Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir, i am 26 year old..i am having Dark circle around my eye...i became noticable from last 3-4 years...i have used all cosmetics available in market but no improvement...i took medical advice where i was told to have periorbital melanosis and i was adviced to use Depiwhite but again there is no improvement...plz advice me ...thanx ### REPLY: Hi, Thanks for writing in.  Periorbital Melanesia can be due to anemia, stress, a lot of computer/laptop usage. Effective oral and topical medications are now available for Hyperpigmentation around eye.  My advice to you would be to use topical Guyana cream with good moisturizer. Take vitamin C tablets daily.  Few treatments like microdermabrasion and chemical peel can help to treat periorbital Melanesia effectively.  Discuss these options with your dermatologist.  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: Respected Doctor, My ECG result showed P 47 degree, Incomplete Right Bundle Branch Block QRS (T) Contour abnormality consistent with Inferior infarct Probably Old, dated 23-02-2013. I am Suffering From Transverse myelitis since1989 with sensory loss, low back pain , weakness left lower limb etc. In 2010, again diagnosed as old case of transverse myelitis / now with sequel. I was treated with dose of Methylprednisolone(Iv) and later orally for 20 days.(40mg,20 mg.10mg & 5mg, reducing ). 21-11-2010. MRI Multiplanner T1W,T2W,STIR Sequences done. Scan done on 1.5 T scanner. 13-11-10 report suggests:- Compression myelopathy( Extramedullary at D10 level. Degenerative changes:- Mild spondylosis appreciated in form of anterior and posterior osteophytes at multiple levels in dorsal spine. Fatty haemangioma at D12 level. Disk osteophyte complex indents the anteriorepidural fat at D2-D3level also. D8-D9 Dick level: Diffuse disk bulge with left sided posterior para central disk protrusion is appreciated with mass effect on the left sided exiting nerve roots at this level. central canal space per se is maintained. D10-D11: Diffuse disk bulge with focal central posterior broad based disk protrusion with associated stretch of the PLL is appreciated at this disk level. There is indentation of the anterior epidural fat with central canal space being reduced to anteroposterior of 10mm in the sagittal scan at this level. No cord edema/ malacia appreciated in scanned cord the dorsal spine. Besides the mentioned findings the following areas were also examined and found to be normal elsewhere-----. dorsal spine curvature maintained, interverteberal disk space maintained,vertebral bodies and posterior elements are normal, cord is with normal MR signal morpholgy, preverteberal,paraspine tissues normal, anterior and posterior longitudinal ligaments are normal, facet jointsare normal, epidural/ thecal/ formalin spaces are maintained in all dorsal vertebral levels, the AP sagittal diameters of the canal space at disk levels are within normal limits. L2-3 andL3-4 discs show mild bilateral posterolateral disc protrusion indenting the thecal sac and mild compromising both the lateral recesses Pain killers avoiding, only during acute pain,using muscles relaxant ointments massage, one multivitamins pill a day.(BECASULES / REVITAL capsules, On 05-03-2013:- CBC Investigations in normal range. urine R/E, C/S :- physical / Chemical,Microscopic examinations as all with in normal range. Latest report of Ultra sound for whole abdomen:- normal. On 05-03-2013:- MAg 160/100, Treatment- DEPIN / PROLOMET AM 50. Now mAg varies from 85 -95 / 130 - 150. shoots during reacting to others. My height is 173cms & gained weight after the treatment,resulting 95 kg. Presently Feeling acute back pain,Neuropathic Pain & symptoms related to T.M, specially in the morning, Hypersensitive,Spasticity,Depression,Fatigue,Problem after climbing stair cases, pain increases in lower back & results in sweating & mild deep breathing for few minutes then feel better,other than 24x7x365 pain in back, traveling in right leg,numbness,tickling,burning sensation etc. At present no odd feeling in chest, no heavy breathing or shoulder pain,other than pricking sensation feeling in center of left palm during Hypertension , due to uncontrollable situation created by others at work or family. I may be over reacting, though I try to avoid confrontations but some times it becomes intolerable. After relaxation or taking B.P Pill it vanishes. Positive Points:- Walking without support, on average office work sitting:- 6-7 Hrs a day , Driving,Traveling, but can t exert much or exercise as T.M aggravates, no satisfactory sexual relationship because of erectile dysfunction. Previously Sildenafil Citrate was effective to some extent, now even 100mg not helping. Food :- 95% Vegetarian intake,Low fat, green vegetables,fruits,wheat, rice,cereals,olive oil,milk,curd,nuts,juices, avoiding junk & oily food. Non Veg. only eggs & poultry, Red meat hardly twice a year, lots of water / liquids, Low sugar. Drinks:- Average;- Maximum 2-3 bottles of 650 ml whiskey in a month, with absent days in between.(Drink soothes acute pain & mood swings better at that hour). Cigarettes:- Average 4-5 a day. Age factor is also effecting my life, will power & grace of God, I have come out from total paraplegic condition in 1989. I feel better, but not normal any time in the past 24 years,please help. What does this means and what are the possible treatments. What do I need to do to improve quality of life. Thanks R.Kakkar ### REPLY: Thanks for the details. Since you have many issues (old and newer ones) there should be proper monitoring under experts. I would suggest you make a diary and note your symptoms for spine and related disease in separate chronological order and group your other cardiac or related events in a separate sequence and make a third group of additional symptoms in chronological order. Likewise, treatment taken in past and present symptoms' treatment separately. This will give a clearer view of what needs priority attention and supportive treatment for acute and chronic problems. A check-up with spine specialist to sort your disc related problem, if your physical conditions allow objectively, then some surgical treatment for spine may be indicated. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a bad fall yesterday in the bathroom he hit d floor with his lower back in a sitting like position and a bit supine like position. he went to look for a doctor and had an xray. he had a history of slip disc. he was complaining yesterday bout his lower back aching. i want to ask, is it possible that xrays could not detect slip disc and fracture of d bones when indeed he had a bad fall? pls reply. thank you very much. ### REPLY: Hi, Welcome to . After going through your query I think your husband is suffering from muscular pain due to injury. Treatment of it is rest and analgesics (diclofenac three times a day after meals). It may take a week time to relief.  It is possible that x-rays could not detect slip disc and minor fracture of the bones.Indeed, slip disc is not seen in x-rays. However, you can get his MRI done to detect these. I think your query answered. Welcome to any follow-up query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 got my tooth removed on Saturday and my blood clot where I got my tooth removed turn white,grey and alittle brown after two days after I got my tooth removed . Is it bad that it is white and grey and brown ? And how does the whole healing process work this is my first time getting my tooth removed? ### REPLY: Thanks for your query, I have gone through your query. The healing process following extraction starts from the time soon after extraction. Following extraction, the blood will get clot in the socket, then it becomes hard to form a callus in weeks, later it calcifies to become a soft bone. This is how the socket heals. It takes around 15 days for the socket to close completely. The gray and brown color of the clot formed at the site of extraction is normal. Nothing to be panic. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband had a quadruple bypass 5 months ago and has done well. However over the last month he seems to have problems with his stomach and feels likes his chest caves in . Especially when walking. What is cause. He has been to the hospital and stress tests and the results and ECC are ok. ### REPLY: Thanks for your question on . In my opinion he is having HERD (Castro Esophageal Reflux Disease). It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Any thoracic surgery can damage the sphincter and makes it more lax. So better to follow this treatment for better symptomatic control in HERD.1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and anxiety. 