Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 14 months old and has been 8kg since she was 8 months old. She refused solids until she was 12 months old. She has been eating (very fussy) for the last 6 weeks but still no weight gain. She was put on Osmolax by her ped as she is terribly constipated 6 weeks ago. She started eating once the osmolax started her pooing. In the last 2 weeks she has started refusing food again. I have also noticed that the osmolax doesn t seem to be working as well and we will need to put her dose up again soon to continue her pooing. This is worrying as she is so little and the laxatives can t be good for her. She seems to have not a lot of interest in food. She was exclusively breastfed for the first 6 months but never even seemed that interested in breast milk either. She also gets a rash on her face when she starts to refuse food. She scratches it a lot and we put steroids cream on it to calm it down. We have also noticed her gums and mouth bleed a lot for no apparent reason. Our ped got her cheeks swabbed to test for the celiac gene and her cheeks bled from the gentle brush of the swab. ### REPLY: Thanks for follow up. At the first you should give laxative medicine - cephalic 5-10 ml before night. The second thing-bifilac 1 capsule 1 time 1 month for normalization of flora. Do ccorrection in diet, give more rubber carrots, boiled beets roots with 1 teaspoon of sunflower or Olive oil, fresh Dali, fresh carrot, beetroot juice 100-200 ml. Do exercise with baby, he should walk more. Please give antiallergic-cetirizine or desloratidine syrup 7-10days. Avoid allergic from her food. Give to her absorbent -charcoal 1 tab before night for absorption allergens from Italy 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: hi i ve had the same partner for 8 yrs. I ve noticed a blister on the outer part of the labia which before appearing itches. oonce it appears the itching sensation dies down a little and sometimes stings. I ve tried squeezing it and clear fluid coms out. I ve had it for 4 days now and it hasn t scabed over either... I m shy and scared to go to the gyno , what could it be???. ### REPLY: Hi there, It seems like herpes simplex infection to me, although it has to be clarified once it has been examined by a dermatologist. The symptoms and description you have given in your brief question is leading towards the Herpes, but I can understand your concerns. The thing is if it's a hopes infection then it can recur again, and you need to be given prophylactic anti-viral therapy for that. But for the time being you can apply Viral ointment four times day to the blisters and can take Tablet Zyrtec 10 mg once a day to relieve the itch.I hope the information will help. Thanks and all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is 60 and just had surgery to remove kidney stones.  They used the laser and basket and put a stent inside.  Since he has come home he has been in escruciating pain and it kills him to urinate.  Nobody told him it would be this painful. Is this normal? ### REPLY: Hello and welcome to .  As a Urologist, I can understand your anxiety. The stent does cause pain in some people, when it moves. Some people are more sensitive to this pain and need treatment for this. Also, . Some people have stone fragments passing down alongside the stent. This is the cause for the pain and burning sensation, while passing urine. Gradually, pain reduces and after stent removal, will disappear completely. If you've any doubts, send it as a direct question to me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 uncle(30+ years) came to know that he is infected by HBsAg and he  is very much about that and when we consulted a doctor(jaundice specislist) he said that there is no medicine for this.when my uncle heard this he is very much upset.i want to know is there any way to cure  him.. ### REPLY: Hello, Welcome to , Series of blood tests should be done to diagnose the condition. His treatment is based on those test results. Following tests are done to look for liver damage if your uncle is having hepatitis B.1.HBV Viral load2. Liver function test3. Albumin level4. Prothrombin timeout hepatitis needs no treatment other than careful monitoring of liver and other body functions with blood tests. He should take adequate rest, .  If there is abnormality in blood investigations he should be taken to the gastroenterologist to prevent chronic Hepatitis B state. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi there I have a sore hard lump on the side of my leg, I 1st felt it and expected a big bruise, but there was no mark on it all, it is slightly red, on the inside about 1/2 way between foot and knee, it feels hot to the touch, but there is no mark on it to suggest an insect bite. it is oval in shape, and around the size of a 10p ### REPLY: Hi! Whenever a patient visits my clinic with any kind of leg lump which is sore and red, I usually get following possibilities as per needle biopsy experience:1. An abscess 30%2. Infected inclusion cyst 30%3. Benign tumors like dermatofibroma, lipoma or neurofibroma 20%4. Benign tumors of the bone or tendon 10%5. Soft tissue infection like folliculitis, panniculitis etc.10%Therefore, it is time to see a surgeon for an opinion and please don't worry as this is infective only and never malignant!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: hey. i am 16 weeks of amenorea and a lot of contraction. i take natural progesterone utrogestan but I am living in Kenya and my doctor in kenya asked me to get an injection of primolut 250mg, I have called my doctor from my country in Belgium who said not to take that injection because its useless in my case and not good for baby and forbidden since many years in pregnancy in belgium, my cervix is closed but long of 2cm only and many contractions. primolut injection or not? thxs a lot ### REPLY: Hi there,Both Primal and Progestin are forms of progesterone and given safely in pregnancy. They are given in women whom we suspect to have threatened abortion to prevent from losing the pregnancy. Any one form of the progesterone is fine, you need not take both. They both have similar effectiveness and since you are taking progestin you should continue it. And more so if your cervix is long and closed the likelihood of you losing this pregnancy is very small. You need to relax and be positive, once reached 16 weeks and with cervix closed and no prior history of miscarriage, you are very unlikely to miscarry. Please continue the progestin till 24 weeks and relax. Also continue the Folic acid and other vitamins you may be taking. Anxiety and stress will only make matters worse, continue the progestin. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, doctor.My husband is 35 years old and 172 cm height , underwent medical checkup and found that his SGPT is high; 98 due to fatty liver since one month and he is on strict diet and exercising daily but still its high and barely coming down to 82.Please advice ### REPLY: Hello, Welcome to . I read carefully your query and I understand your concern. I see your husband problem description, as you mentioned here the SGPT (ALT) is high because the fatty liver. Fatty liver need a lifestyle changes that mean diet with a low saturated fat food and exercise minimally 30 minutes of brisk walking every day, also your husband should monitor the weight, he should maintain a healthy weight for his height. Your husband should avoid absolutely the alcohol intake. You can add to these the medication that can help with detoxification of the liver and also normalize the metabolism of lipids and proteins like Essential L these help to reduce SGPT. He can add to this treatment the intake of omega-3 fatty acids and antioxidants e.g. vitamin C he can take vitamins B. I recommend you to follow up your husband with a gastroenterologist. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Kind regards, . Maria BANK ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 both osteoporosis and Factor V Leiden, and my understanding is that foods high in vitamin K are very good (essential?) for bone strength, but they should be avoided for Factor V Leiden. I m trying to minimize my bone loss through diet and exercise (I m not willing to take medication), but how likely am I to succeed without vitamin K? Thank you very much. ### REPLY: Hi, thank-you for providing the brief history. As per the history it looks you have a bony ailment. The pathophysiology of the bone needs an understanding and also as you are doing exercises I will make some add on. The line of action is very simple, and it works in the majority of cases.- Clinical examination and DEXA scan for assessing osteoporosis.- Simple blood tests.- Calcium and iron Supplement-Vitamin D3 Injection - Diet & Exercises - Regular milk & Sun bath. In my clinical practice with weight-bearing exercises, milk products, sun bath, etc. patients responds well.  The calcium & vitamin D3 levels also increase. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi My name is nikita and I m trying to conceive since 1 and half years. Once i got misscarrige before 2 year and now Me and my Husband done all the report. behind that. In my husband s report Low sperm count came near 50 million and sperm motality is 80%. And now my doctor started medicine for both of us. She recommended my husband for fertly M.[25mg] daily one at bed time and Provironum[25mg] at bed time. And for me OVA Shield and its come in 30 capsules pack. from 1 days of my period i have to start 2 tab for 5days in that 1 capsule contains 2.5mg letrozole and another is contains Astaxanthin 4 mg. After 5 days i have to take 1 capsule daily contain Astaxanthin 4mg. So i want to know what is the use of this. And how much is useful to me. When i have to take in the night or in the day after lunch. Waiting for prompt reply. ### REPLY: Welcome to ChatDoctorRead your prob, as per your report your husband has normal sperm count, it should be more than 15 million. N active form should be 40% of total count. You should rule out cause of infertility by getting hormonal assay for gonadal n thyroid Mormon. As hormonal imbalance is cause of it. You should get sonography of uterus n follicular study. Consult with your doc, reach to cause of infertility n start proper treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good day, my husband has been getting a fever for the last 2 weeks, we have gone from one antibiotics to the next, this weekend he got a fever again and we went to the doctor which drew blood. ESR 64mm/hr and monocyte of 1.01 the doctor advised this could be an infection so he gave him another course of antibiotics for 10 days. Is there anything we should be worried about or go see a physician? ### REPLY: Hello, THX to contact us. I understand your concern. If I am your doctor I advise you to go for blood for culture and sensitivity. Since the cause of infection is not known, so first important parameter is to check whether it is bacterial or parasitic or viral infection. There after we can start our treatment accordingly. 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: Hello there, I had a kidney removed about 12 days ago. Starting around day 7, I noticed my right testacle (same side as the removed kidney) was tender to the touch and my ejaculate was very yellow. A day or two later I noticed a slight red tinge to the yellow, and now today my ejaculate is mostly light red. Not exactly the deep red colour of blood. I went to my family doctor today and he couldn t think of a reason why this may be happening. He sent me for a blood and urine test and the results should be available within 24 to 48 hours. My doctor is not aware of the red ejaculate from today. I m more than a little concerned.... ### REPLY: HelloThanks for query. Was your kidney removed for any inflammatory condition or malignancy. The swelling of the testicle and red colored semen (Hesperia) is mostly due to infection of testicle (Orchids). Please visit to operating surgeon and get your ultrasound scanning of scrotum done to confirm the diagnosis.In the meanwhile start taking antibiotics like Definite and anti-inflammatory medicine like Diclofenac twice daily. Ensure to . Ensure to avoid sexual activities. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dad, 73, has been diagnosed with Esophagel cancer stage 4 he also has pneumonia and a feeding tube to the stomach, plus a fistula eso/traq. He had a heart attack 30 years ago. Dr has said that cant do anything for him. No chemo, radiation, anything. That chemo wd kill him in a week. Do you agree. What is the time frame? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your dad has esophageal cancer stage 4.  No surgery will help. Treatment options are chemotherapy and radiotherapy. Despite treatment prognosis remains poor. Life expectancy is not good. He has not good health, so chemotherapy side effects leads to worsening of life.  There is no major difference between life expectancy with or without chemotherapy. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi.. my dad was diagonised with cancer in de food pipe only a couple of days back.. he is 70 yrs old.. jus wanted 2 know if dis is curable...currently he is unable to swallow anything.. n doctor has suggested 2 take a laser treatment first ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He has esophageal cancer. Treatment depends on type, stage, location, grade and spread of cancer. In early stage laser treatment and surgical treatment is helpful.  In advanced stage surgery is not helpful and chemotherapy and radiation therapy are the treatment options.  Consult your oncologist and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a cold now but have had dry mouth in the winter months. a few times per week I may see streaks of blood in my spit, it goes away after a hour or so ### REPLY: Hello. Welcome to . Spitting thin streaks of blood during or immediately after recovery from sore throat infection is a common finding and is due to increased blood flow in the pharynx during inflammation. So, it is not something to be worried about.  You can have soothing effect or relief by having sips of warm water instead of normal temperature water whenever you are thirsty. Coughing out or spitting blood in your case may be a cause of worry if you also have otherwise cough with sputum production, or have other symptoms (loss of weight or loss of appetite)suggestive of tuberculosis. In any case if this finding of cough with blood streaking persists beyond sore throat, you must have X-ray and visit a chest specialist. 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: Dear DoctorI am a 60 year old woman who was diagnosed with type 2 diabetes 3 years ago! In May 2013 I started Urine therapy both ingesting my own urine and daily massage before I shower everyday. Two months ago, my right shoulder began to hurt! Movement is a bit restricted. I hope its not FROZEN shoulder. Will Urine therapy still help me? Or do i have to go through painful Pysiotherapy?Mrs. Barbara Ann John ### REPLY: Hi Barbara, Thanks for asking. Based on your query, my opinion is as follows.1. It appears to be frozen shoulder.2. It is commonly seen in elderly and more commonly with diabetes. Clinical examination of shoulder and MRI necessary to rule out any associated pathology.3. Yes, you will require physiotherapy along with mild exercises. 4. I am not sure about urine therapy, but not advisable. It is not sterile and contains chemicals which are supposed to be discarded. Risk of infection, especially with diabetes is present. Control blood sugar within normal range. Also, mild exercises, weight reduction, and multiple small meals will be helpful. Medication to be continued regularly. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! My husband was recently diagnosed with cancer of the small intestines. He was confined for a week because of all the blood he had lost. He is working as a security personell at the embassy, a very stressful job. My question is, should he be going back to work before the operation or should he stay at home and rest to avoid all the stress and heave work? ### REPLY: Hi, Thanks for writing in. A patient having small intestine cancer with bleeding should be taking rest for some time. His body is weak, and he is not fit to work as a security person as it involves a lot of physical and mental stress. He might take up a desk job if possible which might be less stressful. Doing a security job is not recommended at the moment due to his health condition. He should also be provided nutrition and vitamins as recommended by his doctor. Since cancer treatment is a stressful period, please help him by giving emotional support and trying to know if he is having any pain in the abdomen for which he might require pain relief medicines. You might make a request to his employer to provide alternate employment. Following his surgery he might require few weeks rest. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: please wil you telme if my husban have postate cancer in the first stage? Sorry for my mistaques buth my lenguaje is Espanol , hi start with the problem both hi dosent want me to tock his Doctor. Hi is very stoborn, Can he star Radietion or medication? Tanks. Jenny. P.S. His taking terazosin cap 5.MG ### REPLY: Hi, Thanks for writing in. Prostate cancer is confirmed by doing certain tests specific to the prostate gland. At first the serum PSA level is important and if this is high then the patient is recommended for a transrectal ultrasound of prostate. This will show any suspicious lesions. Any lesion in the peripheral zone of prostate is to be biopsied and this biopsy is done under ultrasound guidance. A bit of tissue from the suspicious region is taken out with a needle and sent to the lab to study the cells. Only if there are cancer cells then a diagnosis of cancer is established. Once a patient is confirmed with caner of prostate, it is better to do a bone scan and ultrasound abdomen and chest X-ray to know the spread of disease. If there is no spread and the tumor is smaller than 3 cm in size then it is in first stage. Teratogen is a .  Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi im a boxer and in sparing two weeks ago i was punched very hard by a much bigger guy in the middle of my chest ever since then iv hard alot of pain. When i cough the the pain is unbearable and also when im led down i cant turn around or nove with out pain i also have really bad pains when standing back up. There is no bruising visable however the pain has not eased ever since should i be worried or wot shall i do to stop the pains. Thank you ### REPLY: Thanks for your question on . I can understand your situation and problem. You are having blunt chest trauma. And following are the complications of it that can cause pain on breathing and coughing. 1. Rib and sternum fracture. 2. Pulmonary contusions 3. Pneumothorax 4. Musculoskeletal injury. So better to get done chest x-ray first. If chest x-ray is normal then no need to worry about major complications. You are mostly having musculoskeletal injury. So avoid heavyweight lifting and strenuous exercise. Avoid movements causing pain and bad postures in sleep. Apply warm water pad on affected site. Start painkiller and muscle relaxant .  Don't worry, you will be alright in 1-2 weeks. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was coughing for the past month and have asthma like attack when I wake up coughing at night. A Dr told me that I might have walking pneumonia and gave me some antibiotics. Towards the end of my cough the left side of my rib started to hurt (about two weeks ago). I had that side of my rib injured before (hairline fracture). Which I think may be a reinjury of some sort due to excessive coughing, however, in the past week this pain had traveled from my left side and extend to my right side also. However, the right side pain is more towards the sternum. I don t feel extensive pain going about my day, just have a hard time getting up in the morning when it hurts the most, and when I have any residual cough. Not sure what is wrong with me, and are there thing I can do to get better? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of bronchitis is more. Bronchitis is inflammation of airways. It can cause excessive coughing, asthma like attacks, chest pain on coughing etc. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father passed away from liposarcoma on January 2, 2010 at the age of 62. He had liposarcoma in 1995 and had radiation to treat it and then in 2007 he got prostate cancer and felt as though he had beat it. But this time around he complained of a burning in his throat on December 14, 2009, was sent to the hospital, and stayed there for a few days and was released. On Christmas Day, he went back to the hospital and never got to come home again. While there, the doctors told us he had stage IV cancer. Does that mean he had had cancer for years without knowing it for it to be stage IV? Is there a risk that my sisters and I could get liposarcoma as well? Is there something we could do to prevent it? ### REPLY: Hi, Thanks for writing in. Liposarcoma is a malignant tumor of fat origin. It is a violent and quick growing cancer, and probably it was of large size when detected. Surgery might have been done in early stage but possibly the size of the liposarcoma was large and the extent and involvement did not allow surgical treatment. It is not clear where he had the liposarcoma and if the liposarcoma and prostate cancer were related in any way. Stage 4 cancer is advanced disease and shows that the condition has spread to other organs. Treating stage 4 cancer is difficult, and life expectancy is 2 years with recommended chemotherapy and supportive care. There is no significant risk of liposarcoma occurring in you and your sisters however please be alert of any swelling in your body and have it clinically evaluated immediately. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been taking Ortho-tricyclen lo birth control for 2 years now. I recently started taking Rapidcuts fatburner. I asked a pharmacist and they said that the ingredients will not interfere with my birth control. Should I trust the pharmacist or get a second opinion? ### REPLY: Hi, There is no documented interactions between these two. Claimed to be one of the potent formulations to lose body fat by virtue of its important active ingredients like green coffee extract, insulin PF (cinnamon extract) and ashwagandha, rapid cuts fat burner does not appear to interfere with the contraceptive actions of birth control pills or tho tricycle. Hence, these two medications can be taken safely. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My right hand side intestine fill pain. Look like swollen.I have been go through Scop and few tissue taken for test but negative.Now I m 42 yr and I can feel paint when make movement.Pls advice what should do .Thanks Siva Blood test - negative, scop ### REPLY: Brief answerRenal stone or colitis Detailed answer I have read your question would like further details to help you better1. Is there any urinary problem you are facing with like increased frequency or burning sensation while passing urine2.are you running fever, diarrhea or having vomiting during the attacks3.What's your ultrasound report if you have undergone that 4. Avoid smoking and alcohol if you are into that Hope this information will help you good luckRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 our 11 year old daughter has had bad stomach pains and high fever causing her to be sick.  