constipation has to be avoided. She has to be on prophylactic antibiotics which I think she is on, but that should be chosen after proper culture and sensitivity reports. To get hold of the cause of recurrent UTI certain investigations are required like ultrasonography PUB, X-ray PUB, maturating cystourethrography, DMS scan. ### END