4. Start proton pump inhibitor. 5. Keep 2 - 3 pillows under head in the bed. 6. Go for walk after meals. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 heart rate keeps racing. It comes on all off a sudden and it about 148bpm and my normal resting heart rate is 70 after this happens my head starts to ache and with the help off a blue inhalor which isnt mine i can bring the heart rate down. Am i in danger? ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would recommend you to perform a cardiac check-up to rule out any structural or rhythm disorders. A resting ECG, cardiac ultrasound and an ambulatory ECG monitoring are helpful to that issue. It seems to be just stress, that produces those symptoms and your heart racing, nevertheless we have to be cautious. I would not encourage you to continue using that blue inhaler, but to try to ad . Some blood tests would be necessary to exclude some systemic disorders (anemia, thyroid dysfunction, renal disorders, etc.). Hope to have been helpful to you. Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor,I had protected casual sex with a lady about 4 weeks ago. I went to the bathroom, took off the condom And washed my penis right after. After about 3 hours, i started having serious itching on my penis and scrotum all Over. I week later a spot was itchy again which turned to a collection of small blisters at the base of my penis that turned to a sore and took about a week to heal. Then right after that, another on the bottom of the penis close to the scrotum, then another close to the head and currently a fourth one at the base close to the location of the first one.please what could this be. I experienced this for the first time about 2 years ago after having sex with a girl friend then unprotected. It was only one sore then. I went to the hospital, I did a blood test and a swab of the sore but it was already healing with almost no oozing. The swab tested positive for staphylococcus aureus which I was given antibiotics for. Over the last 2 years, it has reoccurred maybe about 4 time but never have i experiences this small blisters that turn into sores back to back like this.Please what could this be. Thanks. ### REPLY: Hello, Can I come to know whether these blisters are painful or painless? If these blisters are oozing, then I will advise doing culture sensitivity test of that discharge. If they are painful, then you can take tablet Ciprofloxacin, tablet Diclofenac, tablet Sanitizing, and Newsprint H powder locally after consultation. Along with that keep private parts clean and keep yourself well HY .  I will suggest you to review here with detailed history or consult with the dermatologist with reports and do regular follow up. 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: yes doctorim 31 male  5.7 height & 79 kg weight recently when i gone for a medical checkup they told i have high blood pressure  but last year i was 65kg without any issue - so i really wondered about this change - can u please help me out to bring my BP normal naturally? ### REPLY: Hi I have gone through your query. I am unable to find the description about your BP count and since when you are having it ? What are the symptoms you are facing ? Anyway, before going to get any remedy, you should find out the cause of trouble. In Ayurveda , the 3 factors dominate our metabolism of Vat, Pitta , Kafka imbalance among these 3, cause different health problems. BP is normally outcome of disorder equilibrium of Vāyu , due to psychic and physical factors like mental strain, worry, anxiety, lack of exercise, excessive intake of salts and fats, indiscriminate use of alcohol are few to count, persistent constipation IF you try to keep control on them, half of the battle is won.  Correction of your lifestyle is the biggest Home remedies, regularity in taking meals, walk exercise and rest should be maintained.PANAMA / DEEP BREATHING , ANGLO -FILM, BRAVERY SHAV-AASSAN VERY HELPFUL TO BRING DOWN BP Our two Nostril have different role to play. The right one is Surya Nazi --for controlling heat of body, and left is Chan .  In case of HBP generally, right nostril becomes active. In daytime our left nostril should work and at night, right nostril functions, If you are having HBP always check your nostril, if it is right nostril , close this with you thumb and start the left one. Lie down straight, calmly .keep your mind calm and quite, without any mention, Within 10 minutes BP will calm months an instant remedy.supplement are to be used --Garlic 5-6 cloves cut into pieces , gulp with glass of water in the morning. Take lemon in water twice before meals, Take buttermilk with simple meals containing low fat, fiber, veges fruit vitamins, minerals, coconut water, garlic, ginger in every meal oranges guava apples are good. Avoid fried, fast foods' tea, coffee, alcohol, mental strain. Almond oil 1 spoon in cup of hot milk at bedtime, help relaxing nerves of brain If you hold magnet south pole in your right hand sitting on a wog gen stool feet also on wooden plank , will bring down your BP within 10 -15 minutes hope this will help to solve your query Take care All the behave any doubt mail at  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,Last year i find out that I have a high prolactin level from my blood work which is 35. So I have MRI done and they find 2mm cyst on pituitary gland. they suggested i see neurology for follow up. The reason why im worry is because , my breast hurts so bad every month but my period have been very regular for the pass 8 months. So now should i worry about it and see neurology?will this cause infertility since we are just starting trying to conceive. ### REPLY: Dear Madam, Hi & Welcome. Based on the history and the lab tests done you seem to be suffering from hyperprolactinemia (increased prolactin level in the blood) due to small tumor (fibroadenoma) in the anterior pituitary gland. Hyperprolactinemia can cause infertility due to amenorrhea or irregular menses, breast engorgement and galactorrhea (increased milk secretion). You need to consult a gynecologist who is specialized in fertility treatment. You may be given treatment in the form of dopamine agonists like Bromocriptine or Caroline which are effective in decreasing the prolactin levels, and they may also shrink the tumor. Cabergoline is usually preferred over since it is more effective and causes fewer adverse effects than Bromocriptine. The response to therapy should be monitored by checking fasting serum Prolactin levels and checking tumor size with MRI. Most women (approximately 90%) regain cyclic menstruation and achieve resolution of galactorrhea. Therapy should be continued for approximately 12-24 months (depending on the degree of symptoms or tumor size) and then with .  If  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear doctor i m 42 year old woman ,i have a habit of squeezing and peeling the pimples and black heads i m so addicted to this habit from my adulthood so from the age of 14-42 i still have marks and pimples on my face i have never seen a clear face of mine after age 14.now as i m getting older i want to see a clear face at least once in my life.can i use melaglow gel? (abbot).i m very fair also. ### REPLY: Hi, To treat your skin concerns a Glycolic acid or salicylic acid face wash (seismic or Delaware)Get your blackheads removed regularly not squeeze or pick your lesions as it can lead to scarring and pigmentation bothApply clindamycin gel and retina a cream over pimplesApply comic acid cream(Comic) over pigmentation marks. Apart from these an appointment with your dermatologist is required for below-mentioned treatment options acne is too severe taking a course of oral antibiotics and isotretinoin might helps you still having acne in your 40s, hormonal pills might be required totaling sessions of chemical peels would help not only in scarring, pigmentation but also in treating active acne lesions. Hope that answers your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hii i m 20 Years old female.. m suffering from iron deficiency anemia . My Hb count is 6.5. i consulted 3 doctors.. all recommended me different iron supplements like dexorange capsules, victofol, and Globac capsules. right now m taking dexorange capsules twice a day in morning and at night after meal. and also m taking mebex which doc recommendad me twice a day for 3 days. will this work?? are der any side-effects of this ### REPLY: Hi. Iron deficiency anemia is a very common problem in young females throughout India, and is usually due to menstrual loss and poor iron content in food. So do not worry. Make sure that your cycles are not too prolonged and that you do not pass excessive clots. Mebendazole (WebEx) has been given to take care of any parasite/ worm infection in your intestine. For iron deficiency, derange is not a very good option because the amount of iron available for absorption in this preparation is very less. Please take Desolate 200 mg thrice daily, together with Folic acid 5 mg once daily (and add Methycobolamine 1500ug once daily if you are a vegetarian). This combination should supply the necessary iron, folic acid and It. B12 which are all important in red blood cell production. Take this for a minimum of 3 months and recheck your He at the end of every month, to check the response.  .  You may get black tarry stools for which you need not worry. 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: Hai doctor. I have cough and cold problem of 2 year .. 3 or 4 times I took blood test ,xray, Result comes as eosonophilia doctor prescribed hetrozen tablet and cough syrup... But not reduced.. Daily morning after wake up time I have this cough and cold problem.. After that it not comes... Why it not curing ... What I have to do.. ### REPLY: Hi, Thanks for asking. Based on your clinical history and query, my opinion is as follows:1. Eosinophilic indicates possible allergy. The levels should be more than 10% on DLC2. Identification of allergen is important. You need to change your surroundings to identify the cause and avoid it. 3. You can take antihistamines, if it is severe. Symptoms appear to be allergic. If not sure, take an allergen test or an antibody title for confirmation. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i am 15 years old female and recently ive been losing my at various places . at some part i am virtually bold, ive also been feeling dizzy and weak + been coughing blood however i havent seen my doctor.....i am very worried that i might have cancer... could you please help me! ### REPLY: Thanks for your question on . I can understand your concern. Coughing out blood, weakness etc. can be seen in lung cancer. But at your age possibility of lung Infection is more than lung cancer. So better to get done chest x-ray. Chest x-ray will tell you about lung cancer and infection both. About baldness and loosing hair, hyperthyroidism can be the cause at your age. So get done thyroid function test to rule out this. So no need to worry much for cancer, but you need above-mentioned investigations for the treatment. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 10 and he has viral infection and is coughing a lot. Well he ate a lot of ice cream yesterday and now he woke up coughing and vomiting. He is continuing to vomit and then he his nose started to bleed and he started coughing and vomiting up blood each time and this has went on for 20 min. He is not coughing as much and stopped vomiting. Is it a good idea to give him water now or is there something that he can take? ### REPLY: HIT hanks for posting your query to .  You can start with warm water and if he is taking it you can give him hot soup. But he needs to be seen by a doctor as he seems to be having Infection of throat. This added with bleeding from nose is not a good sign and definitely requires a doctors intervention and most likely an antibiotic course.  Also make him do salt water gargling 3 -4 times a day.  Avoid Non veg and oily food. Avoid Citrus Fruits. Hope this information was useful to you. Any clarifications feel free to ask. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband has stage IV colon cancer and has been through surgery, chemo, radiation and for the past few months on maintenance. His count dropped until about 4-5 months ago when it started creeping up slowly. He has had a CT scan and nothing showed and the oncologist tells him it is stable and nothing new yet the numbers continue to climb. Any suggestions on where to go from here? Thank you ### REPLY: Hi, Thanks for writing in. Stage IV colon cancer includes metastasis spread to organs like liver and lungs and this occurs in half patients with colon cancer. Treatment of stage IV colon cancer includes the following methods1. Surgery.2. Neoadjuvant chemotherapy.3. Local ablation (e.g. radiofrequency ablation).4. Adjuvant chemotherapy.5. Intra-arterial chemotherapy. Treatment for metastasis is often guided due to criteria evolved to administer various treatment methods. Survival in this situation depends on his general condition. He should be provided with adequate nutrition and good food.However, the final outcome of the situation in colon cancer stage IV might not always be completely curable; however we must fight the battle with cancer till the end. Survival in metastasis might be from 6 months to over 2 years if the disease remains stable when given chemotherapy. 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, my 4 month old kid (male) has been diagnosed with UTI infection. The culture indicates for E- coli. My doctor has recommended for Taxim-o twice daily. But culture shows the component of Taxim-o resistant to E-coli. What shall I do, shall we continue with the same medicine or change? ### REPLY: Hi, The antibiotic being given to your baby for his UTI needs to be changed as soon as possible!  Continuing to take the medication that the E. coli is resistant to will not sterilize his urine to cure his UTI.  And the longer he has the infection, the greater the chance of complications developing.  Also, a young infant needs to have his urinary tract studied for any abnormalities when he gets a UTI(for example, ultrasound of kidneys, bladder, and urethra).  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: Dear doctor sir,My son having 13 years getting persistent dry cough having more than 10 months, there  is no particuar time for that day full, his bolld AFC test done 980 is the count can you suggest any natural or harmless medicine for complete cure thanksthomasmy mail id  YYYY@YYYY Cell 0000 ### REPLY: Hi dear I read your problem of your sons persistent . U also told that there is no particular time for that day or full coughingFirst of all u must go for investigation -GBP(GENERAL BLOOD PICTURE)CONTOUR TEST CXR PA VIE WCT SCAN CHESTPCRADA(ADENOSINE DEAMINATE)THESE INVENTIONS R NECESSARY SO MUST DO IT.TREATMENT-1- U CAN GIVE ONE TEASPOON TALISAADDI PURANA WITH GHEE.2- U GIVE 40 ML SHIRISADDI QUOTH TWO TIMES IN DAY BEFORE MEAL.3-GIVE LAX MI VILLAS 200MG TWICE A DAY.4- USE BOIL WATER IN UR Lifestyle.5-TAKE RICH PROTEIN DIET.THANKS FOR QUERY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Im 18 year old male and within the past 4-5 days I have been experiencing a sharp pain in my right nipple. Its almost feels pulsing and only lasts about 2-3 minutes and happens about 5 times a day. It feels more sensitive and tender than my left. ### REPLY: Hi welcome to the  Here nipple and breast physical examination needs to be done as per history along with palpation... There might be mastitis like breast inflammation or infection or superficial bacterial skin infection... If no specific cause found than it could be muscular pain For inflammation relief ibuprofen might prescribe for five days If during examination any mass palpable than FNAC like investigation done for that... Take care Consult physician for examination ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 16 and I was curious about how to tell the difference between a spermatocele & a Testicular Cancerous tumor. I was attending Health Class at my school the other day and we learned about self examination of the body etc., So when I got home I performed a self-examination of my testicular area and found a (slightly loose and/or barely connected lump to my right testicle.) I was scared & did some research on it and learned that it MIGHT just be a spermatocele. But im still not quite sure. ### REPLY: Hello welcome to  Thanks for your queryRegarding spermatocyte, it is an abnormal cyst that develops in the epididymis. It contains clear fluid and may contain sperms. It is painless, and non-cancerous. It doesn't cause any harm to you. But when it grows larger and pain then you need to undergo a small surgery called spermatocelectomy under local anesthesia... Regarding testicular cancer at this age is unlikely. It will grow and invades adjacent structures. Consult general surgeon for further suggestions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello my daughter tried pulling out her tooth but then realized that her roots were all out but her gums are stuck into the middle of her tooth. She only feels a little pain when she tries to pull it. I am worried that she will rip her gums and do damage. What do I do?? ### REPLY: Hithank you for consulting ChatDoctorPulling of teeth with all roots out and sticking into the middle of her tooth should be considered seriously. Firstly you should stop her doing this activity and identify the cause why she is doing. Is it because of unwanted habit, anxiety, stress etc. ?visit your dentist get OPG X-ray done to reveal the status of tooth and periodontics both which will reveal the current status of teeth. 