We have seen our gp and also taken her to hospital. They have carried blood tests and urin tests and sent us home with no answers. No pain relief is helping as the pain both in stomach and head is very high. Please help as this our fourth with no sleep ### REPLY: Hi, If I were your treating Doctor, I would exclude herpes infection, high level of uric acid, acute gastritis. I suggest:-Definite -4 mg/kg/dose twice a day for 5 days- ORS and plenty of water-Charcoal 3 tablets once a day for 5 days Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Okay so Im having some oral problems :( Every morning I awake to this absolutely disgusting taste in my mouth, my teeth, tongue and gums are like covered in a layer of this gooey white crap. I always get these slightly painful small white dots on my tongue and at the moment I have this painful ulcer like thing on the side of my tongue. I would really like to know what to do. (I have my tongue pierced if this helps at all) Thankyou.. ### REPLY: You are probably having oral candidiasis. Oral candidiasis is an infection of yeast (Candida)on the mucous membranes of the mouth. Candidiasis usually appear as thick white or cream-colored deposits on mucosal membranes. Risk group includesNewborns, Diabetics,those taking oral corticosteroids, people with immune deficiency, smokers etc. Lightly brushing the lesions away reveals a reddened, tender area that may bleed slightly. A microscopic examination of tissue from a lesion can confirm the diagnosis. Antifungal medications, which are generally taken for 10 to 14 days, are often prescribed to treat thrush. These medicines are available in tablets, lozenges, or liquids. The treatment approach is designed for you based on your age and the cause of the infection. Because the presence of candida infection can be a symptom of other medical problems, i suggest that you seek care from a local medical doctor as well, so that any underlying health problems you may have can be treated ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my husband is 50yrs old and his job is physical, he is not overweight, but yesterday afternoon, the palm of his hands and the soles of his feet are burning, today there are some medium sized red spots on his feet. Should he go to the doctors or could this be an allergic reaction? Thank youRhonda ### REPLY: Hello, Welcome to , As he is having burning sensation in the feet and the palm, it may be several reasons. As his occupation is physical and strenuous if he is using any glove or gum boots that may be reason, The symptoms are may be due to physical or chemical irritants. By knowing the occupation and environment of the work we can suspect but with this medical history it is just an eczema which will subside by itself. If the symptoms are worsening and rashes spreading to other parts of the body then you have to consult your doctor. 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, Couple of months ago, a dentist did a filling for me. It was some kind of small tube, after filling it looks exactly like a part of tooth , same color. Now I moved to Italy, and here the temperature is too cold right now. I have this bad tooth / jaw ache. what could be the reason ? Temperature ? Also, I never had tooth ache until the day I started using Sensodyne tooth paste! a serious mistake! My private insurance doesnt cover dental problems. Are there any home remedies apart from warm water + salt ? Some thing that can help me for a few months. ### REPLY: Hello and welcome to , toothache indicates bacterial decay or infection in the tooth that involves the exposed tooth nerve tissues.  Such infected tooth needs to be treated by a root canal procedure, so please consider getting the treatment done by consulting a dentist.  You may need an X RAY examination done for your teeth to confirm the spread of infection and the surrounding structures involved.  I would suggest you to start with antibiotic Augmenting 625 mg along with analgesics like diclofenac two times daily for 3 to 5 days.  Medications will help in subsiding the symptoms. I hope this helps, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i am 23yr old female, wt 55kg, last yr i got married, after my marriage i took an mtp cipla kit, and then after 3 months an ipill and then again after 3 months another ipill.. After taking mtp kit, i started loosing hair and acne on my face, but now the problem is that i am loosing weight, the last ipill that i took was 4 months back,, can it be any side effect of these pills.?? ### REPLY: Hallow Dear, I believe, you had taken MPT kit for performing medical termination of pregnancy. Then twice after that you have taken I-pill pills at the interval of three months. I hope you took these pills within 72 hours after the unprotected sex each time as emergency contraceptive measures. These pills or MTP kit are not responsible for your weight loss and loss of hair; that to 4 months after the last pill had been consumed. Please get your general health check up done; in particular get your X-ray chest done for any evidence of tuberculosis and also get complete blood examination done. These symptoms are usually seen in general debilitating diseases like tuberculosis, anemia and also in protein deficiency. Please increase the amount of proteins in your diet, consume good amount of green leafy vegetables and fresh fruits. Please do not ignore the weight loss. Report to your Physician ASAP> ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dr. Sir, I am working in steel plant as an Engineer,the place is very dusty, last 2 to 3 month I am suffering from cold & cough, today I have checkup from one Medical Physician he is diagnosis Eosinophils, the % of Eosinophils is 12%, let mw know the diease is curable or not ### REPLY: Hi, Thanks for asking. Based on your clinical history and query, my opinion is as follows:1. Eosinophil is marginally raised. Normal levels are 1-6 %.2. Due to allergic condition in previous days, and associated cold and cough, it would have increased.3. Avoid allergen and once your cold and cough are under control, the eosinophil levels will come back to normal levels within a month. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: for last 1 week i have been experiencing pain in most of the joints like ankle knee hip and wrist. I have never before had anything like it except for a stiff lower back which still persists.the pain remains even while sleeping.it is difficult to take the first step in the morning. ### REPLY: Dear Sir/Madam have gone through your query and read your symptoms. In my opinion, you are having multiple joint pains, with early morning stiffness, and these are signs of early arthritis of inflammatory nature, It must for you to get yourself investigated for this, and the primary screening is done with a battery of tests, including CBC, ESR,CRP, RF.one other possibility is post viral arthralgia, which becomes a possibility if you have had an episode of fever in the recent past. In both these conditions, a short course of steroids to reduce inflammation is helpful but has to be taken under guidance of your doctor. I hope that answers your query. If you want any more clarification, contact me back. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have RUQ pain, i have been on a no fat diet for months, I have had an US, CT Hida scan and will be having a scope done soon, they think it is my galbladder, but sometimes without eating fatty foods if Im stressed i have an attack, and these attacks put me to my knees. I had my son naturally and I would rather go through child birth again then continue with these attacks, that s how painful they are. Is there anything else this could be. ### REPLY: Hi, right upper quadrant pain if it is colicky and radiating to back probably you are having some issues with gall bladder, and few more things I want to know like are you having jaundice, fever, nausea or vomiting, if yes it more likely gall bladder problem like cholelithiasis or choledocholithiasis. Better get an ultrasound abdomen which will give basic information regarding the disease per se with that complete blood count and liver function test. Till then, you can consider taking some analgesics which will help you in relieving the symptoms. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I started taking Microgynon about 6 weeks ago. We had sex after only 3/4 days and now Im worried could i be pregnant? I took a 7 day gap between packs and did bleed. I keep burping all the time which is not likeme at all and have very sore breasts. Thanks. ### REPLY: Hello, and I hope I can help you today.First, if you've been taking your birth control pills every day, and you did have a menstrual period during the seven-day break, there is no reason to suspect that your pill is not effective in preventing pregnancy. Birth control pills can have very similar side effects to the symptoms of pregnancy in the first three months of use. These include bloating, breast tenderness, nausea, mood changes, and spotting when you're not supposed to have your period.  