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: For about two weeks, my mother has been experiencing back pain in her right middle back as well as pain in her side/front under her rib cage. She has been to the doctor a few times and all of the tests have come back clean. The pain was a little better for about a week, but tonight she started complaining about it again. The same symptoms, only this time I noticed that her right middle back was a little swollen. Any ideas on what s going on? ### REPLY: Hello!!! Thanks for posting your query with us. I wish you had described the tests a bit more clearly. I'm guessing the doctor did an X-ray plus some blood tests and all came clean.  The pain in the middle back - Is it right under the shoulder bone (wing like scapula bone) at the back?? If yes then the pain could be due to an alteration of the scapula bone. This happens because of weakness in the scapula thoracic muscles. You can probably go to a physical therapist and get a few sessions of ultrasonic therapy and icing to take care of the swelling.  Also, how old is she?? Does she have any chest infection as then she needs a physician right away?  You can help her strengthen the scapulothoracic muscles by finding the following exercises online.1. Scapular Retraction2. Shoulder Bracing3. Shoulder push-ups standing (push on wall)4. Shoulder External Rotation (actively) As far as the rib cage is concerned if there is nothing wrong with the blood tests and x-rays then make her do some breathing exercises and stretching for the pectoral (chest) muscles. Also make her inflate a balloon 5-10 times a day to strengthen her chest and breathing muscles. Hope this helps her. Give my best wishes!!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father has undergone CABG last week. He is now under CAPD for last 1 month. After the surgery there is lot of swelling in legs and hands. The swelling in the hands has come down after the CAPD but the legs are still showing the swelling and from yesterday we are observing some red patches in his toe and foot. Please tell me the cause of it. ### REPLY: Swelling is because of kidney dysfunction. Kidney is not able to excrete water so need to consume fewer fluids. As it is resolving with card, it will resolve within some time. If not consult your nephrologist to increase dose if . Red patches may be because he must be taking blood thinners together with kidney dysfunction lead to excessive blood thinning lead to red patches. Still you need to show those patches to your doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Sir, i am Rakesh from jamnagar,Gujarat.Since from last two year I am taking CLONOTRIL 1 MG for my chest pain and balancing problem.But my problem yet not solved,now iam totally dependent on this medicine.When i left this medicine i start feeling balancing problem and acute chest pain also pain an teasing on all over the body.Some 7 year earlier i was detected with VITAMIN B12 deficiency ,but now it is normal.My balancing problem started some 6 years back,it increase with the time passes,Chest problem started 1.5 years back.Along with these I also face teasing and burning sensation all over the body.For this chest pain i have been to doctors many times,they take ECG and it all comes right.But still i feel acute chest pain along with little dizziness and light headed. When i take clonotril 1 mg i feel little relax but not completely fit . I have done brain MRI also sonography for any kind of stomach trouble but all in vein.Dr. Darshan Bhatt from Rajkot told me that you have a vertigo problem thats why you are feeling balancing problem ,but there is no way to proof it .Kindly suggest me upto what time i have to take this CLONOTRIL 1 MG tablet.Also please suggest me how to get rid of this chest pain and light headiness(Balancing problem).Sir, I already checked my BP,its normal.I am taking clonotril 1 mg right now on daily basis(ONE TIME AT NIGHT),when i have to reduce it.Earlier also I have a problem of Vitamin B12,i have not checked it in recent times,can i have to go with multivitamin with excess B12 like NEUROMET.SIR IS THERE ANY SIDE EFFECTS OF VERTIN 8 MG.Sir I do have gas problem from few days,Is it possible to take Vertin in gas problem.Is it also good for chest pain.Please Help me. ### REPLY: Respected user, hi I evaluated your query thoroughly.* There is gross discrepancy between your problem & treatment.* Control is not meant for chest pain & balancing problem at all.* You are consuming the molecule since years which is of no value in it.* By this time your body has been addictive of Control & now you require dead diction treatment with an expert Psychiatric doctor.* Vermin can be taken with gas problem also vermin has no role for chest pain. Hope this clears your doubts. Thanks for using  & giving me an opportunity to assist you. Welcome for any further queries. Wishing you a healthy life ahead. Regards dear take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 52 year old female am 5 ft. tall, and weight 120 lbs. I am pretty active...but for the last year I seem to not be able to get a deep enought breath of air. No matter how hard I try I cant get my lungs to expand. I have woke up a time or to on my back gasping for air so I no longer sleep on my back. I took maloxicam as needed but have discontinued it. I have never smoked and thought I was in good health. Please advise. ### REPLY: Thanks for your question on . I can understand your concern. Difficulty in breathing can be due to bronchitis. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2.  PUT (pulmonary function test). PFT is must for the diagnosis of bronchitis. IIT will also tell you about severity of the disease and treatment is based on severity only. You may need inhaled bronchodilator and inhaled corticosteroids (ICS). If PFT is normal then no need to worry about bronchitis. 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: Hi, I had a foot of my colon removed 5 years ago and in the last two days I have had pain in the lower left abdominal , hard to pass gas , dont want to eat, stools are loose and today green. Now I did take a Senokat and a muscle relaxant to sleep through the pain. I also had a low grade fever last night at work. 37.8 . Could this mean a return of diverticular disease, ( that is why I had a partial removal of my colon)..?? ### REPLY: Hi ! Yes, it could be a recurrence of possibly previously existing diverticular disease of the remaining part of colon. It could also be just a food poisoning, if you are not careful on your diet. With the known past history of diverticular disease, I would suggest you not to neglect, and show yourself to your treating doctor/surgeon at the earliest possible if the symptoms persist or increase. Wishing you an early recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there i am a 30 year old male, i see my GP once a year and he sends me for regular blood and urine work. Lately i have been having a dull pain in my upper left abdomen. It comes and goes. I dont have yellow skin or eyes, nor have i lost weight or lost my appetite. I get nausea once in a while.With all the talk about pancreatic cancer in the news, i am worried. Should i be? ### REPLY: Hi. Thanks for your query. There is nothing to be not concerned about. This is a good practice to have a regular check up. The pain in the upper left abdomen can be due to :Colitis as the commonest cause and a proper course of medicines should get you alright. Left kidney infection, stone or swelling;Yes, cancer of the pancreas as you suspect. Splenic problematic ulcer and cancer. I would suggest you the following:First get an ultrasonography and colonoscopy done after an appropriate course of an antibiotic and metronidazole. If suspected then only you can go for a CT scan of the abdomen for detailed diagnosis. Pancreatic cancer is a very rare tumor to occur and is always painless to start with, but the auspiciousness alone can have early detection and proper treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my doctor has just perscribed gabepentin for my MS nerve and back pain he also started me on targin tablets I have stopped the targin tablets as I was feeling VERY unwell on them .I am going to start all over again just taking Gabepentin 300 mg 3 times A day and see how I feel .dO YOU THINK THAT IS A GOOD IDEA AND WILL THE GABEPENTIN TABLETS HELP WITH MY BACK PAIN. mANY THANKS FOR READING MY LETTER  I DO FEEL MY BACK PAIN IS NOT HELPING MY LEGS AT ALL . ### REPLY: Hello. If your back pain is by irritation of a nerve (neuropathic pain), Gabapentin is effective, but usually is necessary to associate another painkiller . Even with higher doses of gabapentin is difficult to improve pain taking only gabapentin. In my opinion Tramadol 50 mg(usually better tolerated than oxycodone) thrice a day, can be combined with Gabapentin for treating your back pain. Please consult your local doctor for a prescription. I wish you good health.