Most women see the side effects decrease after their body gets used to the pill which takes about three months. So in your case, as long as you're taking your pills every day according to the package directions and do not have more than seven days in between packs, your chance of pregnancy is less than 1%. The most common sign of pregnancy is missing your period. So if for any reason you do not bleed during the pill free week, especially if you do not miss any pills during the month or deviate from your schedule, that would be a time when I recommend performing a pregnancy test. I hope I was able to adequately answer your question today, and that this information was helpful. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: DEAR DOCTOR, FOLLOWING DISCOMFORT AND CHEST PAIN WHILE PLAYING A CRICKET MATCH, I WAS ADMITTED IN HOSPITAL. EVENTUALLY A 4.5 X 20 MM LIBERTE STENT WAS DEPLOYED ON 18/12/2010. HAVE BEEN TAKING TAB CARVEDELOL 20 MG,CLOPIDOGREL 75 MG,CARVEDELOL 12.5 MG,REMIPRIL 5 MG. ALTHOUGH ALL REPORTS ARE NORMAL , I GET TIRED VERY FAST, I GET SEVERE PAIN WHILE CLIMBING STAIRS. RECENTLY I STARTED GETTING NUMBNESS IN MY FEET AND TWO HANDS. NOW I M IN INDIA AND MY DR IS IN THAILAND. HOW DO I DO SIR ? I AM VERY WORRIED. PL ADVICE ! THANKING YOU ! SHEKHAR A.MULYE ### REPLY: Hello, You do not need to be worried about this. India is a good country for health services, and we can handle all type of situations.  I would recommend you to meet a cardiologist and get your ECG and 2d echo done. It will tell us If your heart is normal or something is not right.  You might need an angiography also. Tingling and numbness can be either due to nerve pathology or brain issue. So I would suggest you to meet a neurologist also. You might need a ct scan.  I hope this answer will be useful for you. Let me know if there is any other followup questions. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi I am seven month pregnant. From start of 7th month I had loose stools and had constipation last week for just 2 days. But on 2nd day it caused bleeding. Went to my doctor and she recommended to tale 15ml Gut clear to cure constipation. I took this and was immediately relieved next day. icontinued this one more day and now have loose stools. What can I do to cure both? ### REPLY: HI, I understand your concern.  You seem to have either digestive problem/ infection of bowels which give you such symptoms of alternate loose motions & constipation.  A thorough history, physical examination & stool examination (if advised) would pinpoint the cause of problem followed by treatment which may contain antibiotics/ anti America/ digestive enzymes as per need.  - Small & frequent servings help digestion in pregnancy.  - Regular yoga exercises & walking help good appetite/digestion of food - Constipation without any infection of bowels indicates less intake of fibers in diet/ less water intake. (it should be at least 10-12 glasses / day) 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: helo doctor iam sowdamini unmarried ,resently my blood was tested that gives positive result for hbsag is there any danger to present and future i mean for marrage? my father is worried very much about me please give me the clear details and suggestions.thank you ### REPLY: Hello, Im afraid this single piece of information is not enough for a complete answer, but I'll do my best to give you the most clear picture I can. HbsAg is the surface antigen of hepatitis B virus. This if found in the blood after the body gets infected with hepatitis B (acute hepatitis). If it is detected for more than 6 months after infection then this is called chronic hepatitis. Chronic hepatitis could be active or inactive (carrier). The active state is the most dangerous one both for you and for the others. Transmission can occur during the carrier state as well. 1 out of 4 carriers develop active chronic hepatitis. If you do not have an active disease then you cannot do much about it (treatment is not indicated). Your girlfriend/spouse can protect herself by immunization, unless she's already infected too. If you need further clarifications on your condition, please ask again, including more information from geologic testing. I hope I've ad .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pain in rhumboid muscle, cracking left shoulder, occasional pain around collar bone and swollen muscle near left collarbone.  Soreness has been there for about 4 months.  I am thinking I might have right hip out of place because right abdomen is protruding just below rib cage.  Also, excess abdominal gas.  Could it be hip related? ### REPLY: Hi. Thanks for your query and an elucidated history. The symptoms complex of pain in Rhomboid, left should crackle, pain and swelling around collar bone and now bloating of upper with abdomen with hip problem is suggestive of some serious problem like the can be a cancer problem with secondaries in the place you have talked about. I would advise you the following:CT scan or a PET scan of the affected parts. Blood: Alkaline phosphatase, Liver function tests and others.FNAC of the suspected area. These investigations will lead to a diagnosis and give a plan for further treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a fibroid(s) which do not cause any problems with my menstrual cycle , however I have noticed recently that in the morning when I am laying down, before I empty my bladder , I have a large cone shaped raised lump below my navel. I have also noticed two bruises one near my hip which has a small lump. The other on the other side lower down in the groin. I have been feeling sick recently whicChatDoctores and goes. Do you think this is caused by the fibroid (s). Jo ### REPLY: Hello welcome to  .madam you did not mention your age and the size of fibroid at the time of diagnosis.even without the fibroid in your uterus,you will feel a lump in the lower abdomen with full bladder...but it does not assume conical shape.other common swellings in the lower abdomen are ovarian masses etc.,.do an ultrasound lower abdomen and pelvis to diagnose what that lump is.swelling near the groin is most probably hernia.fibroid is visible as lump when it grows to a very large size.consult gynecologist for further suggestions and diagnosis...thank you .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am getting excruciating pains in my lower back when I lie down especially if I have been standing for a long time. I don t know what I have been doing to cause this or what I should do about it. The pain will subside after lying down for a while but the first 20 minutes is pure agony. Suggestions on what it may be or how to help it? ### REPLY: Hello and Welcome to , Thanks for writing to us. Low backache looks like a positional anomaly. The low backache is a result of muscle spasm which in itself is a protective mechanism body develops so that the back avoids abnormal posture. For pain to go, it takes not only rest (on a comfortable bed) but also avoidance of particular positions (during work, rest or recreation). Avoid sleeping on sides and stomach in case you do. While on work don't sit in one position for more than an hour and take frequent stretch breaks. Do not bend forward to lift things up, bend the knees and hips for that. Also discontinue any strenuous activity or exercises for some time Hope this helps you. Wishing you good health... Regards.  . Orthopedic Surgeon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: is there advancement in endoscopy treatment after 2004? i my family my grandfather had food pipe cancer n went for endoscopy and we lost him after 2-3 days of the test. is this suitable for patient of 80+ age group?? now my grandmother has this cancer... so please suggest wat should be done?? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Treatment of esophageal cancer depends on type and stage of cancer. In early stage surgery is possible. In late stage surgery is not possible. Chemotherapy and radiotherapy is the treatment. At age of 80 surgery is risky. So cardiac function and other parameters should be checked first. Please send me details of her reports so that I can help you further. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doc, My child having small red dots on his leg since 20 days n he itches a red spot appears we went to doc he recommend zithrox 200 n cz3 syrup what happens to him say..... N he is having fever since 2 days...n his fever appears again after few hours.... Thankyou ### REPLY: Hi... Thank you for consulting in . It could be any viral erythematous illness. But as you quote them as itchy blisters - the possibility is trivial viral exanthem. I suggest you use calamine lotion as its giving results along with oral antiallergic like HY .  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My brother had a small rash of dark patch on this leg . It has spread to his entire lower leg. He got medical treatment but didnot work. He also has kidney stones at the same time the rash appeared on his leg . He is twenty five years. Is there some skin disorder that is causing this. The rash spread in a month . ### REPLY: Hello, Thank you for posting on . I can understand your concern regarding the skin lesions your brother is having. It seems he must have got some fungal skin infection (Tina) but It's difficult to point specific diagnosis in absence of clinical examination. Therefore, I insist you to post good clinical pictures to me so that I can help you in a better way. You can mail pictures to attachments@ChatDoctor.com with subject titled ATTN . 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 had high blood pressure for awhile, but have lost 60 pounds and no longer need to take meds for that.... but now I seem to have a low pulse rate..resting rate is 36...active rate is in the 60s..sometimes I have chest pains and I can feel my heart beating hard...but still a low pulse. Thanks ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of heart block is more. Heart block means there is interruption in impulse conduction in the heart. Resting heart rate of 36 and low blood pressure are mores suggestive of heart block. So better to consult cardiologist and get done 1. ECG.2. 2d echo 3. Stress test 4. Holder monitoring (24 hours continuous recording of ECG). You may need pacemaker insertion to increase your heart rate. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Jump Squats, stair climbers, and just about anything that forces me to get up and down quickly makes me out of breath, light headed and gives me an asthma attack.  Ive always had physically induced asthma and take Singulair.  Any idea why these movements are so problematic for me? ### REPLY: Hi, Dear,Thanks for your query to . Dear I read facts of your query and reviewed it in context to your health issues submitted in your query. I understood your health concerns and feel Concerned about them. Based on the facts of your query the reply of your query is-Your current health issues seem to be due to -EIB-exercise induced Bronchoconstriction, which leads to breathlessness soon after the exercises. With exercise the air friction and speed-increases inflammatory reaction besides the increase in cold air causing destabilization of the bronchial mucosal function of humidifying the cold air for proper percussion of gases. This friction and inflammatory response increases some chemicals which activate mast and eosinophils. And overactivity of these cells, leads to leukotriens excess, which gets controlled by anti-leucotrien antagonist . Hence, these advanced medicines are needed in some individuals whose broho-mucosal response is fragile to cold and high speed air with exercise. This is therefore more alarming condition and situation needs to be dealt by urgent Consultation with Chest and allergy Physician.Therefore, Cause of these complaints -as GI infections and sinus infections or lung infections like TB, making them more fragile to the exercise with asthmatic response needs to be ruled out. Other causes-like Chronic infections like TB, autoimmune diseases accompanied by GI and other infections and others, need to be verified, as discussed above. For this you need to consult Chest and allergy Physician.Thus, it's the immuno-chemical response to the high speed cold air destabilizing the air-perfusion functional balance, which increases certain chemicals which increase the mast and eosinophil response, which leads to breathlessness in your case after the exercise.Thus, You should consult Chest and Allergy Physician. This would resolve the complaints of yours. Constant follow-up with local family or specialist Chest and allergy Physician for long term would give you long remissions of sucChatDoctorplaints in time to come, which would depend on meticulous follow-up treatment of your health concerns. Just don't worry and be patient and co-operate with your doctors, till you verify with your attending doctors. For early recovery-please follow above dos which would resolve your complex health issues. Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard to following link-http://doctor. .com/Funnel?page=askDoctorDirectly&docId=70229Wishing Good Healthy Life!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Doctors, I am having more frequent urination from yesterday, almost once in an hour a must. I fee no pain, no color of urine. I feel hungry after meal very early as compared to before. I have a lumbar lordosis and a fatty belly. What could be cause of this is that I started exercise for belly fats and lordosis. My age is 24. Here you can see what exercise I started. http://www.youtube.com/watch?v=Cypm7NibSEk&list=PLRIGfw8q_5gByeJ0c8oAWeMXwpyG6SnQl Also I feel like I loose fats or feeling belly very light weight in my lower portion of belly. ### REPLY: Hi. Thanks for your query. Get your blood sugar checked, let us confirm you are not diabetic. The reason for frequency can be due to urinary tract infection or can be due to diabetes - the reason being there is more sugar in the urine which . Hunger after food again is an indication of diabetes. Once the diagnosis is done, treatment is easy and with proper treatment the symptoms will be abated. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 64 y/o female. last week i had 1 or 2 days where if i looked at the thermostat on the wall. it was moving sideways and vertically. didnt happen with any other stationary objects on the wall, like outlets etc. symptoms left. was this a visual disturbance or a hallucination. im not psycotic. did have a mild tbi several years ago,, which did affect my vision. meds are adderal 30 mg daily, xanax 1 mg prn for insomnia and paxil 40 mg daily.and synthroid .5 daily. b/p is borderline high. i do smoke and enjoy a glass or two of red wine while watching tv. and l. mastectomy 6 years ago.i mfeel fine now. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Such hallucinations do occur in everybody's life. They are just hallucinations and nothing real at all. You can ask anyone. This happens when we are worried, when our eyes are watery, when we are in deep thinking, anxious, suddenly move head and come back to previous position etc. There is nothing to understand about it. Just forget the incident and that is it. For such hallucinations you need not be a psychotic of neurotic. 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, i m nidhi. my baby is 9 month old. from morning i think she is suffering from stomach pain as she was doing like pressuring. and when she goes for potty she pressure a lot from mouth. she does nt hd constipation. and she vomit also when i gave her milk & biscuit. plz help. wt should i do. ### REPLY: Hi....by what you quote I feel that your kid is having a starting stage of viral diarrhea.  Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My lab show bilirubin of 1.1 and my lab rates that as high, can some meds cause this to occur my cholesterol is total 157 HDL 62 and they rated that high as well and LDL is 76 with trigly at 93. I did back in the late 60 s have the hepatitis. What could be a reason for elevated bilirubin I am 71 yo I had a dinner party the night before test and I always stress out, I am obsessive about all going well. NO THANKS, I THOUGHT IT WAS A FREE SERVICE.... ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your bilirubin is slightly high.  If you have any symptoms then you should go for complete liver function test.  Otherwise, just monitor your bilirubin level. Your HDL cholesterol is high.  It is a very good sign.  It is protective against cardiovascular disease.  So no need to worry about high HDL cholesterol. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a hard lump under my testicles that appeared two weeks ago. I went to doctor for my sore throat. Turns out I had strep. I took my antibiotics and have been off them for a week. Why is there still a lump? Doctor thought it was probably my lymphnodes. It looks to be red now and a little softer. Its not too painful. Just uncomfortable. What child it be? How can I get rid of it? ### REPLY: Hi, Lumps and swellings in the testicles are a relatively common symptom in boys and men and can have a number of different causes. The vast majority of testicular lumps and swellings are caused by benign (non-cancerous) conditions that may not need treatment.  Some main causes are: varicocele, HY .  Some more serious issues such as tumors and carcinomas are less common but should be considered if there is pain and rapid growth of it.  In every case, it would be good to do an ultrasound of testicles by a urologist and this will show us what type of issue this is.  If this is benign then there is no need for urgent treatment unless there is pain and inflammation. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, doctor my baby was 6 months completed she is having fever from 3 days , now fever gone but she having lots of weekness. She cant play or nothing to eat so please suggested me any homemade mediicne or any supplyment for her....thanksAge : 6 months 6 daysWeight : 8.5 kg ### REPLY: Hai, For a 6 month 6 days baby weight is normal. And after a fever episode normally child will not have immediate activeness. Baby will regain the activeness within 2 to 3 day sand she takes normal amount of milk per day. As your baby feeding will be Breast milk or any formula milk (main food intake).as your baby is more than 6 months you can start in a (small amount) of vegetable soup, fruit juice, some messed potato, boiled apple and double boiled rice in a semi-solid nature. If the activeness (weakness) didn't get back after 4t o 5 days consult the near child specialist. Hope I answered your query 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: My 70 yr old husband had diarrhea with 104.7 temp, lack of appetite, very dehydrated but no abd pain. CT showed collapsed gallbladder . He was on cipro for (chronic) ear infection 1 day when this began. Stool culture showed no c diff or salmonella but a blood culture was positive for gram + rods after 3 days. He is now on flagyll, lomotil, and sulpha antibiotic for ear infection. A gallbladder test is scheduled in 2 days. He continues to have fatigue and low grade fever on day 7. Blood culture repeated yesterday. Is this related to the gallbladder? Are we moving too slowly? ### REPLY: Hi welcome to  forum. Dear miss, Positive blood culture is a serious finding. And first thing to do is broad spectra antibiotic treatment, intravenous if possible. Second thing to do is to find the source of infection, it can be intra-abdominal but also urinary or lung infections too. So you should focus on these 3. When the source is found and the right cause identified then more accurate antibiotic can be used.  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 nicole, I had unprotected sex, I took postinor2 and a week later I bled for 11days bsefore it stopped in november, ihave also seen my period this december for 3days and now I feel funny about to puke like I am pregnant, could I really be pregnant??? ### REPLY: Hi, Thanks for sharing your health concern with us. Emergency contraceptive pill contains high doses of progesterone and this is the reason for the with .  If you took the pill within the stipulated time you are well protected. Moreover, since you experienced a natural period you need not worry about pregnancy. Your symptoms are not specific for pregnancy; you could be experiencing gastrointestinal symptoms also. Please remember to restrict the use of emergency contraceptive pill for one or two occasions per year to avoid hormone imbalances. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 20 year old , only history is high cholesterol , dermiod cyst, removed at age 16 months. I have a lump size of 2 inch on right side of neck, at my colar area. red with a pulse in it, at time, the same side of my neck, is tender to touch, lump is hard in areas. ### REPLY: Hi! Thanks for writing to us ! If I were your doctor and had you presented to me with this problem of the hard and tender red lump with pulses on the side of your neck , I would like to consider following possibilities, as per my experience of ultrasound, CT scan and needle biopsies:1. Abscess2. Infected lymph node could be tuberculosis3. Infected benign cysts like sebaceous cyst, bronchial cyst, hypoglossal cyst4. Hemangioma or infected lymphatic cystTherefore, redness and pulsation means infection, and you might need urgent antibiotic therapy; please see a surgeon today for a direct examination and proper line of management... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 10 month old daughter was having fever and phelgm formation for last few days. We got her checked up by a pedoatrician, who prescribed meds for the same. The fever has almost dispappeared by yesterday, but cold/phlegm is still there. Today morning, we noticed tiny rashes all over her body, except the face. They look like the ones coming out of some allergic reactions. We are waiting till after noon to see if it gets worse, before running to hospital and loading the lil one with more meds. Please advice what this could be the result of. ### REPLY: Hi...by what you quote I feel it could be a viral illness with cough and cold. Am I telling this because bacterial infections will not come down like that in matter of few days, though you have used antibiotics. Even some antibiotics have the tendency to cause this type of rash and I suggest you take the kid to the pediatrician who has prescribed the antibiotic. Meanwhile, the allergic rash you can give some over the counter anti-allergics. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 yr old had a 103.6 temp @ 7pm last night that spiked again at 4:30 am. Has not had a temp since (alternated ibuprophen & acetaminiphen evry 2 hrs). No cold symptoms- no runny nose or cough, complains of a very sore throat- pain w/ swallowing to the pioint of crying. Went to urgent care, they took a throat culture = no strep and no ear infection. My child now is in cold sweats and severe throat pain. What should I do to ease her besides more motrin? ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I went to the ER per my doctors orders, I am having right flank pain(history of stones) and severe mid abdominal pain. Ive thrown up multiple times I a week for no reason, theres no pain when I get sick. They did tests and everything was fine, but the pain is still there. And I had 2 seizures and passed out. I cant control my pain at home. I cant even describe the belly pain, I woke up one morning on my belly and when I turned over the pain went to my stomach. Ive tried everything. Theyve done gallbladder tests and are negative as well. I just left 3 hours ago and the pain is worse. Also I told them that Ive been having right chest pain. And it came back an hour ago even more intense. I asked if I could be admitted bc I cant control my pain and I havent eaten in 4 days, also I can barely urinate, I have done it only 2 times today. What should I do? Page my family doc and can she have me admitted until I can see her? The pain is unbrarable. And Ive had 20+ stones, a neph tube and a broken femur and that pain is cake compared to this. ### REPLY: DEAR SIR/Adams-Onís IN THE RENAL PELVIS OR CALCULI MAY PRESENT WITH THE FOLLOWING COMPLAINTS, BUT AS YOU ARE TELLING THERE WERE MULTIPLE STONES. MY NEXT QUESTIONS TO YOU ARE VERY OBVIOUS1. DO YOU Get ANY HY ?  