(In case the answer would have been useful please indicate this) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 3 year old child has told me the roof of her mouth is very sore and she has had a high temp. Also has loss of appetite but that may be due to her not wanting to eat due to the soreness. I have had a look in her mouth and can see no obvious signs of redness or ulcers or any kind of soreness. This came on quite suddenly yesterday. What could this be? ### REPLY: Hi! Soreness in the roof of mouth (palatal region) or ulcers can be due to multiple reasons, the most prominent being an upset stomach or a previous course of certain antibiotics. The child may also feel soreness due to intake of hot or spicy food. The best thing would be to get it clinical assessed by a dentist nearby. Also, it is possible that the child is unable to localize the soreness which may be towards the throat or tonsil region as the rise in temperature could be due to some throat infection as well which might be posing difficulty for the kid to eat. I hope this information would be of some use to you. Warm regards! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...sir, my 14 months daughter is not eating properly bcoz of some inconvinience in stomach. can u suggest some home remedy... last 2 days diet for her is pupkin, black beans, whole milk, lentils ### REPLY: What kind of discomfort is she having? Is she having colicky pain, cramps or bloating sensation. Does she have normal bowel movements? Sometimes child .  This can also be a possible cause for discomfort. Make sure not to give beans, onions, or any gas forming food. If she has pain in stomach soon after ingesting food, then it could be due to gas. You can give gripe water to the child to relieve discomfort and rub a small amount of asafoetida (hing in Hindi) after roasting it on gas flame. Cool down to a suitable temperature and rub it around the navel. You can dissolve asafoetida in mustard oil and rub it around the navel to relieve gas and strengthen babies abdominal muscles too. You can also give buttermilk with added carom seeds powder (again in Hindi) and black salt to relieve stomach discomfort. Hope this will be helpful in solving your problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dog bit my 12 years old son. He had his 0 and 3 days shots he just need to come back for the seventh day does he needs to finish all his shots? And my dog doesnt have a rabis shot yet on he day he bit my son because his only 2 months and 3 weeks but a week later we let him have his rabis shot what are the signs I need to look for my dog and how long do I need to observe the dog ### REPLY: Hi, Welcome to  Forum. I have gone through your Query & I really appreciate your concern about the problem you are facing. As a physician I would like to tell you that you need to observe your dog till15-20 days. Also, your son needs to take 3rd shot, i.e., of 7th day. Also, you did the right thing by vaccinating our dog. So you need not worry about anything. Thanks for Trusting & Posting your Query on this forum. Hope this will help you. Feel free to ask any further question. Have a nice Day. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell the end of Jan. Since then I have dizziness, buzzing in my head, loss of balance and a slight headache. When i fell I was unconscious for 15 25 mins. Very confused when I came around. All these dx I m experiencing but a result of that. I was taken to hosp. Cat scan down which was normal...but I had to fight for release ### REPLY: Hello! Welcome on  ! Your symptoms are quite common after a head concussion. You should know that this clinical situation can last up to some months, and it will gradually improve. If your situation does not improve or even worsens, I would recommend performing a new brain CT scan to check for possible delayed intracranial bleeding. Physical activity can help improve your situation. I would just recommend avoiding a possible repeated brain trauma. Hope you will find this answer helpful! Kind 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: So, today me and partner had sex. This is not the first time we had sex and every time we have had sexual intercourse we have been careful and used a condom while I have also been on birth control. This is the first month I have been off of the pill. Today while we were having sex, the condom ripped at the top. We believe that the head of his penis was only exposed for about 1-3 minutes before he pulled out and we realized what happened. 3 minutes being the most. We are absolutely positive that he did not cum inside of me but there is a pretty good chance that there was pre-cum. My period is due in two weeks. What do you think the chances of me being pregnant are? ### REPLY: Hello Welcome to . Thanks for posting your query. If you are so pretty sure that the semen did not enter, then congratulations you need not worry. We have seen so many such cases and I can say more than 90% of the times, you are safe. And as you say, we shall wait for your dates and once you have periods this time, just forget it. If not, you can contact me. Will guide you on further details. Don't worry. Contact back If you have some more queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: doc, my first sgpt reading is 135. so the doctor told me to have a medication for 1 week and advice me to take godex 2x a day for seven weeks. after 1 week, i go back again and see wat happens. i was so disappointed with the result because i took medicines for 1 week and then my sgpt result becomes higher. it reaches 160 instead it decreases..wat should i do?please give me guidelines for wat i have to do to make it normal. ### REPLY: Hi, Welcome to , You have high liver enzyme called SGPT, first it is most important to know the cause of such rise then treatment becomes easy. Commonly liver enzymes rise due to Viral Hepatitis, . These are some of common causes, it is not clear from your description what was the cause of liver dysfunction. Please visit a Physician /Gastroenterologist and examination followed by required investigations like complete liver function test, abdominal ultrasonography. Treatment depends on cause, so no specific therapy is there for liver. In some cases these enzymes may take some time before they come back normal. We must remove cause to improve this, take care of diet and do not take alcohol if it is there. I am sure this is mild derangement of live and in few weeks time it will come back to normal. Take care Good Luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was punched and two of my front teeth have been in pain for 6 days.  The gum in between the two teeth has become red and inflamed and has today leaked puss for the first time.  I visited the dentist two days ago and x rays were taken and the dentist said there was no major damage to the teeth or roots.  Will some anti-biotics clear this up? What could be the problem? ### REPLY: Hello, Thanks for consulting ChatDoctorRead your query, as you have trauma in upper front teeth result in pus discharge from tooth this is due to injury of Periodontal ligament fibers result in inflammation in gums and pain in teeth as your dentist has given you course of antibiotics complete it and if lessening of tooth is there you can go for splinting also. In meantime do warm saline rinses and avoid chewing solid food from front teeth take soft diet in period of treatment. Hope this will help you. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with SDS, high vTach and low Brac Tach in 2005 after being on Vioxx for a long period of time. After being taken off the Vioxx my heart went down. I have had 1 full heart abaltion and four attempted abalations to fix the problem. After all said and done a on demand pacemaker had to be installed, due to synescope and high Vtach. I am now 53 and noticed I am slowing down and getting exhausted very quickly and get dizzie when I lay down. I have no known heart problems Valves are good no blockages but get fatiqed very fast. ### REPLY: Sir you need to get a good medical check up done. The exhaustion could be simply due to age or there might be underlying medical problem. If you feel its not just age related, Anemia usually presents with such symptom. Or any problem in your pacemaker could affect the pumping capacity of your heart leading to less supply of blood to organs. Hence, the early exhaustion. I recommend you to get a thorough medical examination done. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 27 . Since from 5 years I have liver problems my SGPT level is 125 Sgot 75 which is not coming in normal range. I am talking my medicine regularly which is silver 200 mg daily 1 tablets and evion 400 mg 1 daily .. ultrasound conclusion is fatty liver and infilrative changes plz tell me the solution I am so tired regularly with this medicine. ### REPLY: HelloIncreased SGPT and GOT may indicate liver injury, and it may be due to many causes like hepatitis, altered lipid profile, metabolic disorder etc. It may be due to fatty liver(fatty infiltration in liver)in your case. You may need few more investigations like routine hologram, random blood sugar, lipid profile, urine RE/ME. I suggest taking tablet ursodeoxycholic acid 30 mg twice daily for three months. It helps in regeneration of liver cells. You should avoid alcohol if you take it. Mild fatty liver is a reversible condition. You should increase your physical activity and go for brisk walk regularly. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 67yo woman recently diagnosed with Hashimotos and COPD. Quit smoking 15 yrs ago have been very active biking, hiking, walking. About 9 months ago I sarted noticing a slight shortness of breath. Now I have severe trouble breathing when I Stand up and try to walk. Two months ago I was walking around a little slower but still had quality of life. due to feeling tired I went to a dr who did a blood test and discovered the Thyroid problem. I was put on 50mcg of Levothyroxin. I had two stents put in ten years ago.EKG 2mos ago showed a normal heart for my age. 81% on the Bruce Protocol. Over the last two months my breathing has worsened to the point that I can t take more than 2 steps without severe loss of breath. As soon as I lie down I can breathe again. Have very little appetite and have lost 25 lbs since May. ### REPLY: Thanks for your question on . I can understand your situation and problem. You are having weight loss and breathlessness on minimal exertion. All these indicate worsening of underlying COPD in you. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PUT (Pulmonary Function Test). PFT will tell you about severity of the disease and treatment of COPD is based on severity only. You should start inhaled bronchodilators and inhaled corticosteroid (ICS). Enroll yourself in Pulmonary Rehabilitation center where chest physiotherapy and deep breathing exercises are done. All these are important in COPD patients. They will improve lung functions and reduce symptoms. So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was washing my hands two days ago and had a severe pain in the left side of my upper back that took my breath. over the last two days it hurts all the way around my side right above my hip in about three different spots. I can walk around and do really well, but when I sit down or drive it hurts really bad. I have had kidney stones like about 10 times and this feels nothing like any of those. ### REPLY: Howell come to ChatDoctorThe pain that you described here may not be due to kidney stone, but this could be due to spinal cord disk herniation such sudden pain commonly possible in slip disk and this need to be ruled out, some time both the condition of stone and spinal disease can be treated simultaneously till the final diagnosis made, you need to differentiate these two conditions till then this can be managed with the following .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 took a photo of my son today and after posting it on facebook had a message from a friend telling me to get his eyes checked coz one of his eyes is reflecting a funny colour i looked it up and it can be a symptom of eye cancer and now im panicked how do i tell the difference between normal photo reflections and an actual problem?? ### REPLY: A common symptom of eye cancer is a white pupil in one or both eyes. This is called leucocoria and in child .  However, other color changes are not so significant in terms of cancer. Since you have seen this in a photo, I suggest you see his eye yourself in normal white light and see if you can make out any difference. If not then be rest assured, It's nothing but a camera thing. If you do see a difference, there is no harm seeing an eye specialist. It may be something other than cancer. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 feel light heade all the time light sensitivity had all tests done they keep coming back normal I feel as this is taking over my life I can t drive can t run can t go shopping I start to get more lightheaded when I walk its ruining my life I don t know what to do? ### REPLY: Hello, It would explain that if lightheadedness is related to standing up position, this could indicate possible orthostatic hypotension. In such case a Head-Up Tilt test would be necessary.  I would also recommend consulting with an ENT specialist in order to exclude a possible inner ear disorder and performing a cervical spine X-ray study.  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: What is the risk of disease or infection from a hypodermic needle stick?  I was going through a box of my parents things and was stuck.  (Dad is a hoarder)  wrapped around the syringe was a label from a hotel in Budapest.  They had traveled there in the mid-1990s. Im sure the syringe and needle have been in the box ever since. ### REPLY: Hello, Thank you for contacting ChatDoctorI understand your concern, I am , Infectious Disease Specialist answering your query. There is no risk of any viral infection by this syringe. But there is possibility of rusted needle and chance of tetanus infection. I advise you to not worry regarding viral infections like HCV, HBO, HIV etc. Tetanus vaccine should be taken by you in order to prevent infection caused by it. Also maintain hygiene at the site of prick. Frequent cleaning and . You can take the antibiotics like definite under your doctors' guidance to reduce the chance of infection. Application of polypoid ointment can also help in prevention of infection. You can ask for further queries here on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Dr, Hello.Im 24 yeas old boy. as i know from 18 years old, hair loss issue started in my hair. I met various doctors about 4 or 5 time along these years. many of theme prefer the things bellow:1. MD-Finastraide (1ml)2. Alpecine shampoo i have used Minoxidile for a long period too, but as i said two medicine that the last Dr offer me were told before.almost all of the Doctors believe that hair loss issue  is related to inheritance and is hereditary issue.I keep to use MD-Finastraide almost the begining it. but it seem that these havent enough effect, because my hair loss is seemed to increase.I asked about the surgery method from the doctor too, but all of them didnt offer for me, because (as they say) my hair loss is not as big as for surgery.I want to ask about this that is there anything (medicine, method or something else) that i can use for health care? what is your idea about that (my issue)?Thanks very much. ### REPLY: Hello, You are suffering from an .  Medical treatment has only a transient effect. The effect lasts as long as you continue the treatment. Make sure you are not having any other scalp problem along with AGA. If yes, then treat it too. Nowadays, people go for hair transplant for cosmetic purposes also. If this problem is troubling you more than you can opt for surgery after a consultation off course. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have a rash on my back in between my shoulder blades. I wear a corset for work four times a week. i have no fever, swollen glands or any other symptoms. its usually a light pink or flesh colored until i start scratching it. it doesnt seem like hydrocortizone cream is working ### REPLY: Hi there. I do believe the rash you describe may be linked to the wearing of your corset but possibly not directly. As a result of occlusion & sweating, it is very possible to have developed some sort of fungal infection & that would explain why the HY . Ideally, please upload a clear digital image of the region or visit a dermatologist nearest you. Off the cuff, perhaps the use of a cream like Candid-B containing beclomethasone with an antifungal (steroid-antifungal combination) applied twice daily for 3-5 days may prove useful. If so, stop after 5 days & follow up with a plain antifungal such as 2% ketoconazole (e.g. Mizoram) for a further week. In this time, please do try to avoid use of the corset. Good Luck & Cheers! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 52 year old female and I was recently diagnosed with hypertension because of a headache I would get during sex or exercise.  I exercise 6 days a week and eat a totally organic diet with no processed foods.  I only drink filtered water and green tea.  I take supplements every day.  My blood pressure was 189/108.  I am not overweight but do have high stress as a caregiver for a handicapped teenager.  I dont want to take medication but have started Cozaar and Dyazide.  Why is this happening? ### REPLY: Hi, Even if your lifestyle is good, you can still have blood pressure because it's also an age related change and genes in our body. But If you have it, you need to take medicine for that, otherwise it might be detrimental. Monitor your resting BP, low salt diet. Also get one lipid profile and sugars tested. Besides get renal function test done. 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 17month year old boy is having blood stains in his diaper.before 2 days of this incident I noticed a swlling of his penis.now I think he is having pain while urinating for sometime.we consulted the doctor&gave his urine for testing,but it wil ta 24 hours to get the result.doctor didnt gave any medicine right now.can you give any solution for this?is there any home remedy? ### REPLY: Hello17 months old child passing urine with pain, and you also notice a swelling when he urinates. As this is now a day very common and the reason is narrow opening of urethra. As I have noted in my so many patients that there is narrowing opening on the prepuce, due to this narrowing, passing of urine causes pain and also blood in few cases. In my opinion you should consult a surgeon and get his opinion. When such type of patient visit I open this with the help of forceps. This is known as paraphimosis, however treatment depend on concerning doctor .2nd reason of such painful urination may be urinary tract infection (urine culture report is awaiting). No home remedy, just consult a surgeon, and it is a matter of 1/2 hour. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 5 year old granddaughter who has a bowel problem. She is unable to completely evacuate her bowls and it ends up stuck between the cheeks that we have to take multiple wipes to clean her up and 30 minutes later it may happen again. My daughter says she has had constipation probelms for a long time. Now my granddaughter does not want to tell anyone when she goes and she developes severe irritation of course because she has poop in her crack for hours. Could it be her diet. You know children don t want to eat a well balanced diet. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query your daughter have symptoms of difficulty in bowel movement. Well there can be many reasons for symptoms you mention in query like irritable bowel syn . . Need not worry. I would suggest you to avoid eating heavy and spicy, eat small and frequent meals, eat 1-2 banana in a day and take ibuprofen or acetaminophen for pain. You should give diet to child rich in fibers. If condition doesn't get well then consult gastroenterologist for proper examination. Doctor may order certain tests like endoscopy and stool test and take history. Doctor may prescribe operative, ornidazole along with anti-inflammatory. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a partial cholectomy and post op partial small bowel obstruction and ileus which cleared with conservative treatment last week. I have severe joint pain all over including back ls area and hands. Potassium normal level at discharge and sed rate normal. Why woukd I have such bad joint pain so severe I can hardly walk? ### REPLY: You need to understand that any surgery happens slows down your physiological movements. Slowly start doing small free exercises and FROM exercises under a guided physical therapist. Which will help the muscle tone to improve, and you will be fine soon. Multiple joint pains can be due to non use rather a surgery u have undergone. Kindly meet a close by physical therapist and workout on daily basis. Slow and steady wins the race. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 currently experiencing breathing issues. the shortness of breath gets better and worse as i swivel my back and keep my hips in place. it also gets bad when i lay on my LEFT side. It feels as though the air in my lungs is escaping. i also have a tight pain in  my chest and have been burping non stop. what could cause this? i also wake up with strong headaches which have been getting worse. should i go into the ER? ### REPLY: Thanks for your question on . I can understand your concern. Yes, you should definitely go to Emergency room and rule out hypertension and other heart diseases. You should get done blood pressure monitoring, ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry about heart diseases. Sometimes stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relaxed and calm. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic . Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having pain in my upper addomen for several months.  The pain only occurs when I move.  Usually gets worse during the day and when I first go to bed, it is difficult to get up due to the pain.  After sleeping, overnight, the next morning, no pain until I start movement or straing the stomach area.  Had a Cat scan yesterday, and they found nothing.  I have no pain except when I move or stretch the abdoment area.  The pain can be pretty severe when it occurs. ### REPLY: Hi ! Good evening. I am  answering your query. With the kind of history you narrated, possibly you have got some kind of muscle spasm which is causing pain during movement. If I were your doctor, I would advise you to go for some anti-inflammatory .  Even though your CT scan is normal, I would advise you for an ultrasound of abdomen if it was not done to rule out any gall stone disease though unlikely in your case. Further management would depend on the result of a clinical examination and investigation reports. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: SIR MY SON AGED 3 Yrs old he is suffering from high grade fever when the doctor asked me to do the blood test of ESR & CRP & blood cultre after i get the reports the esr value is 60 mm/hr for the 1sr hour & 80 mm/hr for the next hour and the crp value also is very high i.e 4.8   he is getting this problem repeatedly can u pls suggest me what can i do ### REPLY: Welcome, Multiple causes of high E S R & C R P, You do not worry about it, Let us investigate the cause of high fever. Consult your family doctor for physical examination, Get blood test for, Hemogram’M P, tidal test, culture,Ultrasound abdomen, X-ray chest, Urine test, culture, And many more than needed, Treatment depend on cause, E S R & C R P are non-specific measurement of inflammation., increased by any cause or focus of inflammation. The ESR is increased in pregnancy, inflammation, anemia or rheumatoid arthritis, cancer. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my question is; I am 31 weeks pregnant and have sever pain in my lower back and inner thigns. The pain is so bad that I have a hard time walking and playing with my son. Not only am I pregnant but I also have Hepatitis C. Which has ment no Ibepofen and nothing with Tylenol. My worry is I still have awhile to go with this pregnancy and the pain has been getting worse as my stomach expands. I have tryed home remadies (such as hot bath)and nothing has helped. Is there any medication that you could recomend to help me? please and thank you. Sincerly, Ashleigh B. ### REPLY: Hi there,What you are experiencing could be preterm labor, and it is essential for you to go to a Gynecologist and get yourself checked, if you are in labor or not. It is very necessary to rule out preterm labor, especially since the pain is severe and radiating from abdomen to the thigh. Preterm birth can lead to problems for your baby, and it may require NICU admission and help with breathing. Hepatitis C has nothing to do with the pain, and it has a less than 20% chance to be passed on to the baby. If you have only hepatitis C infection with no infection of Hepatitis B virus then it is absolutely safe for you to go for a normal vaginal delivery. Only if you have coinfections with either hepatitis B or HIV that it is necessary for you to undergo a cesarean to decrease risk of transmission of virus to baby. Inform your neonatologist about the hepatitis C infection so that appropriate care of the baby can be taken at birth. Do not neglect the pain and see a doctor immediately. Hope this helpsRegards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: First of all, I ve had to leave my job to take care of my terminally I ll daughter, I have no insurance. ( sorry). I ve been having severe right sided shoulder and neck pain for about two weeks and then this morning , I filled the toilet bowl with bright red blood, my neck pain radiates down under my right arm pit and right breast. I m sorry to take up your time, if I could afford a Dr. , I d of seen one last week. Can you help me, I m all my daughter has. Gail ### REPLY: Hello, I read carefully your query and understand your concern. The neck pain is probably related to a pinched nerve. I suggest using anti-inflammatory medications such as Acetaminophen to relieve the pain. I also suggest maintaining the area immobilized. As per the blood in the toilet, it should be evaluated the source of the blood. It can be a hemorrhoid. I suggest consulting a proctologist for a physical examination. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards!  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a hard lump on forehead after fall 2 weeks ago is it natural for it to still be here? i was taken to A&E and they sent me home without a brain scan as the Doctor thought it unnecessary i had the biggest black eye I ve ever seen, feeling a little of colour today ### REPLY: Hi there, as you had fall 2 weeks back, and I suppose you are not having neurological issues like one-sided weakness, giddiness, prolonged headache etc., so CT scan is not necessary as per information provided by you. And about your lump, suppose after fall if there is any local subcutaneous bleed swelling (lump) will occur, it will be prominent if any bone present behind the swelling., it will take sometime to comedown, if it's not coming down consult your doctor. For any such kind of queries you can ask me. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear doctor my recent test result was Hepatitis-B surface antigen (HBsAG) - Non reactive- 250iu/ml,                                                            Hepatitis surface antibody (HBeAG)- Non Recativeplease clarify about my result weather my result positive or negative. ### REPLY: Hi, How are you? You need not worry about the test as the results show that you do not have Hepatitis B infection at present. Although Hepatitis surface antibody is not the same as Head as stated by you in the question. Please clarify as these are two different entities. I would suggest you get vaccinated with hepatitis B vaccine to protect yourself from future risk of infection. Hope this helped, and please do not hesitate to consult me for further clarifications - rxsuresh@gmail.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 severe abdominal pains for 3 days it started off really bad where i could not move as i was in so much pain then for the next 2 days i could still feel the pain but it was not as bad as the first day here i cld not even move it felt a bit like labour pains, now i have been getting watery clear sringey discharge alot and am worried about what it is i had a baby 15wks ago and also have 3 other children my first child was born by caesarian and then 3 vaginal births, i had my first period 10wks after my baby which was light and lasted 3 days, and had another period 2 wks later which was really long and heavy, i have had this pain once before about 4wks ago. ### REPLY: Hello;welcome to  There are many reasons to have severe pain as it can be due to infection of pelvis;renal or ureteric stone;ovarian cyst and even extra uterine pregnancy so first see if you have missed periods and get a urine pregnancy test done to rule out pregnancy. If it is positive then you need to consult a GAEC and if it is negative please get an ultrasound done to find the reason and with the reports consult a doctor for treatment. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes;thanks slowly having increasingly bad pain in right upper arm. In resting position it doesn t hurt but to raise just enough to get a top on hurts. Left wrist on right hand first started hurting ~ went to Dr & got a steroid shot in it & it got better. Now @ that same area my skin is slowly losing color??? But the pain in my upper arm is my main concern. ### REPLY: Hi. Pain in upper arm when lifting your arm up could be due to impingement in the rotator cuff. These are the tendons of the muscles that attach in the upper arm to lift or rotate the arm. Tests by a doctor can help isolate which one is impinging, and usually a cortisone infiltration in the shoulder can help, plus physio. Discoloration is a worrying problem(left/right??) as that might be due to insufficient blood supply, or possibly side effect of the cortisone. You must have this assessed properly. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: thelocal doctor had prescribed Mecobal Od once a day and Gabapentin tablets two times.After taking the prescribed dose two days ago I had terrible night.My sleep was disrupted,I had horrible dreams.Some fear was there and some suicidal thoughts also and in the morning I had drowsiness,headache,dullardness.Since then I am not using anymore please confirm what was wrong?Sarin ### REPLY: Gabapentin may because these symptoms in some patients. There is no way to predict which patients will get these side effects. Therefore, you should inform your local doctor about them. You have not mentioned the condition for which you were prescribed Gabapentin. The doctor will be able to evaluate whether there is something else that is causing the symptoms. Since you have discontinued the medicine you should not worry, but do see your doctor or some other specialist. I hope this answers your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 5 9 300 pounds, diabetic taking Metformin, Glipizide, fluoxetine and Lisinopril. My a1C was at 5.8 on my visit last week. I am also taking a Fat burner pill from wakaya, Turmeric and Ginger... The past couple of weeks my blood sugar has been dropping in the mornings after I take my pills. I get light headed, dizzy, anxious and sweaty. I recently repurchased a glucometer and the past three episodes my blood sugar has been at around 57 when I have these symptoms. But it was at 120-140 when I woke up. I am wondering if I should stop taking the glipizide. ### REPLY: Hi, I understand your concern regarding your low sugar levels. Let me tell you that if your a1C was 5.8,then there was no way that you continue taking Glipizide. You are at a very good a1C level, and you just have to maintain it, so Metformin will be sufficient. All the symptoms that you were experiencing were of hypoglycemia. Please stop Glipizide ASAP. Hope my answer helps. Please feel free to ask more 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: I was recently diagnosed with stage 4 prostate cancer. I had two shots of Firmagon on Nov 28. I later met with a medical oncologist to talk about treatments. He suggested that, within 3 months of the first shots, one option is six injections of taxotere three weeks apart for a total of 18 weeks. Then a recheck of bone scan and CT scan to see if cancer is still outside the prostate. If so, he said radiation could then be used to try to kill that. I have been looking at the side effects of taxotere. Is it effective in killing cancer and is it a good choice to make? ### REPLY: After hearing your history I would advise you to take Texture (docetaxel) six injections 6 weeks apart. It is very effective in killing cancer, and it is a good choice to make. Taxotere contains docetaxel which is a cancer medicine that interferes with the growth and spread of cancer cells in the body. Its major side effects are burning, numbness, tingling, or pain in the arms, hands, legs, or feet, swelling of the stomach, face, fingers, hands, feet, or lower legs which can be managed with oral medications. Regards .  ### END