DO YOU Get ANY STONES LODGED IN URETER3? HOW IS YOUR KIDNEY FUNCTIONING??THESE ARE OBVIOUS QUESTIONS WHICH ARE NEEDED TO BE ANSWERED.STONES IN THE KIDNEY AND GALL BLADDER PRESENT WITH THE FOLLOWING COMPLAINTS AS YOU HAVE MENTIONED??HAVE YOU UNDERWENT ANY INVESTIGATIONS LIKE1. U S G ABDOMEN AND PELVIS2. X RAY OF KIDNEY URETER AND BLADDER3. SERUM CREATININE LEVEL SIN THESE TYPE OF PAIN TAKING TABLET. DICYCLOMINE RELIEVES THE PAIN FOR SOME TIME BUT AGAIN IT REAPPEARS. YOU NEED TO TAKE SOME PROTON PUMP INHIBITORS LIKE PANTOPRAZOLE CAPSULE BEFORE FOOD  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...  hi my name is emmaly and I was wondering about my niece and that she has a runny nose sinus congestion green snot and a cough and I dont know what to do. She is so congested that it sounds like she is having trouble breathing. Could u help cause from the look of it, its looks like a sinus infection and allergies togther ### REPLY: Hi, I understand your query. Sinus infection is due to blockage of sinus outlet by allergic inflammation/ thick mucus plug... collected secretions in sinuses get infected to form sinusitis.  The origin of all the symptoms being similar (allergy,-congestion- infection)& there being anatomical connection between Throat-nose- sinus, common cold, sinusitis, throat & lung involvements tend to follow each other/ seen all together.  The breathing trouble can be due to congestion & blocked nostrils Or allergic bronchitis A sufficient course of suitable antibiotic/ anti-inflammatory & anti-allergic .  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 son is 16 years old and weights 70.5kg. He has been having mild to severe pain in his lower abdomen (shifting from left to right) and lower back pain since early December.  He has done an ultrasoud, ct scan, urine test, several blood tests and several xrays.  At one point they said he had sacreolitis and after 2 1/2 weeks of taking indomethecian they said he in fact did not have this disease after all and told us to stop taking the medication and have still left him undiagnosed.  Today he is once again in severe pain on his right lower abodomen and lower back, he has taken advil all yesterday and still today with no relief any suggestions?? ### REPLY: Hi. Thanks for your query and an elucidated history. If the area of pain is constant in position I would advise you to request for an MRI of the whole spine, details of the thoracic region as this can get us the reason. This is not uncommon but rarely diagnosed. He has already undergone all the other tests. Also consider the IBS- irritable bowel syn . Colonoscopy. Color Doppler of abdomen to see for the blood vessels, any obstructions or so. The diagnosis is always to be sought after as then only a proper treatment is possible. A trial with Gabapentin, antidepressant may help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is sobha i got ectopic pregancy 5 month back and dr told me folic acid tab 5 month now i have thyroid on borderline dr told me to take thyroid tab and again try for 3 months after that they will do hsg ihave only my right tube can i have to chance to conceive again 1 st i conceive naturally after 8 yrs of my marriage im 30 now ### REPLY: Hello, and I hope I can help you today. Unfortunately, having had a history of ectopic pregnancy is a risk factor for infertility as well as damage to the other remaining tube. However, thyroid disease can also affect ovulation and regular cycling of your period, so the treatment with the thyroid medication may help your chance of conceiving. However, I agree with your doctors' recommendation to check an HSG to determine if your one remaining fallopian tube is blocked.  If you find out that your right tube is open, you certainly could conceive on your own.  Many women with only one tube and ovary are able to get pregnant successfully. If it turns out that your right tube is blocked also, pregnancy can be achieved with in vitro fertilization which can be performed by a fertility specialist. So in summary-the results of the HSG test will be able to tell you definitely if you are able to conceive again.  I hope I was able to adequately answer your question today and that this information was helpful. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, for the past week i have been experiencing back lower pain, mad tiredness , stomach aches, frequently use of toilet (urine) neck pains which only least for 20 seconds but are very sharp also thirstiness i have to drink every 5 minutes. could you please help me ? ### REPLY: Hello I have studied your case. There is possibility of urinary track infection. You may need to investigate in form of complete blood count, ESR, CRP, urine culture. You may need clinical examination also to confirm diagnosis. Till time, you can start medication and antibiotic consulting your treating doctor. Ultrasonography will help to rule out abdominal infection. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have had a urine infection started off with bad flank pain.. I am 20 weeks pregnant. I have finsihed course of antibiotics. However still not feeling right I have done a dip test yesterday it showed +++125 today says +70 lecokycyes.. no other traces everything else normal not sure if I should go to drs  or see how things go ### REPLY: Hi, UTI (Urinary tract infection) is very common among pregnant women. One course of antibiotics is not always enough to treat it. So, you should repeat another course, but this time run urine culture and sensitivity testing to determine the right antibiotic. Furthermore, try to take cranberry supplement to make the urine more acidic and reduce chances for UTI. Get back to your doctor to get another prescription of antibiotics. 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: hello, I have 3 small skin colored bumps on the shaft of my penis below the wrinked skin underneath the head of the penis. They are not itchy or painful, it s been 3 years since my last sexual encounter which was with protection, just noticed them this week. I saw my doctor, a year ago when i had one, which went away. My doctor told me it was normal and not to worry, but now it s returned and i have 3 of them so i m wondering if he was wrong and it is something i should be worried about. ### REPLY: HelloThanksfor query. Based on what you have stated I would say that you have small Sebaceous Cysts in the foreskin.However, it needs to be confirmed by a clinical examination by a qualified Surgeon, The genital skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. If needed is they are big enough may need to get excised in Toto (Completely along with the sac) .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I need a CBC but I have Cold Aggulutinin . How shouuld the lab handle my CBS when they draw blood... The dont know anything about Cold agglutins and nither do I.... But my Doctor ordered a CBC and the lab said the Blood clotted. what do they need to know? ### REPLY: Hello and welcome to , Cold agglutinin disease will not interfere witChatDoctorplete blood counts. Proper collection of blood will prevent clotting of blood. Thus, blood should be collected in anti-coagulant as soon as it is . Cold agglutinin disease can lead to agglutination of red blood cells, but it will not affect the white blood cell count or the platelet counts. 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: I went to a dentist and he says I have peridontal disease and must be on Periostat for @ least 9 months. I have talked to nurses, RNS and they save they have never heard of being on antibiotics for that long. The nurses have told me it could cause heart infection break down my immune system and several other  things I didnt understand. I am deathly scared of dentist and that is why I waited so long to go. ### REPLY: Hello, Thanks for writing to us. Cause of occurrence of periodontal infection has to be evaluated and treatment has to be planned based on that. Get a thorough scaling done. If there is bone loss, osseous respective surgery has to be done. Antibiotics can only just relieve the underlying infection by acting on microorganisms. I would suggest you to visit a periodontist for further reference. Take care. ### END